Dental Asia November/December 2021

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

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


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www.dentalasia.net<br />

NOVEMBER / DECEMBER <strong>2021</strong><br />

Under the Spotlight:<br />

Forging ahead to make the world smile<br />

Clinical Feature:<br />

Innovative dental implant solutions<br />

Behind the Scenes:<br />

Best strategies to jumpstart digital orthodontics<br />

Photo Courtesy of exocad

<strong>Dental</strong>CAD<br />

The powerful CAD software<br />



Imagine the CADABILITIES<br />

DENTAL ASIA NOVEMBER / DECEMBER <strong>2021</strong> 51

I love using many different<br />

tools to create art. In my<br />

lab, I enjoy the infinite<br />

possibilities <strong>Dental</strong>CAD<br />

gives me.<br />

Carla Arancibia<br />

<strong>Dental</strong> technician<br />

and illustrator<br />

<strong>Dental</strong>CAD, with its cutting-edge features accelerated my<br />

lab’s workflows. Instant Anatomic Morphing adapts tooth<br />

anatomy in real time during anatomic tooth placement<br />

and AI detects facial features in Smile Creator, saving valuable<br />

time and boosting design speed.<br />

Explore how this powerful design software will<br />

make your life easier and improve your productivity.<br />


Contents<br />


6 Advertorial: <strong>Dental</strong> Technology<br />

Made in Germany<br />

36<br />

TRENDS<br />

18 Industrial design bridges the<br />

gap between technology and<br />

user<br />

20 Four tips on lowering risks to<br />

osseointegration<br />

22 Advertorial: Pay32: Clinic<br />

powered by artificial<br />

intelligence<br />

24<br />


24 Forging ahead to make the<br />

world smile<br />

26 How digital technologies help<br />

Tee Hee <strong>Dental</strong> Works<br />

46<br />

62<br />


28 Dentsply Sirona continues to<br />

future-proof dentistry<br />


31 Digital scans and human<br />

identification<br />

36 Innovative dental implant<br />

solutions<br />

42 Advertorial: CS MAR reveals<br />

pathology and reduces risk of<br />

misinterpretation<br />


46 Simplifying digital implant<br />

prosthetics<br />

49 Fast and predictable<br />

aesthetics with injectable<br />

composites<br />

54 Efficient conversion of a<br />

conventional complete<br />

denture to Straumann ® Pro<br />

Arch using Smile in a Box<br />


60 More than a simple<br />

manufacturing alternative<br />

18<br />

61 Automatic denture cleaning that<br />

works<br />

62 Best strategies to jumpstart digital<br />

orthodontics<br />


66 Advancing oral prophylaxis<br />

67 Rolence Enterprise: Commitment<br />

to quality and added value<br />

68 Silicone hoses with spray water<br />

flow adjustment<br />


76 Dentsply Sirona World <strong>2021</strong>: The<br />

highly anticipated return of the<br />

Ultimate <strong>Dental</strong> Experience<br />


79 GC Corporation celebrates<br />

centennial anniversary and<br />

welcomes dental professionals<br />

to the Fifth International <strong>Dental</strong><br />

Symposium<br />

80 Mectron Spring Meeting<br />

2022: The appointment with<br />

innovation<br />


4 First Words<br />

70 Product Highlights<br />

81 Giving Back to Society<br />

82 Events Calendar<br />

84 Advertisers’ Index<br />

76<br />

2<br />

DENTAL ASIA NOVEMBER / DECEMBER <strong>2021</strong>

#whdentalwerk<br />

wh.com<br />

EM-12 L electric motor<br />

Functionality meets comfort<br />

Made in<br />


Range of applications with electric power.<br />

Cavity and crown preparation, excavation or polishing: With the W&H electric motor<br />

and the portfolio of contra-angle handpieces, there are no limitation as of application.<br />

Select the transmission instrument according to the application, set the motor speed<br />

and work with the recommended bur rotation. For optimal treatment results!<br />

Available as smart Add-on, with flexible installation options or as Built-in Solution<br />

for full integration in your dental unit. More info: wh.com/yelecticmotor<br />

DENTAL ASIA NOVEMBER / DECEMBER <strong>2021</strong> 3

First Words<br />

A year of trailblazers<br />

Czarmaine Masigla<br />

Assistant Editor<br />

With the world wearied by the COVID-19 pandemic, developments<br />

to re-establish the pre-pandemic normalcy has now come<br />

to fruition as restrictions slowly eased. Regular testing, mass<br />

vaccination and continued social distancing measures mitigate<br />

the burden on the healthcare system, allowing us to live with the<br />

virus.<br />

It has been astonishing to witness this progress and how the<br />

dental industry has sustained the momentum to emerge<br />

stronger than ever from this challenging circumstance.<br />


Publisher<br />

Publications Director<br />

Senior Editor<br />

Assistant Editor<br />

Graphic Designer<br />

William Pang<br />

williampang@pabloasia.com<br />

Jamie Tan<br />

jamietan@pabloasia.com<br />

Pang Yanrong<br />

yanrong@pabloasia.com<br />

Czarmaine Masigla<br />

czarmaine@pabloasia.com<br />

Jolin Tan<br />

jolintan@pabloasia.com<br />

For instance, Dentsply Sirona’s DS World <strong>2021</strong> concluded with an overwhelming<br />

success, connecting more than 7,000 world-leading experts, industry leaders, dental<br />

practitioners, and students in one memorable hybrid event (p.76).<br />

GC Corporation also celebrated its centennial anniversary this year alongside the<br />

announcement of its Vision 2031. In line with this milestone, the company is organising<br />

the Fifth International <strong>Dental</strong> Symposium in Tokyo, Japan, from 16 to 17 April 2022 to<br />

present the latest treatment concepts and practise techniques in the field (p.79).<br />

There is no stopping the dental industry especially with the open-minded and<br />

forward-thinking mentality of its practitioners as reflected in Dr Valerie Tey and Dr<br />

Keng Mun Wong utilisation of a fully outsourced digital workflow by Smile in a Box<br />

on a Straumann® Pro Arch protocol for the immediate conversion of a conventional<br />

complete denture into a fixed full-arch restoration (p.54).<br />

Dr Hanke Faust, on the other hand, shared how he optimised the advanced CS Metal<br />

Artifact Reduction technology of Carestream <strong>Dental</strong>’s CS 8100 to obtain a more<br />

accurate diagnosis and deliver a more predictable treatment to his patients (p.42).<br />

Indeed, the dental field has no shortage of innovations and evidence-based solutions.<br />

As the vibrant dentist of Teehee <strong>Dental</strong> Works, Dr Yang Xiao, emphasised: “Change is<br />

always happening, and you have the choice to either be proactive or reactive (p.26).”<br />

As we welcome the year 2022, let us make every step forward count, and embrace the<br />

uncertainty ahead with enthusiasm!<br />


Circulation Manager<br />


General Manager<br />


Senior Editor<br />

Shu Ai Ling<br />

circulation@pabloasia.com<br />

Ellen Gao<br />

pablobeijing@163.com<br />

Sharon Wu<br />

pabloshanghai@163.net<br />



3 Ang Mo Kio Street 62 #01-23<br />

Link@AMK, Singapore 569139<br />

Tel: (65) 62665512<br />

Email: info@pabloasia.com<br />

Website: www.dentalasia.net<br />

Company Registration No.: 200001473N<br />

Singapore MICA (P) No. 075/05/2019<br />

Malaysia KDN: PPS1528/07/2013 (022978)<br />



Tel: +86-10-6509-7728<br />

Email: pablobeijing@163.com<br />



Tel: +86-21-52389737<br />

Email: pabloshanghai@163.net<br />

@dentalasia<br />

Dr William<br />

Dr Choo Teck Dr Chung Kong Dr George<br />

Dr Fay<br />

Dr Clarence Prof Nigel M.<br />

Dr Anand<br />

Dr Kevin<br />

Dr William<br />

Dr Wong Li<br />

Dr Adrian U<br />

Dr Christopher<br />

Dr How Kim<br />

Dr Derek<br />

Prof Alex

invis is<br />

comprehensive<br />

care<br />

reimagined.<br />

Rethink comprehensive dentistry with pre-restorative orthodontic treatment.<br />

Invisalign treatment offers digital tools and support to help you design a more comprehensive treatment<br />

experience that works for your patients and your practice.<br />

Learn more about how you can become a provider today.<br />

5<br />

© <strong>2021</strong> Align Technology, Inc. All rights reserved. Invisalign, the Invisalign logo, among others, are<br />

trademarks and/or service marks of Align Technology, Inc. or one of its subsidiaries or affiliated companies<br />

and may be registered in the U.S. and/or other countries. | MKT-0005927 Rev A<br />

DENTAL ASIA NOVEMBER / DECEMBER <strong>2021</strong> 5

<strong>Dental</strong> Advertorial Updates<br />

<strong>Dental</strong> technology Made in Germany<br />

The German family business DÜRR DENTAL in Bietigheim-Bissingen is one<br />

of the few international market leaders in the dental industry. This year, the<br />

family business celebrates a momentous occasion: its 80 th anniversary.<br />

For 80 years, the brand DÜRR DENTAL<br />

has been known for its high-end “Made<br />

in Germany” products and technical<br />

innovations. How did it all start? With a root<br />

canal treatment and a broken dental drill.<br />

Frida Dürr, the wife of precision engineer<br />

Wilhelm Dürr, had to visit the dentist in the<br />

autumn of 1946. However, during the root<br />

canal treatment, the dental drill broke. Since it<br />

was very difficult to find new equipment after<br />

the war, the dentist had to finish the treatment<br />

manually. Knowing about Wilhelm‘s technical<br />

skills, the dentist gave his patient the broken<br />

drill to take home. Surprisingly, although<br />

Wilhelm had never repaired dental equipment,<br />

he managed to fix the drill and it all worked<br />

out.<br />

That was how Wilhelm, who ran a precision<br />

workshop with his brother Karl, discovered a<br />

gap in the market almost accidentally. From<br />

1948 onwards, the brothers established their<br />

business in the dental sector. Today, DÜRR<br />

DENTAL is one of the international leaders in<br />

the market, celebrating its 80th anniversary.<br />


DÜRR DENTAL can look back on a successful<br />

company history. The name DÜRR DENTAL<br />

stands for innovation and a proud history of<br />

countless developments and enhancements<br />

in modern dentistry. The invention of the<br />

suction system enabled dentists to treat their<br />

patients lying down for the first time – a major<br />

step forward in dental care. DÜRR DENTAL<br />

has pioneered the development of effective<br />

spray mist extraction systems, in addition to<br />

the invention of oil-free compressors. DÜRR<br />

DENTAL has steadily refined and developed this<br />

technology and remained the industry specialist<br />

for the oil-free “heart of the practice” to this day.<br />

DÜRR DENTAL also has a pioneering role in<br />

value-preserving hygiene, low-pain therapy<br />

and products offering the best protection for<br />

the practice team and the patient. This position<br />

has been further strengthened in recent times.<br />

Milestones in imaging, such as image plate<br />

technology, round off DÜRR DENTAL’s extensive<br />

portfolio.<br />


DÜRR DENTAL is currently led by Martin<br />

Dürrstein, the third generation of the Dürr family.<br />

He continues to place great importance on<br />

innovation: “We strive to understand the dentists’<br />

requirements and offer them exact and reliable<br />

solutions so that they can provide excellent<br />

treatment to their patients.”<br />

DÜRR DENTAL is known for innovative products<br />

such as the first suction unit or its long-time<br />

bestseller, the disinfectant Orotol. In general,<br />

the experts for dental technology offer products<br />

across four different ranges: compressed air and<br />

suction, imaging, dental care and hygiene, as<br />

well as prevention and therapy.<br />

At present, the team focuses on smart solutions<br />

for the dental practice 4.0. The experts are<br />

developing cloud-based software solutions and<br />

equipment, which can be connected and linked<br />

with each other. For example, VisaSoft Cloud<br />

allows the sharing of X-ray images quickly and<br />

directly with the lab. With VistaSoft 3.0, DÜRR<br />

DENTAL brings artificial intelligence into the dental<br />

practice and supports the practice team efficiently<br />

in their daily work. Numerous other pioneering<br />

techniques are currently being discussed and<br />

undergoing further development. Even after 80<br />

years, the pioneering spirit lives on at DÜRR DENTAL.<br />

DÜRR DENTAL also wants to pass on the<br />

necessary know-how in addition to selling<br />

products. Thus, DÜRR DENTAL Academy plays<br />

a crucial role for their business. It offers around<br />

140 seminars for dental staff,<br />

technicians and students<br />

around the year.<br />

“We accept responsibility<br />

with each product we sell<br />

in the dental field,” said<br />

Martin Dürrstein. “Therefore,<br />

it is essential for us to provide<br />

training, expertise and excellent<br />

service. Our customers’ and their<br />

patients’ satisfaction are of<br />

utmost importance to<br />

us.” DA<br />

Martin Dürrstein,<br />


6<br />

DENTAL ASIA NOVEMBER / DECEMBER <strong>2021</strong>

Discover the color ful world<br />

of Dürr <strong>Dental</strong>!<br />

www.duerrdental.com/80<br />

Dürr <strong>Dental</strong> celebrates its 80th company anniversary: Many innovations in dental<br />

practices can be traced back to developments from Dürr <strong>Dental</strong>. As a leader in quality<br />

and innovation, Dürr <strong>Dental</strong> supports dental practices and dental laboratories worldwide<br />

with its system solutions. Discover the colorful world of Dürr <strong>Dental</strong> and click<br />

through special moments of the 80-year company history.<br />


<strong>Dental</strong> Updates<br />

Align Technology announces exclusive supply and distribution agreement<br />

with Ultradent Products<br />

Align Technology, Inc., a leading global<br />

medical device company that designs,<br />

manufactures and sells the Invisalign<br />

system of clear aligners, iTero intraoral<br />

scanners and exocad CAD/CAM software<br />

for digital orthodontics and restorative<br />

dentistry, has announced an exclusive<br />

supply and distribution agreement<br />

with Ultradent Products Inc., a leading<br />

developer and manufacturer of high-tech<br />

dental materials, devices, and instruments<br />

worldwide.<br />

As part of the multi-year agreement,<br />

Align will offer Invisalign-trained doctors<br />

an exclusive professional whitening<br />

system with the leading Opalescence<br />

PF whitening formula from Ultradent,<br />

optimised for use with Invisalign clear<br />

aligners and Vivera retainers.<br />

The system will carry the co-branded<br />

name of “Invisalign Professional Whitening<br />

System – powered by Opalescence”<br />

and will offer the same great whitening<br />

outcomes and streamlined practice<br />

experience dental professionals expect<br />

from the Opalescence PF product during<br />

active tooth movement with Invisalign<br />

aligners, as well as during passive retention<br />

using Vivera retainers. The Invisalign<br />

Professional Whitening System will be<br />

commercially available globally in 2022.<br />

“A brighter, whiter smile is an important<br />

part of the Invisalign patient journey. In<br />

fact, a survey of North American Invisalign<br />

practices1 shows that half of their patients<br />

ask for teeth whitening during or after they<br />

complete Invisalign treatment,” said Raj<br />

Pudipeddi, chief product and marketing<br />

officer, SVP, and managing director of the<br />

<strong>Asia</strong> Pacific region at Align Technology.<br />

“We believe that by providing an all-in-one<br />

solution that combines a leading teethwhitening<br />

system with the most advanced<br />

clear aligner system in the world, we enable<br />

Invisalign-trained doctors to enhance<br />

their patients’ treatment experience with<br />

a seamless workflow that also enables<br />

practice efficiency and growth. We’re<br />

very excited to partner with Ultradent<br />

to offer the first professional whitening<br />

system optimised for use with Invisalign<br />

clear aligners and Vivera retainers.<br />

Invisalign system trained doctors can use<br />

Opalescence PF for in-office teeth whitening<br />

treatment and for doctor supervised athome<br />

whitening.”<br />

“We’re honoured to partner with Align to<br />

make the top professional teeth whitening<br />

products available to more clinicians and<br />

patients around the world,” said Dirk Jeffs,<br />

president and chief executive officer of<br />

Ultradent. “Providing Align with teeth<br />

whitening products, ideal for use with<br />

Invisalign aligners and Vivera retainers, is<br />

a considerable step toward our mission of<br />

improving oral health globally and we look<br />

forward to pursuing this mission together.” ■<br />

Ultradent is an ISO13485 certified facility<br />

and will manufacture the products<br />

according to those standards.<br />

1<br />

2017 online survey of Invisalign doctors,<br />

data on file at Align Technology<br />

Amann Girrbach introduces fully automatic Ceramill Map 600+<br />

The fully automatic Ceramill Map 600+,<br />

Amann Girrbach’s new scanner flagship<br />

for open articulator scanning, excels<br />

with outstanding precision for perfect<br />

restorations and optimally supports dental<br />

technicians in their work.<br />

The new high-performance scanner<br />

heralds the advent of Industry 4.0 in the<br />

laboratory. The intelligent software algorithm<br />

automatically assigns the upper and lower<br />

jaws, thereby eliminating the vestibular<br />

scan and up to 30% of the manual steps<br />

in the laboratory. Due to its integrated<br />

universal carrier plate for all common types<br />

of articulators, the Map 600+ saves timeconsuming<br />

plate changes and the intelligent<br />

scan height control automatically moves the<br />

object to be scanned into the best possible<br />

scanning area.<br />

In parallel, Amann Girrbach has equipped<br />

the Map 600+ with an Ultra HD camera.<br />

The highly sensitive industrial 3D sensor<br />

with blue light technology ensures<br />

outstanding depth of field and a<br />

scanning accuracy of four micrometres.<br />

The optimal use of the advantages of<br />

digitisation and a seamless workflow<br />

requires precise conversion of the model<br />

situation from the real articulator into a<br />

data set.<br />

The new, more efficient calculation<br />

algorithm also reduces the matching<br />

time by up to 35%, depending on the<br />

indication. This reduces the active waiting<br />

time of a scanning process by up to 25<br />

seconds. Depending on the indication,<br />

the Ceramill Map 600+ therefore provides<br />

time savings of between 15-38%. ■<br />

8<br />

DENTAL ASIA NOVEMBER / DECEMBER <strong>2021</strong>

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• Precise dosage without excess<br />

• Simple restoration of cervical cavities, undercuts etc.<br />

First-class aesthetics<br />

• 12 shades, including new shade GA5 for cervical restorations<br />

• Excellent polishability and permanent lustre<br />

VOCO GmbH · Anton-Flettner-Straße 1-3 · 27472 Cuxhaven · Germany · Tel. +49 4721 719-0 · www.voco.dental

<strong>Dental</strong> Updates<br />

SmileDirectClub allows new patent for innovative SmileBus concept<br />

SmileDirectClub, Inc., the next generation<br />

oral care company with the first medtech<br />

platform for teeth straightening, has<br />

announced that the United States Patent<br />

& Trademark Office (USPTO) will issue<br />

a patent on the company’s innovative<br />

SmileBus concept. SmileDirectClub’s<br />

investment in its SmileBus fleet and its<br />

SmileBus concept, which the USPTO<br />

has recognised as novel, underscores its<br />

commitment to its mission of increasing<br />

access to oral care. The patent will further<br />

strengthen protection for SmileDirectClub’s<br />

intellectual property as one of the<br />

methods for bringing premium, affordable,<br />

accessible oral care to more people<br />

through its telehealth platform.<br />

Since its launch in the United States in<br />

2018, SmileDirectClub’s fleet of SmileBuses<br />

has travelled across the continental US.<br />

Subsequently, a similar SmileBus concept<br />

was launched in the United Kingdom in<br />

2020. The US and UK fleets have made<br />

nearly 1,200 stops and empowered<br />

SmileGuides to take nearly 100,000 3D<br />

images to date, helping consumers get<br />

a smile that they love wherever they live,<br />

including the many areas without access<br />

to an orthodontist.<br />

“For far too long, access to orthodontic<br />

care was limited to only those areas<br />

that could support an in-person<br />

practice. Thanks to the SmileBus and<br />

SmileDirectClub’s industry-first telehealth<br />

platform for teeth straightening, more<br />

communities than ever now have a<br />

premium, affordable, accessible<br />

option,” said Susan Greenspon<br />

Rammelt, chief legal officer and<br />

executive vice-president of Business<br />

Affairs at SmileDirectClub. “We are<br />

pleased the USPTO has acknowledged<br />

the novelty of our SmileBus concept<br />

by allowing this patent. The SmileBus<br />

has helped thousands of people in the<br />

US and UK get started on their smile<br />

journey – many of whom live in ‘dental<br />

deserts’ without convenient access to<br />

orthodontic treatment.”<br />

This newest patent will join the<br />

company’s robust intellectual<br />

property portfolio, which includes<br />

SmileDirectClub’s patentprotected<br />

and innovative digital<br />

customer journey, ground-breaking<br />

advancements in the manufacture<br />

of clear aligners, award-winning<br />

whitening system and many other<br />

premium oral care offerings. ■<br />

exocad’s ChairsideCAD is <strong>2021</strong> Cellerant Best of Class Technology<br />

Award Winner<br />

exocad GmbH (exocad), an Align<br />

Technology, Inc. company and a leading<br />

dental CAD software provider, was the<br />

<strong>2021</strong> Cellerant Best of Technology Award<br />

winner for its ChairsideCAD, an openarchitecture<br />

CAD software for single-visit<br />

dentistry. This is the third consecutive year<br />

that ChairsideCAD has been recognised<br />

for this award.<br />

“We are honoured to receive this<br />

prestigious industry award from dental<br />

industry leaders once again for our<br />

best-in-class software solution, and<br />

we’re excited to share the power of<br />

ChairsideCAD with clinicians. This<br />

software can enhance the chairside<br />

design process, making it faster and more<br />

accurate,” said Larry Bodony, president<br />

of exocad America, Inc. “The intuitive<br />

design workflow of ChairsideCAD, plus the<br />

freedom to use any open hardware, makes<br />

this a fantastic tool to streamline even the<br />

most challenging cases.”<br />

exocad stands as the software of choice<br />

for leading manufacturers of dental<br />

CAD/CAM systems because it is flexible,<br />

reliable and intuitive. <strong>Dental</strong> professionals<br />

consistently turn to exocad software to<br />

streamline their workflows for a broad<br />

range of indications.<br />

Based on exocad’s renowned lab software<br />

<strong>Dental</strong>CAD, ChairsideCAD is the first<br />

complete open-architecture CAD software<br />

platform for single-visit dentistry. The<br />

software includes a step-by-step guide<br />

through the design process, simple<br />

integrations with a broad spectrum of<br />

devices and the ability to seamlessly share<br />

information between clinicians and labs.<br />

Since the inaugural presentation in 2009,<br />

the Cellerant Best of Class Technology<br />

Awards have grown to occupy a unique<br />

space in dentistry by creating awareness<br />

in the community of manufacturers who<br />

are driving the discussion in how practices<br />

operate now and in the future. The <strong>2021</strong><br />

Cellerant Best of Class Technology Award<br />

was judged by a panel of prominent<br />

technology leaders in dentistry. ■<br />

10<br />

DENTAL ASIA NOVEMBER / DECEMBER <strong>2021</strong>

Study in JDE finds gender<br />

differences in dental students’<br />

self-assessments<br />

Male dental students overestimate their performance more<br />

significantly than females, and both genders self-assess their<br />

skills more positively compared to scores given by faculty,<br />

according to a study published in the Journal of <strong>Dental</strong> Education<br />

(JDE), a peer-reviewed monthly journal that publishes a wide<br />

variety of educational and scientific research in dental, allied<br />

dental and advanced dental education.<br />

PIONEER SINCE 1985.<br />


The study, “The effect of gender on student self-assessment<br />

skills in operative preclinical dentistry”, focused on third-year<br />

dental students from six class years (Classes of 2016-<strong>2021</strong>), and<br />

its participants included students at the Harvard School of <strong>Dental</strong><br />

Medicine, United States.<br />

“Recognising factors that affect self-assessment ability is<br />

important because dentists must learn to accurately evaluate<br />

their clinical work in order to improve through self-directed<br />

learning,” the authors wrote. “The results of this study illustrate<br />

that self-assessment skills differ between males and females,<br />

with males on average overestimating their performances to a<br />

greater extent than females in operative preclinical dentistry.”<br />

The results of the study, according to the authors, fall in line<br />

with previous studies that show gender differences in selfassessments<br />

in other health care training settings. The authors<br />

of the study are David L. Kornmehl, BS; Ruchika Agrawal, BS;<br />

Jacqueline R. Harris, BS; and Aisha K. Ba, BS (all with the Harvard<br />

School of <strong>Dental</strong> Medicine in Boston, MA, US); Eshani Patel, DMD<br />

(VA Loma Linda Healthcare System in Loma Linda, CA, US) and<br />

Hiroe Ohyama, DDS, MMSc, PhD, DMD (Department of Restorative<br />

Dentistry and Biomaterials Sciences, Harvard School of <strong>Dental</strong><br />

Medicine, US).<br />

The student self-assessments used the same rubrics as faculty<br />

on four operative dentistry competency examination procedures:<br />

Class II amalgam preparation and restoration and Class III resincomposite<br />

preparation and restoration. The study found that the<br />

student-faculty (S-F) gap was 8.28% for males and 6.08% for<br />

females. The S-F gap is defined as the difference between the<br />

student’s self-assessment score and the faculty’s mean grade.<br />

“Knowledge of the findings in this study may allow faculty to<br />

be aware of how gender impacts self-assessment, which may<br />

impact curriculum design and implementation,” according to the<br />

article. “By recognising and addressing gender differences in selfassessment<br />

at earlier stages of dental training, a more equitable<br />

learning environment can be created. In addition to increasing<br />

faculty awareness, male and female students may be more<br />

attuned to their cognitive biases and become more conscious of<br />

them during self-assessment.” ■<br />


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© Dr. Julio Gomez Paris, Santa Fe, Argentina<br />

DENTAL ASIA NOVEMBER / DECEMBER <strong>2021</strong> 11<br />

3591E_VITABLOCS_Gomez-Paris_95x250.indd 1 21.09.<strong>2021</strong> 10:58:43

<strong>Dental</strong> Updates<br />

<strong>Dental</strong>Monitoring launches ScanBox pro<br />

<strong>Dental</strong>Monitoring, the company that<br />

pioneered artificial intelligence in dental<br />

and orthodontic care, has launched the<br />

ScanBox pro . Built upon the success of<br />

their previous DM ScanBox, their latest<br />

FDA-registered innovation is a portable<br />

device that patients can take with them<br />

for precise AI-powered scans anytime and<br />

anywhere.<br />

This hardware accompanies the flagship<br />

software solution <strong>Dental</strong>Monitoring, a<br />

customisable cloud-based platform for<br />

remote clinical monitoring of orthodontic<br />

treatments designed to create a single<br />

automated workflow per patient and<br />

boost practice scalability.<br />

The device consists of two components<br />

— a cheek retractor tube designed to draw<br />

the cheeks and lips from the buccal and<br />

labial surfaces of the teeth and gums<br />

during scanning and a phone holder<br />

designed to accommodate a smartphone.<br />

Paired with the unique DM app for patients,<br />

the ScanBox pro offers:<br />

• Consistent imaging over time for precise<br />

tracking of treatment progress including<br />

aligners, braces and retainers of all brands<br />

• Excellent occlusal and lateral views,<br />

including molar occlusion<br />

• Increased portability<br />

• An adapted design for all patients from six<br />

years old<br />

• Easy storage capability with 41% less<br />

volume<br />

• Autoclavable capacity<br />

“We couldn’t be prouder to introduce our<br />

latest innovation as we continue to go<br />

further and break new ground with our<br />

solutions,” said Phillipe Salah, chief executive<br />

officer of <strong>Dental</strong>Monitoring. “The ScanBox pro<br />

is a game-changer for patients. It is<br />

lightweight, portable and can easily join them<br />

on-the-go, anywhere, for high-quality scans<br />

powered by the first and most robust AI in<br />

the industry. In turn, it allows doctors to have<br />

control at every stage of treatment and helps<br />

automate their workflow while enhancing their<br />

patient experiences.”<br />

The ScanBox pro is the newest addition to<br />

<strong>Dental</strong>Monitoring’s family of devices and<br />

software solutions including SmileMate, for<br />

engagement, triage and patient conversion;<br />

and <strong>Dental</strong>Monitoring, the only available AIbased<br />

remote monitoring solution available<br />

to both fixed and removable orthodontic<br />

appliances of all brands. ■<br />

FDA grants 510(k) market clearance to Vivos Therapeutics’ mmRNA Oral<br />

Appliance<br />

Vivos Therapeutics, Inc., a medical<br />

technology company focused on<br />

developing and commercialising innovative<br />

diagnostic and treatment modalities for<br />

patients suffering from sleep-disordered<br />

breathing, including mild to moderate<br />

obstructive sleep apnoea (OSA), has been<br />

granted 510(k) market clearance by the<br />

US Food and Drug Administration (FDA)<br />

to its Vivos’ mmRNA (modified mandibular<br />

Repositioning Nighttime Appliance) device.<br />

This FDA clearance paves the way for<br />

expanded insurance reimbursement<br />

coverage for the mmRNA device, including<br />

Medicare, as well as for potential future<br />

government contracts and reimbursement<br />

from commercial payers that follow<br />

Medicare guidelines.<br />

More than one billion people globally<br />

and 54 million Americans suffer from<br />

sleep apnoea, 80% of whom remain<br />

undiagnosed. A serious chronic illness, sleep<br />

apnoea increases the risk of comorbidities,<br />

including high blood pressure, heart failure,<br />

stroke, diabetes, dementia and other lifethreatening<br />

diseases. Vivos’ oral appliances<br />

address the dental tissue anomalies and<br />

malformations known to be associated<br />

with OSA. Unlike current standard-of-care<br />

interventions, patients treated with the Vivos<br />

System typically complete their therapy in<br />

12 to 24 months and, in most cases, do not<br />

require lifetime intervention.<br />

“The FDA’s market clearance of Vivos’<br />

newest device, the mmRNA appliance,<br />

represents a significant milestone in<br />

our ongoing efforts to provide the best<br />

possible treatment for people who<br />

continue to suffer needlessly from OSA,<br />

a debilitating condition that causes or<br />

contributes to a wide range of chronic<br />

health issues,” said Kirk Huntsman,<br />

chairman and chief executive officer<br />

of Vivos. “Next-generation products<br />

like the mmRNA are vital for allowing<br />

medical doctors and dentists to continue<br />

pushing forward in their joint mission<br />

to give patients a better alternative for<br />

effectively treating their OSA. Further,<br />

this FDA clearance for the mmRNA<br />

enables us to expand commercial<br />

insurance reimbursement, soon to<br />

include Medicare, making this a more<br />

cost-effective solution for patients<br />

suffering from OSA.” ■<br />

12<br />

DENTAL ASIA NOVEMBER / DECEMBER <strong>2021</strong>

3Shape TRIOS<br />

<strong>Dental</strong> Updates<br />

Patient engagement<br />

you can sense.<br />

We’re creating an<br />

emotional connection<br />

with our patients.<br />

Dentist, Chatswood, Australia<br />

Boost case acceptance by engaging<br />

– even more – with your patients.<br />

Together, TRIOS 3D color scans and the TRIOS<br />

engagement apps create a perfect opportunity<br />

to show patients their unique dentition and<br />

help them understand their treatment needs.<br />

These visual tools make it easy to personalize<br />

patient experiences and address all their<br />

concerns. They’ll notice the difference. And<br />

you’ll feel the engagement.<br />

Explore more at 3Shape.com<br />

DENTAL ASIA NOVEMBER / DECEMBER <strong>2021</strong> 13

<strong>Dental</strong> Updates<br />

W&H Sterilization in Brusaporto, Italy, celebrates its production of<br />

100,000 sterilisers<br />

W&H Sterilization in Brusaporto, Italy,<br />

has reached a milestone of producing<br />

100,000 sterilisers. These sterilisers<br />

ensure the highest levels of hygiene<br />

and safety and fit in every workflow. This<br />

achievement is celebrated with the W&H<br />

community on social media alongside an<br />

exclusive competition where the winner<br />

will receive a W&H steriliser of their<br />

choice.<br />


Brusaporto is W&H’s know-how centre<br />

for sterilisers. An experienced 120-strong<br />

team guarantees excellent quality<br />

and compliance with medical device<br />

standards and only high-end devices with<br />

the best properties make it to the market.<br />

A steriliser leaves the factory every eight<br />

minutes and is delivered all around the<br />

world – now for the 100,000 times.<br />

W&H Sterilization has been manufacturing<br />

medical devices since 1999. The best-selling<br />

steriliser is without a doubt Lisa – the<br />

result of Italian passion and the first B type<br />

steriliser on the market. Lisa has become<br />

a real stand out product over the past two<br />

decades. With its innovative functionalities,<br />

it meets the highest medical standards and<br />

fits in seamlessly in every hygiene workflow.<br />

The Lisa has now been backed up by a<br />

range of other devices such as the Lara,<br />

Lina, Lyla and Lexa sterilisers for different<br />

practice requirement. ■<br />

Premier <strong>Dental</strong> ® continues strong innovation push with four new inspired<br />

solutions<br />

Premier <strong>Dental</strong> ® , a global privately-held<br />

developer, manufacturer and distributor of<br />

dental and medical products, has discussed<br />

its <strong>2021</strong> innovation agenda, encompassing<br />

four new products that will provide dental<br />

professionals with important new solutions<br />

that help deliver efficacy, convenience and<br />

improved patient outcomes.<br />

Julie Charlestein, chief executive officer of<br />

Premier <strong>Dental</strong>, stated: “Even during the<br />

challenges of the COVID-19 pandemic, we<br />

remain committed to delivering meaningful<br />

innovations that help enable first-rate care<br />

from the dental community to patients<br />

worldwide. As an agile fourth-generation,<br />

family-run business, we continue to identify<br />

unmet or under-served customer needs<br />

and deliver differentiated new products that<br />

become standard-setting solutions in the<br />

marketplace.”<br />

The new products include:<br />

• Premier X5 Sectional Matrix System:<br />

Built as a complete, high-quality, fivecomponent<br />

system, X5 is designed to deliver<br />

reliability, convenience and better value. The<br />

anatomically-shaped matrices ensure proper<br />

contouring and tight contacts each time.<br />

The proprietary resin rings are strong, flexible<br />

and reusable for up to five autoclave cycles.<br />

Compatible with other wedges and matrices,<br />

X5 is easy to use compared to Tofflemire-type<br />

retainers.<br />

• BioGREEN Biodegradable Micro-Applicators:<br />

Strong and bendable, these are smart,<br />

environmentally-friendly alternative to<br />

traditional plastic micro-applicators. Made from<br />

a food production straw-by-product, they are<br />

biodegradable and compostable. Even the<br />

packaging is made from post-recycled Kraft<br />

paper to embrace the sustainability mission.<br />

• NexTemp ® Clear Temporary Resin Cement: A<br />

reliable temporary cement with firm retention<br />

that lasts between patient visits and can easily<br />

be removed when needed. It is the only eugenolfree<br />

resin cement with a proprietary potassium<br />

nitrate, chlorohexidine and fluoride formula,<br />

which studies show may help prevent post-op<br />

sensitivity. It is available in two shades: opaque<br />

and clear.<br />

• BioCoat ® Opaque Bioactive Pit & Fissure<br />

Sealant: Now in a new opaque white shade that<br />

fluoresces under a black light for easy verification<br />

of placement and sealant integrity, BioCoat<br />

remains the only bioactive resin pit and fissure<br />

sealant that delivers daily remineralisation. This<br />

technology provides the benefits of extended<br />

release of calcium, phosphate and fluoride ions<br />

to strengthen tooth enamel and protect against<br />

acid attacks. It features excellent handling and<br />

adhesion properties for reliable results. ■<br />

14<br />

DENTAL ASIA NOVEMBER / DECEMBER <strong>2021</strong>

<strong>Dental</strong> Updates<br />

DENTAL ASIA NOVEMBER / DECEMBER <strong>2021</strong> 15

<strong>Dental</strong> Updates<br />

How a microscopic fungus could lead to a breakthrough in oral cancer<br />

research<br />

Microscopic fungus may have more to do<br />

with oral cancer and ageing than initially<br />

thought, according to new research from<br />

Case Western Reserve University, United<br />

States. Researchers from the School of<br />

<strong>Dental</strong> Medicine, Case Comprehensive<br />

Cancer Center and School of Medicine are<br />

hoping a new study can lead to a medical<br />

breakthrough in understanding certain<br />

types of oral cancer.<br />

Pushpa Pandiyan, an associate professor<br />

of biological sciences at the dental school,<br />

led a team of local researchers studying the<br />

function of specific T cells, known as Tregs,<br />

during the development of oral cancer in<br />

ageing mucosa — the moist inner lining of<br />

some organs and body cavities, such as<br />

the nose, mouth and lungs. Their findings<br />

recently appeared in Frontiers in Oncology.<br />

Pandiyan and the researchers examined the<br />

role of dectin-1, a cell’s pattern-recognition<br />

and immune receptor, and its ability to<br />

trigger an inflammatory response that<br />

resists fungal infection. Dectin-1 is among<br />

the fungi receptors that expresses on a<br />

host cell. Typically, human white blood cells<br />

have regulatory (Tregs) and myeloid derived<br />

suppressor cells, which curb the immune<br />

responses of cancer-fighting immune<br />

cells. Problems occur when these cells<br />

accumulate during tumour growth.<br />

“What we’re finding now is that the dectin-1<br />

receptor, usually responsible for antifungal<br />

immunity, is now responsible for<br />

accumulation of these cells at excessive<br />

levels in tumours,” she said.<br />

Researchers pointed out that the culprit is<br />

likely the result of immune cells somehow<br />

overreacting to fungal microbiota.<br />

Although dectin in normal levels serves<br />

as a protective measure, Pandiyan said<br />

excessive amounts can promote tumour<br />

growth “because of its ability to recruit<br />

immunosuppressive cells”.<br />

“Accumulation of these cells were much<br />

worse during ageing. Our bodies produce<br />

more dectin-1 the older that we get. In other<br />

words, anti-tumour defence mechanisms<br />

are weakened with age,” explained<br />

Pandiyan.<br />

While the research was limited to studying<br />

ageing oral mucosa, Pandiyan said the<br />

findings may have broader implications<br />

for additional cancer research: “We don’t<br />

know about other cancers yet, but in oral<br />

cancers, if there is dectin-1, there’s a better<br />

chance that anti-tumour cells can be<br />

staved off.”<br />

The research was funded by the Case<br />

Comprehensive Cancer Center’s Specialized<br />

Program of Research Excellence (SPORE)<br />

pilot programme. Other researchers<br />

involved in the work include: Natarajan<br />

Bhaskaran, Sangeetha Jayaraman,<br />

Cheriese Quigley and Prerna Mamileti from<br />

the School of <strong>Dental</strong> Medicine; Mahmoud<br />

Ghannoum and Quinton Pan, from the<br />

School of Medicine; Aaron Weinberg, from<br />

the dental school and Case Comprehensive<br />

Cancer Center; and Jason Thuener from<br />

the Case Comprehensive Cancer Center. ■<br />

Neoss ® shows off innovation at work at the IDS <strong>2021</strong><br />

At the latest International <strong>Dental</strong><br />

Show (IDS) <strong>2021</strong> in Cologne, Germany,<br />

Neoss held a press conference with<br />

special guest, Dr Marcus Dagnelid, a<br />

prosthodontist from Sweden. Neoss<br />

presented their past and present<br />

innovations and introduced their strategic<br />

partnership with Purgo Biologics that<br />

will expand the Bone Regeneration<br />

product line. Neoss ® made the<br />

announcement at IDS as part of the<br />

company’s continued support for<br />

Koelnmesse and the event.<br />

In <strong>2021</strong>, Neoss ® has seen significant<br />

growth in sales and expansion<br />

into new business areas. The<br />

Neoss ProActive ® Edge implant<br />

and the NeossONE concept<br />

also received industry leading<br />

attendance and attention<br />

during its global campaigns.<br />

As well as investing heavily in<br />

continued innovation of the<br />

Neoss ® product lines, Neoss<br />

actively creates key strategic<br />

partnerships across the globe to<br />

better service their customers with an<br />

extended offering.<br />

The first product out of the Purgo<br />

Biologics partnership is THE Graft, a<br />

natural porous bone matrix that likens<br />

the physical and chemical aspects of<br />

the mineralised matrix of human bone.<br />

The exciting Xenograft product line<br />

will add new dimensions to Neoss ® ,<br />

existing bone regeneration offering.<br />

Dr Dagnelid showed how THE Graft<br />

was utilised in his ridge preservation<br />

after tooth extraction. This can be used<br />

both within conventional dentistry<br />

as well as implant dentistry. This<br />

procedure is a real benefit for the<br />

patient and for the long-term success<br />

of the treatment. ■<br />

16<br />

DENTAL ASIA NOVEMBER / DECEMBER <strong>2021</strong>

Henry Schein announces new<br />

distribution leadership structure<br />

Henry Schein, Inc., the<br />

world’s largest provider of<br />

health care solutions to<br />

office-based dental and<br />

medical practitioners, has a<br />

new organisational structure<br />

to accelerate the company’s<br />

strategic goals of enhancing<br />

customer experience and<br />

operational performance.<br />




PIEZOSURGERY® touch<br />

The new structure seeks to harness the benefits of consolidating<br />

the management of Henry Schein’s <strong>Dental</strong> and Medical distribution<br />

businesses while continuing to increase the company’s exposure to<br />

faster-growing and higher-margin markets through organic growth<br />

and acquisitions.<br />

Henry Schein will create two groups to lead the management<br />

globally of its <strong>Dental</strong> and Medical distribution businesses, as<br />

follows:<br />

• The North America Distribution Group<br />

• The International Distribution Group<br />

→ best cutting efficiency and<br />

maximum intraoperative control<br />

→ perfect ergonomics<br />

→ over 90 inserts specifically<br />

designed for a wide variety<br />

of clinical applications<br />

→ more than 250 clinical and<br />

scientific studies<br />

“As part of the continuous operational improvement of Henry<br />

Schein, we have been pursuing a strategy called ‘One Distribution’<br />

to more tightly integrate the management of our distribution<br />

businesses globally,” said Mr Stanley M. Bergman, chairman of<br />

the board and chief executive officer of Henry Schein, Inc. “One<br />

Distribution is designed to more fully leverage functions, talent,<br />

processes, and systems across Henry Schein’s distribution<br />

businesses to enhance our customer experience and maximise<br />

efficiency and performance.”<br />

The company will continue to focus on addressing customer needs<br />

by expanding its three specialty products and services businesses<br />

that participate in higher-growth, higher-margin markets, as<br />

follows:<br />

• Henry Schein One<br />

• The Global Oral Reconstruction Group<br />

• The Strategic Business Units Group<br />

“These three business groups reflect the company’s long-standing<br />

commitment to provide software, specialty products, and services<br />

designed to help customers operate more efficient practices and<br />

support clinical care, while contributing to the Company’s financial<br />

performance,” said Mr Bergman. “Our customers increasingly rely<br />

upon Henry Schein’s comprehensive offering of innovative solutions<br />

and services, along with our distribution network, for their success<br />

in a digital world. We look forward to continuing to advance the<br />

seamless, unified integration of our suite of products and service<br />

solutions.” ■<br />

→ www.mectron.com<br />

DENTAL ASIA NOVEMBER / DECEMBER <strong>2021</strong> 17<br />

ad_PStouch_dental_asia_95x250_en_201210.indd 1 10.12.20 14:42

Trends<br />

Karl Malmén, industrial design manager at Planmeca<br />

Industrial design bridges the gap<br />

between technology and user<br />

Every product is created to meet a need, and industrial design<br />

attempts to identify and address them. But what does it take to go<br />

from good to great industrial design?<br />

Kari Malmén, Planmeca’s long-time<br />

industrial design manager, has seen<br />

a fair share of the company’s product<br />

development over time and knows well<br />

what can make or break a product. With<br />

more than 33 years at the company, he has<br />

worked alongside Timo Silvonen, senior<br />

industrial designer; Toni Leinvuo, industrial<br />

designer; Tapio Laukkanen, Planmed’s<br />

industrial and UI design manager; Tero<br />

Pihlajamäki and Veli Rundelin, usability<br />

specialists; and Henni Palomäki, UX/UI<br />

designer. Malmén shares what it takes to<br />

get from good to great industrial design.<br />


According to Malmén, great design comes<br />

from bringing in industrial designers into<br />

the development process from day one.<br />

“You get the absolute best result when<br />

the designer gets to work on, with and<br />

around the concept from the outset,” said<br />

Malmén. “An industrial designer is an idea<br />

man, and this is the time when you both<br />

can and should vent your wildest ideas.”<br />

In developing high-tech medical devices,<br />

such as Planmeca’s dental equipment,<br />

maintaining the all-important user<br />

perspective is critical. This is where the<br />

industrial designer plays a key role in<br />

bridging the gap between the technology<br />

and the user. At Planmeca, this means,<br />

among other things, a good deal of<br />

legwork as the designers visit partner<br />

clinics to interview dental professionals,<br />

hear their thoughts and concerns and see<br />

them in action.<br />

“We try to go quite deep into the user role<br />

to get at the core of what they need from<br />

the device: what does the user do, what’s<br />

the workflow, what’s the currently available<br />

technology. Then there’s the patient angle:<br />

how does the device look and feel to the<br />

patient and what can we do to make them<br />

more comfortable. Because, as we know,<br />

the calmer the patient, the better the result,”<br />

explained Malmén.<br />


<strong>Dental</strong> technology has made gigantic strides<br />

forward in recent years in transforming the<br />

practice of dentistry. Interestingly, however,<br />

the major design principles in the industry<br />

have stayed largely the same. The driving<br />

engines remain the big four: ergonomics,<br />

usability, safety, and aesthetics.<br />

18<br />

DENTAL ASIA NOVEMBER / DECEMBER <strong>2021</strong>

“Something I’ve always said is that one<br />

design element is the seam, and that<br />

remains true to this day. You can’t put a<br />

seam just anywhere, you have to look at the<br />

bigger picture – what’s behind the seam,<br />

who needs to access that, for instance, for<br />

maintenance and how often. You have to<br />

understand the environment the product is<br />

for,” shared Malmén.<br />

It is no surprise, however, that customer<br />

expectations have changed, especially in<br />

terms of user experience (UX) and user<br />

interface (UI).<br />

He noted: “In the early days, the UI of a<br />

dental unit was basically just buttons and<br />

a membrane keypad, but since then we’ve<br />

entered this whole new visual world of<br />

graphic UIs, touchscreens and what not.<br />

People now demand the same kind of<br />

usability and intuitiveness of a dental unit<br />

UI that they would expect of a smartphone.<br />

That’s something that we industrial<br />

designers need to carry over to the product.”<br />


According to Malmén, a great industrial<br />

designer has a good visual eye and knowledge<br />

of manufacturing techniques, is cooperative<br />

and can put their thoughts and ideas down<br />

on paper.<br />

Everything starts from defining the<br />

product requirements, which is followed by<br />

brainstorming and ideation. The mechanics<br />

designers then determine the construction<br />

and dimensions, while the usability specialists<br />

work on the user interface. Finally, the product<br />

is tested and refined in cooperation with<br />

partner end-users.<br />

Yet, although many types of industrial design<br />

follow a similar trajectory, designing health<br />

technology comes with a unique human<br />

factor that sets it apart from other products.<br />

Take a dental unit for example. One dentist<br />

may be looking for easy access to essential<br />

instruments, another for left-handed<br />

operation. Larger clinics and dental schools<br />

are likely to need customisation options, such<br />

as personalised settings that are easy to<br />

enable in any unit. Then there is the patient,<br />

who is probably hoping to feel as comfortable<br />

and safe as possible during a potentially<br />

uncomfortable treatment. Besides all that,<br />

everyone is looking for reliability that can be<br />

counted on for years to come.<br />

A cleverly designed dental unit can respond<br />

to all these needs while conforming to today’s<br />

ever-increasing medical device regulation.<br />

How does one get there? Through great design<br />

that respects and reflects user needs in both<br />

function and form. DA<br />




TeKne <strong>Dental</strong> srl – Italy<br />

info@teknedental.com www.teknedental.com<br />

DENTAL ASIA NOVEMBER / DECEMBER <strong>2021</strong> 19

Trends<br />

Four tips on lowering risks to<br />

osseointegration<br />

With the increasing demands for dental implants, oral surgeon, Dr<br />

Annette Felderhoff-Fischer, offers four tips on avoiding early risks to<br />

osseointegration and how the Nobel Biocare N1 system can improve<br />

the treatment outcome.<br />

By Dr Annette Felderhoff-Fischer<br />

<strong>Dental</strong> implants have become an extremely<br />

successful therapy in recent years, both in<br />

partially edentulous and edentulous cases 1,2,3,4 .<br />

In order to continue and even improve this<br />

success for as many patients as possible,<br />

some basic considerations should be included<br />

in the procedure, starting with the indication<br />

and planning. Based on my clinical experience<br />

and the training I have been involved in and<br />

provided over the past 20 years, I have some<br />

advice on optimising your chance for success<br />

from the start.<br />



Careful patient selection and well-founded<br />

planning are essential. Before each procedure,<br />

always check whether the patient is suitable<br />

for implant treatment based on their general<br />

medical history, periodontal condition and oral<br />

hygiene. In addition, I strongly recommend<br />

diagnosis and planning of the procedure with<br />

3D imaging and planning software. Bone<br />

volume can be analysed with CBCT and allow<br />

for implant selection in terms of length and<br />

diameter preoperatively, taking into account<br />

anatomical risk structures (Fig. 1). Furthermore,<br />

the planning takes the tissue management and<br />

the final prostheses into consideration, allowing<br />

you to optimise the planned implant placement<br />

based on the final treatment outcome desired.<br />



Implant site preparation should aim to keep<br />

bone trauma to a minimum and assist primary<br />

stability. Therefore, site preparation requires<br />

knowledge of bone quality. A big challenge at<br />

this stage is the degree of guesswork that this<br />

entails. While the experienced implantologist<br />

might “feel” the bone quality with the first drill,<br />

if you are not an implant specialist or have less<br />

experience in implant treatment, you should<br />

regularly attend hands-on training to improve<br />

this ability, and I particularly recommend<br />

attending cadaver training courses.<br />

This knowledge is important because the<br />

drilling protocol is adapted depending on bone<br />

quality, to not over- or under-size the implant<br />

site. Conventional site preparation requires the<br />

use of multiple drills with different diameters<br />

which, together with irrigation, cause trauma<br />

to the surrounding alveolar bone 5 : a so-called<br />

“zone of death”. If the trauma is too great,<br />

which can occur especially in a lower jaw with<br />

predominantly cortical bone (bone quality I),<br />

osseointegration might be impeded. If the<br />

trauma is mainly around the platform, vertical<br />

resorption can occur. Excessive preparation of<br />

predominantly cancellous bone (bone quality<br />

IV) also leads to a lack of primary stability of the<br />

implant, and potentially early implant loss 6 .<br />



The next step is the selection of the implant<br />

itself, which is again influenced by bone quality<br />

and the preparation of the implant site. The<br />

choice of the implant (geometry, diameter,<br />

platform) and implant site preparation (underpreparation<br />

of the osteotomy) influences<br />

primary stability and is, therefore, an important<br />

factor for osseointegration 7 . A muchdiscussed<br />

figure is the torque value. High<br />

torque values are often viewed as positive for<br />

Fig. 1: Detailed treatment planning is crucial.<br />

CBCT scanning can be used to analyse bone<br />

volume<br />

immediate loading. However, overtightening<br />

may damage or fracture the implant and<br />

could cause necrosis of the bone site and<br />

early dental implant failure 6 . A 35Ncm<br />

value is often recommended as standard,<br />

however, I personally do not see the torque<br />

values of the individual implant systems as<br />

being comparable with one another, as the<br />

individual geometry of an implant causes<br />

different reactions in the bone. The implant<br />

manufacturer provides guidance on maximum<br />

torque values, and you should follow this.<br />


A gap-free and tension-free connection<br />

between the implant and the superstructure,<br />

and regular follow-ups soon after treatment,<br />

alongside stable oral hygiene are important<br />

for success. You should aim for a gap- and<br />

tension-free prosthetic reconstruction, both<br />

with immediate loading and with delayed<br />

restorations. If this is not the case, vertical<br />

bone loss or screw loosening occurs and<br />

results in peri-implant complications.<br />

20<br />

DENTAL ASIA NOVEMBER / DECEMBER <strong>2021</strong>

Trends<br />

Particularly with connections featuring a<br />

deep cone, taking an impression of multiple<br />

implants carries the risks of inaccuracies<br />

and tension, which should be taken into<br />

account when planning a screw-retained<br />

restoration. If screw loosening occurs, the<br />

restoration must be removed, the cause<br />

determined, and a new original screw of the<br />

implant system inserted again.<br />



Assessing bone quality: How can site<br />

preparation with the Nobel Biocare N1<br />

implant system help?<br />

One of the critical factors in treatment<br />

planning and site preparation is the<br />

assessment of bone quality. Regardless of<br />

pre-surgical investigation, clinical decisions<br />

are often dependent upon tactile and visual<br />

judgement during surgery. Unfortunately,<br />

this is a skill that can only be acquired<br />

through experience 8 .<br />

This is one of the drawbacks that the Nobel<br />

Biocare N1 surgical protocol has been<br />

designed to address. After creating a pilot<br />

osteotomy with the OsseoDirector, the<br />

OsseoShaper site preparation instrument<br />

shapes the osteotomy at low speed and<br />

matches the shape of a co-packed implant.<br />

This protocol provides a gauge to indicate<br />

bone quality, minimising guesswork and<br />

decision making. If the OsseoShaper 1<br />

instrument can be fully seated at the<br />

planned depth, the implant can then be<br />

placed. In a survey of clinicians, the implant<br />

could be placed after just these two steps<br />

in the majority of cases – 87.8%*.<br />

If OsseoShaper 1 does not reach the<br />

planned implant depth before achieving<br />

a torque of 40Ncm, the OsseoShaper<br />

2 instrument can be used. If the same<br />

also occurs with the OsseoShaper 2<br />

instrument, then the N1 Twist Drill can<br />

be used (Fig. 2). Not only does this assist<br />

clinical decision making, but because the<br />

instrument operates at low speed and<br />

without irrigation, it has been shown to<br />

create less trauma, leading to earlier bone<br />

formation compared to conventional highspeed<br />

techniques 5 . It has been designed to<br />

preserve vital bone chips in the osteotomy<br />

to promote fast osseointegration.<br />

Fig. 2: Torques generated using the<br />

OsseoShaper concept guide the surgical<br />

workflow, assist in bone evaluation, and<br />

provide an early prediction of implant<br />

stability. Based on a survey of clinicians, the<br />

majority of cases require just two steps in site<br />

preparation before implant placement<br />

Why have I chosen to use the N1 implant<br />

system?<br />

As an oral surgeon, I am fascinated by the<br />

biological benefits of gentle implant site<br />

preparation based on osseointegration<br />

research by the team led by Prof Jill Helms. As<br />

well as knowing that bone experiences less<br />

biological trauma compared to conventional<br />

techniques, I also find the clinical procedure<br />

much simpler; and based on patients’<br />

feedback, that the reduced noise and vibration<br />

makes it more comfortable for them. Coming<br />

from navigated implantology in which the<br />

drills are guided through sleeves, I also like<br />

minimising guesswork when not using guides.<br />

The OsseoDirector indicates direction, and<br />

the OsseoShaper and implant follow. In most<br />

cases, I can place the implant in just these<br />

three steps. I like the simplicity, and the<br />

benefits it brings to my patients. DA<br />


1<br />

Simonis P, Dufour T, Tenenbaum H. Long-term<br />

implant survival and success: a 10-16-year follow-up<br />

of non-submerged dental implants Clin Oral Implants<br />

Res; 2010 Jul;21(7):772 Read on PubMed<br />

2<br />

Wennerberg , Alrektsson T, Chracanovic B.<br />

Long-term clinical outcome of implants with<br />

different surface modification. Eur J Oral Implantol<br />

2018;11(Suppl 1): S123–S136 Read on PubMed<br />

3<br />

Karl M, Albrektsson T. Clinical performance of dental<br />

implants with a moderately rough (TiUnite) surface:<br />

a meta-analysis of prospective clinical studies. Int J<br />

Oral Maxillofac Implants 2017;32(4):717–734. Read on<br />

PubMed<br />

4<br />

Malo P, de Araujo Nobre M, Lopes A, et al. The Allon-4<br />

treatment concept for the rehabilitation of the<br />

completely edentulous mandible: A longitudinal study<br />

with 10 to 18 years of follow-up. Clin Implant Dent<br />

Relat Res 2019;21(4):565-577. Read on PubMed<br />

5<br />

Chen, C.-H.; Coyac, B.R.; Arioka, M.; Leahy, B.; Tulu,<br />

U.S.; Aghvami, M.; Holst, S.; Hoffmann, W.; Quarry, A.;<br />

Bahat, O.; Salmon, B.; Brunski, J.B.; Helms, J.A. A Novel<br />

Osteotomy Preparation Technique to Preserve Implant<br />

Site Viability and Enhance Osteogenesis. J Clin Med.<br />

2019 Feb 1;8(2):170 Read on PubMed<br />

6<br />

Ikar M, Grobecker-Karl T, Karl M, Steiner C. Mechanical<br />

stress during implant surgery and its effects on<br />

marginal bone: a literature review Quintessence Int.<br />

2020;51(2):142-150 Read on PubMed<br />

7<br />

Fawad Javed, George E. Romanos, The role of<br />

primary stability for successful immediate loading<br />

of dental implants. A literature review, J Dent., 2010<br />

Aug;38(8):612-20 Read on PubMed<br />

8<br />

Velikov S, Susin C, Heuberger P, Irastorza-Landa A.<br />

A New Site Preparation Protocol That Supports Bone<br />

Quality Evaluation and Provides Predictable Implant<br />

Insertion Torque. J Clin Med. 2020;9(2). Read on<br />

PubMed<br />

*303 implants in 160 patients using CE-marked<br />

pre-launch portfolio. April 2019 – May 2020.<br />

Data on file.<br />

Disclaimer: Some products may not be<br />

regulatory cleared/released for sale in all<br />

markets. Please contact the local Nobel Biocare<br />

sales office for current product assortment and<br />

availability. See Instructions For Use for full<br />

prescribing information, including indications,<br />

contraindications, warnings and precautions.<br />

About the author<br />

Dr Annette<br />

Felderhoff-<br />

Fischer is an oral<br />

surgeon with a<br />

referral practice<br />

for oral surgery in<br />

Munich, Germany,<br />

and has been working in the field<br />

of implantology for over 25 years.<br />

As a trainer and speaker, she<br />

has a special focus on navigated<br />

implantology.<br />

DENTAL ASIA NOVEMBER / DECEMBER <strong>2021</strong> 21

Advertorial<br />

Trends<br />

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At present, Malaysia is pushing its medical<br />

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A spokesperson from Lumiere32 said: “In<br />

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problem, Lumiere32 came up with one solution<br />

named Pay32 Clinic, a cloud-based software<br />

that makes inventory data and vendor<br />

payment processing a not so time-consuming<br />

and complicated task to manage.”<br />

According to the Lumiere32 Singapore <strong>Dental</strong><br />

study, more than 75% of clinics have been<br />

spending six hours and more to manage and<br />

order supplies in a week, and 90% of private<br />

clinic owners are still writing more than 30<br />

cheques in a month to settle vendor payments.<br />

With Pay32 Clinic, users can digitise<br />

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Pay32 Clinic has helped a lot of clinics to go<br />

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22<br />

DENTAL ASIA NOVEMBER / DECEMBER <strong>2021</strong>

Trends<br />

Hybrid Event<br />

THE<br />



2022.4.16 17<br />

100 th ANNIVERSARY<br />


SAT<br />

SUN<br />

[Location] Tokyo International Forum<br />

Some sessions will be broadcasted online<br />

Changes might occur due<br />

to COVID-19 pandemic<br />

GC official<br />

website<br />

and app<br />

23<br />

DENTAL ASIA NOVEMBER / DECEMBER <strong>2021</strong><br />

GC Get<br />

Connected<br />

DENTAL ASIA NOVEMBER / DECEMBER <strong>2021</strong> 23

Under the Spotlight<br />

Forging ahead<br />

to make the<br />

world smile<br />

Dr Otani Kazunori, a<br />

prosthodontist and director of<br />

Otani <strong>Dental</strong> Clinic, has more<br />

than two decades of dental<br />

practice. Passionate in restoring<br />

and maintaining oral function,<br />

he shares a glimpse of his career<br />

and what dental professionals<br />

can expect from his lecture in<br />

the upcoming Fifth International<br />

<strong>Dental</strong> Symposium on 16 to 17 April<br />

2022 in Tokyo, Japan.<br />

What are the factors that have<br />

influenced your decision in pursuing a<br />

career in dentistry?<br />

Dr Otani: My father is a dentist, and I grew<br />

up in an environment where his dental<br />

clinic was located on the same premises<br />

as my home. Since then, I started thinking<br />

about dentistry as a career option. I was<br />

also influenced by the daily clinical training<br />

and clinical inquisitiveness of the senior<br />

students in the Department of Crown and<br />

Bridge programmes at Nihon University<br />

School of Dentistry, Japan, where I was<br />

enrolled after my undergraduate degree.<br />

Why did you choose to specialise in<br />

prosthodontics, and what is the most<br />

fulfilling aspect of it?<br />

I have been interested in the field<br />

of prosthodontics since I was an<br />

undergraduate student, so I joined the<br />

prosthodontics programme at graduate<br />

school. The professor of that course took<br />

good care of my extracurricular activities<br />

(club activities) in university.<br />

Currently, patients with various complaints<br />

visit my daily clinical practice. Most of the<br />

treatments is for missing tooth or teeth,<br />

but some patients may be treated for the<br />

entire jaw. In full-mouth reconstruction,<br />

defect treatment on an oral basis and<br />

recovery of function must be considered.<br />

When I get the expected treatment results,<br />

I feel glad that I gained experience in<br />

handling those cases by specialising in the<br />

prosthodontic field.<br />

What is the most challenging case<br />

you have handled, and how did you<br />

overcome it?<br />

A symptomatic TMJ patient had a difficult<br />

case of a full-mouth reconstruction<br />

with occlusal height modifications. We<br />

were able to overcome this problem by<br />

adapting a diagnostic splint, pursuing<br />

jaw position by occlusal analysis, and<br />

setting the final prosthesis after multiple<br />

evaluations with provisional restorations.<br />

As chairman of the Study Group<br />

Esthetic Explorers, what is your<br />

vision for it?<br />

Since many young dentists participate<br />

in this study group, I am conscious of<br />

organising a study group that is not<br />

biased towards any particular field,<br />

but rather provides a good balance<br />

of prosthetic treatment, conservative<br />

treatment, periodontal treatment, and<br />

implants. I hope that dentists of the<br />

study group will be able to increase the<br />

number of their treatment options.<br />

24<br />

DENTAL ASIA NOVEMBER / DECEMBER <strong>2021</strong>

Under the Spotlight<br />

With the advent of digital technologies,<br />

how has your practice, Otani <strong>Dental</strong><br />

Clinic evolved?<br />

I have not yet been able to actively introduce<br />

digital technology in my chairside work, but<br />

I am beginning to use it for the fabrication<br />

of prosthetics. As a result, the quality of<br />

prosthetics has improved and the choice of<br />

materials has increased.<br />

How do you keep yourself updated with<br />

the latest technologies and techniques?<br />

I update myself on new technologies and<br />

treatment techniques as soon as possible by<br />

reading dental journals, attending seminars,<br />

and participating in hands-on seminars.<br />

Recently, I have also been attending more<br />

web seminars.<br />

What is your view on minimally invasive<br />

treatments?<br />

I propose minimally invasive (MI) treatment<br />

to patients not only for dental conservative<br />

treatment but for prosthodontic and implant<br />

treatments too. I believe that MI treatment<br />

can extend the life of the teeth because it<br />

can preserve sound tooth structure as much<br />

as possible.<br />

indispensable in the future because not all<br />

patients will have the mobility to visit a dentist.<br />

What do you hope future dental<br />

innovation will achieve?<br />

We hope that further innovations in digital<br />

technology will lead to the mechanisation<br />

(e.g., surgical robots) of precise treatment in<br />

the oral cavity (caries treatment, root canal<br />

treatment) by direct methods.<br />

Can you give us an overview of<br />

your lecture in the upcoming Fifth<br />

International <strong>Dental</strong> Symposium and its<br />

relevance in today’s practice?<br />

In the Fifth International <strong>Dental</strong> Symposium,<br />

I will talk about the clinical application of<br />

adhesive bridges for the prosthetic treatment<br />

of single tooth defects. Thus far, conventional<br />

three-unit bridges or implants have been the<br />

most common treatments for single missing<br />

anterior teeth. Since around 2013, I have been<br />

actively applying adhesive bridges, which are<br />

less invasive than other treatments, in clinical<br />

practice. I am convinced that the adhesive<br />

bridge has joined the list of treatment options<br />

with high patient satisfaction.<br />

What excites you the most about this<br />

event?<br />

I am looking forward to learning about<br />

the current trends in dentistry around the<br />

world.<br />

As we move forward from the<br />

pandemic situation, what do you think<br />

is the best lesson to take away?<br />

It is necessary to adapt constantly in<br />

response to the rapid changes in society.<br />

Any other closing message for our<br />

readers?<br />

Many dental events have been postponed<br />

or cancelled, and in this day and age,<br />

there is a lot of negative information flying<br />

around. However, just as the rain always<br />

stops, there will always come a day when<br />

the sky is blue and the sun is shining. I<br />

am looking forward to enjoying the Fifth<br />

International <strong>Dental</strong> Symposium with you.<br />

Let’s meet on that day. DA<br />

Interested participants may visit<br />

https://www.gcdental.co.jp/100thsymposium/<br />

for more information.<br />

Could you share with us on the three<br />

must-have devices, systems or<br />

materials that have been useful for your<br />

practice and why?<br />

G-CEM ONE, the self-adhesive resin cement,<br />

is very convenient because it can be used<br />

to set not only ceramic inlays made with<br />

LiSi Press (lithium disilicate) but also various<br />

restorations with one cement. In addition,<br />

the G-Multi PRIMER is a primer that can be<br />

applied to all major restorative materials<br />

currently being used, so the dentist does not<br />

have to use individual primers. The progress<br />

and simplification of the bonding system will<br />

not only lead to more effective treatment<br />

but also to a more stable prognosis, which<br />

will be of great benefit to the patient. Lastly,<br />

G-Fix is useful for anchoring mobile teeth,<br />

and because it is a composite resin with<br />

a little toughness, it is sometimes used<br />

for reinforcing and splinting provisional<br />

restorations.<br />

How do you think an ageing society will<br />

impact dentistry in the years to come?<br />

We believe that home visit dentistry will be<br />

DENTAL ASIA NOVEMBER / DECEMBER <strong>2021</strong> 25

Under the Spotlight<br />

How digital technologies help<br />

Tee Hee <strong>Dental</strong> Works<br />

In this digital era, technology and enhanced patient<br />

experience often go hand in hand. From contactless<br />

payment to fast and efficient dental treatments, the<br />

possibilities are endless. For practitioners like Dr<br />

Yang Xiao, he beams with optimism as he explores the<br />

potentials of digital dentistry.<br />

Dr Yang Xiao, dentist at Teehee <strong>Dental</strong> Works<br />

Influenced by his father, an automotive<br />

engineer, Dr Yang Xiao developed a passion<br />

for craftwork and experimenting with new<br />

technologies from an early age. Deciding to<br />

pursue dentistry though is another interesting<br />

story.<br />

He recalled: “My fondest memories as a child<br />

were the times I spent with my father fixing<br />

model bikes and aeroplanes. Funnily enough,<br />

I stumbled across dentistry through a chance<br />

encounter, around the time I had to pick<br />

my university degree as a teenager. I spent<br />

an afternoon with a friend’s dad who was a<br />

dentist and he shared with me how the job<br />

was both hands-on and people-oriented. It<br />

sounded wonderful.”<br />

Now the owner of Teehee <strong>Dental</strong> Works<br />

Singapore, Dr Yang graduated from King’s<br />

College London, UK, and was awarded the<br />

A.H.R. Rowe Prize for clinical excellence.<br />

The prestigious British Endodontic Society<br />

also awarded him a National UK Prize for<br />

demonstrating excellence in root canal<br />

treatment.<br />

Humbled by these achievements, he shared:<br />

“Given the standard of work by many of the<br />

other dentists, I think it was a combination<br />

of luck and determination to have won these<br />

awards. I enjoy trying new things to challenge<br />

myself and I was fortunate to have been<br />

recognised for trying.”<br />

On top of this, Dr Yang enjoys educating not<br />

just his patients but also the general public<br />

on the importance of good oral health. Thus,<br />

with the advent of digital technologies that<br />

can enhance communication with the patient<br />

and improve their overall experience, Dr Yang<br />

is enthusiastic as he shares his journey in<br />

embracing digital workflow.<br />


As a clinic owner and a practising dentist, Dr<br />

Yang’s role entails a lot of responsibility, such<br />

as attending to his patients and managing the<br />

clinic while continually bettering himself as a<br />

practitioner. For this reason, he is most grateful<br />

to see how his supportive team members grow.<br />

“I’m very lucky that my team has stuck by<br />

me through the good times and bad times.<br />

I would like to give special thanks to Chin,<br />

our clinic manager, for supporting our desire<br />

to continually introduce change and new<br />

technologies into the clinic. I would also like to<br />

thank Naufal, our resident dental technician<br />

for his top-notch lab work. I think that’s<br />

really important when implementing new<br />

technologies to improve patient outcomes –<br />

you need a team who believes and supports<br />

you through all difficulties,” he shared.<br />

In fact, even before COVID-19, their team at<br />

Teehee <strong>Dental</strong> Works had built a new clinic<br />

with a self check-in system.<br />

Dr Yang, said: “This allowed us to function<br />

well when the pandemic hit, given our<br />

systems were already equipped to provide<br />

a completely contactless experience for our<br />

patients. We also invested early on in robotic<br />

arms to automate our production process<br />

in our laboratory and that has been really<br />

helpful in improving our productivity and<br />

efficiency.”<br />

With these systems in place, Dr Yang takes<br />

pride in watching his patients leave the<br />

clinic happy. He revealed that addressing his<br />

patient’s problems and concerns is always a<br />

“wonderful and fulfilling feeling” for him.<br />

26<br />

DENTAL ASIA NOVEMBER / DECEMBER <strong>2021</strong>

Under the Spotlight<br />


As a practitioner, Dr Yang is an advocate of<br />

preventive and minimally invasive dentistry.<br />

He believes that communication is a key factor<br />

in the success of his treatments. With digital<br />

tools, he is more confident in providing a better<br />

patient experience, ensuring they are always<br />

on the same page every step of the treatment.<br />

“With the introduction of 3D printing and new<br />

CAD software in recent years, I am able to<br />

show the patient an almost exact replica of<br />

the final result even before treatment begins<br />

through the use of digital simulations or<br />

through 3D-printed mockups. It is a great<br />

communication tool which allows patients to<br />

visualise the treatment plan along with me, and<br />

give instantaneous feedback,” he said.<br />

Though a game-changer in improving<br />

the workflow in the clinic, digital tools and<br />

technology have a steep learning curve. Dr<br />

Yang acknowledges this, and he constantly<br />

immerses himself in learning the ropes.<br />

He shared: “Firstly, continuing education is<br />

really important – I love hearing how other<br />

dentists are overcoming their problems and<br />

coming up with great innovative solutions.<br />

Secondly, having a good relationship with<br />

your suppliers is essential – this means being<br />

open to try out new equipment and learn how<br />

new technologies can improve your existing<br />

workflows. Lastly, having a network of dentists<br />

to bounce ideas off is invaluable – I found<br />

it particularly rewarding working with other<br />

dentists (both local and international, for some<br />

different perspectives) and sharing new ideas.”<br />

Dr Yang said that these new ideas often lead<br />

to new solutions that solve old age problems<br />

more creatively and improves patients’<br />

experience. For instance, the NextDent 5100<br />

3D printer from 3D Systems has tremendously<br />

improved his practice. He partnered with 3D<br />

Systems because they offer a wide selection<br />

of complete digital dental solutions to match<br />

specific patient requirements with their digital<br />

scalable workflows, materials and software.<br />

and retainers. We have four of these units<br />

because they are just so reliable and good<br />

to use. Our reputation as a clinic and lab is<br />

dependent on the quality of work we produce<br />

so consistency and reliability are keys.”<br />

Dr Yang also added that the clinic has two<br />

intraoral scanners to streamline their workflows<br />

together with a robotic arm.<br />

“Our Kuka robotic arm, affectionately termed by<br />

the team Naulfina, does all the pressure forming<br />

for dental models, for example, clear aligners<br />

and clear retainers. It’s also constantly in use<br />

and one of the centrepieces at our clinic,” he<br />

said.<br />

At present, the team is looking forward to the<br />

new 3D Systems’ NextDent Ortho Flex resin<br />

for making splints, as they heard a lot of great<br />

reviews about it.<br />

Dr Yang shared with enthusiasm: “We are really<br />

excited to try it here in Singapore when it lands<br />

on our shores!”<br />


Moving forward, Dr Yang sees a positive trend in<br />

correcting malocclusions and that the demand<br />

for clear aligners is set to increase in the years<br />

to come leading to potentially higher costs.<br />

However, he added: “With the advancements<br />

being made in the spheres of 3D printing<br />

and CAD software, I am confident that<br />

the manufacture of clear aligners will also<br />

concurrently become more affordable and<br />

accessible to a wider number of dental<br />

practices. This will hopefully help to improve<br />

access to treatment for patients at lower costs.”<br />

In line with this, Dr Yang shared that patients’<br />

perception of treatment might also change as<br />

they will be expecting their dentists to be able<br />

to offer more conservative, economical, and<br />

efficient solutions. He also noted that tapping<br />

digital marketing channels is substantial,<br />

especially for new practices in growing their<br />

practice as fast as possible.<br />

prepare for this is to test and try new ways<br />

of doing things now,” he said.<br />

Dr Yang keeps an open mind to new<br />

possibilities and aspires to be an inspiration<br />

to other practitioners too in achieving their<br />

fullest potentials. He also strives for work-life<br />

harmony so he can always present the best<br />

version of himself to his patients.<br />

“Change is always happening and you have<br />

the choice to either be proactive or reactive.<br />

You have to change before change changes<br />

you,” he advised.<br />

To end with, Dr Yang concluded: “I’d like to<br />

share a quote from Winston Churchill that goes<br />

’Success is not final and failure is not fatal, it’s<br />

the courage to continue that count’. I wish<br />

everyone reading this good health and that<br />

they may find the happiness they seek!” DA<br />

3D Systems’ NextDent 5100 3D Printer<br />

High precision stacked printing on<br />

NextDent 5100<br />

He explained: “We would not have been able<br />

to start our clinic lab without these wonderful<br />

printers. They print equipment which are<br />

absolutely essential to our work, from wax-up,<br />

study models, 3D printed splints, clear aligners<br />

“I look forward to embracing these challenges<br />

to come. I believe automation is going to be<br />

huge in dentistry like it is already becoming in<br />

many other industries. I believe we will be able<br />

to do much more with less. And the best way to<br />

3D Systems’ NextDent Ortho Flex for<br />

splints and retainers<br />

DENTAL ASIA NOVEMBER / DECEMBER <strong>2021</strong> 27

<strong>Dental</strong> Profile<br />

Dentsply Sirona continues to<br />

future-proof dentistry<br />

With the recent success of DS World <strong>2021</strong>,<br />

Dentsply Sirona has once again secured<br />

their foothold as one of the leading dental<br />

companies around the globe. Dr Terri Dolan,<br />

the company’s chief clinical officer, talks<br />

about the latest ground-breaking technology<br />

from Dentsply Sirona and how the team<br />

continuously supports practitioners as the<br />

industry reopens.<br />

Dentsply Sirona’s pioneering role throughout<br />

its history has transformed dental practices<br />

worldwide. From developing complete solutions<br />

that seamlessly integrate hardware and software<br />

to optimising practice efficiency, the company<br />

has tremendously helped dental professionals<br />

deliver the best possible treatment and care to<br />

their patients.<br />

Inspired by this vision and success, Dr Terri Dolan<br />

takes pride in her role as the chief clinical officer<br />

of the company since 2013. With her background<br />

as a dentist and experience as a professor<br />

and dean of the University of Florida’s College<br />

of Dentistry (United States), she is the voice<br />

of clinicians and technicians within Dentsply<br />

Sirona, responsible for ensuring that they<br />

comply with regulations and ethical standards<br />

so customers will feel confident in their products<br />

and services.<br />

“In dentistry, we have a wonderful opportunity<br />

to help people maintain or restore healthy<br />

teeth and beautiful smiles. I have always been<br />

fascinated about how dentists are able to<br />

accomplish so much through their expertise<br />

in science, clinical skills, art, and of course,<br />

the use of modern technology. With the<br />

increasing evidence demonstrating the<br />

importance of oral health to overall health<br />

and well-being, I was most excited about<br />

joining a leading company with a vision to<br />

transform dentistry to improve oral health<br />

globally,” she shared.<br />

Dr Dolan oversees professional education<br />

activities and supports clinical initiatives<br />

and strategies of each Dentsply Sirona unit.<br />

She enjoys having a diverse and inclusive<br />

work environment and culture; and finds<br />

it incredibly fulfilling to be involved in<br />

the company’s support for student-led<br />

research through the Student Competition<br />

for Advancing <strong>Dental</strong> Research and its<br />

Application Awards (SCADA), which Dentsply<br />

Sirona helped initiate in 1959 and is cosponsored<br />

by the American Association for<br />

<strong>Dental</strong>, Oral and Craniofacial Research.<br />

“I truly enjoy working closely with experts<br />

from across the entire spectrum of dentistry<br />

around the world and collaborating with<br />

universities, dental schools and dental<br />

organisations to ensure that the courses<br />

and programmes we offer are not only of<br />

the highest quality but meet the needs of dental<br />

professionals today,” she said.<br />


Safety for the practitioners and their patients is<br />

of utmost importance as the industry recovers<br />

from the impact of COVID-19 pandemic. With<br />

their infection control solutions, Dentsply Sirona<br />

has made it possible for dental practitioners to<br />

re-open their practices confidently.<br />

According to Dr Dolan, safety begins with<br />

a comprehensive and thorough infection<br />

prevention concept. Consequently, Dentsply<br />

Sirona builds hygiene and infection prevention<br />

into their design language.<br />

She explained: “For example, Dentsply Sirona<br />

products have very smooth surfaces and are free<br />

from stylistic elements that could make cleaning<br />

challenging. Gaps and cracks are also avoided so<br />

that dirt and debris cannot get trapped in difficult<br />

to access areas. Our dental treatment centres<br />

are designed and equipped with materials that<br />

prevent moisture from penetrating into the chair<br />

and they even let the dentist or assistant know<br />

28<br />

DENTAL ASIA NOVEMBER / DECEMBER <strong>2021</strong>

that the hoses should be flushed for at least<br />

20 seconds after every patient’s appointment.<br />

Parts such as light handles and trays are<br />

removable so that they can be properly<br />

disinfected separately between uses.”<br />

Dr Dolan also highlighted how their intraoral<br />

scanner, Primescan, proved to be a true<br />

all-rounder as it ensures high-quality<br />

digital impressions and exceeds minimum<br />

recommended hygiene guidelines.<br />

“It is the only scanner that provides a variety<br />

of disinfection and sterilisation procedures<br />

with three different sleeve options. Thanks to<br />

the smooth surfaces of Primescan and the<br />

acquisition centre, the hygienically critical<br />

areas, which are often difficult to clean, can<br />

be reprocessed safely, quickly and easily,” she<br />

added.<br />

In achieving highest level of safety, Dr Dolan<br />

noted that the practice design can also<br />

influence the workflow to make cleaning even<br />

easier.<br />

“I would recommend having a sterilisation<br />

room that is located quite centrally, so that<br />

the team has short distances that ideally<br />

avoid many crossroads between staff and<br />

patients. In light of the COVID-19 pandemic,<br />

many practices have rethought their waiting<br />

room concepts as well to accommodate social<br />

distancing needs,” she said.<br />

When it comes to the important topic<br />

of reprocessing instruments, Dentsply<br />

Sirona offers the DAC Universal family<br />

of reprocessing units. With this device,<br />

all cleaning steps are standardised and<br />

fully automated at the touch of a button,<br />

minimising application errors to the greatest<br />

possible degree. Last year, independent<br />

testing confirmed full virucidal activity of the<br />

DAC Universal. This includes activity against<br />

all enveloped viruses such as SARS-CoV-2,<br />

and non-enveloped viruses.<br />


With the pandemic situation accelerating<br />

the digital revolution in the field, Dentsply<br />

Sirona ensures that the professionals can<br />

keep up with the advancements through their<br />

continuing education programmes.<br />

Dr Dolan, shared: “We have the strongest<br />

clinical education programme in the industry<br />

and are constantly upgrading the courses<br />

to meet the needs of dental professionals.<br />

During the COVID-19 pandemic, we quickly<br />

shifted much of our clinical education training<br />

to an online environment, but we also still<br />

have 60 training facilities, dental academies<br />

and showrooms around the world where<br />

dental professionals can take live courses and<br />

experience our cutting-edge technology that<br />

is transforming dentistry.”<br />

Furthermore, Dentsply Sirona is committed<br />

to supporting their customers’ needs all over<br />

the world as reflected in the new training<br />

facilities within the <strong>Asia</strong> Pacific they opened<br />

over the past several years in Singapore, Hong<br />

Kong, Jakarta, (Indonesia) and Kuala Lumpur<br />

(Malaysia). With the COVID-19 pandemic<br />

reducing their ability to train together in<br />

person, Dentsply Sirona quickly recalibrated<br />

their clinical education offerings at the<br />

beginning of the pandemic by moving most of<br />

their courses online and tailoring them to meet<br />

the current needs of dental professionals.<br />

“In 2020 alone, we had over a million<br />

participants in our clinical education courses.<br />

Especially in the APAC region, which was<br />

hit with COVID-19 before anywhere else<br />

in the world, we reacted fast. Numerous<br />

digital formats, such as online training,<br />

digital congresses, and trade fairs, as well<br />

as internal training and meetings, were<br />

set up immediately at the beginning of the<br />

pandemic,” she said.<br />

Dr Dolan added that one of the many initial<br />

highlights included a new online training<br />

programme that was developed and<br />

implemented in China when the COVID-19<br />

outbreak began in January 2020; the first<br />

real-time online course took place already on<br />

February 9, 2020. In less than three weeks, 46<br />

courses were set up, which were viewed by sixdigit<br />

strong audience of dental professionals.<br />


Dentsply Sirona offers an extensive range of<br />

recent innovations in their solutions pipeline<br />

including Axeos, Astra Tech ImplantEV, Surefil<br />

one, SureSmile, Palodent 360, ProTaper Ultimate,<br />

CEREC MTL Zirconia, as well as updates to their<br />

CEREC and Connect software with many more<br />

highlights coming next year.<br />

Dr Dolan asserted that dental professionals can<br />

expect Dentsply Sirona to expand its research<br />

on the use of artificial intelligence for dental<br />

applications. In fact, this technology is already<br />

used in Primescan helping to compare intraoral<br />

impressions from different points in time for<br />

patient monitoring.<br />

“That gets me to another point about data –<br />

technologies like our Primescan capture an<br />

incredible amount of data and in the future,<br />

we will be able to even more efficiently utilise<br />

this wealth of data for even better diagnostics.<br />

There is also great potential in materials that<br />

can be digitally processed to provide longevity,<br />

DENTAL ASIA NOVEMBER / DECEMBER <strong>2021</strong> 29

<strong>Dental</strong> Profile<br />

compatibility and great aesthetics for<br />

patients,” she said.<br />

Dr Dolan also noted that patients want<br />

treatments that not only give a great result<br />

but also are more comfortable and even<br />

less time-consuming. Therefore, it is not<br />

just digitalisation of individual products,<br />

but entire workflows, which they strive for<br />

when developing new innovations.<br />

“There is tremendous potential for implant<br />

dentistry and integrated workflows by<br />

bridging the gaps between implant<br />

dentistry, imaging, and CAD/CAM, as<br />

well as connected software for smart<br />

procedures,” she said.<br />

Furthermore, in line with the global call<br />

for circular economy and sustainability,<br />

Denstply Sirona has recently released<br />

their inaugural sustainability report and<br />

announced their updated sustainability<br />

strategy aligned with 10 UN Sustainable<br />

Development Goals (UNSDGs) during the<br />

DS world.<br />

Dr Dolan, explained: “Dentsply Sirona’s<br />

sustainability strategy focuses on three<br />

strategic pillars: ‘Healthy Planet’, which<br />

strives to mitigate the environmental<br />

impact of our operations; ‘Healthy Smiles’,<br />

which focuses on improving oral health<br />

quality and access globally, supporting<br />

our customers and fostering a healthy<br />

company culture; and, ‘Healthy Business’,<br />

which ensures our business is built via<br />

responsible and transparent practices and<br />

the effective integration of sustainability<br />

principles across all aspects of our<br />

business.”<br />

With regards to the environment, Dentsply<br />

Sirona established a robust baseline for<br />

Scopes 1 and 2 greenhouse gas (GHG)<br />

emissions and implemented a range of<br />

on-site emissions reduction initiatives.<br />

They aim to reduce Scopes 1 and 2 GHG<br />

Emissions by at least 15% by 2025, and to<br />

achieve net zero carbon emissions (scopes<br />

1-3) by 2050. Dentsply Sirona also aims to<br />

reduce total waste by at least 15% by 2025<br />

and established a goal to reduce water<br />

withdrawal for manufacturing/warehouse<br />

operations by a minimum of 15% by 2025.<br />

“We have also become a founding partner<br />

in the FDI World <strong>Dental</strong> Federation’s<br />

‘Sustainability in Dentistry’ initiative, joining<br />

GSK, Procter & Gamble, Colgate and TePe to<br />

create a Code of Good Practice, which will<br />

provide guidelines and objectives for achieving<br />

a sustainable procurement and supply process<br />

throughout the dental industry,” shared Dr<br />

Dolan.<br />


The digital revolution is occurring in many<br />

industries and the dental field is no exemption.<br />

According to Dr Dolan, one can expect nothing<br />

less from the next generation of dental<br />

practitioners who are ready to embrace new<br />

technologies and seek out trainings to keep<br />

their techniques and practices at the cutting<br />

edge.<br />

However, she noted that it is also important to<br />

understand the specific needs of the patients<br />

and to tailor their dental experience to meet<br />

those needs especially for older patients.<br />

“One of the factors that will influence<br />

innovation and the types of solutions that<br />

need to be developed in the coming years is<br />

the increase in life expectancy in many places<br />

around the world. More and more patients<br />

expect to keep their natural teeth longer. How<br />

dentists care for older patients may therefore<br />

need to evolve to meet these expectations<br />

and challenges – for example, advances in<br />

endodontic care and restoring function with<br />

implant supported prostheses.<br />

“Having a significantly larger elderly patient<br />

population means that dental practices will have<br />

to consider how to best cater to this group – that<br />

may require rethinking how the practice is set up<br />

and designed to accommodate the specific needs<br />

of an older population, but also in the types of<br />

services provided,” she explained.<br />

Dr Dolan also emphasised the importance<br />

of attending clinical education events for<br />

exchanging best practices in light of the<br />

pandemic situation reinforcing dental care as an<br />

essential health service.<br />

“Oral health is an important precondition for<br />

general health and teeth require thorough care.<br />

Prevention and other important dental treatments<br />

are crucial for the health and well-being of<br />

patients,” explained Dr Dolan.<br />

To conclude, Dr Dolan extends her gratitude<br />

to their customers in the region: “It has been<br />

a challenging 1.5 years for all of us in the<br />

industry and yet, we all came together as a<br />

united community to bring the practice of<br />

dentistry forward and to continue to give healthy<br />

smiles to patients. Dentsply Sirona salutes<br />

you – and we remain committed to providing<br />

dental professionals with the most advanced<br />

technologies, training and support so we can<br />

always be prepared for the future.” DA<br />

30<br />

DENTAL ASIA NOVEMBER / DECEMBER <strong>2021</strong>

Clinical Feature<br />

Digital scans and<br />

human identification<br />

The advances in digital technology have evolved dental<br />

models into highly reliable tools for human identification.<br />

Addressing the limitations of traditional stone models and<br />

DNA analysis, it is now possible to utilise 3D digital palatal<br />

model to distinguish monozygotic twins.<br />

By Dr Botond Simon, Dr Ajang Armin Farid, Dr George Freedman, and Dr Janos Vag<br />

The exponential growth of digital<br />

technology in dentistry is inherently<br />

accompanied by a significant<br />

expansion of 2D and 3D dental image<br />

records. Traditional stone models are<br />

impractical to keep long-term due to<br />

storage volume and fragility.<br />

Comprehensive and accurate<br />

models offer an excellent record of<br />

the preoperative dentition for the<br />

complete restoration of a smile that<br />

matches the original (Renne, Evans<br />

et al. 2017, Revilla-Leon, Raney et<br />

al. 2020). The longer-term storage<br />

of dental models facilitates the<br />

resolving legal cases, and might aid<br />

bite mark analysis in some criminal<br />

cases (Khatri, Daniel et al. 2013). Yet<br />

another application of dental models<br />

is for human identification.<br />

In addition to DNA and fingerprints,<br />

dental examination is a primary tool<br />

for disaster victim identification (DVI)<br />

(Interpol, Tsokos, Lessig et al. 2006).<br />

<strong>Dental</strong> models that are discarded or<br />

lost may deprive biologically driven<br />

oral rehabilitation of historical tooth,<br />

bite, and bone reference points, and<br />

may hamper positive identification.<br />

Population-wide databases for<br />

fingerprints (Peralta, Triguero et al.<br />

2016, Thalesgroup.com <strong>2021</strong>) and<br />

DNA (Smith 2006, Amankwaa and<br />

McCartney 2018) are limited and<br />

very fragmented. After the 2004<br />

tsunami disaster in Thailand, 46% of<br />

the victims were identified by dental<br />

records, as compared to only 19%<br />

by DNA and 34% by fingerprints.<br />

The dental identification method is<br />

an analogous visual comparison of<br />

the ante- and post-mortem dental<br />

records (Miki, Muramatsu et al. 2017,<br />

Alsalamah and Nuzzolese 2020).<br />

The basis of this concept is that<br />

dental treatments are always very<br />

specific and unique (Pretty and<br />

Sweet 2001, Ata-Ali and Ata-Ali<br />

2014). To further complicate matters,<br />

teeth are continually impacted by<br />

abrasion, disease, trauma, and dental<br />

treatment. Thus, the available antemortem<br />

data might not correlate<br />

well to the post-mortem data.<br />

Furthermore, treatment notation and<br />

information are not standardised,<br />

and it is exceedingly difficult to<br />

run an automatic search in a large,<br />

fragmented database.<br />

Identifying the victim’s dentist,<br />

or, at the very least, the area<br />

where the victim was treated, is a<br />

mandatory prerequisite for a DVI<br />

search. Antemortem dental records<br />

can be very challenging if no other<br />

victim information is available. In<br />

fact, younger patients may have<br />

only orthodontic records. The<br />

search process can be accelerated<br />

dramatically by accessing the everincreasing<br />

number of digital scans and<br />

cloud-based data storage systems.<br />

Digital dental records must be<br />

retained, depending on national<br />

regulations, from years to decades<br />

(Charangowda 2010, Devadiga<br />

2014). With digital dental records,<br />

new pathways are open for DVI. The<br />

next logical step is to find oral cavity<br />

characteristics with universality,<br />

uniqueness, invariability (stable<br />

throughout the life), and ease of<br />

access.<br />

Monozygotic (MZ) twins cannot be<br />

distinguished by DNA analysis (Bell<br />

and Spector 2011) and they look very<br />

similar (phenotypes). Hence, one<br />

way to prove the uniqueness of an<br />

identification method is its ability to<br />

reliably distinguish MZ twins. This is<br />

compounded by the recent revelation<br />

that palatal morphology (palatal vault<br />

and surface texture) can differentiate<br />

MZ twins through intraoral scans<br />

(Simon, Liptak et al. 2020).<br />

Rugoscopy (also known as<br />

palatoscopy, calcorrugoscopy) is<br />

DENTAL ASIA NOVEMBER / DECEMBER <strong>2021</strong> 31

Clinical Feature<br />

based on the difference in palatal<br />

rugae pattern, and can distinguish<br />

among ethnic and race groups,<br />

offering great assistance during<br />

DVI (Hermosilla Venegas, San Pedro<br />

Valenzuela et al. 2009, Bajracharya,<br />

Vaidya et al. 2013, Azab, Magdy et<br />

al. 2016, Suhartono, Syafitri et al.<br />

2016, Kommalapati, Katuri et al. 2017,<br />

Saadeh, Ghafari et al. 2017, Barbo,<br />

Azeredo et al. 2018, Basman, Puspita<br />

et al. 2018).<br />

The palate is more resistant to burn<br />

deformation injury when compared to<br />

the skin (Muthusubramanian, Limson<br />

et al. 2005). It is stable over time and<br />

varies little after orthodontic treatment<br />

(Bailey, Esmailnejad et al. 1996, Abdel-<br />

Aziz and Sabet 2001, Ali, Shaikh et al.<br />

2016, Lanteri, Cossellu et al. 2020).<br />


The aim of this pilot study was to<br />

compare teeth and palate uniqueness<br />

using the intraoral scans (IOS) of MZ<br />

twins.<br />


Three MZ pairs, aged 17, 22, and<br />

26 were enrolled in the study. The<br />

complete maxillary arch, including the<br />

palate, was scanned by the Emerald<br />

intraoral scanner (Planmeca, Helsinki,<br />

Finland, software version: Romexis<br />

5.2.1). The palate was carefully isolated<br />

on each scan and was exported to<br />

a separate model. The left maxillary<br />

first molar was intact in five subjects<br />

and filled in one subject. The left<br />

maxillary second molar was intact in<br />

each subject. These two teeth were<br />

segmented, and the images were<br />

exported to respective new files.<br />

Palatal digital models and tooth<br />

digital models were aligned between<br />

nonrelatives (Fig. 1) and between<br />

siblings (Fig. 2). The superimpositions<br />

were made using the GOM Inspect<br />

software (GOM GmbH, Germany),<br />

utilising the local best-fit algorithm.<br />

The mean absolute deviations were<br />

calculated for each superimposition<br />

with the surface comparison tool. The<br />

Fig. 1: The surface comparison maps of nonrelative subjects of the maxillary first molars, of the<br />

maxillary second molars, and of the palate. None of the teeth had restorations. Deep red and<br />

blue areas indicate distance deviation higher than the range of the colour scale<br />

data were statistically analysed by<br />

the generalised linear mixed method<br />

using SPSS (IBM SPSS Statistics for<br />

Windows, Version 27.0., United States).<br />


The mean absolute deviations<br />

(± the standard deviation) of the<br />

first and second molars between<br />

non-relatives (Fig. 1) were not<br />

significantly different (0.259±0.039<br />

mm, 0.277±0.037 mm, p=0.733),<br />

but the mean absolute deviation of<br />

the palates was significantly higher<br />

(1.061±0.314 mm, p

Clinical Feature<br />

higher than the IOS trueness, they<br />

jeopardise the confidence in MZ twin<br />

identification.<br />

The palatal deviation between<br />

siblings was three to four times higher<br />

(0.393±0.079 mm, p

Clinical Feature<br />

the determination of human identity.” Br<br />

Dent J 190(7): 359-366.<br />

• Renne, W. G., Z. P. Evans, A. Mennito and<br />

M. Ludlow (2017). “A novel technique<br />

for reference point generation to aid<br />

in intraoral scan alignment.” J Esthet<br />

Restor Dent 29(6): 391-395.<br />

• Revilla-Leon, M., L. Raney, W. Piedra-<br />

Cascon, J. Barrington, A. Zandinejad<br />

and M. Ozcan (2020). “Digital workflow<br />

for an esthetic rehabilitation using a<br />

facial and intraoral scanner and an<br />

additive manufactured silicone index:<br />

A dental technique.” J Prosthet Dent<br />

123(4): 564-570.<br />

• Saadeh, M., J. G. Ghafari, R. V. Haddad<br />

and F. Ayoub (2017). “Palatal rugae<br />

morphology in an adult mediterranean<br />

population.” J Forensic Odontostomatol<br />

35(1): 21-32.<br />

• Simon, B., L. Liptak, K. Liptak, A. D.<br />

Tarnoki, D. L. Tarnoki, D. Melicher and<br />

J. Vag (2020). “Application of intraoral<br />

scanner to identify monozygotic twins.”<br />

BMC Oral Health 20(1): 268.<br />

• Smith, M. E. (2006). “Let’s Make the DNA<br />

Identification Database as Inclusive as<br />

Possible.” The Journal of Law, Medicine<br />

& Ethics 34(2): 385-389.<br />

• Smith, R. N., G. Townsend, K. Chen<br />

and A. Brook (2009). “Synetic<br />

superimposition of dental 3D data:<br />

application in twin studies.” Front Oral<br />

Biol 13: 142-147.<br />

• Suhartono, A. W., K. Syafitri, A. D.<br />

Puspita, N. Soedarsono, F. P. Gultom,<br />

P. T. Widodo, M. Luthfi and E. I. Auerkari<br />

(2016). “Palatal rugae patterning in a<br />

modern Indonesian population.” Int J<br />

Legal Med 130(3): 881-887.<br />

• Taneva, E., C. Evans and G. Viana (2017).<br />

“3D Evaluation of Palatal Rugae in<br />

Identical Twins.” Case Rep Dent 2017:<br />

2648312.<br />

• Thalesgroup.com. (<strong>2021</strong>, 06 March<br />

<strong>2021</strong>). “Biometrics: definition, trends,<br />

use cases, laws and latest news.” from<br />

https://www.thalesgroup.com/en/<br />

markets/digital-identity-and-security/<br />

government/inspired/biometrics.<br />

• Tsokos, M., R. Lessig, C. Grundmann,<br />

S. Benthaus and O. Peschel (2006).<br />

“Experiences in tsunami victim<br />

identification.” Int J Legal Med 120(3):<br />

185-187.<br />

• Uhm, S. H., J. H. Kim, H. B. Jiang, C. W.<br />

Woo, M. Chang, K. N. Kim, J. M. Bae and<br />

S. Oh (2017). “Evaluation of the accuracy<br />

and precision of four intraoral scanners<br />

with 70% reduced inlay and four-unit<br />

bridge models of international standard.”<br />

Dent Mater J 36(1): 27-34.<br />

• Vag, J., Z. Nagy, B. Simon, A. Mikolicz, E.<br />

Kover, A. Mennito, Z. Evans and W. Renne<br />

(2019). “A novel method for complex<br />

three-dimensional evaluation of intraoral<br />

scanner accuracy.” Int J Comput Dent<br />

22(3): 239-249.<br />

• Zhongpeng, Y., X. Tianmin and J.<br />

Ruoping (2019). “Deviations in palatal<br />

region between indirect and direct<br />

digital models: an in vivo study.” BMC<br />

Oral Health 19(1): 66.<br />

About the authors<br />

Dr Botond Simon<br />

Dr Ajang Armin<br />

is a PhD student<br />

Farid is the<br />

at Semmelweis<br />

chief forensic<br />

University,<br />

odontologist<br />

Hungary. He<br />

of Hungary’s<br />

is a specialist<br />

Interpol DVI<br />

in Restorative<br />

dental unit, and<br />

Dentistry and<br />

a member of<br />

Prosthodontists. His research<br />

Interpol’s DVI Odontology subworking<br />

group. He is a fellow of<br />

combines digital dentistry with<br />

dental twin research and human the American Academy of Forensic<br />

identification. He is co-founder<br />

Sciences and a member of the<br />

of Scrunch Ltd., an early-stage<br />

American Society of Forensic<br />

start-up company for providing<br />

Odontology. He lectures at<br />

personalised online dental care<br />

Semmelweis Medical University,<br />

for patients. Dr Simon maintains a Hungary, and maintains a private<br />

private practice.<br />

dental practice.<br />

Dr George<br />

János Vág<br />

Freedman is a<br />

DMD, PhD,<br />

founder and past<br />

is associate<br />

president, AACD,<br />

professor<br />

a co-founder<br />

and head,<br />

CAED, regent<br />

Department of<br />

and fellow,<br />

Conservative<br />

International Academy for <strong>Dental</strong> Dentistry, Semmelweis University,<br />

Facial Esthetics, and Diplomate and Hungary. He is a specialist in<br />

Chair, American Board of Aesthetic Restorative Dentistry, Endodontics,<br />

Dentistry. He is adjunct professor and Prosthodontists. His research<br />

of <strong>Dental</strong> Medicine, Western<br />

focuses on the microcirculation<br />

University, Pomona, California of the gingiva, intraoral scanner<br />

and Professor and Programme accuracy, and digital forensic<br />

Director, BPP University, London, odontology. He has published 45<br />

UK, MClinDent Programme<br />

refereed papers. He is co-founder<br />

in Restorative and Cosmetic<br />

of Scrunch Ltd., a start-up company<br />

Dentistry.<br />

for providing personalised online<br />

dental care for patients.<br />

34<br />

DENTAL ASIA NOVEMBER / DECEMBER <strong>2021</strong>

A<br />

Bone Level<br />

REG & PX designs for<br />

biological integration<br />

With more than 30 years of experience<br />

in implantology, Anthogyr launched the<br />

Axiom® implant system 10 years ago to<br />

improve access to implantology by<br />

offering innovative and accessible<br />

solutions, a greater comfort for practitionners<br />

and performance in their<br />

everyday practice.<br />

DENTAL ASIA NOVEMBER / DECEMBER <strong>2021</strong> 35

Clinical Feature<br />

Innovative dental implant<br />

solutions<br />

Through innovation and creativity, Anthogyr offers a complete range<br />

of implants, instruments and digital solutions to support dental health<br />

professionals in restoring their patients’ smiles. Dr Albert Chou and<br />

Dr Sebrina Malik share how these solutions have allowed them to deliver<br />

effective and predictable implant treatments in their daily practice.<br />

First experience with<br />

Anthogyr Axiom® TL<br />

implant<br />

By Dr Albert Chou<br />

The dental profession has been helping<br />

patients restore their chewing functions and<br />

aesthetics using modern dental implants<br />

since the 60s. There are a variety of designs<br />

and shapes of implants produced since then.<br />

Macroscopically, the most distinctive feature<br />

of a modern dental implant is either a soft<br />

tissue level implant or a bone level implant.<br />

Fig. 1 Fig. 2<br />

However, any attempts to justify which<br />

implant design is superior will probably<br />

end up with a non-conclusive agreement<br />

between different dentists as the decision<br />

to choose one design over the other can be<br />

due to the operator’s training and experience.<br />

What is crucial to know is that both bone level<br />

and tissue level implant offer good implant<br />

survival rate 1 .<br />

Fig. 3 Fig. 4<br />


A 46-year-old female without any pertinent<br />

medical issues wanted to have her missing<br />

lower right first molar (tooth 46) replaced.<br />

During the first consultation, her dentition<br />

presented a moderate amount of attrition.<br />

Abfraction was also noted, and she<br />

mentioned that she did brux at night from<br />

time to time.<br />

Fig. 5 Fig. 6<br />

Her lower left second molar (tooth 47) was<br />

replaced with a Straumann Tissue level<br />

implant some years ago and it had served<br />

Fig. 7 Fig. 8<br />

36<br />

DENTAL ASIA NOVEMBER / DECEMBER <strong>2021</strong>

Clinical Feature<br />

her well without any issues. It was then<br />

proposed to her to have Anthogyr Axiom ®<br />

TL implant with simultaneous guided bone<br />

regeneration on the lower right first molar<br />

site (Figs. 1-8).<br />

Upon detailed examination of the CBCT<br />

(cone beam computed tomography) image,<br />

a radiolucent area was noted at the distal<br />

aspect of the root and the bone of the lower<br />

right second premolar (tooth 45) (Figs.<br />

9a-c).<br />

Fig. 9a<br />

Fig. 9b<br />

The patient was referred to see the<br />

endodontist to assess if the tooth was<br />

restorable. Unfortunately, the tooth was<br />

deemed untreatable and would need to be<br />

extracted. The tooth was then extracted<br />

carefully and with as little trauma as<br />

possible (Fig. 10). Upon inspection of the<br />

extracted tooth, a perforation at the coronal<br />

third of the root at the distal aspect of the<br />

tooth was observed (Figs. 11-12).<br />

Fig. 9c<br />

Fig. 10<br />

Theoretically, it was possible to place an<br />

implant at the tooth 46 site and perform<br />

immediate implant placement at tooth 45<br />

with simultaneous bone graft procedure,<br />

but doing so would be challenging. Since<br />

bone graft was already planned, it was<br />

decided to wait for 12 to 16 weeks (Type 3C<br />

– early placement with partial bone healing<br />

plus conventional loading) of healing before<br />

the implant placement to have a higher<br />

degree of survival rate 2 .<br />

Fig. 11<br />

Fig. 12<br />


CBCT was taken to check the location of the<br />

inferior alveolar nerve. For implant viewing<br />

and planning, both Dentsply Sirona Gallileos<br />

and <strong>Dental</strong> Wings coDiagnostiX were used<br />

(Figs. 13-14). From the CBCT scan, it was<br />

noted that bone agumentation on the<br />

buccal side of the two proposed implants<br />

was needed. For implant planning purpose,<br />

Anthogyr Axiom ® TL PX R2 4.0mmX8mm<br />

was used (Fig. 15). At tooth 46, Anthogyr<br />

Axiom ® TL PX R2 4.6mmX6.5mm was used<br />

for surgical planning (Fig. 16).<br />

Fig. 13 Fig. 14<br />

Fig. 17<br />

On the day of surgery, a surgical stent was<br />

used to aid the implant placement (Fig.<br />

17). Two Anthogyr Axiom ® TL were placed<br />

following manufacturer’s surgical protocol<br />

(Fig. 18).<br />

Fig. 15 Fig. 16<br />

Fig. 18<br />

DENTAL ASIA NOVEMBER / DECEMBER <strong>2021</strong> 37

Clinical Feature<br />

After the two implants were placed with<br />

good primary stability, guided bone<br />

regeneration procedure was carried out<br />

(Figs. 19-20). Two implants placed were<br />

Anthogyr Axiom ® TL PX 4.6X6.5mm with<br />

R2.5 at tooth 46 and Anthogyr Axiom ® TL<br />

PX 4.0X8mm with R2.5 at tooth 45. Cover<br />

screws were used for both implants at the<br />

end of the surgery. Geistlich Bio-Oss 0.25g<br />

was used as the bone graft material with<br />

Geistlich Bio-Gide 13X25mm for membrane.<br />

Primary closure was achieved at the tooth 46<br />

site but it was not possible at the tooth 45<br />

site. Flap was closed with non-absorbable<br />

monofilament 5/0 Prolene by Ethicon and<br />

absorbale glyconate monofilament 5/0<br />

Monosyn by B. Braun (Fig. 21).<br />

When the implants were placed in March<br />

<strong>2021</strong> in Singapore, the only collar height for<br />

the Anthogyr Axiom ® TL was R2.5. Hence,<br />

it was different from what was planned<br />

when using the coDiagnostiX. The healing<br />

phase for the patient was uneventful and<br />

after the suture removal, she was seen<br />

again two months after the surgery. The<br />

soft tissue was healing well but the metal<br />

collar at 45 implant was exposed (Figs.<br />

22-23).<br />

Implants at 45 and 46 were left to heal<br />

for three months before the stage two<br />

surgery was carried out (Fig. 24). The<br />

healing abutment used at 45 was 2mm<br />

in height and 4.8mm in diameter. At<br />

46, it was 4mm in height and 4.8mm in<br />

diameter.<br />

Digital implant impression was utilised<br />

and two Anthogyr Axiom ® TL scan bodies<br />

were used (Figs. 25-26). The data was<br />

acquired using Medit i500 scanner (Figs.<br />

27-29).<br />

The patient preferred to have a toothcoloured<br />

restoration, with monolithic<br />

zirconia crown as the material of choice. It<br />

was also decided that it will be beneficial<br />

to splint the two crowns together due<br />

to the shorter implant used at 46. The<br />

abutment used for both 45 and 46 was<br />

non-engaging Flexibase TL R plural (Figs.<br />

30-34).<br />


In dentistry, one may face an unplanned<br />

situation. In this case, tooth 45 was not<br />

supposed to be replaced by a dental<br />

implant. Using Anthogyr implant system<br />

has made day-to-day clinical practice<br />

more flexible and straightforward when<br />

dealing with unexpected changes.<br />

Fig. 19 Fig. 20 Fig. 21<br />

Fig. 22 Fig. 23<br />

Fig. 24<br />

Fig. 25<br />

Fig. 26 Fig. 27<br />

38<br />

DENTAL ASIA NOVEMBER / DECEMBER <strong>2021</strong>

Clinical Feature<br />

Fig. 28 Fig. 29<br />

Regrettably, the soft tissue height at 45 was<br />

not ideal. However, Anthogyr Axiom ® TL implant<br />

demonstrated excellent tissue response around<br />

the gingival soft tissue. In hindsight, implant 45<br />

could have been placed a bit deeper or if there<br />

was preferably an option to use a shorter collar<br />

height. Unfortunately, a shorter collar height<br />

was unavailable in Singapore when the surgery<br />

was done. Nevertheless, it will be of great<br />

interest to monitor and observe the longevity of<br />

this implant system for the years to come. DA<br />


The author would like to extend his gratitude to<br />

Patrick <strong>Dental</strong> Lab for their prosthetic work and<br />

support.<br />


1<br />

Vouros, Ioannis D.; Kalpidis, Christos D. R.; Horvath,<br />

Attila; Petrie, Aviva; Donos, Nikolaos. Systematic<br />

Assessment of Clinical Outcomes in Bone-Level<br />

and Tissue-Level Endosseous <strong>Dental</strong> Implants.<br />

International Journal of Oral & Maxillofacial Implants.<br />

2012, Vol. 27 Issue 6, p1359-1374<br />

2<br />

German O. Gallucci; Adam Hamilton; Weniji Zhou;<br />

Fig. 30<br />

Daniel Buser; Stephen Chen. Implant placement and<br />

loading protocols in partially edentulous patients: A<br />

systematic review. Clin Oral Impl Res 2018:29 (Suupl.<br />

16): 106-134<br />

About the author<br />

Fig. 31<br />

Fig. 32<br />

Fig. 33<br />

Fig. 34<br />

Dr Albert Chou<br />

obtained his<br />

Bachelor of <strong>Dental</strong><br />

Surgery from the<br />

University of Otago,<br />

New Zealand,<br />

in 2004, and<br />

completed his Graduate Diploma in<br />

<strong>Dental</strong> Implantology with the National<br />

University of Singapore in 2013. He<br />

was president for the NUS Graduate<br />

Diploma in <strong>Dental</strong> Implantology from<br />

2018 to 2020 and now serves as an<br />

executive committee in the Alumni.<br />

A partner at Canaan <strong>Dental</strong> Surgery,<br />

he has always been involved in the<br />

private practice. He is a member of the<br />

International Team for Implantology<br />

(ITI) and the <strong>Asia</strong> Pacific Society of<br />

Osseointegration.<br />

DENTAL ASIA NOVEMBER / DECEMBER <strong>2021</strong> 39

Clinical Feature<br />

Immediate implant<br />

surgery with Anthogyr<br />

Axiom®BL PX Implant<br />

System<br />

By Dr Sebrina Abdul Malik<br />

A 60-year-old healthy female patient presented<br />

a fractured upper left second premolar (tooth<br />

25). She visits the dental office regularly and is a<br />

non-smoker with good oral hygiene.<br />

Fig. 1<br />

Clinically, she had lost over three-quarters of<br />

the lingual wall and the caries had extended<br />

subgingivally (Figs. 1-2). There was insufficient<br />

ferule to restore the tooth as it would need<br />

crown lengthening as well as a root canal<br />

with a post and core. Thus, the prognosis was<br />

considered to be guarded.<br />

Treatment options were explained to the patient.<br />

She preferred to extract the broken tooth and<br />

place an implant crown, as she felt that it<br />

was a more predictable treatment option with<br />

longer longevity. The panoramic radiograph<br />

showed that she has a healthy generalised<br />

periodontium.<br />

Fig. 2 Fig. 3<br />

Treatment protocol for the implant procedure<br />

and technique were discussed in detail,<br />

including whether a delayed or an immediate<br />

approach was to be done. In this case, an<br />

immediate implant placement was equally<br />

predictable as the delayed approach in the right<br />

hands. Since the patient was asymptomatic<br />

with no existing acute periapical lesion or<br />

infection, she was considered suitable for an<br />

immediate implant procedure. She was elated<br />

as she only had to go through one surgical visit<br />

as opposed to two.<br />

An immediate implant procedure entails a<br />

flapless extraction of the tooth followed by<br />

implant insertion into the socket at the same<br />

visit. Since there is no surgical incision nor<br />

buccal flap raised, this results in less surgical<br />

trauma, shorter surgical time, reduction in postoperative<br />

swelling and pain as well as the need<br />

for suturing. Most patients are inclined towards<br />

this technique due to the above advantages.<br />


A flapless atraumatic extraction of the broken<br />

Fig. 4 Fig. 5<br />

Fig. 1: Pre-op<br />

Fig. 4: Extracted tooth 25<br />

Fig. 2: Fractured tooth 25<br />

Fig. 5: One-stage surgery with healing screw<br />

Fig. 3: Extracted tooth 25 socket<br />

abutment was used to maintain the gingival<br />

tooth 25 was carried out with Coupland<br />

emergence profile and aid in healing for the<br />

elevators and upper premolar forceps (Figs.<br />

future prosthetic crown. Implant positioning<br />

3-4). The empty socket was irrigated with<br />

was verified by a post-operative panoramic<br />

saline and curetted leaving only healthy<br />

radiograph (Fig. 6).<br />

surrounding alveolar bone. It was followed by<br />

insertion of an optimally positioned Anthogyr<br />

Three months later, a closed tray impression<br />

Axiom ® BL PX 4.6x 10.0mm with great<br />

technique was carried out and successful<br />

primary stability of 35Ncm (Fig. 5). Since<br />

delivery of a screw-retained zirconia crown<br />

the ‘’jumping gap’’ was less than 2.0mm,<br />

was achieved (Figs. 7-10).<br />

a bone graft was not required. A healing<br />

40<br />

DENTAL ASIA NOVEMBER / DECEMBER <strong>2021</strong>

Clinical Feature<br />

Fig. 6<br />


This case delivered a high-quality dental<br />

implant and crown treatment without the<br />

need for more surgical downtime, including<br />

minimal surgical trauma and reduced<br />

post-operative swelling and pain. Anthogyr<br />

Axiom ® BL PX dental implant is designed<br />

to engage well in the socket for immediate<br />

implantation with great stability. Studies<br />

have shown the success rate of immediate<br />

implant technique is nearly as successful<br />

as the delayed approach if done the correct<br />

way. DA<br />


The author would like to extend her sincere<br />

appreciation to Yttria Lab for their highquality<br />

prosthetic work.<br />

Fig. 7<br />

Fig. 8<br />


1<br />

Fernando Salimon Ribeiro et al. Implant Dent.<br />

2008 Mar. Success rate of immediate nonfunctional<br />

loaded single-tooth implants: immediate versus<br />

delayed implantation._<br />

2<br />

Stephen T Chen et al. Int J Oral Maxillofac<br />

Implants. 2004. Immediate or early placement<br />

of implants following tooth extraction: review of<br />

biologic basis, clinical procedures, and outcomes.<br />

About the author<br />

Fig. 9<br />

Fig. 10<br />

Fig. 6: Post-op<br />

Fig. 7: Pop-in impression closed tray technique<br />

Fig. 8: Crown received from lab<br />

Fig. 9: Final restoration<br />

Fig. 10: Post-op radiograph to verify the fully seated restoration<br />

Dr Sebrina Abdul<br />

Malik graduated<br />

from the Trinity<br />

College Dublin,<br />

University of<br />

Ireland, with<br />

a Bachelor of<br />

<strong>Dental</strong> Science in 2009 and has been<br />

practicing general dentistry since<br />

then. With special interest in dental<br />

implants and dentoalveolar surgery,<br />

she co-founded Azure <strong>Dental</strong> in<br />

Singapore where she currently works.<br />

A certified implant dentist, she is also<br />

a fellow of International Congress<br />

of Oral Implantologist and an active<br />

member of the International Team<br />

of Implantology and Academy of<br />

Osseointegration.<br />

DENTAL ASIA NOVEMBER / DECEMBER <strong>2021</strong> 41

Advertorial<br />

Clinical Feature<br />

CS MAR reveals<br />

pathology and reduces<br />

risk of misinterpretation<br />

Carestream <strong>Dental</strong>’s CS 8100 3D features the CS MAR (Metal<br />

Artifact Reduction) technology, which drastically reduces metal<br />

artefacts caused by dental restorations, implants, and fillings.<br />

As discussed by Dr Hanke Faust, this feature compares images<br />

dynamically to obtain a more accurate and advanced diagnosis.<br />

By Dr Hanke Faust<br />

A 50-year-old patient with extended<br />

soft tissue swelling around teeth 43<br />

and 44 came to the practice (Figs.<br />

1-2). The patient reported no pain<br />

and irritability on the lesion but the<br />

panoramic image revealed multiple<br />

coronal and apical pathological<br />

findings (Fig. 3). An extraoral image<br />

was captured with the CS 8100 3D.<br />

Fig. 1 Fig. 2<br />

A CBCT volume was taken with<br />

a 150-micron resolution for<br />

further diagnostics using the FDK<br />

reconstruction, as well as the new<br />

CS MAR (Metal Artifact Reduction)<br />

algorithm, which greatly increased<br />

the spectrum of diagnostic<br />

possibilities. The 3D view revealed<br />

osteolysis (Fig. 4).<br />

Fig. 3 Fig. 4<br />

When comparing the panoramic<br />

images extracted from the 3D scan<br />

(Figs. 5-6), the image with CS MAR<br />

applied (Fig. 6) showed significantly<br />

lower artefacts caused by implants,<br />

fillings and dental crowns. Various<br />

pathological findings, such as apical<br />

brightening at teeth 15, 26, 37 and<br />

47; coronal brightening at teeth<br />

15 and 45; and osteolysis at 15, 43<br />

Fig. 5 Fig. 6<br />

Figs. 1-2: Initial clinical finding<br />

Fig. 3: Coronal and apical pathological findings<br />

Fig. 4: Osteolysis in the region indicated by the blue arrows<br />

Figs. 5-6: Panoramic reconstruction from the 3D volume showed FDK and CS MAR<br />

42<br />

DENTAL ASIA NOVEMBER / DECEMBER <strong>2021</strong>

Clinical Feature<br />

Advertorial<br />

Fig. 7 Fig. 8<br />

and 44, were easily identified. For<br />

confirmation of the diagnosis, the<br />

transverse and horizontal planes<br />

were also examined in both FDK and<br />

with CS MAR applied (Figs. 7-11).<br />

The artefacts shown in the FDK<br />

reconstruction consisted mainly<br />

of hardening, extinction, noise and<br />

motion artefacts.<br />


The osteolytic-pathogenic<br />

processes in 3D X-ray diagnostics<br />

were assessed preoperatively<br />

within the framework of the WHO<br />

classification of odontogenesis<br />

Fig. 9<br />

Fig. 10<br />

Fig. 11<br />

lesions:<br />

1. Neoplasms and other tumours of<br />

the odontogenic apparatus (benign/<br />

malign)<br />

2. Tumours and other lesions of the<br />

bone (osteogenic tumours, nonneoplastic<br />

bone lesions)<br />

3. Epithelial cysts (developmental or<br />

inflammatory)<br />

There was a need to distinguish<br />

between giant cell granulomas,<br />

fibromas and ameloblastic fibromas,<br />

as well as other osteolytic tumours.<br />

In this case, a polycystic<br />

ameloblastoma at teeth 43 and<br />

44 was suspected. The displaced<br />

expulsion of the bone and<br />

degradation of the bone and teeth<br />

where the tumour had penetrated<br />

them were all typical clinical<br />

characteristics.<br />

Fig. 12 Fig. 13<br />

Figs. 7-8: Coronal cross section of FDK reconstruction and with CS MAR algorithm applied at<br />

150microns<br />

Figs. 9-10: 1x1 slice for detailed display<br />

Fig. 11: Coronal plane shows the vertical section of teeth 37 and 47<br />

Figs. 12-13: The CS MAR reconstruction (Fig. 13) provided additional diagnostic capability<br />

compared to the FDK reconstruction<br />

DENTAL ASIA NOVEMBER / DECEMBER <strong>2021</strong> 43

Advertorial<br />

Clinical Feature<br />

Fig. 14 Fig. 15 Fig. 16<br />

Fig. 17 Fig. 18 Fig. 19<br />

Fig. 20<br />

When comparing the two<br />

reconstructions, the CS MAR<br />

reconstruction clearly revealed<br />

radicular processes in teeth 37 and<br />

47; the osteolysis at 43 and 44; a<br />

mesioperiodontal lightening; as well as<br />

a distal fracture line at tooth 45 (red<br />

arrows in Fig. 13).<br />

Using CS MAR in the CS 3D Imaging<br />

software allowed for more advanced<br />

diagnostics while decreasing the<br />

chance of misidentifying artefacts<br />

with moiré patterns and motion<br />

artefacts. For example, several<br />

implants (34, 35, 36) in the FDK<br />

reconstruction caused a strip-like<br />

hardening and extinguishing artefacts<br />

that made it hard to make a diagnosis.<br />

When applying CS MAR, the hardening<br />

and artefacts were significantly<br />

reduced. With the aid of CS MAR, the<br />

suspicion of root canal fracture was<br />

confirmed at tooth 45 (Fig. 14).<br />

Fig. 14: Extracted tooth 45<br />

(horizontally cut at the level of the<br />

fracture line)<br />

Fig. 15: Surgical removal of the<br />

pathology<br />

Fig. 16: Excised polycystic<br />

ameloblastoma<br />

Figs. 17-20: Post-op follow-up<br />


Teeth 15, 37, 45 and 47 were extracted.<br />

Based on the main finding of the<br />

CBCT volume, the space-demanding<br />

osteolysis with a suspected tumour<br />

at teeth 43 and 44, a fine-tissue<br />

examination (histological clarification)<br />

of the tumorous tissue was conducted<br />

to confirm the initial diagnosis. The<br />

tumour was then surgically treated<br />

(Fig. 15). After the tumour was<br />

removed (Fig. 16), the bone defect was<br />

reconstructed.<br />

The patient returned about three<br />

months later for a post-op follow-up<br />

showing good signs of healing (Figs.<br />

17-20).<br />

However, current literature shows<br />

a recurrence rate of up to 30% for<br />

these types of tumours. Therefore, the<br />

patient will be recalled and observed<br />

for several years. DA<br />

About the author<br />

Dr Hanke Faust<br />

successfully<br />

completed an<br />

apprenticeship<br />

as a dental<br />

technician and<br />

studied at the<br />

University of Hamburg, Germany,<br />

where he also received his<br />

doctorate in dental studies with a<br />

focus on fully ceramic restorations.<br />

Instead of an in-university career,<br />

he decided early on to work in his<br />

own practice where he mainly<br />

focuses on aesthetic prosthetic<br />

care and the field of adhesive<br />

composite trusts.<br />

In addition to guided surgery, Dr<br />

Faust is particularly interested<br />

in radiological imaging using<br />

Carestream <strong>Dental</strong> imaging system.<br />

He has also written for and been<br />

published by the German Medical<br />

Publishers.<br />

44<br />

DENTAL ASIA NOVEMBER / DECEMBER <strong>2021</strong>

User Report<br />

Simplifying digital implant<br />

prosthetics<br />

Digital technologies have enabled simplified and predictable protocols<br />

for interdisciplinary treatment planning, surgical placement and<br />

prosthetic implant rehabilitation. This case study highlights how to use<br />

the TRIOS intraoral scanner and 3Shape scan bodies, and seamlessly<br />

transfer the digital data to 3Shape <strong>Dental</strong> System software.<br />

By Dr Anthony Mak<br />


This case study describes a prosthodontic<br />

restoration of the lower right first premolar<br />

(tooth 44) with a screw-retained, implantsupported<br />

crown. Planning was driven by TRIOS<br />

implant scanning, software and 3Shape scan<br />

bodies.<br />


Upon completion of the eight-to-12-week<br />

post-surgery healing phase and the integration<br />

of the fixture, a master digital impression<br />

using the TRIOS implant scan strategy was<br />

performed.<br />

Fig. 1<br />

In this scan strategy (Figs. 1-6), the following<br />

sequence of digital scans was taken:<br />

1. A pre-preparation scan with the healing<br />

abutment in situ<br />

2. An emergence profile scan taken immediately<br />

after the healing abutment was removed to<br />

record gingival contours around the implant<br />

before any collapse of the tissues<br />

3. The scan body scan<br />

Fig. 2a<br />

Fig. 2b<br />

All other prosthodontic records including the<br />

bite registration and the opposing arch were<br />

also captured with the intraoral scanner. The<br />

data were then sent to the ceramist through<br />

the 3Shape Communicate portal for the<br />

fabrication of the screw-retained crown.<br />

Fig. 3a<br />

Fig. 3b<br />



A direct access screw-retained crown (Lithium<br />

Disilicate crown to a zirconia abutment with a<br />

Fig. 1: Shade image prior to intraoral 3Shape TRIOS surface scan<br />

Figs. 2a-b: Pre-preparation scan with healing abutment in situ<br />

Figs. 3a-b: An emergence profile scan that was taken immediately after the healing abutment<br />

was removed to record gingival contour around the implant before any collapse of the tissues<br />

46<br />

DENTAL ASIA NOVEMBER / DECEMBER <strong>2021</strong>

User Report<br />

titanium interface) was then fabricated and<br />

the contact and occlusion were verified by<br />

means of printed models (Figs. 7-8).<br />

The completed prosthesis was then sent back<br />

for the restoration to be inserted (Figs. 9-10).<br />


Digital implant impressions constitute a major<br />

role in developing a fully digital workflow<br />

for fixed implant prosthetic restorations<br />

(Christensen 2009). Intraoral scan bodies<br />

have been developed for most major implant<br />

brands that facilitate the transfer of the<br />

implant specifics, position and alignment by<br />

scanning; and the transmission of information<br />

to the laboratory CAD software.<br />

Fig. 4a Fig. 4b Fig. 4c<br />

Once received in the CAD software, 3Shape<br />

<strong>Dental</strong> System, the corresponding abutment<br />

library is matched to allow the dental<br />

technician to design the implant prosthesis<br />

and manufacture the abutment and crown.<br />

However, each company traditionally<br />

manufactures a specific scan body for their<br />

digital library, causing problems between<br />

the clinical team and the dental laboratory<br />

fabricating the implant prosthesis in many<br />

occasions. The common problem is when<br />

dentists and technicians are not in harmony<br />

and do not have the same clinical and<br />

laboratory parts, as well as information to put<br />

the digital pieces of the puzzle together.<br />

Fig. 5<br />

An example is when a dentist scans an<br />

implant fixture with one type of scan body<br />

and then sends it to a laboratory without<br />

all the information, parts (e.g., implant<br />

analogue) or access to the library of that<br />

scan body. This has been challenging and<br />

has made clear communication with the<br />

dental technician crucial, particularly prior<br />

to implant scanning of a case, and in<br />

the final design and manufacture of the<br />

prosthesis.<br />

Fig. 6a Fig. 6b Fig. 6c<br />

3Shape has solved this with their universal<br />

scan body that will marry up all original and<br />

third-party implant libraries with whom they<br />

collaborate. This has allowed for a much<br />

simpler system, where one scan body can<br />

be used with multiple implant abutment<br />

libraries in the laboratory lab software<br />

3Shape <strong>Dental</strong> System.<br />

Fig. 6d<br />

Fig. 6e<br />

Figs. 4a-c: 3Shape scan body positioned and screwed into position<br />

Fig. 5: Periapical radiograph confirming the seat of the scan body<br />

Figs. 6a-e: The scan body scan digitally capturing the position and orientation<br />

of the implant fixture<br />

DENTAL ASIA NOVEMBER / DECEMBER <strong>2021</strong> 47

User Report<br />

This is a world-first that has eliminated many of<br />

the limitations and boundaries for both the clinical<br />

and laboratory team in dentistry. Most importantly,<br />

it has made digital implant prosthetics more “open<br />

sourced” as the libraries in 3Shape <strong>Dental</strong> System<br />

is available at no additional cost to the user.<br />

3Shape scan bodies (Figs. 11a-b) provide the<br />

following benefits in simplifying the digital<br />

implant impression process:<br />

• Auto-recognition of the implant system<br />

and connection: The new 3Shape scan bodies<br />

feature a unique ID code to determine the implant<br />

system and connection. When scanned with the<br />

3Shape TRIOS intraoral scanner, the software<br />

will detect and read the ID code on the scan<br />

body and automatically fill out the order form<br />

with the correct implant system and connection.<br />

Fig. 7<br />

• Scan bodies are manufactured<br />

from titanium, highly durable and<br />

autoclavable: Scan bodies can be used<br />

up to 100 times if proper care and cleaning<br />

is maintained between each use. Since<br />

they are made from titanium, the 3Shape<br />

scan bodies will not bend or deform if the<br />

screw is over-tightened. Most other scan<br />

bodies are made from PEEK (polyetherether-ketone),<br />

which is a softer material<br />

that can be more prone to bending. Once<br />

a scan body is bent, the alignment will be<br />

off, which will result in errors in the final<br />

restoration design.<br />

• Visible in clinical X-rays to confirm fit<br />

to implant: It is vital to be able to see the<br />

implant scan body connecting accurately<br />

with the implant fixture.<br />

Fig. 8<br />

• One piece, one material manufacture:<br />

This allows for optimal accuracy and<br />

minimises tolerance issues if different<br />

materials are used and need to be placed<br />

together in a scan body. DA<br />


This article was co-written with Dr Andrew Chio from<br />

Melbourne, Australia. The author would like to extend<br />

his gratitude to him for his support and input.<br />

About the author<br />

Dr Anthony Mak<br />

graduated with multiple<br />

awards from the<br />

University of Sydney,<br />

Australia, in 2002 and<br />

went on to complete his<br />

Post Graduate Diploma<br />

in Clinical Dentistry<br />

(Oral Implants). He is a much sought-after<br />

speaker, especially in the field of digital<br />

and restorative dentistry, and has lectured<br />

extensively in Australia, New Zealand and<br />

across <strong>Asia</strong>. His hands-on workshops have<br />

gained such popularity that they are almost<br />

always booked out soon after registrations<br />

open. He is also gaining great popularity on<br />

the International circuit.<br />

Fig. 9a<br />

Fig. 9b<br />

Dr Mak is the author of two compelling<br />

compendiums detailing direct composite<br />

and indirect ceramic restorations, the<br />

clinical photography and documentation<br />

can only be described as exceptional. He<br />

has published numerous case studies and<br />

articles for local and international dental<br />

bodies and associations. His interest lies in<br />

dental technologies, advances in materials<br />

and techniques; and he has a unique<br />

understanding of CAD-CAM digital dentistry.<br />

Fig. 10 Fig. 11a Fig. 11b<br />

Figs. 7-8: A direct access screw-retained crown (Lithium Disilicate crown to a zirconia abutment<br />

with a titanium interface) was then fabricated and the contact and occlusion verified by means of<br />

printed models<br />

Figs. 9a-b: Final screw-retained restoration inserted<br />

Fig. 10: Final peri-apical radiograph of completed implant retained restoration on the lower right<br />

first premolar (tooth 44)<br />

Figs. 11a-b: 3Shape intraoral scan body<br />

At present, Dr Mak runs two practices in<br />

metropolitan Sydney, focusing on quality<br />

modern comprehensive care, including<br />

implant dentistry. He is also a clinical<br />

consultant and key opinion leader for<br />

several global dental companies focusing on<br />

development of new dental technologies.<br />

48<br />

DENTAL ASIA NOVEMBER / DECEMBER <strong>2021</strong>

User Report<br />

Fast and predictable<br />

aesthetics with<br />

injectable composites<br />

Restoring young permanent teeth with distinct internal and surface<br />

characteristics can pose a challenge in daily clinical practice. With the<br />

new Beautifil range of bioactive nano-hybrid Injectable composites,<br />

clinicians can efficiently achieve a high degree of aesthetic<br />

predictability with a fast and simple technique.<br />

By Dr Amit Gulati<br />

Aesthetic dentistry is a highly demanding clinical science especially<br />

when it comes to restoring anterior dentition in young individuals.<br />

Young permanent teeth display an array of characterisations.<br />

These characterisations range from visible dentinal effects like<br />

mamelon patterns to enamel effects like high translucency,<br />

opalescence, surface effects and macro-micro textures.<br />

These variations and characterisations make it challenging for<br />

clinicians to create natural, life-like restorations in the anterior<br />

aesthetic zone with predictability and long-term success.<br />

Achieving the desired aesthetic outcomes in such cases generally<br />

requires intricate layering of packable composites that consequently<br />

takes up a significant amount of clinical chairside time. However,<br />

with advances in composite resin technology today, clinicians have<br />

the option to replicate natural aesthetics with increased efficiency.<br />

The Beautifil range of bioactive nano-hybrid composites<br />

from Shofu provides additional benefits of minimising plaque<br />

accumulation 1 with anti-bacterial 2 and acid-neutralising<br />

properties to reduce secondary caries 3 , promoting gingival health<br />

and enhancing the longevity of the restorations. The following<br />

clinical case demonstrates an anterior Class IV restoration<br />

where bioactive Beautifil Injectable X composites and colour<br />

tints were used to achieve a high degree of aesthetic success<br />

in a fraction of the chair time as compared to the conventional<br />

layered technique commonly used for anterior restorations.<br />


A young, 15-year-old female patient was presented with<br />

an Ellis Class I fracture involving tooth 21 (Fig. 1), caused<br />

due to a minor traumatic sports injury that occurred almost<br />

immediately after debonding of her orthodontic appliance<br />

Fig. 1<br />

Fig. 1: Ellis Class-I fracture in tooth 21<br />

a few months ago. The patient had no symptom of pain or<br />

discomfort to said tooth and the concern was purely aesthetic.<br />

Upon intraoral examination, there was no pain or sensitivity<br />

observed in relation to tooth 21. It was not tender to percussion<br />

and the radiographic examination revealed healthy peri-radicular<br />

tissues. Vitality test was performed and the tooth gave similar<br />

readings as the adjacent teeth. It was concluded that the tooth<br />

was healthy and free from any pulpal or peri-radicular pathology.<br />

After careful examination and discussion with the patient, it was<br />

decided that the fractured tooth will be restored with a minimally<br />

invasive treatment approach utilising MiCD (Minimally Invasive<br />

Cosmetic Dentistry) concept. As the patient was a 15-year-old, the<br />

restorative procedure was modified to reduce the clinical chairside<br />

time using a new type of bioactive injectable composite materials.<br />


Shade selection, mock-up and putty index<br />

Tooth 21 was thoroughly examined for internal and external<br />

DENTAL ASIA NOVEMBER / DECEMBER <strong>2021</strong> 49

User Report<br />

characterisations. A high degree of enamel translucency was<br />

observed in the incisal third, along with a fair amount of surface<br />

texture and incisal opalescence. Before commencing isolation of<br />

the anterior segment with rubber dam, shade selection was<br />

completed using the VITA classical shade guide. The closest shade<br />

tab in terms of hue and chroma match was identified as A2 (Fig. 2). A<br />

quick freehand mock-up was created using Beautifil II LS Composite<br />

shade A2 (Shofu Inc. Japan) and aesthetic evaluation was done<br />

for shade verification (Fig. 3). After occlusal adjustment, a palatal<br />

putty index was made with A-Silicon impression material (Fig. 4).<br />

Isolation and tooth preparation<br />

The anterior sextant was isolated with a rubber dam (Sanctuary<br />

<strong>Dental</strong>, Malaysia) with its margins everted, and floss ties were<br />

secured to maintain retraction (Fig. 5). The teeth were polished<br />

with pumice slurry using a prophy rubber cup to remove the<br />

plaque biofilm (Fig. 6). Sharp enamel edges were removed<br />

and a long bevel was created on the facial surface with TR11F<br />

fine-grit bur (Mani Inc. Japan) (Fig. 7), followed by smoothing<br />

of the prepared surface and defining short and long bevels<br />

with Super-Snap coarse disk (Shofu Inc. Japan) (Fig. 8).<br />

Etching and bonding<br />

The prepared tooth was ready for the bonding protocol. First, the<br />

prepared palatal putty index was checked to confirm the fit (Fig. 9).<br />

Then, the enamel was etched with 37% ortho-phosphoric acid<br />

(Etch-Rite, Pulpdent, USA) for 30 seconds (Fig. 10). The adjacent<br />

central incisor, tooth 11, was protected with Teflon tape. The<br />

etching was done slightly beyond the long bevels prepared on<br />

the tooth to help achieve a smooth restorative margin. FL-Bond<br />

II Primer was applied on a slightly exposed dentin surface and<br />

left undisturbed for 10 seconds followed by FL-Bond II bonding<br />

agent (Shofu Inc. Japan) applied in an even layer over the entire<br />

etched tooth surface (Fig. 11) and photocured for 20 seconds.<br />

Fig. 2 Fig. 3 Fig. 4<br />

Fig. 5 Fig. 6 Fig. 7<br />

Fig. 8 Fig. 9 Fig. 10<br />

Fig. 2: Shade selection using Vita Classical shade guide<br />

Fig. 3: Free hand mock-up created with Beautifil II LS shade A2<br />

Fig. 4: Putty index made with A-Silicon impression<br />

Fig. 5: Isolation achieved with rubber dam<br />

Fig. 6: Teeth polished with pumice slurry to remove the plaque<br />

biofilm<br />

Fig. 7: Minimal surface preparation and bevels done with a fine<br />

diamond point<br />

Fig. 8: Smoothening of prepared surface and defining of the short and<br />

long bevels with Super-Snap coarse disk<br />

Fig. 9: Palatal putty index checked before the bonding protocol<br />

Fig. 10: Etching of enamel surface with 37% phosphoric acid<br />

50<br />

DENTAL ASIA NOVEMBER / DECEMBER <strong>2021</strong>

User Report<br />

Creating the palatal shell<br />

A small amount of Beautifil Injectable XSL shade A2 (Shofu Inc. Japan), a<br />

bioactive restorative material, was injected in a small amount and placed<br />

on the palatal putty index in the area of the tooth to be restored (Fig. 12).<br />

The putty index was then placed on the palatal aspect of anterior teeth.<br />

The restorative material was spread and teased with a thin probe onto the<br />

palatal aspect of the preparation and photocured for 20 seconds (Fig. 13).<br />

The self-levelling flow properties of this novel restorative material permits<br />

gentle spread and preparation of a thin even palatal base layer. The<br />

putty index is removed and the prepared palatal shell is examined (Fig.<br />

14). Photocuring is done for 20 seconds from the palatal aspect. Excess<br />

material was gently trimmed using No.12 surgical blade. This palatal<br />

shell will serve as a base for further placement of restorative material.<br />

Inject and shape with bioactive injectable composite<br />

A layer of Beautifil Injectable X was then placed on the palatal shell<br />

layer and gently spread using a probe and No. 5 Unibrush (Shofu Inc.<br />

Japan). The unique properties of this restorative prevented the material<br />

from flowing freely and allowed the material to holds its shape. The<br />

material was injected and shaped to be slightly thick on the apical<br />

aspect of the defect and gently spread over the fracture line while<br />

forming a thinner layer towards the incisal aspect (Figs. 15-16). The<br />

injectable composite layer was then photocured for 20 seconds.<br />

The translucency effect was created by adding Lite Art blue stain<br />

(Shofu Inc. Japan) on the incisal aspect and gently spread using<br />

No. 5 Unibrush before photocuring for 20 seconds (Figs. 17-18). Two<br />

more layers of Beautifil Injectable X A2 were added subsequently<br />

to get the desired shape and anatomy of the fractured segment<br />

(Figs. 19-20). Each layer was photocured for 20 seconds and final curing<br />

of 40 seconds for each surface was carried out after application of<br />

glycerine to minimise the oxygen inhibited layer on the surface (Fig. 21).<br />

Fig. 11<br />

Fig. 12 Fig. 13<br />

Fig. 14 Fig. 15<br />

Fig. 16<br />

Fig. 17<br />

Fig. 18<br />

Fig. 19<br />

Fig. 20<br />

Fig. 21<br />

Fig. 11: Bonding with FL-Bond II sixth generation bonding system<br />

Fig. 12: Small amount of Beautifil Injectable XSL bioactive composite<br />

injected on to the putty index<br />

Fig. 13: Putty index placed on palatal aspect injected material spread<br />

evenly and photocured<br />

Fig. 14: Palatal shell created to form a thin and even base layer<br />

Fig. 15: Beautifil Injectable X was injected and placed on the palatal shell layer<br />

Fig. 16: Material was gently spread using a probe and No. 5 Unibrush<br />

Figs. 17-18: Translucency effect was created by adding Lite Art blue<br />

stain<br />

Figs. 19-20: Beautifil Injectable X was injected in layers to obtain the<br />

desired anatomy and minimise adjustments<br />

Fig. 21: Oxy-barrier applied and light-cured to minimise the inhibition<br />

layer<br />

DENTAL ASIA NOVEMBER / DECEMBER <strong>2021</strong> 51

User Report<br />

Finishing and polishing protocol<br />

Gross finishing was completed under<br />

rubber dam using Super-Snap medium<br />

disk (purple) and TR21F (Mani Inc. Japan)<br />

fine-grit bur on slow speed handpiece<br />

(Figs. 22-23). OneGloss Midi point (Shofu<br />

Inc. Japan) was then used to smoothen<br />

the surface and create secondary surface<br />

anatomy (Fig. 24). After fine finishing,<br />

the rubber dam was removed, occlusion<br />

was adjusted and the final aesthetic<br />

outcome was examined (Figs. 25-26).<br />

The patient was recalled after three<br />

days for the final finishing and polishing<br />

of the restoration (Fig. 27). The aesthetic<br />

outcome observed after hydration appeared<br />

satisfactory. Final finishing was done using<br />

One-Gloss with minimal pressure and<br />

fleeting strokes (Fig. 28). This method of<br />

finishing with One-Gloss can be easily termed<br />

as pre-polishing as it creates a smooth<br />

surface ready to be polished (Fig. 29). The<br />

polishing step was initiated with Super-<br />

Snap X-Treme Disk fine (Green) followed<br />

by extra-fine (Pink) (Figs. 30-31). As the<br />

disks are flat and tend to flatten the surface<br />

characterisations, they should be held at a<br />

slight angle while polishing the facial surface<br />

so as not to flatten the lobular anatomy.<br />

Fig. 22<br />

Fig. 23<br />

Fig. 23 Fig. 24<br />

Fig. 25<br />

Fig. 26<br />

Fig. 27<br />

Fig. 28<br />

Fig. 29<br />

Fig. 30<br />

Fig. 30 Fig. 31<br />

Fig. 22: Gross finishing with fine diamond CA point<br />

Fig. 23: Finishing with Super-Snap medium disk (purple)<br />

Fig. 24: OneGloss Midi point was used to smoothen the surface and<br />

obtain surface texture<br />

Fig. 25: Fine finishing completed before removal of the rubber dam<br />

Fig. 26: Immediate post-op<br />

Fig. 27: Restoration at the three-day recall visit for finishing and polishing<br />

Fig. 28: Final finishing was done using One-Gloss with minimal<br />

pressure and fleeting strokes<br />

Fig. 29: Pre-polished surface after finishing with OneGloss Midi<br />

Fig. 30: Polishing step was initiated with Super-Snap X-Treme disk<br />

fine (Green)<br />

Fig. 31: Further polish was achieved with Super-Snap X-Treme super<br />

fine disk (Pink)<br />

52<br />

DENTAL ASIA NOVEMBER / DECEMBER <strong>2021</strong>

User Report<br />

attempt was made to create an incisal halo using any opaque tints,<br />

except for mimicking the natural incisal edge slope towards palatal,<br />

the incisal halo was still distinctly visible in the final restoration.<br />

This points towards the good refractive opalescence properties of<br />

the restorative material. The final finish and polish of the restoration<br />

were easily achieved with the comparable lustre of the natural<br />

enamel surface. DA<br />

Fig. 32<br />


1<br />

Miki S et al. Antibacterial activity of resin composites containing surface prereacted<br />

glass-ionomer (S-PRG) filler. Dent Mater. 2016 Sep;32(9):1095-102<br />

2<br />

Koji Yoshida et al: Anti-plaque property of newly developed fluoride releasing<br />

adhesive system; Japanese Journal of Conservative dentistry magazine. Vol.51,<br />

No.5, 493-501, 2008.<br />

3<br />

Hiraishi N et al. Interactions of boron released from surface pre-reacted glass<br />

ionomer with enamel/dentin and its effect on pH. Sci Rep. <strong>2021</strong> Aug 3;11(1):15734.<br />

Fig. 33<br />

Fig. 32: Final lustre was achieved with Super-Snap Buff disk used with<br />

fleeting strokes<br />

Fig. 33: Final restoration with natural aesthetics that blend well with<br />

the rest of the dentition<br />

Final lustre was achieved with Super-Snap Buff disk (Shofu<br />

Inc. Japan) used with fleeting strokes (Fig. 32).<br />


An aesthetically pleasing restoration was easily created using the<br />

above protocol, where the restoration was almost undetectable<br />

from the rest of the tooth and also the adjacent tooth (Fig. 33).<br />

The translucency of the incisal third appeared optimal with<br />

the body of the restoration having the depth of colour which<br />

matched perfectly with the rest of the tooth structure making<br />

the restoration invisible. The fracture line appeared well masked<br />

where the restoration margins were well blended with the natural<br />

tooth surface. Overall, the aesthetic outcomes achieved were<br />

beyond the patient’s expectations and she was very happy.<br />

The new injectable restorative materials, Beautifil Injectable<br />

XSL and Beautifil Injectable X, used in this clinical case<br />

demonstrated very good handling and optical properties<br />

to make a complicated restoration plan simple and<br />

predictable with a mono shade restorative procedure.<br />

The optical properties of these bioactive composites are truly<br />

impressive as the restoration does not appear too translucent or<br />

greyish in colour, however at the same time permits the optical<br />

effects of tints used in sub-surface layer to create the effect of<br />

the natural translucency required to perfectly match the adjacent<br />

tooth. The fracture lines were masked well, along with seamless<br />

integration of restoration margins and tooth surface. Though no<br />

About the author<br />

Dr Amit Gulati, is a BDS and MDS from the<br />

University of Mumbai, India. He completed<br />

an advanced training in aesthetic perioplastic<br />

surgery, implantology and osseous<br />

regeneration at the University of Hamburg,<br />

Germany, and further expanded his<br />

expertise with advanced prosthodontic<br />

training under eminent clinicians in Germany.<br />

A diplomate of the Indian Society of Oral Implantologists (ISOI),<br />

a fellow of International Congress of Oral Implantology (ICOI)<br />

and associate fellow of World Clinical Laser Institute (WCLI), Dr<br />

Amit is trained in Digital Smile Design (DSD) under Dr Christian<br />

Coachman and was instrumental in introducing the Style<br />

Italiano concept in India through his academy. He also had<br />

extensive training on Minimally Invasive Cosmetic Dentistry<br />

(MiCD) and is a certified MiCD clinical trainer.<br />

During his 17 years of aesthetic and implant practice, Dr<br />

Amit has delivered numerous scientific presentations and<br />

conducted training programmes on implants and aesthetics<br />

both locally and internationally. Apart from consulting for<br />

various aesthetic clinics in Mumbai, he also runs a busy<br />

practice with special focus on aesthetics, implantology<br />

and oral rehabilitation. He is a passionate teacher and runs<br />

“Synqronize”, an academy established with other like-minded<br />

colleagues, to share knowledge and train extensively on<br />

implant and aesthetic dentistry.<br />

DENTAL ASIA NOVEMBER / DECEMBER <strong>2021</strong> 53

User Report<br />

Efficient conversion of a<br />

conventional complete denture to<br />

Straumann® Pro Arch using<br />

Smile in a Box<br />

Outsourcing digital workflows have found its way into the dental field.<br />

Dr Keng Mun Wong and Dr Valerie Tey share how they utilised a fully<br />

outsourced digital workflow by Smile in a Box on a Straumann® Pro<br />

Arch protocol for the immediate conversion of a conventional complete<br />

denture into a fixed full-arch restoration.<br />

By Dr Valerie Tey and Dr Keng Mun Wong<br />

Immediate implant-supported full arch<br />

restorations represent a well-established<br />

and increasingly endorsed treatment<br />

modality for the rehabilitation of fully<br />

edentulous patients 1,2 . Survival rates as<br />

high as 97% and more have been reported<br />

for this type of restoration, with an average<br />

follow-up period of five years 3 . Attributed<br />

to favourable bone quality and anatomy,<br />

mandibular immediate full-arch restorations<br />

have been documented to display even<br />

higher success rates 4 .<br />

Digital technologies like guided implant<br />

placement and computer-assisted<br />

prosthetic planning and manufacturing<br />

can significantly facilitate diagnosis,<br />

treatment planning and surgical procedures,<br />

and therefore provide more predictable<br />

and efficient treatments 5,6 . In particular,<br />

surgically advanced procedures like full-arch<br />

reconstructions may significantly benefit<br />

from these advantages, which may reduce<br />

chair time and invasiveness for the patient 5,7 .<br />

Access to digital technologies may be<br />

hindered by financial and time constraints,<br />

as well as a steep learning curve that has<br />

been associated with such technologies 8,9 .<br />

Recently, digital workflows have become<br />

available as part of an outsourced service<br />

through Smile in a Box. This enables<br />

practitioners using conventional<br />

workflows to readily benefit from the<br />

advantages of digital technologies<br />

without having to overcome the hurdles<br />

associated with their first-time access.<br />

This case report describes a successful<br />

immediate conversion of a conventional<br />

complete denture into an immediate<br />

full-arch restoration by applying an<br />

outsourced fully digital workflow provided<br />

by Smile in a Box. The application<br />

of a Straumann ® Pro Arch protocol,<br />

combined with Smile in a Box, allowed<br />

ready access to a fully digital workflow<br />

that could efficiently be integrated<br />

into conventional prosthetic workflow,<br />

providing a highly satisfying clinical result.<br />


A 65-year-old male patient, fully<br />

edentulous restored with conventional<br />

acrylic full dentures, visited the clinic<br />

complaining of unsatisfactory mandibular<br />

denture retention and associated<br />

problems. It included poor speech and<br />

masticatory function, specifically related<br />

to his lower denture. Clinical examination<br />

revealed a round to knife-edge mandibular<br />

ridge form, and adequate vertical but<br />

inadequate horizontal bone availability<br />

specifically in the posterior aspects 10 .<br />

Fig. 1<br />

Fig. 2a<br />

Fig. 2<br />

Fig. 2b<br />

Fig. 2c<br />

Fig. 1: Pre-treatment diagnostic panoramic<br />

radiograph<br />

Figs. Fig. 2a-c: 4 Pre-treatment intra-oral situation:<br />

(a) existing conventional complete dentures<br />

(b) maxillary and mandibular arches at the<br />

approximate occlusal vertical dimension<br />

(c) horizontal mandibular<br />

54<br />

DENTAL ASIA NOVEMBER / DECEMBER <strong>2021</strong>

User Report<br />

The diagnostic panoramic radiograph<br />

revealed a mandibular arch presenting<br />

moderate atrophy of Class III to IV, with a fair<br />

volume of relatively dense cortical bone of<br />

type I - II present in the interforaminal area<br />

(Fig. 1).<br />

The patient both had well-controlled type<br />

II diabetes and hypertension. No systemic<br />

and local risk factors or contraindications<br />

that would have excluded the patient from<br />

implant treatment were identified. After a<br />

thorough discussion on various treatment<br />

options with their advantages and<br />

limitations, the patient opted for an implantsupported<br />

mandibular restoration combined<br />

with a new conventional full upper denture.<br />


The treatment strategy included the<br />

determination of the maxillomandibular<br />

relationship, occlusal vertical dimension, and<br />

teeth position using conventional complete<br />

denture techniques (Figs. 2a-c). The findings<br />

were used as prosthetic references for the<br />

delivery of the fixed mandibular restoration 11<br />

(Figs. 3a-b, 4a-b).<br />

Data acquisition for the generation of the<br />

virtual patient model was based on dual<br />

cone beam computed tomography (CBCT)<br />

scans using a radiographic template of the<br />

new conventional dentures 12 (Figs. 5a-b).<br />

Equidistant radiopaque fiducial markers<br />

(gutta-percha) were positioned along the<br />

vestibular rim of the template, allowing for<br />

precise matching of the individual DICOM<br />

data sets from patient scans wearing the<br />

radiographic template and the template<br />

alone.<br />

Conversion of the lower mandibular<br />

conventional denture into a fixed implantsupported<br />

restoration was accomplished<br />

using Straumann ® Smile in a Box. DICOM<br />

data sets from dual CBCT scans were used by<br />

the Smile in the Box team to establish the<br />

virtual patient model. Based on this model,<br />

the team explored possible concepts for the<br />

implant restoration and associated surgical<br />

protocols and guides using coDiagnostiX ®<br />

surgical planning software.<br />

Fig. 3a Fig. 3b Fig. 4a<br />

Fig. 4b<br />

Fig. 5a<br />

Fig. 5b<br />

Fig.6a<br />

Fig. 6b<br />

Fig. 6c<br />

Fig. 7a<br />

Fig. 7b<br />

Figs. 3a-b: Maxillomandibular occlusal records<br />

and final wax-up on master casts<br />

Figs. 4a-b: New set of acrylic dentures on the<br />

master casts and in close-up<br />

Figs. 5a-b: (a) Transparent radiographic template<br />

on master cast (b) After the modification of<br />

template with radiopaque fiducial markers in<br />

preparation for the dual scan CBCT<br />

Figs. 6a-c: Implant restoration planned in<br />

coDiagnostiX ® (a) 2D projection (b-c) 3D<br />

representations of the planned implant and<br />

prosthetic restorations<br />

Figs. 7a-b: (a) Pin guides for pin fixation (b)<br />

surgical guide for implant placement designed<br />

in coDiagnostiX ®<br />

DENTAL ASIA NOVEMBER / DECEMBER <strong>2021</strong> 55

User Report<br />

Subsequently, the team designed the<br />

immediate provisional restoration using<br />

CARES ® Visual software. Specific details and<br />

aspects of the planned restorations and<br />

treatment concepts were explored, validated<br />

and approved during virtual planning<br />

sessions between the Smile in a Box team<br />

and the clinicians.<br />

Following approval, the surgical templates,<br />

provisional restoration, implants, and<br />

any additional prosthetic parts and<br />

surgical tools required for the full surgical<br />

treatment procedure were conveniently<br />

assembled by the Straumann team and<br />

delivered in an all-in-one shipment to the<br />

clinic.<br />

Specifically, the plan involved a firstmolar-to-first-molar<br />

prosthetic restoration<br />

supported by four interforaminal BLX<br />

Roxolid ® SLActive ® implants, consisting<br />

of two anterior Ø3.75 x 12mm implants in<br />

positions 32 and 42, and two Ø4.75 x 12mm<br />

implants in positions 35 and 45. Inclination<br />

of the posterior implants by 17 degrees<br />

Fig. 8a Fig. 8b Fig. 8c<br />

Fig. 9a<br />

Fig. 9b<br />

Fig. 9c<br />

Fig. 10a<br />

Fig. 10b<br />

Fig. 10c<br />

Fig. 11a<br />

Fig. 11b<br />

Fig. 11c<br />

Fig. 12a<br />

Fig. 12b<br />

Fig. 12c<br />

Figs. 8a-c: Clinical situation on the day of surgery<br />

Figs. 9a-c: Positioning of the lower pin guide in occlusion with the opposing transparent radiographic template. An occlusal record was used to<br />

further stabilise the mandibular pin guide in the correct position<br />

Figs. 10a-c: Fixation of the BLX surgical guide<br />

Figs. 11a-c: Osteotomy preparation (position 32) (a) Access preparation using a mucosal punch (b) flattening of the alveolar crest using a milling<br />

cutter and (c) pilot drilling with a Ø 2.2mm pilot VeloDrill<br />

Figs. 12a-c: Finalisation of the osteotomy and implant placement (position 32) (a) Final drilling with a Ø 2.8mm VeloDrill (b) BLX Roxolid ®<br />

SLActive ® implant Ø 3.75 x 12mm (c) implant placement using a motorised handpiece<br />

56<br />

DENTAL ASIA NOVEMBER / DECEMBER <strong>2021</strong>

User Report<br />

Fig. 13a<br />

Fig. 13b<br />

Fig. 13c<br />

Fig. 14a<br />

Fig. 14b<br />

Fig. 14c<br />

Fig. 15a<br />

Fig. 15b<br />

Fig. 15c<br />

Fig. 15d<br />

Fig. 15e<br />

Fig. 15f<br />

Figs. 13a-c: (a) Occlusal view after implant placement (b) mounting of screw-retained abutments (SRAs) and (c) fixation of the temporary<br />

provisional<br />

Figs. 14a-c: Installation of shortened titanium copings and fixation of the provisional restoration<br />

Figs. 15a-f: (a-c) Before and (d-f) after the removal of anchoring flanges and polishing of the finalised temporary prosthesis with installed<br />

titanium copings in occlusal, frontal, and intaglio views<br />

increased the A/P spread and helped reduce<br />

the distal prosthetic cantilevers, removing<br />

the need for any augmentative procedures<br />

(Figs. 6a-c) 13 .<br />

The planned surgical templates consisted of<br />

a combination of a pin guide for pin fixation<br />

and a surgical guide for implant placement.<br />

Both guides were supported by crestal<br />

mucosa and four anchoring pins in positions<br />

36, 33, 43 and 46 (Figs. 7a-b).<br />


Surgery was carried out under local<br />

infiltration anaesthesia (Figs. 8a-c). Proper<br />

seating and positioning of the mandibular pin<br />

guide on the alveolar crest were verified with<br />

the upper radiographic template in occlusion<br />

(Figs. 9a-c). After the correct positioning<br />

of the anchoring pins, the pin guide was<br />

removed and replaced with the surgical<br />

guide, and secured with anchoring pins (Figs.<br />

10a-c).<br />

Osteotomy preparation was carried out<br />

corresponding to the instructions and<br />

surgical protocols provided by coDiagnostiX ® .<br />

This included the preparation of a defined<br />

access profile to the alveolar bone with a<br />

mucosa punch (Ø4.7mm), flattening of the<br />

alveolar ridge with a milling cutter (mesial<br />

Ø3.5mm, distal Ø4.2mm) and pilot drilling<br />

with a Ø2.2mm pilot VeloDrill at 800rpm<br />

(Figs. 11a-c).<br />

All osteotomies were prepared to a final<br />

diameter of Ø2.8mm to achieve good<br />

primary stability and retain a high degree<br />

of surgical flexibility 14-16 . Straumann ® BLX<br />

implants were placed using a motorised<br />

handpiece, followed by manual insertion<br />

and final verification of appropriate insertion<br />

torque of >35Ncm (Figs. 12a-c).<br />


The surgical procedure was directly<br />

followed by immediate provisionalisation,<br />

which includes the installation of screw-<br />

DENTAL ASIA NOVEMBER / DECEMBER <strong>2021</strong> 57

User Report<br />

retained abutments (SRAs) with a<br />

torque of 35Ncm and pin fixation<br />

of the temporary provisional (Figs.<br />

13a-c). An optimal fit of the premanufactured<br />

provisional restoration<br />

with the prosthetic emergence<br />

profiles of the implant restoration was<br />

achieved.<br />

Next, titanium copings were adjusted<br />

in length to suit the contours of the<br />

provisional and mounted on the<br />

implant restoration. Subsequently,<br />

the immediate provisional was<br />

mounted, secured with anchoring<br />

pins and fixed to the titanium copings<br />

using flowable composite (Figs. 14ac).<br />

Fig. 16a<br />


Optimal functional and aesthetic<br />

results were achieved thanks to<br />

the digital pre-planning. There was<br />

a satisfactory occlusal fit with the<br />

maxillary complete denture, and no<br />

adjustments were required (Figs.<br />

15a-f). The patient showed optimal<br />

immediate phonetic and functional<br />

adaptation to the new provisional and<br />

reported that he was pleased and<br />

satisfied with the results (Figs. 16a-c).<br />

Fig. 16b<br />


The presented case illustrated<br />

the conversion of a mandibular<br />

conventional complete denture into<br />

an implant-supported fixed fullarch<br />

restoration using Straumann ®<br />

Pro Arch and Straumann ® Smile in<br />

a Box. Conversion of the existing<br />

restoration included the delivery of<br />

a new set of stable conventional<br />

dentures after re-establishing the<br />

maxillomandibular relationships<br />

and occlusal vertical dimensions by<br />

conventional laboratory workflows.<br />

Smile in a Box facilitated quick and<br />

easy access to a digital workflow,<br />

with the associated advantages<br />

of precise prosthetically driven<br />

implant planning, guided flapless<br />

implant placement and immediate<br />

restoration 6,8 . The outsourced<br />

workflow could be perfectly<br />

Fig. 16c<br />

Figs. 16a-c: Delivery of the immediate provisional on the day of surgery<br />

integrated into the clinic’s existing of the virtual planning models<br />

clinical and prosthetic setup.<br />

based on the visualisations from<br />

coDiagnostiX ® and CARES ® Visual<br />

Key success criteria that contributed to provided by the team.<br />

seamless integration of the outsourced<br />

workflows and an optimal result for Efficient communication with the<br />

the patient included appropriate<br />

team also ensured that all other<br />

and accurate data collection and critical factors related to immediate<br />

communication with the Smile<br />

implant placement and restoration<br />

in a Box team. This allowed a<br />

were appropriately addressed,<br />

straightforward definition and approval without having to overcome the<br />

58<br />

DENTAL ASIA NOVEMBER / DECEMBER <strong>2021</strong>

User Report<br />

initial learning curves associated with<br />

digital techniques 8 .<br />


The application of Smile in a Box on<br />

a Straumann ® Pro Arch protocol has<br />

enabled convenient and seamless<br />

access to a digital workflow for<br />

the immediate conversion of a<br />

conventional complete denture into a<br />

fixed full-arch restoration. DA<br />

For more information:<br />

https://bit.ly/siab-sg<br />


1<br />

Rohlin M, Dr O, Nilner K, et al (2012) Treatment<br />

of Adult Patients with Edentulous Arches: A<br />

Systematic Review. The International Journal<br />

of Prosthodontics 25:553–567<br />

2<br />

Pera P, Menini M, Pesce P, et al (2018)<br />

Immediate Versus Delayed Loading of <strong>Dental</strong><br />

Implants Supporting Fixed Full-Arch Maxillary<br />

Prostheses: A 10-year Follow-up Report.<br />

Int J Prosthodont 32:27–31. https://doi.<br />

org/10.11607/ijp.5804<br />

3<br />

Daudt Polido W, Aghaloo T, Emmett TW,<br />

et al (2018) Number of implants placed for<br />

complete‐arch fixed prostheses: A systematic<br />

review and meta‐analysis. Clin Oral Impl Res<br />

29:154–183. https://doi.org/10.1111/clr.13312<br />

4<br />

Papaspyridakos P, Mokti M, Chen C-J, et al<br />

(2014) Implant and Prosthodontic Survival<br />

Rates with Implant Fixed Complete <strong>Dental</strong><br />

Prostheses in the Edentulous Mandible<br />

after at Least 5 Years: A Systematic Review:<br />

Implant and Prosthesis Survival Rates<br />

in Edentulous Mandible. Clinical Implant<br />

Dentistry and Related Research 16:705–717.<br />

https://doi.org/10.1111/cid.12036<br />

5<br />

Wismeijer D, Joda T, Flügge T, et al (2018)<br />

Group 5 ITI Consensus Report: Digital<br />

technologies. Clin Oral Impl Res 29:436–442.<br />

https://doi.org/10.1111/clr.13309<br />

6<br />

Colombo M, Mangano C, Mijiritsky E, et al<br />

(2017) Clinical applications and effectiveness<br />

of guided implant surgery: a critical review<br />

based on randomized controlled trials. BMC<br />

Oral Health 17:150. https://doi.org/10.1186/<br />

s12903-017-0441-y<br />

7<br />

Arisan V, Karabuda CZ, Ozdemir T (2010)<br />

Implant surgery using bone- and mucosasupported<br />

stereolithographic guides in<br />

totally edentulous jaws: surgical and postoperative<br />

outcomes of computer-aided vs.<br />

12<br />

standard techniques. Clin Oral Implants Res Ramasamy M, Giri, Raja R, et al (2013)<br />

21:980–988. https://doi.org/10.1111/j.1600- Implant surgical guides: From the past<br />

0501.2010.01957.x<br />

to the present. J Pharm Bioall Sci 5:98.<br />

8<br />

Al Yafi F, Camenisch B, Al-Sabbagh M<br />

https://doi.org/10.4103/0975-7406.113306<br />

13<br />

(2019) Is Digital Guided Implant Surgery<br />

Morton D, Gallucci G, Lin W-S, et al<br />

Accurate and Reliable? <strong>Dental</strong> Clinics of<br />

(2018) Group 2 ITI Consensus Report:<br />

North America 63:381–397. https://doi.<br />

Prosthodontics and implant dentistry. Clin<br />

org/10.1016/j.cden.2019.02.006<br />

Oral Implants Res 29 Suppl 16:215–223.<br />

9<br />

Tahmaseb A, Wismeijer D, Coucke W,<br />

https://doi.org/10.1111/clr.13298<br />

14<br />

Derksen W (2014) Computer Technology<br />

Javed F, Ahmed HB, Crespi R, Romanos<br />

Applications in Surgical Implant Dentistry: GE (2013) Role of primary stability for<br />

A Systematic Review. Int J Oral Maxillofac successful osseointegration of dental<br />

Implants 29:25–42. https://doi.org/10.11607/ implants: Factors of influence and<br />

jomi.2014suppl.g1.2<br />

evaluation. Interventional Medicine and<br />

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Cawood JI, Howell RA (1988) A<br />

Applied Science 5:162–167. https://doi.<br />

classification of the edentulous jaws.<br />

org/10.1556/IMAS.5.2013.4.3<br />

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International Journal of Oral and<br />

Javed F, Romanos GE (2010) The role of<br />

Maxillofacial Surgery 17:232–236. https://doi. primary stability for successful immediate<br />

org/10.1016/S0901-5027(88)80047-X<br />

loading of dental implants. A literature<br />

11<br />

Terzioğlu H, Akkaya M, Ozan O (2009) The review. Journal of Dentistry 38:612–620.<br />

use of a computerized tomography-based https://doi.org/10.1016/j.jdent.2010.05.013<br />

16<br />

software program with a flapless surgical<br />

Ophir Fromovich, Karim Dada, Leon<br />

technique in implant dentistry: a case report. Pariente, Marwan Daas (2019) BLX: a new<br />

Int J Oral Maxillofac Implants 24:137–142<br />

generation of self-drilling implants<br />

About the authors<br />

Dr Valerie Tey graduated with Bachelor and Master of<br />

<strong>Dental</strong> Surgery degrees from the National University of<br />

Singapore, where she is currently serving as a part-time<br />

tutor. In the course of her study, she was placed on the<br />

Dean’s list and awarded a number of medals, including<br />

the Academy of Medicine Prize, Dr FAC Oehlers Medal<br />

(Best clinical student), Terrell Silver Medal (Best student<br />

with distinction in prosthodontics) and the Q&M <strong>Dental</strong> Surgery Medal for<br />

Operative Dentistry (Best student with distinction in operative dentistry).<br />

She holds a membership in Prosthodontics from the Royal College of<br />

Surgeons, Edinburgh, and is also a fellow of the Academy of Medicine,<br />

Singapore.<br />

Dr Keng Mun Wong is a member of numerous<br />

professional organisations. He is an affiliate assistant<br />

professor at the University of Washington, United States,<br />

and a visiting senior lecturer at the National University<br />

of Singapore. In 2005, Dr Wong founded T32 <strong>Dental</strong><br />

Academy, a centre dedicated to educating, motivating,<br />

stimulating and sharing knowledge with other dental<br />

professionals. Dr Wong is currently the managing director of T32 <strong>Dental</strong><br />

Group. His practice focuses on all areas of restorative care including<br />

aesthetic dentistry, full mouth reconstruction, fixed, removable and implant<br />

prosthodontics.<br />

DENTAL ASIA NOVEMBER / DECEMBER <strong>2021</strong> 59

Behind the Scenes<br />

More than a simple<br />

manufacturing alternative<br />

Thanks to validated Ceramill workflow, precisely fitting<br />

3D-printed full dentures is now possible.<br />

Ceramill workflow is a “for Ceramill” support<br />

and Buildstyle for the printing process we<br />

developed together with 3D Systems. These<br />

are adapted to the workflow of Amann<br />

Girrbach and also contribute to creating<br />

an excellent fit. The focus here was on<br />

the fit of the teeth and bases.<br />

in the final fabrication of the full denture.<br />

Additionally, there is a checklist which, in case<br />

of problems, points out possible sources of<br />

error and highlights the important steps for an<br />

accurately fitting result. DA<br />

Amann Girrbach has successfully developed<br />

and marketed innovations for digital dentures<br />

over the years. With the addition of 3D printing<br />

capabilities, the Ceramill Full Denture System<br />

offers the broadest range of digital denture<br />

fabrication options in the industry – from<br />

the highest quality, highly individual milled<br />

dentures to cost-efficient 3D printed dentures.<br />

So, how can these benefit the users?<br />

Gerrit Scholz, MSc, development engineer at<br />

Amann Girrbach’s Research and Development<br />

department (above), answers this question<br />

by giving light to the integrated and easy-toimplement<br />

workflows of the Ceramill System.<br />

What makes 3D printing of full dentures<br />

within the Ceramill System so unique?<br />

Scholz: The Denture 3D+ material from 3D<br />

Systems has been extensively validated by<br />

our research and development department.<br />

This thorough examination has enabled us<br />

to greatly optimise both the design and the<br />

production process, so that reproducible and<br />

accurately fitting full dentures are guaranteed<br />

and can be fabricated by Ceramill customers<br />

in a most efficient manner (Fig. 1).<br />

On the software side, validated and<br />

coordinated CAD parameters are essential for<br />

the 3D printing result. To this end for example,<br />

the Ceramill D-Flow software offers tooth<br />

pocket gap parameters adapted to the tooth<br />

concept (Ceramill FDS or Vigo) (Fig. 2). On the<br />

production side, the special feature of the<br />

In addition, during validation of the material at<br />

our facility, the print or fit accuracy was found<br />

to be dependent on the material level or level of<br />

the 3D printer. To this effect, we have developed<br />

a Level Tool (available in the C3 and/or AG.Live<br />

portal) (Fig. 3), with which the appropriate<br />

filling level for the respective printing job can<br />

be achieved. In direct interaction with the “for<br />

Ceramill” Buildstyle, the Filling Level Tool creates<br />

precisely fitting results for the customer.<br />

Automatic orientation and additional<br />

assistance structures are further features<br />

offered by the Ceramill workflow. What<br />

roles do they play?<br />

Both are important factors which influence an<br />

accurately fitting result. Even slight deviations in<br />

orientation can significantly influence the fit of<br />

full dentures. For this reason, orientation of the<br />

full dentures in the Ceramill workflow is selected<br />

such to ensure an optimal tooth and base fit<br />

on the model. This orientation is automatically<br />

transferred from the Ceramill software to the 3D<br />

Sprint 3D-printing software from 3D Systems,<br />

thus avoiding incorrect orientation. The placing<br />

of additional assistance structures (Fig. 4)<br />

serves as stabilisation during the printing<br />

process and thus prevents distortion during the<br />

fabrication process with the NextDent5100 for<br />

Ceramill.<br />

How difficult is this step for beginners?<br />

To provide customers with a quick and<br />

easy introduction, detailed instructions are<br />

available, which explain all the steps involved<br />

Fig. 1: Checking the final fit of the printed full<br />

dentures in the articulator<br />

Fig. 2: Selecting the tooth pocket gap (here: FDS<br />

system) in the Ceramill Mind Software<br />

Fig. 3: The Filling Level Tool helps to find the<br />

appropriate material level<br />

Fig. 4: Assistance structures (yellow) in the 3DSprint<br />

for Ceramill Software<br />

60<br />

DENTAL ASIA NOVEMBER / DECEMBER <strong>2021</strong>

Behind the Scenes<br />

Automatic denture cleaning<br />

that works<br />

SYMPRO is a compact denture cleaning unit from Renfert especially<br />

suited for cleaning removable dental restorations, orthodontic<br />

appliances, and splints. Dr Christopher Tuxford shares his experience<br />

using the system and how he integrated it into his daily practice.<br />

Upper denture with stubborn deposits before<br />

initial cleaning<br />

Upper denture after cleaning<br />


Trade Exhibition Stuttgart: Full aisles, lots<br />

of booths, practically information overload!<br />

Everything new, everything great and<br />

everything expensive. But then, I saw<br />

something out of the corner of my eye<br />

as I passed it by. Small, white-grey and<br />

unspectacular but somehow, something<br />

special. I only then realised that it was<br />

the Renfert stand where I had stopped.<br />

Laboratory stuff! I’m a dentist! What is that?<br />

The friendly answer was on point: SYMPRO<br />

Denture Cleaning Unit; also for, or only for the<br />

practice. Great! The laboratory has something<br />

like that in large. It takes two to three hours<br />

to get the teeth back again. But then again,<br />

they looked new. Hence, I asked for more<br />

information. For 20 to 40 minutes of cleaning<br />

time, post-polishing is not necessary. Wow!<br />

And that works? Okay, the price was less than<br />

I expected.<br />

Whilst waiting for the device to arrive, I did<br />

my research. It all sounded very positive. And<br />

then, at last, my first practice run. It was all<br />

true, within 20 to 40 minutes, depending on<br />

the state of the denture, one can achieve<br />

very good results, which are very close to<br />

professional cleaning in the laboratory. It is<br />

ideal for cleaning the dentures at the same<br />

time as the professional oral prophylaxis<br />

and be able to send the patient away with<br />

completely clean teeth.<br />

It is fair to say that now, approximately 80% of<br />

denture cleaning is done in the practice. The<br />

unit is now well and truly integrated within<br />

the daily practice routine and works reliably.<br />


We see the dentures again, which were<br />

cleaned a few months ago. There are no<br />

increased deposits on the dentures that<br />

indicate any micro-abrasion that may have<br />

occurred. In the meantime, patients with<br />

heavily discoloured dentures due to smoking<br />

have spoken to us and asked directly for the<br />

denture cleaning service.<br />

The plan to use the device for regular<br />

cleaning of the dentures from retirement<br />

home residents is currently still failing due to<br />

logistics. There is a need, but whether this will<br />

be paid for remains to be seen.<br />

A year has passed. With the exception<br />

of new patients, there are hardly any<br />

dentures requiring significant and<br />

therefore longer cleaning times of more<br />

than 20 minutes.<br />


Denture cleaning only takes less than 20<br />

minutes and can be easily carried out<br />

during half a professional tooth cleaning<br />

session. I would say the introduction of<br />

the SYMPRO Denture Cleaning system<br />

into my dental office has been a great<br />

success. DA<br />

About the author<br />

Dr Christopher<br />

Tuxford studied<br />

dentistry in<br />

Heidelberg,<br />

Germany (1996<br />

to 2001), after<br />

completing his<br />

professional training as a dental<br />

technician. He has been working<br />

as a dentist since 2002, initially as<br />

an assistant dentist. At present, Dr<br />

Tuxford now runs his own dental<br />

office in Linkenheim-Hochstetten,<br />

Germany, since 2006. As a dental<br />

technician and dentist, he focuses<br />

his work on prosthodontics, aesthetic<br />

and conservative dentistry.<br />

DENTAL ASIA NOVEMBER / DECEMBER <strong>2021</strong> 61

Behind the Scenes<br />

Best strategies to jumpstart<br />

digital orthodontics<br />

There is no way around it: the future of orthodontics is inevitably<br />

digital. With cutting-edge digital solutions for digital impressions,<br />

treatment planning, design, and 3D printing, what was once<br />

prohibitively expensive is now accessible, transforming thousands<br />

of orthodontic practices worldwide.<br />

As CAD/CAM technology continues to replace<br />

traditional workflows and become the standard<br />

of care, digital solutions have become a<br />

necessary consideration for any orthodontic<br />

practice or laboratory for the following:<br />

• High quality and precision: No two<br />

orthodontic treatments are the same.<br />

Achieving consistent, high-quality and<br />

affordable orthodontic products with so<br />

many potential sources of error is incredibly<br />

difficult. Fully digital orthodontic treatments<br />

reduce the risks and uncertainties caused by<br />

human factors, providing higher consistency,<br />

accuracy, and precision at every stage of the<br />

workflow.<br />

• Improved efficiency: In terms of time<br />

and cost savings, digital orthodontics<br />

can be a no-nonsense business choice,<br />

improving efficiency in clinical procedures<br />

and streamlining workflows. For instance,<br />

fast and efficient impression taking with 3D<br />

intraoral scanners reduces chair time, provides<br />

instant feedback and omits manual errors like<br />

voids, bubbles, or tears, reducing the need for<br />

secondary or duplicate impressions.<br />

• Better patient experience and<br />

outcomes: Quicker appointments, more<br />

comfortable treatments, and better, faster<br />

results can be accomplished. A satisfied<br />

patient is more likely to return and recommend<br />

a clinic to others, contributing to the long-term<br />

success of any orthodontic business.<br />


While the design of different orthodontic<br />

treatments varies depending on the<br />

application, they all follow the same basic<br />

workflow:<br />

1. Scan (Fig. 1): 3D intraoral scanners can<br />

be used to capture scans digitally from the<br />

patient, replacing manual impressions with<br />

fast, accurate, digital impressions. Alternatively,<br />

desktop optical scanners, typically used by<br />

dental and orthodontic labs, can be used to<br />

scan traditional impressions or plaster models.<br />

62<br />

DENTAL ASIA NOVEMBER / DECEMBER <strong>2021</strong>

Behind the Scenes<br />

2. Plan and design (Fig. 2): After scanning,<br />

patients’ digital impression is imported into<br />

orthodontic CAD software for planning<br />

treatments. For simple diagnostic models,<br />

users can also convert intraoral 3D scan<br />

files directly into printable models such as<br />

in PreForm, Formlabs’ print-preparation<br />

software. Most software packages use design<br />

processes similar to traditional workflows,<br />

employing highly visual interfaces. After<br />

the treatments are designed, models can<br />

be exported for manufacturing. If a remake<br />

is needed, the same digital design can be<br />

reused without additional effort.<br />

Fig. 1<br />

3. Manufacture (Fig. 3): 3D models are<br />

uploaded to the CAM or print-preparation<br />

software and then sent to a 3D printer or<br />

a milling machine. They work by solidifying<br />

parts layer by layer to form the shape of the<br />

appliances and models.<br />

With the traditional workflow, the practice<br />

takes a physical impression of the patient<br />

and ships it to a lab that creates the required<br />

models or other indications. The lab then<br />

ships back to the practice for the treatment.<br />

In digital workflows, the individual steps can<br />

alternate easily between lab and practice,<br />

depending on the complexity of the case,<br />

indication and tools available at a practice.<br />

Fig. 2<br />

Thus, digital technologies simplify the<br />

process, improve communication and make<br />

interactions nearly instantaneous between<br />

the practice and lab (Fig. 4).<br />



Additive manufacturing is the latest piece<br />

of the workflow in digital orthodontics that<br />

has become a logical business choice for<br />

orthodontic practices and labs, combining<br />

high quality with low costs and streamlined<br />

processes. The market has been expanding<br />

rapidly, bringing this technology within reach<br />

for more businesses.<br />

Today, two 3D printing technologies are<br />

common in orthodontics: stereolithography<br />

(SLA) and digital light processing (DLP).<br />

Fig. 3<br />

Fig. 3<br />

Fig. 1: 3D intraoral scanners capture<br />

scans digitally from the patient<br />

Fig. 2: Digital design results in easier,<br />

more precise treatments and simplified<br />

communication<br />

Fig. 3: 3D models are uploaded to the<br />

CAM or print-preparation software and<br />

then sent to a 3D printer or a milling<br />

machine<br />

Fig. 4: The digital orthodontics workflow<br />

can move back and forth between<br />

practice and lab, increasing efficiency<br />

and collaboration<br />

In SLA, a vat of liquid resin is selectively<br />

exposed to a laser beam across the print<br />

area, solidifying resin in specific areas. Low<br />

Fig. 4<br />

DENTAL ASIA NOVEMBER / DECEMBER <strong>2021</strong> 63

Behind the Scenes<br />

For example, the Form 3B LFS 3D printer can<br />

produce a single orthodontic model in about<br />

20 minutes with Draft Resin and eight models<br />

per print in approximately one hour, while the<br />

large build volume of the printer also allows<br />

users to produce up to 18 models at once<br />

for overnight “lights out” production. The<br />

Form 3BL, Formlabs’ large-format dental and<br />

orthodontic 3D printer, can produce up to 52<br />

models per print.<br />

Fig. 5: The most common dental and orthodontic 3D printers work by selectively exposing liquid<br />

resin to a light source — SLA and LFS a laser, DLP a projector— to form very thin solid layers of<br />

plastic that stack up to create a solid object<br />

Force Stereolithography (LFS) technology,<br />

used by Formlabs’ Form 3B 3D printer, is the<br />

next phase in SLA 3D printing that reduces<br />

the strain created on a part when peeling it<br />

from the resin tank between layers, producing<br />

parts with unmatched surface finish, clarity,<br />

and accuracy.<br />

DLP operates with the same chemical process<br />

as SLA and LFS, but uses a digital projector as<br />

a light source to solidify the resin rather than<br />

a laser.<br />

SLA, LFS and DLP 3D printers work similarly<br />

— the differences in print quality, workflow,<br />

available materials, costs, and other factors<br />

are bigger from machine to machine more<br />

than technology to technology (Fig. 5).<br />



Accuracy and precision: Guaranteeing<br />

high-quality, accurate, final parts is the<br />

most important concern for any orthodontic<br />

practice. Unfortunately, not all 3D printers<br />

marketed for dentistry or orthodontics can<br />

deliver the quality, precision, and accuracy<br />

needed for orthodontic applications.<br />

Additionally, comparing different 3D printing<br />

solutions goes beyond looking at technical<br />

spec sheets.<br />

Fundamentally, accuracy and precision<br />

depend on many different factors: the quality<br />

of the 3D printer, the 3D printing process,<br />

materials, software settings, post-processing,<br />

and how well-calibrated all of these systems<br />

are, so a 3D printer can only be judged on its<br />

final printed parts.<br />

Users must always evaluate accuracy studies<br />

with real scan data of printed parts; or better<br />

yet, ask for a free sample part or a custom<br />

sample of their own design to check the fit<br />

or measure themselves against the original<br />

design.<br />

Speed and productivity: When thinking<br />

about speed in 3D printing, it is important to<br />

consider not just raw print speed, but also<br />

the overall productivity of an orthodontic 3D<br />

printer. Raw print speed for SLA, LFS and<br />

DLP 3D printers is comparable in general. As<br />

the projector exposes each entire layer all at<br />

once, print speed in DLP 3D printing is uniform<br />

and only depends on the height of the parts,<br />

whereas SLA and LFS 3D printers draw out<br />

each part with a laser. As a rule of thumb,<br />

this results in SLA and LFS 3D printers being<br />

comparable or faster when printing a single<br />

part or smaller parts, while DLP 3D printers are<br />

faster to print multiple parts that fill up much of<br />

the platform.<br />

However, there is a trade-off between<br />

resolution and build volume for DLP printers: a<br />

small DLP 3D printer might be able to print fast,<br />

but users can only fit a few models on the build<br />

platform. A different machine with a larger build<br />

volume might be able to print more parts, but<br />

only at a lower resolution, which means that<br />

it might not be accurate enough for printing<br />

indications that require higher accuracy.<br />

SLA and LFS 3D printers can produce all<br />

of these options in one machine and offer<br />

orthodontic practices the freedom to decide<br />

whether they want to optimise for resolution,<br />

speed, or throughput, depending on the case.<br />

Ease of use: Another important<br />

consideration is the ease of using a 3D<br />

printer, as users should know how to use the<br />

equipment and maintain it on a daily basis.<br />

Practices can get a sense of the learning<br />

curve that will come with a new 3D printer by<br />

watching videos online, visiting a trade show,<br />

contacting sales teams, or asking colleagues<br />

about their experience.<br />

It is also critical to consider the types of<br />

everyday interactions and maintenance the<br />

printer will need once it is up and running.<br />

For example, automatic resin dispensing on<br />

Formlabs SLA and LFS 3D printers means<br />

that users never need to worry about running<br />

out of material (Fig. 6).<br />

Costs and return on investment: When<br />

adopting a new technology, it needs to<br />

make sense for the business. The cost<br />

of orthodontic 3D printers has dropped<br />

significantly since early days and the systems<br />

on the market today offer the lowest costs for<br />

many applications.<br />

Fig. 6: Modern 3D printers, like the Form<br />

3B, are designed intuitively so that any<br />

orthodontic lab or practice can get familiar<br />

with the process easily<br />

64<br />

DENTAL ASIA NOVEMBER / DECEMBER <strong>2021</strong>

Behind the Scenes<br />

For example, a practice printing models to<br />

produce thermoformed aligners in-house can<br />

often reduce costs by 80% for each treatment<br />

compared to outsourcing to labs or service<br />

providers — enough to pay for a 3D printer in a<br />

few months and save many times its price tag<br />

over the years.<br />

When comparing different 3D printing<br />

solutions, remember to consider:<br />

• Upfront costs, including not just the<br />

machine cost, but also training, setup, and<br />

potentially software<br />

• Running costs, best estimated with per-part<br />

material costs<br />

• Service and maintenance costs<br />

Materials and applications: Professional 3D<br />

printers are some of the most versatile tools<br />

found today in orthodontic practices and labs,<br />

and the key to their versatility is dedicated<br />

materials. Formlabs 3D printers can produce<br />

a variety of orthodontic indications, including<br />

models for thermoforming aligners and<br />

retainers, diagnostic models, splints, indirect<br />

bonding trays, and more.<br />

Some 3D printers work only with proprietary<br />

materials, where options are limited to the<br />

offerings of the printer manufacturer. Others<br />

have an open system, and can use materials<br />

made by third-party manufacturers.<br />

However, when using third-party materials, it<br />

is important to ensure that the results achieve<br />

clinically acceptable quality and accuracy.<br />

Furthermore, using biocompatible materials<br />

on non-validated 3D printers that claim to<br />

be “open” breaks the usage requirements<br />

and thus will produce non-biocompatible<br />

appliances. It is vital to know the risk that<br />

the practice takes by using non-validated 3D<br />

printers and materials.<br />

products to 3D print because they do not<br />

require a third-party design software to<br />

prepare a digital impression for printing.<br />

For instance, Formlabs <strong>Dental</strong> 3D printer<br />

customers can use the Scan to Model feature<br />

in PreForm to turn their digital impressions<br />

into physical models for free.<br />

Once simple models and retainer fabrication<br />

were mastered, expanding to clear aligners<br />

is only a matter of adding the treatment<br />

planning component. After aligners, users<br />

can also expand to other indications using<br />

the same 3D printer, like indirect bonding<br />

trays, occlusal guards, or even direct-printed<br />

brackets.<br />

Define and test a digital workflow: With<br />

a specific application in mind, piece together<br />

the complete step-by-step digital workflow<br />

for that application, ensuring that all the<br />

pieces needed for scanning, design, and<br />

manufacturing are understood.<br />

First, consider whether it makes sense to<br />

invest in an intraoral scanner for the practice<br />

or it will be better to send stone models or<br />

physical impressions to the lab for scanning.<br />

For designing parts in-house, ensure to<br />

get a demonstration of the workflow of any<br />

design software to understand the stepby-step<br />

process before adopting it. Then,<br />

select a software package compatible with<br />

the scanning and manufacturing equipment<br />

according to preference.<br />

When considering different 3D printers,<br />

always source samples before buying<br />

equipment. Technical data and marketing<br />

specs can be misleading and hard to<br />

decipher. Instead of comparing sales<br />

brochures, compare actual parts — do not<br />

hesitate to ask for a physical sample.<br />

ever before and affordable machines enable<br />

users to add capacity as needed.<br />



With thousands of orthodontic practices<br />

and labs already adopting digital workflows,<br />

there has never been a better time to start<br />

exploring how to take advantage of new<br />

technology in the business. While 3D printers<br />

were only affordable to the largest dental and<br />

orthodontic labs and milling centres a few<br />

years ago, they are now a common sight in<br />

orthodontic practices and labs (Fig. 8).<br />

Consider the factors discussed above and the<br />

needs of the practice, some solutions might<br />

suit some businesses better than others.<br />

Ensure to do research, evaluate actual parts,<br />

and avoid paying a hefty premium. DA<br />

Fig. 7: An in-house 3D printer empowers users<br />

to create advanced applications like indirect<br />

bonding trays<br />

Manufacturers release new materials on a<br />

regular basis, so there is a good chance the<br />

printer bought today will become capable of<br />

creating an increasing variety of orthodontic<br />

products in the near future.<br />




Pick an application: Simple models are<br />

the best place to start. These are the easiest<br />

Start small and scale up: To start, trial the<br />

workflow for a few weeks before going to<br />

full production, leaving time to learn each<br />

step and iron out any wrinkles. As the user<br />

gets comfortable with the results, it is time<br />

to switch the workflow fully to digital, and<br />

start scaling up. In digital workflows, scaling<br />

up is a simple matter of adding scanning,<br />

design, or production capacity, depending on<br />

where bottlenecks appear (Fig. 7). Desktop 3D<br />

printers offer more production flexibility than<br />

Fig. 8: Manufacturing thermoformed appliances<br />

like clear retainers and aligners over 3D printed<br />

orthodontic models is fast and affordable<br />

DENTAL ASIA NOVEMBER / DECEMBER <strong>2021</strong> 65

In Depth With<br />

Advancing oral prophylaxis<br />

Mectron has launched ultrasound inserts specially designed for<br />

gentle and effective removal of supra- and subgingival biofilm as<br />

well as for safe periodontal debridement.<br />



Perio P3 is indicated for the removal of supraand<br />

subgingival biofilm. Its slim shape allows<br />

easy access in deep periodontal pockets and<br />

interproximal spaces in all the quadrants.<br />

Thanks to its remarkable linear movement,<br />

it is minimally invasive for the soft tissues<br />

and root cementum. Hence, it is ideal for<br />

preserving the epithelium.<br />

It is best utilised for interproximal and<br />

subgingival cleaning. It effectively removes<br />

extrinsic stains too.<br />

Perio P3 gives the clinician an optimal<br />

intraoperative control and a secure feeling<br />

while working interproximally, supra- and<br />

subgingivally.<br />

With its Soft Mode function which<br />

reduces the amplitude of the ultrasound<br />

oscillations and allows the insert to<br />

move gently and efficiently, it is highly<br />

recommended for sensitive patients<br />

for a more pleasant and comfortable<br />

treatment.<br />




Perio anatomic inserts P15, P16R,<br />

P16L are indicated for periodontal<br />

debridement. The inserts guarantee<br />

maximum efficacy without risk of injury to<br />

the soft tissues and periodontal ligament.<br />

Its shape allows optimal access to hardto-reach<br />

areas, characterised by deep<br />

periodontal pockets such as furcations,<br />

root surfaces, and concavities, thereby<br />

preserving epithelial tissue and promotes<br />

new attachment formation.<br />

Additionally, the cavitation effect allows<br />

for mechanical biofilm disruption, bacteria<br />

dispersion, and periodontal pockets<br />

detoxification.<br />

The inserts in detail:<br />

P15: Recommended for the debridement<br />

of deep periodontal pockets. Easy access<br />

to canine and anterior teeth. Replaces<br />

manual curettes n° 1-2, 3-4, 5-6, 7-8<br />

P16R – P16L: Recommended for supraand<br />

subgingival interproximal spaces and<br />

an efficient root planing on molars and<br />

premolars. Replace manual curettes n°<br />

11-12, 13-14, 15-16, 17-18 DA<br />

Perio P3 for interproximal and<br />

subgingival cleaning<br />

P15: Universal curette for supra- and<br />

subgingival treatment<br />

P16R – P16L: angled periodontal curettes for<br />

subgingival concrement and biofilm removal<br />

from furcations and deep pockets<br />

66<br />

DENTAL ASIA NOVEMBER / DECEMBER <strong>2021</strong>

Rolence Enterprise:<br />

Commitment to quality and<br />

added value<br />

In Depth With<br />

Rolence Enterprise Inc. has been highly<br />

devoted to the research, development, and<br />

manufacturing of high-quality equipment<br />

for dental professionals for over 40 years.<br />

Their factory has been awarded Taiwan’s<br />

GMP of excellence. All of their products<br />

are extremely high quality and efficient.<br />

They also supply ODM dental products,<br />

OEM design, and development with their<br />

professional expertise.<br />

The company is always actively engaged<br />

in product research, development and<br />

innovation. Not only have they achieved an<br />

excellent outcome in innovating curing light<br />

technology, but they are also continuously<br />

developing new high-tech products.<br />

Rolence Enterprise is are fully fully committed<br />

to continuing their innovative research<br />

and development in advanced dental<br />

technology, and to vigorously improve<br />

the worldwide competitiveness of their<br />

products. All Rolence products have been<br />

awarded ISO 13485:2016 certification and<br />

meet FDA, CE standards, besides, their<br />

current products chain are distributed<br />

through a worldwide network of partners<br />

in the United States, Europe, Japan, India,<br />

China, Middle East and others.<br />

Rolence always carefully examines their<br />

customers’ needs and adapts their products<br />

to real world demands. The key ingredient<br />

to their success has been, and will always<br />

be, their commitment to quality and added<br />

value. They look forward to offering this<br />

commitment to their customers.<br />

Rolence Enterprise is the partner that every<br />

dental professional can trust. Head on to<br />

www.rolence.com.tw for more information. DA<br />

X-Ray Series<br />

Magneto Scaler Systems<br />

Portable X-RAY<br />

Large capacity battery of Panasonic able to take more than 1000 shots after fully charged.<br />

Latest TOSHIBA X-RAY Tube specifically for Portable X-ray.<br />

Unique double scatted shield provide extremly low dose during operation.<br />

MS-1<br />

LAB Curing Box Series<br />

Digital Sensor<br />

Extremely durable cable passed 70,000+ bending test<br />

Exchangeable cable easily replaced.<br />

Up to 50,000 shots with no quality loss.<br />

Theoretical 33/lp in high resolution<br />

Tray-LED<br />

LQ-BOX<br />

<br />

<br />

<br />

<br />

DENTAL ASIA NOVEMBER / DECEMBER <strong>2021</strong> 67

In Depth With<br />

Silicone hoses with spray<br />

water flow adjustment<br />

Reducing aerosols in dental clinics has become a priority in today’s<br />

practice with the current pandemic threat. With TeKne <strong>Dental</strong>’s silicone<br />

hoses, clinicians can finely adjust the spray water level from their<br />

handpieces to minimise potential contamination from the COVID-19 virus.<br />

Aerosol-generating procedures carry<br />

exposure risks that are almost inevitable in<br />

dental practices. Hence, with the pandemic<br />

threat, it has become a priority for dental<br />

professionals to reduce their exposure and<br />

potential contamination.<br />

TeKne <strong>Dental</strong> (TKD), an independent Italian<br />

manufacturer of dental handpieces, offers<br />

silicone hoses with adjustable spray water<br />

level to aid dental professionals in minimising<br />

exposure to harmful aerosols. Exporting their<br />

products worldwide, the company offers four<br />

types of silicone hoses:<br />

• Pneumatic: A wide range of pneumatic<br />

straight silicone hoses is available for<br />

turbines, air micromotors and scalers. Sizes<br />

of the internal polyurethane tubing have<br />

been optimised to get the best performance<br />

of the attached instrument and minimise the<br />

kinking effect of sharp bends.<br />

• Electric: A wide range of straight silicone<br />

hoses is available for supply of electric<br />

micromotors, piezo-electric scalers and<br />

curing lamps. The electric contacts are goldplated<br />

and crimped according to a precise<br />

standard to guarantee the best electric<br />

connection. All electric wires are extraflexible<br />

and adequately sized to the passing<br />

current, and are insulated with a special<br />

oil-resistant material.<br />

• Swivelling: Straight silicone hoses with<br />

540° (270° clockwise, 270° anti-clockwise)<br />

swivelling connection are available for<br />

pneumatic instruments and electric<br />

micromotors.<br />

• Multifunction: There is a range of straight<br />

silicone hoses with a special multi-function<br />

connection on the unit side. This special<br />

connection permits to manufacture dental<br />

units with easily detachable hoses. Four<br />

pneumatic ways and up to 11 electric ways are<br />

available on each multi-function connection.<br />

Multifunction silicone hoses come only in grey<br />

with special connectors suitable for use with<br />

KaVo, Anthos, Stern Weber, Castellini dental<br />

units.<br />

Pneumatic, electric, and swivelling hoses<br />

feature a silicone sheath and the connectors<br />

can be easily and safely cleaned with any<br />

commercial cleansers. Nuts and sleeves are<br />

chrome-plated and specially stained to reduce<br />

uncomfortable surface glare.<br />

In addition, the internal tubing is extruded in<br />

a controlled environment without added latex<br />

and phthalates, meeting main food regulations<br />

(Directive 2002/72/EC and FDA standard)<br />

and therefore comply with Directive 2007/47/<br />

EC. The inner waterline tubing can also be<br />

extruded with an antimicrobial additive on<br />

special request to prevent the proliferation<br />

of bacteria on the inner surface. DA<br />

68<br />

DENTAL ASIA NOVEMBER / DECEMBER <strong>2021</strong>

User Report<br />

DENTAL ASIA NOVEMBER / DECEMBER <strong>2021</strong> 69

Product Highlights<br />

Meyer<br />

Meyer <strong>Dental</strong> CBCT 3D PRO: Smart all-in-one tailored for<br />

professional needs<br />

The Meyer extraoral 3D PRO CBCT<br />

system collects complete oral data in<br />

one scan and reconstructs all aspects<br />

of high-resolution images as needed for<br />

accurate clinical diagnostics. The resulting<br />

3D images and analytical data provide<br />

essential basis for dental filling, implant,<br />

and orthodontics. The device is fully<br />

upgradable to include the cephalometric<br />

device with acquisition modes including<br />

CBCT, Pano, Ceph, Part CT, and model<br />

scanning.<br />

Offering multiple FOV (field of view)<br />

configurations, the advanced algorithms<br />

of 3D PRO integrate with advanced<br />

hardware technology to achieve higher<br />

quality, closer-to-reality images, providing<br />

dentists with more accurate clinical<br />

information for diagnosis.<br />

In addition,<br />

the patented<br />

hybrid pulsed<br />

X-ray source<br />

technology enables lower dose<br />

radiation, while allowing accurate<br />

diagnosis with high-definition<br />

images. The X-ray dose can be<br />

adjusted according to the patient<br />

age and physique to minimise<br />

radiation exposure.<br />

With self-built mass data of clinical<br />

images, 3D PRO overturns the traditional<br />

iterative reconstruction algorithm by its<br />

image reconstruction technology that has<br />

greatly enhanced computing capacity.<br />

The instantaneously reconstructed mass<br />

images have also significantly saved the<br />

waiting time.<br />



Meyer’s MyDent Viewer 3D diagnostic<br />

software implements advanced<br />

software engineering through modular<br />

design, with functional modules<br />

including multiplanar reconstruction,<br />

curved surface reconstruction, implant<br />

simulation, TMJ modelling, and 3D<br />

orthodontic simulation.<br />

Functions associated with various<br />

modules also include 3D panoramic<br />

view, 3D positioning, automatic neural<br />

tube labelling, and bone density<br />

measurements. ■<br />

The machine is now available in<br />

Singapore under A2Z <strong>Dental</strong> & Medical<br />

Supplies and Oracare Group.<br />

W&H<br />

The breakthrough in oral surgery<br />

The Implantmed Plus is now a true allrounder<br />

thanks to the new Piezomed on hand in a compact and space-saving<br />

as users always have the right device<br />

module from W&H. The new module can form. The modular system’s standardised<br />

also be retrofitted to the implantology motor operation simplifies the practice team’s<br />

easily and affordably, combining piezo daily workflows. In addition, only one<br />

surgery and implantology in one device. irrigation tubing and one saline solution are<br />

This, coupled with the implant stability required, enabling optimised handling.<br />

measurement and documentation features,<br />

makes W&H the first manufacturer to cover With the Piezomed Plus and Piezomed<br />

the entire surgical workflow. Oral surgeons Classic, W&H has two module versions<br />

can look forward to discovering a new world available to meet all piezo surgery<br />

of treatment possibilities.<br />

requirements in practice, whether for<br />

day-to-day or intensive use including easy<br />

The Piezomed module simplifies the<br />

operation, patented automatic instrument<br />

processes in oral surgery and implantology, detection, precise cutting performance and<br />

optimal cooling of the treatment site from a<br />

special spray design.<br />


The combination of Implantmed Plus<br />

and Piezomed module changes working<br />

methods in oral surgery and implantology.<br />

All products and functionalities that<br />

come with the new modular system<br />

are fully tailored to the user’s workflow:<br />

W&H’s surgical contra-angle handpieces<br />

allow procedures to be performed with<br />

unrivalled precision, while the wireless<br />

foot control ensures greater comfort and<br />

freedom of movement.<br />

The Osstell Beacon for measuring the<br />

implant stability provides certainty in<br />

assessing the correct loading time for an<br />

implant. Comprehensive documentation<br />

guarantees full traceability. The easy addon<br />

ensures seamless transition between<br />

the two technologies, representing a real<br />

step forward. Implantology and piezo<br />

surgery combined in a single unit – a true<br />

breakthrough in every respect. ■<br />

70<br />

DENTAL ASIA NOVEMBER / DECEMBER <strong>2021</strong>


Great on their own,<br />

inseparable in a team<br />

SOLOCEM®<br />

SoloCem® is a resin cement for almost all indirect luting<br />

indications, such as cementing crowns and bridges, root posts,<br />

inlays and onlays on tooth structure or implant abutments.<br />

Depending on the situation, SoloCem can be used either selfadhesively<br />

or adhesively, in combination with ONE COAT 7<br />


SoloCem offers aesthetically pleasing luting due to its fluorescent<br />

properties. The fillings remain invisible under special lighting<br />

conditions, such as black light in a nightclub. Available in three<br />

shades – Dentin, Trans, and White Opaque – it virtually matches the<br />

natural tooth shade, and offers good colour stability and resistance<br />

to foods with a strong discolouration effect to achieve perfect<br />

integration.<br />

A safe luting for universal use, SoloCem results in long-lasting<br />

restorations. With SoloCem’s simple and straightforward range,<br />

clinicians can avoid marginal gaps from low shrinkage and<br />

streamline their procedures.<br />

Product Highlights<br />



COMBI touch<br />



→ easy switch from supra to subgingival<br />

air-polishing by a simple click<br />

→ subgingival perio air-polishing tip – flexible, soft<br />

and anatomically adjustable to the periodontal pocket<br />

→ more than 40 inserts for scaling, perio, endo and prosthetics<br />

→ SOFT MODE: the ultra-gentle scaling<br />

for sensitive patients<br />


ONE COAT 7 UNIVERSAL is a light-cured, one-component bonding<br />

agent used with the self-etching, selectively etching or total etch<br />

technique for adhesive restoration.<br />

It features a low-evaporation formula; nanofilled technology,<br />

delivering a homogenous bond layer and improves mechanical<br />

properties; an outstanding shear bond strength; and superior<br />

marginal integrity with low risk of marginal sensitivity.<br />

ONE COAT 7 UNIVERSAL is proven to be antibacterial by the Quality<br />

Labs (Germany) after conducting a proliferation assay for testing<br />

the antimicrobial activity with S. epidermidis.<br />

Available in a user-friendly bottle or single dose, ONE COAT 7<br />

UNIVERSAL can be used as an adhesive attachment of composite<br />

materials and compomers on enamel and dentine; ceramic and<br />

composite restorations to enamel and dentin; composite material<br />

on ceramic, composite material, metal and amalgam; and dentin<br />

sealing.<br />

The application techniques include:<br />

• Self-etch: ONE COAT 7 UNIVERSAL is<br />

applied on enamel and dentin<br />

• Selective-etch: Enamel is<br />

etched, ONE COAT 7 UNIVERSAL<br />

is applied on enamel and dentin<br />

• Total-etch: Enamel and dentine<br />

is etched, ONE COAT 7 UNIVERSAL is<br />

applied on enamel and dentin. ■<br />

→ www.mectron.com<br />

DENTAL ASIA NOVEMBER/ DECEMBER <strong>2021</strong> 71<br />

ad_ct_dental_asia_95x250_en_201210.indd 1 10.12.20 14:42

Product Highlights<br />

Dentsply Sirona<br />

Performance unlimited with ProTaper Ultimate<br />

With ProTaper Ultimate, Dentsply Sirona and uninstrumentable portion of the root<br />

has introduced a technologically driven, canal space, utilising the novel SmartLite<br />

fourth generation system. The treatment Pro EndoActivator, which will be launched<br />

concept is based on three pillars: shaping, soon.<br />

3D cleaning, and filling root canal systems<br />

while the standard sequence of the shaping The SmartLite Pro platform offers three<br />

pillar includes three file types: slider, shaper attachments: the SmartLite Pro curing light,<br />

and finishers. These feature-specific files the transilluminator, and the EndoActivator.<br />

are designed to safely prepare a full range Finally, the obturation pillar enables dentists<br />

of endodontic anatomy. Novel auxiliary files to successfully fill and seal the root canal<br />

are available for larger and straighter canals system thanks to predictable shaping and<br />

and all files are available to prepare canals cleaning.<br />

mechanically and/or manually.<br />

The ProTaper Ultimate Solution also<br />

The ProTaper Ultimate Solution offers<br />

includes dedicated gutta-percha master<br />

extensive options. The cleaning pillar is cones based on the unique Conform Fit<br />

focussed on eliminating pulp, bacteria, concept and technology. Jointly used with<br />

debris, and breaking down products<br />

a Conform Fit gutta-percha master cone,<br />

when present. To facilitate cleaning, a the new AH Plus Bioceramic Sealer will help<br />

highly flexible, polymer canula with a bifid ensure filling root canal systems where the<br />

apical flow channel can safely deliver<br />

sealer bonds to the cleaned dentin walls to<br />

irrigant deep into the apical portion of ensure healing.<br />

the preparation. With a fluid-filled canal,<br />

a reagent of the clinician’s choice can be “From its inception so many years ago,<br />

exchanged into both the instrumentable our thinking has always been continuous<br />

improvement,” said Dr Clifford Ruddle,<br />

endodontist and one of the inventors of<br />

ProTaper Ultimate from Santa Barbara,<br />

United States. “ProTaper Ultimate has<br />

been designed to provide confidence and<br />

predictability for the clinician and patient<br />

alike. This comprehensive file system<br />

balances safety and efficiency when<br />

preparing canals that range from easy<br />

and straightforward, to large and open, or<br />

that exhibit challenging curvatures and<br />

recurvatures.” ■<br />

VITA<br />

Bringing colour and character to hybrid ceramic, composites and<br />

polymers<br />

The light-curing composite stain system VITA<br />

AKZENT LC brings colour and character to<br />

the digital workflow. Monolithic restorations<br />

made of hybrid ceramic, composites or<br />

polymers are growing increasingly popular as<br />

a straightforward and economical all-ceramic<br />

alternative.<br />

With 14 multi-faceted effect stains, VITA<br />

AKZENT LC breathes new life into these types<br />

of restorations with natural stain effects. With<br />

four glazing chroma stains, shade adjustments<br />

can be made within a shade group in<br />

VITA classical A1-D4 and in VITA SYSTEM<br />

3D-MASTER, if required.<br />

VITA AKZENT LC GLAZE provides the final<br />

surface sealing. The external and internal stain<br />

system can also be used in the same way in<br />

combination with veneering composites and<br />

ready-made teeth. ■<br />

72<br />

DENTAL ASIA NOVEMBER / DECEMBER <strong>2021</strong>


Product Highlights<br />


The bond for all situations<br />

The light-curing ONE COAT 7 UNIVERSAL is the only bond you<br />

need for direct and indirect filling therapy in your practice. No<br />

priming, no silanising – just apply, disperse with air and cure –<br />

finished.<br />

up to 300<br />

applications<br />

per bottle<br />

https://www.facebook.com/COLTENE.<strong>Asia</strong>Pacific<br />

006957 09.21<br />

DENTAL ASIA NOVEMBER/ DECEMBER <strong>2021</strong> 73

Product Highlights<br />

Ivoclar Vivadent<br />

Ideal solution for the efficient and gentle cleaning and polishing of<br />

teeth<br />

Systematic and professional cleaning and<br />

polishing of teeth, restorations and implants<br />

are standard treatments for preventing<br />

caries, periodontal and peri-implant<br />

diseases. Smooth, clean and polished dental<br />

surfaces offer few possibilities for bacteria<br />

and plaque to accumulate. Apart from<br />

promoting oral health, professional oral care<br />

enhances pink and white aesthetics, making<br />

the teeth and gums look their best.<br />

The new Proxyt Single Dose pastes from<br />

Ivoclar Vivadent have been developed with<br />

the aim of ensuring the efficient and effective<br />

cleaning and polishing of natural teeth,<br />

dental restorations and implants. They help<br />

keep teeth and restorations in impeccable<br />

condition and maintain their natural-looking<br />

and aesthetic shine.<br />

The Single Dose cups can be inserted into<br />

the corresponding prophy ring with ease.<br />

The unique formula and smooth consistency,<br />

as well as the easy-rinse properties, allow<br />

plaque and tartar to be removed quickly and<br />

effectively and the surfaces to be polished to<br />

a high lustre. Furthermore, the Proxyt pastes<br />

adhere well to the teeth and instruments,<br />

making handling easy. All these features<br />

combined speed up the treatment process<br />

considerably. Moreover, the pastes do not<br />

splatter or create a mess.<br />

Customers can choose between two new<br />

Proxyt Single Dose paste options: fine and<br />

coarse. This helps to avoid unnecessary<br />

wear or abrasion of the tooth structure,<br />

restorations, implants or other prosthodontic<br />

appliances. Patients who have implants<br />

require special attention. Since they need<br />

professional teeth cleaning at regular<br />

intervals, the treatment they receive must be<br />

gentle and comfortable.<br />

Proxyt fine is a pumice-free polishing paste<br />

that is exceptionally kind to sensitive fillings<br />

and tooth structure, such as dentin and<br />

dental enamel; as well as the surfaces of<br />

high-quality composite resin and ceramic<br />

restorations, for example, IPS e.max from<br />

Ivoclar Vivadent. Proxyt fine is effective,<br />

gentle and minimally abrasive. It is suitable<br />

for restorations and implants. Furthermore,<br />

it is kind to sensitive gum tissue. The<br />

Proxyt pastes from Ivoclar Vivadent contain<br />

xylitol, which disturbs the metabolism of<br />

cariogenic bacteria.<br />

Available in mild mint flavour leaving a<br />

clean and fresh feeling in the mouth, Proxyt<br />

pastes is also 100% gluten and lactose<br />

free. A packet contains 1.8g, including an<br />

adjustable prophy ring into which the cups<br />

can be effortlessly inserted. ■<br />

Amann Girrbach<br />

The gold standard for precisely fitting dentures<br />

The key to a perfect restoration is based The Artex CR universal diagnostic and<br />

on flawless model management. Amann therapeutic device in Arcon design<br />

Girrbach offers specifically developed features a reproducible centric system<br />

and perfectly coordinated premium<br />

that ensures a safe start and end position<br />

solutions for every single work step in of each patient movement. Defects of less<br />

the process chain – for both digital and than 20µm can be detected, controlled<br />

classical workflows. This enables efficiency and eliminated with the Artex articulator.<br />

from model fabrication to analysis of<br />

the finished model in the articulator,<br />

The Artex is lightweight, stable, ergonomic<br />

preventing inaccuracies from sneaking in. and highly precise – features which<br />

simplify and speed up working on the<br />

Working with the articulator is<br />

model. This drastically reduces errors and<br />

indispensable for maximum fit accuracy saves on material and labour costs in the<br />

of the denture in the classic analogue laboratory and dental practice. Therefore,<br />

workflow. In this context, the Artex system not only the patient benefits from a<br />

is an effective tool for the laboratory perfectly fitting restoration.<br />

and dental practice to record static oral<br />

situations with maximum precision and Amann Girrbach now presents the special<br />

simulate jaw movements 1:1.<br />

edition Artex CR Gold, limited to 1000<br />

units. The carbon gold-look of the<br />

articulators is symbolic of the Artex<br />

premium quality and its status as the<br />

most widely used chewing simulator<br />

in the world. ■<br />

74<br />

DENTAL ASIA NOVEMBER / DECEMBER <strong>2021</strong>

Show Review<br />

Don Casey, chief executive officer of Dentsply Sirona<br />

Dentsply Sirona World <strong>2021</strong>: The<br />

highly anticipated return of the<br />

Ultimate <strong>Dental</strong> Experience<br />

Keeping with the company’s commitment to<br />

empowering dental professionals, Dentsply<br />

Sirona hosted its annual Dentsply Sirona<br />

World <strong>2021</strong> from 23 to 25 September <strong>2021</strong><br />

with overwhelming success, connecting more<br />

than 7,000 world-leading experts, industry<br />

leaders, dental practitioners, students and<br />

more in one memorable hybrid event.<br />

“The past 18 months have pushed the dental<br />

industry to new heights and challenges.<br />

Dentsply Sirona World is our special way to<br />

connect with an ever-growing community of<br />

practitioners, elevate the future of dentistry<br />

and celebrate as a community together,” said<br />

Don Casey, chief executive officer of Dentsply<br />

Sirona. “On behalf of Dentsply Sirona, we<br />

would like to thank all participants and<br />

partners who enabled us to come and learn<br />

together how to better serve patients and<br />

bring them healthier smiles.”<br />

Guests were given the option to join this<br />

year’s Dentsply Sirona World (DS World)<br />

either in person at Caesars Forum in Las<br />

Vegas, Nevada, United States, or virtually via<br />

livestreams and special digital programming.<br />

To ensure the health and safety of DS World<br />

attendees, exhibitors, vendors and staff<br />

present onsite, the company established<br />

a health and safety protocol that aligned<br />

with state and local mandates as well as<br />

requirements of the venues.<br />




Dentsply Sirona kickstarted the three-day fest<br />

with its most notable product and corporate<br />

announcements of the year. The theme of DS<br />

World <strong>2021</strong> was to “connect”, focussing not<br />

only on the human connection of smiles and<br />

coming together again after more than a year<br />

apart, but also the power of the connected<br />

workflows of Dentsply Sirona.<br />

In front of thousands of participants from<br />

across the dental community, Dentsply<br />

Sirona announced the re-launch of their<br />

Implant Business to focus on integrating<br />

innovative technologies with quality and<br />

reliability. It offers clinicians connected,<br />

seamless workflows that enable dental<br />

professionals to take full advantage of digital<br />

dentistry and conduct more accurate and<br />

efficient procedures, resulting in excellent<br />

patient outcomes.<br />

This was marked by a comprehensive<br />

restage of the company’s Implant<br />

Business, including three signature<br />

workflows to provide dental professionals<br />

with a completely new way of practicing<br />

implantology and the unveiling of DS<br />

76<br />

DENTAL ASIA NOVEMBER / DECEMBER <strong>2021</strong>

Our dental implants have<br />

an outstanding survival rate<br />

98%<br />

Show Review<br />

With maintained marginal<br />

bone after 5 years<br />

0.3 mm<br />

Great today<br />

and even better<br />

tomorrow.<br />

Thanks to<br />

science.<br />

After 30 years of research and more<br />

than 1,000 scientific publications, we can<br />

confidently say that Astra Tech Implant<br />

System® EV delivers life-long function and<br />

natural esthetics.<br />

Thanks to science, our implants have an<br />

outstanding survival rate and a marginal<br />

bone maintenance far better than the<br />

industry standard.<br />

If you are looking for endless possibilities and<br />

superior outcomes, this is the only system you<br />

need. Today and tomorrow.<br />

Follow Dentsply Sirona Implants<br />

for the latest in implant dentistry<br />


Show Review<br />

PrimeTaper, a self-tapping implant with a<br />

tapered design that can be inserted with<br />

ease.<br />

Other notable product announcements<br />

included:<br />

• A series of updates to the SureSmile Aligner<br />

Software, enhancing the user experience and<br />

making treatment planning with SureSmile<br />

easier than ever.<br />

• The latest 5.2 upgrades to the Connect and<br />

CEREC Software, providing users both new<br />

and improved functionalities and even better<br />

performance, making Primescan twice as<br />

fast.<br />

• The introduction of ProTaper Ultimate,<br />

specifically designed for clinicians who<br />

frequently perform endodontic procedures<br />

and wish to expand the range of anatomical<br />

treatment they provide their patients.<br />

• Based on the validation of the Atlantis IO<br />

FLO-S scanbody, Primescan is now the first<br />

and only intraoral scanner validated for a full<br />

digital workflow for full arch fixed implant<br />

restorations with Atlantis suprastructures.<br />

“After 18 months of being distanced from<br />

colleagues during the COVID-19 pandemic,<br />

it was extremely exciting to come together<br />

with peers and continue learning how to offer<br />

the best possible treatments to patients,”<br />

said Dr Shivi Gupta, a dentist from San<br />

Diego, California, US. “In this industry, it is so<br />

important to remain current on new products<br />

and technologies, and I am looking forward<br />

to putting the noteworthy updates from<br />

Dentsply Sirona to use in my practice as we<br />

continue to innovate in digital dentistry.”<br />

Beyond product updates, Dentsply Sirona<br />

also announced its future-focused<br />

sustainability strategy, coinciding with the<br />

release of its inaugural Sustainability Report<br />

(SASB-aligned) and including a five-year<br />

partnership with Smile Train, the world’s<br />

largest cleft-focused non-profit organisation.<br />

13 educational tracks offering 159.5 hours of<br />

educational content covering nearly every<br />

area of dentistry. Other highlights included<br />

an inspirational presentation by motivational<br />

speaker and international best-selling author<br />

Mel Robbins, whose most recent works<br />

include The 5 Second Rule and The High 5<br />

Habit.<br />

Dentsply Sirona was also proud to enable<br />

networking across the dental industry,<br />

including among top female leaders in<br />

dentistry. Women across dentistry gathered<br />

for a dinner during DS World to honour their<br />

important contributions to the field.<br />

“I am thrilled to be here in person teaching<br />

alongside many industry-leading experts<br />

while continuing to deepen my knowledge<br />

of the latest advancements in the dental<br />

industry,” said Dr Dan Butterman, a dentist<br />

from Centennial, Colorado, US. “It truly is a<br />

different and more enriching experience to be<br />

here in person, and I cannot wait to leverage<br />

the new innovations announced at Dentsply<br />

Sirona World in my practice.”<br />

winning acts, including Gwen Stefani and<br />

The Chainsmokers entertained onsite event<br />

guests with their hit songs.<br />

Additionally, early bird pricing for Dentsply<br />

Sirona World 2022 Las Vegas from 15-17<br />

September 2022 is already available. DA<br />

Press conference speakers (from the left)<br />

Don Casey, Dr Dan Buterman, Dr John West,<br />

Dr Shivi Gupta, Dr Terri Dolan, and Marion<br />

Par-Weixlberger<br />




DS World is renowned for its first-class<br />

educational programme in a unique modern<br />

atmosphere. This year was no different as<br />

inspiring leaders and experts in the dental<br />

industry led more than 100 courses across<br />

More than the educational activities, DS<br />

World is also known for bringing today’s top<br />

acts to close each day of the event, and this<br />

year was no exception. On the first evening,<br />

Emmy award-winning writer-comedian<br />

John Mulaney kept the smiles and laughs<br />

going with fresh jokes and witty stories. The<br />

next two evenings major Grammy award-<br />

78<br />

DENTAL ASIA NOVEMBER / DECEMBER <strong>2021</strong>

Show Preview<br />

GC Corporation celebrates centennial<br />

anniversary and welcomes dental professionals<br />

to the Fifth International <strong>Dental</strong> Symposium<br />

The origins of GC can be found in Tokyo,<br />

Japan, where three young Japanese<br />

chemists created the first standard cement<br />

in 1921 that served as the stepping stone<br />

to today’s one of the largest and most<br />

successful dental materials companies<br />

in the world.<br />

Well-known for its high-performance<br />

materials and an enduring ambition to<br />

improve and promote oral health worldwide,<br />

GC continues to develop materials and<br />

equipment designed to give effective and<br />

simple solutions to dental professionals.<br />

Rejoicing its 100 years of history, GC<br />

announced their Vision 2031 to all its<br />

associates across the group of companies:<br />

“To become the leading dental company<br />

committed to realising a healthy and longliving<br />

society”, on 11 February <strong>2021</strong>.<br />

President Kiyotaka Nakao, explained: “While<br />

achieving sustainable growth, GC strives to<br />

bring value in dental care to realise a healthy<br />

long-living society. Instead of just seeking<br />

to be the first in sales volume, the goal is to<br />

become an ‘incomparable’ company for all<br />

the stakeholders of GC.”<br />

The celebrations continue in 2022, on<br />

16 and 17 April, with GC hosting the Fifth<br />

International <strong>Dental</strong> Symposium in Tokyo,<br />

Japan.<br />

With the overall theme of “Smile for the world<br />

– beyond the century”, the event will bring<br />

together over 100 prominent lecturers from<br />

all over the world. In the programme, there<br />

will be 28 sessions presenting advanced<br />

insights on academic and dental practice<br />

topics as well as relevant information on<br />

improving oral health around the globe. From<br />

one session to another, the participants will<br />

be offered the opportunity to test the latest<br />

GC products and equipment at the GC <strong>Dental</strong><br />

Show.<br />

As a 100-year company, GC Corporation<br />

encourages the entire organisation to realise<br />

the challenge of becoming the world’s best<br />

dental company that contributes to a healthy,<br />

long-lived society, while being continuously<br />

open to practitioners’ feedbacks. DA<br />

To become the<br />

leading dental<br />

company committed<br />

to realising a healthy<br />

and long-living<br />

society”<br />

DENTAL ASIA NOVEMBER / DECEMBER <strong>2021</strong> 79

Show Preview<br />

Mectron Spring Meeting<br />

2022: The appointment with<br />

innovation<br />

After the success of the first edition, Mectron<br />

welcomes dental professionals to the Spring<br />

Meeting 2022 on 6 and 7 May (Friday-<br />

Saturday) in Venice, Italy. The scientific<br />

programme is focused on the new REX<br />

PiezoImplant, a revolutionary wedge-shaped<br />

implant specifically developed to simplify the<br />

surgical treatment of narrow ridges.<br />

The second important topic involves a new<br />

piezoelectric surgical protocol dedicated to<br />

the third-molar extraction procedure, which<br />

will make such an advanced technique safer<br />

and faster in daily clinical practice.<br />

Illustrious international and national<br />

speakers will introduce different piezoelectric<br />

surgical techniques such as: sinus lift by<br />

crestal and lateral approach, peri-implantitis<br />

therapy, bone augmentation procedures<br />

and corticotomy-assisted orthodontics.<br />

Each technique will be presented in detail<br />

by the clinicians who developed them,<br />

with particular attention to relevant clinical<br />

protocols illustrated by a wide range of<br />

clinical cases, arising from great experience<br />

and continuous scientific research. This is an<br />

innovative one-day chance to get the most<br />

out of PIEZOSURGERY ® techniques in daily<br />

practice.<br />


Friday, 6 May 2022<br />

Update in piezoelectric extraction techniques<br />

(morning session):<br />

• Germectomy<br />

• Third molar extraction<br />

• Root extractions with new piezoelectric<br />

tools<br />

Update in daily practice (afternoon<br />

session):<br />

• Sinus Lift procedures<br />

• Periodontitis and peri-implantitis<br />

procedures<br />

• Corticotomy techniques<br />

• Bone augmentation procedures<br />

Saturday, 7 May 2022<br />

REX PiezoImplant state of the art (morning<br />

session):<br />

• Advances in narrow ridges treatment<br />

• Clinical outcome<br />

• Digital workflow<br />

• Clinical innovation and what is coming<br />

next. DA<br />

80<br />

DENTAL ASIA NOVEMBER / DECEMBER <strong>2021</strong>

Giving Back To Society<br />

Dentsply Sirona announces five-year partnership agreement with<br />

Smile Train and US$5 million donation<br />

Globally, one in 700 babies are born with<br />

a cleft lip and/or palate. Clefts can have<br />

devastating effects on the quality of life<br />

of a child by compromising the ability to<br />

communicate and to eat properly, and<br />

from social stigma resulting in feelings of<br />

anxiety and a lack of self-confidence. A<br />

child with a cleft requires more than just<br />

surgery. Essential cleft care includes nutrition<br />

programmes, dental and orthodontic care,<br />

speech therapy, and social and emotional<br />

support.<br />

Smile Train’s sustainable model empowers<br />

local medical professionals to provide free<br />

cleft surgery and essential cleft care in their<br />

own communities. Hence, Dentsply Sirona<br />

has launched a partnership with Smile Train<br />

to improve oral health globally and to build a<br />

brighter, more sustainable future for children<br />

and families affected by clefts worldwide.<br />

The company goes beyond traditional<br />

financial and equipment donations. The<br />

Dentsply Sirona and Smile Train partnership<br />

will advance the future of cleft care by:<br />

• Supporting global treatment standards<br />

and best practices for digitised cleft care<br />

• Leveraging digital technologies to make<br />

treatments more efficient and convenient<br />

for children<br />

• Providing high quality equipment to<br />

develop state-of-the-art centres for cleft<br />

treatment<br />

• Making their entire online catalogue of<br />

clinical education courses available to all<br />

Smile Train oral health professionals<br />

• Offering financial support for cleft<br />

surgeries<br />

The company is focused on making sure<br />

that the benefits of Smile Train partnership<br />

have a lasting impact. Therefore, in<br />

addition to funding life-changing cleft<br />

surgeries and providing free dental<br />

equipment, the collaboration focuses on<br />

global, oral healthcare training initiatives<br />

to equip people in local communities with<br />

the skills needed to provide treatment and<br />

raise the standard of care to the highest<br />

level through clinical education and the use<br />

of cutting-edge technologies in the long<br />

term.<br />

Additionally, the partnership includes the<br />

development of an International Smile Train<br />

Scholars programme, which will support<br />

in-person and virtual training, and learning<br />

opportunities for Smile Train dental partners.<br />

A group of 16 scholars attended DS World<br />

<strong>2021</strong>, participating in clinical education<br />

sessions and growing their professional<br />

networks. ■<br />

TePe expands its support for Pink Ribbon in favour of cancer<br />

awareness and research<br />

October has become known as the pink<br />

month when companies and individuals<br />

come together to raise awareness for<br />

cancer. In 2020, TePe’s Pink Ribbon<br />

initiatives was a success, resulting in<br />

around 60,000 euros for cancer research<br />

in Sweden and Finland. This year, the<br />

TePe Group hopes for even better results<br />

by extending its campaign collaboration<br />

with cancer awareness organisations in<br />

Europe and the United States.<br />

and France, as well as distributors in<br />

Greece, Ukraine, Portugal, and Serbia,<br />

also participated in various Pink Ribbon<br />

initiatives.<br />

“We constantly work to raise awareness<br />

of oral health and its connection to<br />

general health. Since cancer research is so<br />

important for global health development,<br />

we are glad to support the Pink Ribbon<br />

campaign as part of our sustainability<br />

initiatives,” said Helena Ossmer Thedius,<br />

director of Marketing and Innovation at<br />

TePe. ■<br />

In particular, the company has<br />

expanded the Nordic collaborations<br />

to include Denmark and Iceland, and<br />

engaged several other markets across<br />

the globe. TePe subsidiaries in Italy,<br />

the Netherlands, the United States,<br />

DENTAL ASIA NOVEMBER/ DECEMBER <strong>2021</strong> 81



3 – 6 DenTech China <strong>2021</strong><br />

Shanghai, China<br />

Venue: Shanghai World Expo Exhibition and<br />

Convention Centre<br />

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

5 (Virtual) <strong>Dental</strong> Technician International<br />

Meeting <strong>2021</strong><br />

https://www.cappmea.com/dtim-<strong>2021</strong><br />

11 – 14 (Virtual) 16 th CAD/CAM & Digital Dentistry<br />

Conference<br />

www.cappmea.com/digital-dentistry<br />

18 – 21 (Virtual) 13 th <strong>Dental</strong> Facial Cosmetic Conference<br />

https://cappmea.com/aesthetic-dentistry<br />

19– 20 (Virtual) DICE <strong>2021</strong> – <strong>Dental</strong> International Congress<br />

and Exhibition<br />

https://cappmea.com/aesthetic-dentistry<br />

24 – 26 IndoHealthcare Expo <strong>2021</strong><br />

Jakarta, Indonesia<br />

Venue: JIExpo Kemayoran<br />

https://indohealthcareexpo.com<br />

26 (Virtual) Digital Orthodontics Symposium <strong>2021</strong><br />

https://cappmea.com/digital-ortho-<strong>2021</strong><br />

26 (Virtual) <strong>Dental</strong> Hygienist Seminar <strong>2021</strong><br />

https://cappmea.com/dhs-<strong>2021</strong><br />

28- 1Dec 97 th Greater New York <strong>Dental</strong> Meeting <strong>2021</strong><br />


New York, United States<br />

Venue: Jacob K. Javits Convention Centre<br />

https://www.gnydm.com<br />

1 – 3 Vietnam Medi-Pharm Expo <strong>2021</strong><br />

Hanoi, Vietnam<br />

Venue: Hanoi International Centre for Exhibition<br />

http://hn.medipharmexpo.com/en<br />

2 – 4 Barcelona <strong>Dental</strong> Show<br />

Barcelona, Spain<br />

https://www.dentalshowbcn.com/en<br />

10 –12 10 th Hong Kong International <strong>Dental</strong> Expo<br />

and Symposium<br />

Hong Kong<br />

Venue: Hong Kong Convention and Exhibition Centre<br />

https://hkideas.org<br />

15 – 17 Annual General Meeting and 112 th Academic<br />

Conference<br />

2022<br />


Thailand<br />

https://www.thaidental.or.th<br />

20 – 22 SIDC 2022 – 33 rd Saudi <strong>Dental</strong> Society<br />

International <strong>Dental</strong> Conference<br />


Riyadh, Saudi Arabia<br />

Venue: Hilton Riyadh Hotel and Residence<br />

https://sidc.org.sa<br />

1 – 3 AEEDC 2022 – The 26 th edition of the UAE International<br />

<strong>Dental</strong> Conference & Arab <strong>Dental</strong> Exhibition<br />

Dubai, United Arab Emirates<br />

Venue: Dubai World Trade Centre<br />

https://aeedc.com<br />

11– 13 Famdent Mumbai 2022<br />

Mumbai, India<br />

Venue: Bombay Exhibition Centre Goregaon (East)<br />

https://www.famdent.com/mumbai-show<br />

24 – 26 157 th Midwinter Meeting – Chicago <strong>Dental</strong> Society<br />

Chicago, United States<br />

https://www.cds.org<br />

82<br />

DENTAL ASIA NOVEMBER / DECEMBER <strong>2021</strong><br />

With the evolving COVID-19 situation, kindly check with organisers<br />

for updates on the related events. Please refer to the local airports’<br />

websites for the latest travel advisories too.

NEW<br />

VENUE<br />




8-10<br />

APRIL 2022<br />



www.idem-singapore.com<br />

Connect with us<br />

Endorsed by<br />

Supported by<br />

Held in<br />

Organised by<br />

IDEM Singapore<br />

IDEM Singapore<br />

idem.sg<br />

@IDEMSingapore<br />

83 DENTAL ASIA NOVEMBER / DECEMBER <strong>2021</strong><br />

Singapore <strong>Dental</strong> Assocation

Advertisers’ Index<br />


PAGE<br />

3Shape A/S 13<br />

Align Technology 5<br />

Anthogyr France 35<br />

APAC Oral Care International Exchange Summit 69<br />

Carestream <strong>Dental</strong> 45<br />

Coltene 73<br />

<strong>Dental</strong> South China 2022 75<br />

Dentsply Sirona 77<br />

Social Distancing?<br />

No problem!<br />

It’s safe.<br />

Connect your<br />

brand through our<br />

media platforms.<br />

DÜRR <strong>Dental</strong> (advertorial) 7<br />

exocad IFC , 1<br />

exocad<br />

IBC<br />

GC <strong>Asia</strong> 23<br />

IDEM Singapore 2022 83<br />

Mectron 17<br />

Mectron 71<br />

Medical Protection Society<br />

OBC<br />

Rolence inc 67<br />

Shofu inc 15<br />

Tekne <strong>Dental</strong> 19<br />

VITA 11<br />

For information, visit us www.dentalasia.net or<br />

contact us at sales@pabloasia.com<br />

@dentalasia<br />

VOCO 9<br />

W&H 3<br />

Company Registration No: 200001473N<br />

All rights reserved. Views of writers do not necessarily reflect the views of the Publisher. No part of this publication may be reproduced in any form or by any means, without<br />

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

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

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<br />

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

of criteria. Paid subscription is available to those who do not fit our terms of control. Please refer to subscription form provided in the publication for more details.<br />

Printed by Times Printers Pte Ltd<br />

84<br />

DENTAL ASIA NOVEMBER / DECEMBER <strong>2021</strong>

<strong>Dental</strong>CAD 3.0 Galway<br />

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and AI detects facial features in<br />

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DENTAL ASIA NOVEMBER / DECEMBER <strong>2021</strong> 85

Unpredictable tomorrows<br />



Our protection has the flexibility to adapt to the unexpected. Even if your<br />

world is turned upside down, know that we’re ready to help you through it.<br />

• A wide range of protection beyond claims<br />

• Advice for any eventuality your career may face<br />

• Fast to respond to unexpected situations<br />

• Support today, tomorrow and yesterday<br />

Always there for you<br />

dentalprotection.org<br />

<strong>Dental</strong> Protection Limited is registered in England (No. 2374160) and is a wholly owned subsidiary of The Medical Protection Society Limited (“MPS”) which is registered in England (No. 00036142).<br />

Both companies use ‘<strong>Dental</strong> Protection’ as a trading name and have their registered office at Level 19, The Shard, 32 London Bridge Street, London, SE1 9SG. <strong>Dental</strong> Protection Limited serves and<br />

supports the dental members of MPS with access to the full range of benefits of membership, which are all discretionary, and set out in MPS’s Memorandum and Articles of Association. MPS is not<br />

86 an DENTAL insurance ASIA company. NOVEMBER <strong>Dental</strong> Protection® / DECEMBER is a registered <strong>2021</strong>trademark of MPS.<br />

2109272550 10/21

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