Dental Asia March/April 2023

www.dentalasia.net
MARCH / APRIL 2023
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CONTENTS
18
22
30
TRENDS
14 HKU Dentistry new jaw surgery concept
is effective in treating moderate-tosevere
obstructive sleep apnoea
16 Artificial intelligence in dental practice
UNDER THE SPOTLIGHT
18 Under one roof: A multi-disciplinary,
patient-centric model
DENTAL PROFILE
21 Optimising dental scanning process
with Scanningspray
22 Same-day dentistry made a reality by
Ackuretta
CLINICAL FEATURE
26 Next generation synthetic graft
materials: Clinical and scientific review
30 Using occlusion technology to
simplify and improve functional risk
assessment
34 Clinical management of root resorption
and separated instruments
48
USER REPORT
38 Mini Implants: Simplified protocol for
stabilising removable dentures
42 Innovative leap in glass ceramics
BEHIND THE SCENES
46 Heralding the era of digital dental
technicians
48 Inside story of press technology
IN DEPTH WITH
50 Choosing the best loupes
52 Severe dental problems in children on the
rise: Finnish innovation keeps tooth decay
at bay
EXCLUSIVE FEATURE
58 100 Years of IDS: Shaping the dental future
SHOW PREVIEW
61 Advertorial: Seven reasons to attend the
International Osteology Symposium
62 Edentulism 2023: Glimpse into the
speakers’ presentations
63 Implant Solutions World Summit:
The latest innovations and science
transforming implant dentistry
64 Sino-Dental 2023: All-in-one platform
SHOW REVIEW
66 AOSC celebrates successful first in-person
edition back out of the pandemic
REGULARS
4 Editor’s note
6 Dental Updates
54 Product Highlights
67 Events Calendar
68 Advertisers’ Index
46
50
62

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EDITOR’S NOTE
Era of dental
revolution: Where
past and future
collides
PABLO SINGAPORE
Publisher
Assistant Editor
Graphic Designer
William Pang
williampang@pabloasia.com
Czarmaine Masigla
czarmaine@pabloasia.com
Agatha Wong
agatha@pabloasia.com
Amira Yunos
amira@pabloasia.com
Cayla Ong
cayla@pabloasia.com
The dental industry is in a very exciting era —
the once considered futuristic idea is now the
reality. From 3D printing, software integrations
and artificial intelligence (AI), the advancement
in technology has enabled dental practices
and laboratories to scale up their practices in
multiple ways.
For instance, the plug-and-play solutions of
Ackuretta have made it possible for practitioners
to adapt same-day dentistry. Thomas Wu,
CTO of Ackuretta, shares how crucial it is to
incorporate customers’ feedback in designing
and building a product to make it more userfriendly.
By tapping into AI technology, they
aim to minimise the learning curve in using 3D
printing technology, so more practitioners can
use and benefit from it (p.22).
As the dental sector continues to be more
digitalised with integrated workflows, Prof Dr
Sebastian Gell, co-founder of Scanningspray,
said that scanning and 3D printing will play an
important role for dental laboratories in the
coming years. With their self-cleaning scanning
spray, they aim to optimise the scanning
process and improve the scan quality so dental
laboratories can generate reproducible results
in the 3D scan (p.21).
Technological advancements have no doubt
further enhanced treatment outcomes
as exampled by how Dr Lee Ann Brady
utilises dental occlusion technology to
acquire a more complete picture of a
patient’s temporomandibular joint and
better understand how it contributes to
temporomandibular disorders (p.30).
In the past decade, we have seen a dramatic
transformation in the workflow of dental
clinics and laboratories. And with the
return of in-person events and trade fairs —
starting with the 40th edition of IDS — the
digital revolution in dentistry is set to run at
full throttle (p.58).
Czarmaine Masigla
Assistant Editor
Scan for digital copy
of Dental Asia
Circulation Manager
Media Representative
PABLO BEIJING
General Manager
PABLO SHANGHAI
Senior Editor
Shu Ai Ling
circulation@pabloasia.com
Jamie Tan
jamietan@pabloasia.com
Ellen Gao
pablobeijing@163.com
Daisy Wang
pabloshanghai@163.net
HEAD OFFICE
PABLO PUBLISHING &
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ADVISORY BOARD
Dr William Cheung
Dr Choo Teck Chuan
Dr Chung Kong Mun
Dr George Freedman
Dr Fay Goldstep
Dr Clarence Tam
Prof Nigel M. King
Dr Anand Narvekar
Dr Kevin Ng
Dr William O’Reilly
Dr Wong Li Beng
Dr Adrian U J Yap
Dr Christopher Ho
Dr How Kim Chuan
Dr Derek Mahony
Prof Alex Mersel

#whdentalwerk
wh.com
Modularity for
optimal flexibility
Electric motor
Particularly small and
surprisingly light. It enables
you to work with ease.
Osstell Beacon
Bluetooth connection
to the Osstell Beacon
for easy measurement
of implant stability.
Straight & Contra-angle
Handpieces
Provide optimal illumination
of the treatment site and
facilitate perfect, accurate
treatment results.
PDF
XLS
Documentation of
osseointegration
The documentation
function conveniently
saves all values of the
implant insertion on a
USB stick (.pdf and .xls).
Piezomed Plus
and Classic module
Combine piezo surgery and
implantology in one device.
Wireless or wired foot control
Control the Implantmed Plus
and Piezomed module with
just one foot control.

DENTAL UPDATES
Ackuretta launches ALPHA AI
Ackuretta, a global manufacturer of 3D printing
solutions for dental professionals, has launched
the new AI-assisted 3D slicing software —
ALPHA AI. The new 3D printing slicing software
is an evolution of Ackuretta’s ALPHA 3D
and includes several improvements from its
predecessor.
Extensive research has driven Ackuretta
towards artificial intelligence as the next
logical step in their journey to make 3D dental
printing accessible to everyone. Moreover, such
technology provides predictable results every
time — building upon Ackuretta’s signature
reliability.
ALPHA AI offers a streamlined process to
guarantee success and eliminate human
error: Import an STL file on the software, click
the icon for the desired application and start
printing in seconds.
Ayush Bagla, CEO of Ackuretta, said: “Up
to 75% of 3D printed applications result in
failure because of poor orientation. Some
clinicians and dental technicians have to
go through a learning curve — which leads
them to experience failed prints due to a few
reasons, such as choosing the wrong printing
parameters, not using the correct resin, lack of
training, and dealing with complex dental 3D
printing software.
“ALPHA AI comes to solve that exact problem.
It uses machine learning to analyse data from
thousands of real designs and comes up with
the optimal orientation for a given application,
including adding the necessary supports. Users
can achieve the best result with just one click.”
Unlike most 3D printing slicing software in the
market, ALPHA AI allows its users to orient
an application, add the necessary supports,
and save it not only as i3dp and ibf (Ackureta
Solution proprietary file format) but also as an
STL file.
Ackuretta aims to empower its customers by
offering them a truly open system — everything
from 3D printing solutions to digital dentistry
software. Users could configure the print they
want on ALPHA AI (such as placing it with
the right orientation and adding supports)
and export the STL file to use on any other 3D
printing CAM software specific to non-Ackuretta
devices for printing.
Ackuretta’s ALPHA AI is capable of orienting
and creating supports for splints, crowns,
bridges, and surgical guides. Moreover, the
company releases constant updates every three
months to add new features and functions to
the dental 3D printing software. DA
KaVo and MELAG agree on sales partnership
With their cooperation, KaVo and MELAG are
forming a new team that will additionally drive
the future in instrument reprocessing with
coordinated product and service offerings
in order to continuously make daily work in
dental practices safer, more reliable and more
effective.
The focus of the closer sales cooperation
is, among other things, joint training for
specialised trade partners as well as
coordinated marketing and sales campaigns.
Joint events for end customers are also
planned worldwide. Stronger mutual support
is also planned for the future in the area of
research and development.
Under the slogan “Dental Excellence”, KaVo
Dental has been offering dental expertise and
an almost complete premium product portfolio
for dental practices and dental laboratories
for over 100 years. KaVo has been a guarantor
of outstanding premium products for over
100 years and a leading supplier in the dental
instrument segment with a large number of
patents and utility models.
As an owner-managed family business, MELAG
has established itself as a market leader in dental
hygiene with quality and innovative strength.
Since the company was founded over 70 years
ago, MELAG has been developing and producing
innovative and technologically robust solutions
for instrument reprocessing exclusively in Berlin,
Germany. With its outstanding system solutions,
including autoclaves, washer disinfectors
and sealing devices, MELAG has been able to
continuously develop and significantly shape
instrument reprocessing.
It is therefore not surprising that KaVo explicitly
recommends products from MELAG for the
reprocessing of its own premium instruments.
“The high standards of our own products and
the values of an innovative, traditional company
make MELAG the perfect partner for KaVo in
dental instrument reprocessing. As a reliable
four-in-one solution, the Careclave from MELAG
harmonises perfectly with our high-quality KaVo
instruments and is therefore also our clear
recommendation for reprocessing our KaVo
instruments,” said Armin Imhof, CTO at KaVo.
Dr Niklas Gebauer, managing partner of
MELAG, added: “KaVo straight and contra-angle
handpieces have always been the benchmark
for us, not only in terms of quality and aboveaverage
durability. Therefore, we have also
tested intensively with KaVo instruments during
the development of the Careclave.”
At the International Dental Show in Cologne,
which opens its doors on 14 Mar, the
cooperation will also be visible to the general
public: the MELAG Careclave will also be on
the KaVo stand and on the MELAG stand
the Careclaves will be equipped with KaVo
instruments. DA
6 DENTAL ASIA MARCH / APRIL 2023

DENTAL UPDATES
Carestream Dental introduces IO
Scanner Link
PERFECTION IN
BONE SURGERY
Carestream Dental is now making a seamlessly connected digital
practice a reality with IO Scanner Link, its latest innovation that allows
CS Imaging version 8 software to directly connect to third-party intraoral
scanners’ acquisition software not developed by Carestream Dental.
IO Scanner Link is more than a manual file import/export option.
It leverages CS Imaging 8 — the imaging hub that centralises and
displays all of a user’s Carestream Dental imaging data — as the core
practice platform to drive efficiency and connectivity. By aggregating,
storing and managing all images through a single software and patient
database, a practitioner can optimise and simplify the workflow in
their digital dental practice.
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“In today’s digitally connected practice, it’s all about choice,” said
Philippe Maillet, general manager, imaging equipment, Carestream
Dental. “The choice to connect your existing technology with a
multitude of partners or devices to create the workflow that’s right for
your practice.”
Within CS Imaging 8, an integrated button allows intraoral scans from
supported third-party scanners, along with all the necessary patient
data, to be launched with just one click. When the scan is complete, the
intraoral scan is automatically imported back into CS Imaging 8 to be
used for implant planning through Carestream Dental’s Prosthetic-driven
Implant Planning (PDIP) module; surgical guide design with Smop
software; sharing with labs; or exporting to other third-party software.
“Making it easy for practitioners to use the intraoral scanner of their
choice and giving them unrestricted access to their preferred clinical
solutions aids them in optimising their daily treatments through an
efficient workflow,” said Maillet.
Medit is the latest intraoral scanner manufacturer to integrate with CS
Imaging 8 through IO Scanner Link. This will allow users of Carestream
Dental imaging equipment and Medit intraoral scanners to integrate
their favourite devices with a single click of a button. Medit scanning
solutions support both Windows and Mac computers.
CS Imaging 8 also connects with Dexis intraoral scanners. In the
coming months, Carestream Dental intends to expand the number of
integrations to give practitioners even more choices. CS Imaging 8 is
one of the most widely used dental imaging software on the market,
thanks to its extremely user-friendly, modern interface. DA
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DENTAL ASIA MARCH / APRIL 2023 7
ad_PStouch_dental_asia_95x250_en_211214.indd 1 14.12.21 15:38

DENTAL UPDATES
Dürr Dental partners with 3Shape
As a supplier of system solutions for the dental
market, Dürr Dental relies on partners who also
pursue the goal of supporting practices in their
future-oriented development. In addition to
manufacturing innovative 2D and 3D large x-ray
units and imaging plate scanners, Dürr Dental
has also developed the VistaSoft imaging
software.
“Practices that use a TRIOS intraoral scanner
from 3Shape can now work with 3Shape Unite
from VistaSoft,” explained Frank Kiesele, head
of Product Management Diagnostic Systems
at Dürr Dental. “Users switch to 3Shape Unite
with just one click.”
The integration between Dürr Dental and
3Shape Unite adds an intuitive workflow for
patient management.
The Danish 3Shape drive progress in digital
dentistry with industry-recognised scanners
for clinics and labs, and connect dentists and
technicians with software workflows. 3Shape
advances and coaches professionals on every
step of their digital journey — helping to elevate
the customer experience.
For both companies, user-friendly software
offerings are inseparably linked to the added
value of their products for dental practices
and clinics. That is why Dürr Dental’s VistaSoft
software now has an interface to 3Shape Unite
from version VistaSoft 3.0.20.
“With the integration between VistaSoft and
3Shape Unite, we are initiating a seamless
digital workflow in the clinic. Together we
are committed to deliver a more streamlined
workflow, allowing the dentist to focus only on
the patient,” said Rune Fisker, SVP of Product
Strategy, 3Shape. DA
Ivoclar celebrates centennial anniversary
The year 2023 marks Ivoclar’s 100-year
anniversary, which will be celebrated under
the theme “A Century of Innovation”. Founded
in Zurich, Switzerland, in 1923, the company
relocated to the principality of Liechtenstein
in 1933, where it established its present-day
headquarters. Over the years, the former tooth
factory evolved into a leading manufacturer
of integrated solutions for high-quality dental
applications. The family-owned business
advanced to become a global market leader
in various product segments, for example,
ceramic furnaces (Programat series), by
supplying a comprehensive portfolio of
products and systems specially designed
for dental practices and laboratories. The
introduction of one of the most popular
products of Ivoclar’s recent history — the highly
aesthetic IPS e.max lithium disilicate glassceramic
— ushered in the aesthetic revolution
in 2005. The product went on to become a
global market leader in its segment. Ivoclar
also made a name for itself in the manufacture
of highly aesthetic tooth replacements, which
was the main business when the company was
founded, and therefore links the company’s
origins to its 2023 centenary.
Diego Gabathuler, CEO of the Ivoclar Group,
said: “We build our success on customerrelevant
innovations paired with integrated
system solutions, efficient applications,
excellent quality and constant reliability as well
as trust and respectful cooperation.
“We focus on giving people a healthy and
beautiful smile, resulting in a better quality of
life. For this purpose, we supply our products to
around 130 countries. We employ roughly 3500
people worldwide, who continuously strive to
optimise the company’s offerings of integrated
solutions that feature intelligent systems,
practice-oriented training and education as
well as comprehensive after-sales support and
customer-centric service.”
In 2021, the group, which has more than 47
subsidiaries and branch offices throughout
the world, including production facilities in
Liechtenstein, Germany, Austria, Italy, Sweden,
the US and the Philippines, achieved a record
increase in turnover of CHF 842 million in all of
its markets. An additional growth in turnover
has been achieved for the 2022 business year.
“The 100th birthday of the Ivoclar Group takes
place in dynamic times. Nevertheless, I am
certain that the company will continue to be
successful in the future,” said Helmut Schuster,
chair of the Supervisory Board of the Ivoclar
Group. “Why am I so confident? Because the
corporate values of respect, smile, focus, act
and grow are deeply rooted within the company,
and they are upheld by the employees and
managers of the company and above all by
Christina and Christoph Zeller and the next
generation of the entrepreneurial family.”
The dental company maintains longstanding
and trusting business partnerships
with suppliers, customers and universities
throughout the world, who — including the
employees of the family-owned business — are
all on a mission to “Making People Smile”.
In the 2023 jubilee year, they can look forward
to a series of special activities and events,
such as trade fairs and further education and
training courses as well as the inauguration of
the new head office building at the company
headquarters in Liechtenstein, which will
also house the visitor and education centre.
All these activities and events will highlight a
century of innovation. DA
8 DENTAL ASIA MARCH / APRIL 2023

DENTAL UPDATES
Neoss Group launches simplified
digital workflow and a patented,
single tooth PTFE implant-secured
membrane
For over 20 years, Neoss has developed smart solutions that allow
dental professionals to provide reliable and cost-effective treatments
to their patients with predictable long-term results. Now Neoss has
created a digital workflow that all dental clinicians can implement. It
consists of six steps that will help them save time, money and at the
same time increase predictability that deliver the best functional and
aesthetic outcomes for their patients.
In this new workflow, clinicians will not only find the fast and precise
impression machine NeoScan 1000, they also have the Neoss
exclusive integrated aesthetic healing and scan abutment, Neoss
Esthetic Healing Abutment with ScanPeg. This simple cost-effective
solution is also patient-friendly, maintaining the biological seal and
giving excellent aesthetics.
“Building off the successful launch of NeoScan 1000, an intraoral
scanner that changed the industry giving more dental professionals
the possibility to afford to do digital impressions, we now have a
simplified digital workflow that will help them save even more money
and time,” said Dr Robert Gottlander, CEO and president of Neoss
Group.
In addition, Neoss has launched a new type of PTFE membrane
exclusive to Neoss — the NeoGen Cape PTFE membrane. It is a new
addition to the successful NeoGen PTFE family which is proven
to support the regrowth of lost bone. This solution for predictable
vertical bone growth helps with buccal bone deficiencies in the
aesthetic zone and gives fewer treatment steps thanks to direct
fixation to the implant.
“The NeoGen PTFE Cape Membrane takes the GBR for the
reconstruction of bone defects in the aesthetic area to a new level.
The innovative membrane fixation method on the implant leads to
a predictably undisturbed healing process and significantly reduces
the complication rate. The excellent aesthetic results support this
impressively,” said Dr Christian Schober, specialist in maxillofacial
surgery in Vienna, Austria. DA
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DENTAL ASIA MARCH / APRIL 2023 9

DENTAL UPDATES
Amann Girrbach presents a check over €17,000 to the Cleft Kinderhilfe
A check to the amount of €17,000 was
presented by Jörg Mayer, CFO of Amann
Girrbach, to Stephanie Günther, representative
of the Austrian Cleft Kinderhilfe.
Amann Girrbach has been supporting the Cleft
Kinderhilfe since 2018 in Germany as well as
in Austria since 2019, and has already initiated
several fundraising campaigns, in several cases
together with dealers and customers. As part
of a Christmas raffle by employees and with the
support of the company’s top management, a
further donation check has now been handed
over: at the turn of the year 2022/23, sum of
€17,000 was donated to the Austrian Cleft
Kinderhilfe.
“We are very pleased to be able to give
something back to society in 2022/23 as
well. It is important to us that we make our
contribution and actively live commitment.
Since we began our support for the German
and Austrian Cleft Kinderhilfe, numerous
surgical interventions and therapies have
already been made possible,” said Mayer.
Günther, who herself is also an employee
at Amann Girrbach, was delighted with the
generous donation.
“I’m doubly happy, so to speak — I’m delighted
to receive this fantastic donation check for
something that is very close to my heart,
and at the same time I’d like to thank my
colleagues and our management for their
great commitment. We can really make a
big difference with this. To give an example
— in the years 2020 to 2022, more than
150 children were helped thanks to Amann
Girrbach. After difficult and sometimes rather
paralysing times due to the pandemic, it is
wonderful to be able to get back on track
and give as many children as possible the
prospect of a future. After all, this is not a
mere cosmetic correction, but often a matter
of survival for the affected children.” DA
Koite Health expands to Germany, signs Lumoral
accord with white cross
Finnish health technology company Koite
Health has signed an agreement with German
distribution and training company, white cross.
Following the agreement white cross will
focus their marketing efforts on over 55,000
dentistry professionals in the German market
to promote the use of Lumoral — the latest
technology on the market for improved oral
health self-care.
With its training institute — praxisDienste
Institut für Weiterbildung — white cross has
been for the past 22 years market leader
in Germany in the field of training dental
prophylaxis specialists including prophylaxis
assistants and dental hygienists. white cross
is responsible for educating one third of
all new prophylaxis assistants and dental
hygienists in Germany. In addition, the CEO of
white cross also runs a private university —
Medical School 11 — in Heidelberg, Germany,
which educates health professionals through
its BSc Dental Hygiene study programme. The
educational programme of the praxisDienste
Institut für Weiterbildung is offered in 11 major
cities in Germany with Heidelberg being the
administrative headquarter.
The agreement between Koite Health and white
cross includes all activities necessary to launch
a novel medical device and a new technology
in the German market. Through training and
education, the company seeks to ensure that
dental professionals in the world’s second
largest market are well informed about Lumoral
so that they can recommend the treatment to
patients.
“We have about 55,000 active dentists in
Germany in addition to around 25,000-30,000
dental prophylaxis assistants and dental
hygienists. Our mid-term goal is to see 10% of
this target group becoming familiar with the
Lumoral-treatment and actively recommending it
to their patients based on the patients’ individual
oral health risk profile,” said Prof Werner
Birglechner, who leads both white cross and
Medical School 11 private university.
Prof Birglechner stressed that cutting-edge
technologies are essential for the company’s
training and distribution business. He said: “Our
customers expect that they are trained with the
latest scientifically proven technologies. We
strongly believe that this is the case for Lumoral.”
Prof Werner Birglechner, CEO of white cross and
Medical School 11
white cross strives to provide patients with the
best possible modern treatment for oral diseases.
The Lumoral-collaboration fits well with this goal.
Sakari Nikinmaa, CEO of Koite Health, said:
“Partnership with Prof Werner Birglechner and
white cross is an important step for Lumoral’s
geographical expansion from Nordics to Central
Europe. Our strategy is to partner with industry
leaders to raise awareness among professionals
about the Lumoral product and its benefits and
to build global sales structure to secure product
availability globally.
“Prof Birglechner and his team have excellent
resources, and they are experts in educating new
solutions to the dental segment. We see them
as a perfect partner in building a presence in
the second biggest dental market globally. By
working together, we can take oral health to a new
level and provide patients with the best possible
treatment experience and outcomes.” DA
10 DENTAL ASIA MARCH / APRIL 2023

DENTAL UPDATES
Nobel Biocare awards Dr Paulo Malo for 25 years of
the All-on-4 treatment concept
Dr Paulo Malo has been presented a Quarter
Century Award from Nobel Biocare, honouring
the 25th anniversary of the All-on-4 treatment
concept. At a gathering in Nobel Biocare’s
Dental Experience Centre in Zurich, Switzerland,
Patrik Eriksson, company president, presented
the trophy.
Dr Malo led the development of this treatment
protocol in the early 1990s, with much-valued
support from the late Dr Bo Rangert of Nobel
Biocare. In 1998, he treated the first patient
documented in the first scientific study, with
the final version of the concept that became
commercially launched.
The All-on-4 treatment concept is widely
recognised as one of the most significant
developments in implant dentistry. It brought
a revolutionary way of providing patients with
a cost-efficient, graftless solution for fixed full-
arch prostheses on the day of surgery, on just
four implants.
Dr Malo said: “In the early years of the All-on-4
treatment concept, very few people believed
that it was possible. But I was seeing first-hand
how successful the technique was for my
patients and became completely dedicated to
making it available for more people who suffer
from edentulism. Twenty-five years ago, it was
beyond my wildest dreams that it would reach
the scale that it has today.
“This level of impact is all thanks to Nobel
Biocare. They could see its true potential
despite scepticism in the industry, and they
took it to a global level like no other company
would.”
Eriksson, said: “I’m delighted to award Dr Malo
in recognition of this milestone. While many
companies have tried to copy the All-on-4
treatment concept, Dr Malo and Nobel Biocare
have focused on pushing the boundaries to
improve the products and further develop the
end-to-end workflow. Together, we continue
taking the lead for the future of the All-on-4
treatment concept.”
Throughout 2023, there will be a series of
events to mark the 25th anniversary, including
training courses, webinars and the continuation
of the All-on-4 Centre of Excellence programme,
which awards practices that have distinguished
experience in, and loyalty to, the genuine Allon-4
treatment concept. DA
DENTAL ASIA MARCH / APRIL 2023 11

DENTAL UPDATES
Roland DGA announces key changes to its leadership team
Roland DGA Corporation, a provider of wideformat
inkjet printers, vinyl cutters, 3D milling
machines, and other digital imaging technology,
has announced three key changes to its
leadership team under President Amado Lara.
Dan Johansen has joined Roland DGA as
vice-president of Sales, replacing Lara, who
previously held this position. Prior to joining
Roland DGA, Johansen, a sign and graphics
industry veteran of more than 22 years, served
as US director of Sales and Marketing for
Industrial Printing at Ricoh USA. In his new
position with Roland DGA, Johansen will be
responsible for driving sales and growth across
multiple industries. In addition, as a member
of the company’s senior management team,
he will also collaborate with other members
to create strategy and synergy across
departments.
Sid Lambert, who has been with Roland DGA
for more than 18 years, serving most recently
as US sales manager, has been promoted to
director of Sales. In his expanded role, Lambert
will be responsible for digital print division
sales in North America and South America,
excluding Brazil, overseeing Roland DGA’s
current and growing reseller channel.
Dan Wilson, who has held several positions
at Roland DGA over the last 16 years, serving
most recently as marketing director, has been
promoted to vice-president of Marketing
and Customer Development. In his new role,
Wilson’s responsibilities centre around driving
demand for the company’s product offerings
— overseeing marketing, customer service and
sales development functions to cultivate new
customers and markets. Like Johansen and
Lara, Dan Wilson also serves on Roland DGA’s
senior management team.
“We are extremely excited about these
important organisational changes,” said Lara.
“Johansen brings a wealth of talent and
experience to our existing team, and his unique
perspective will help generate new ideas that
will allow us to expand outside of our current
markets. We’re also thrilled about being able to
promote from within. Both Lambert and Wilson
have been instrumental in helping Roland DGA
achieve its industry-leading position and record
sales in recent years. We look forward to the
future contributions they will make in their
expanded roles.” DA
exocad supports the nonprofit Mini Molars Cambodia
exocad, an Align Technology company and
dental CAD/CAM software provider, donated
€10,000 to the Germany-based nonprofit
Mini Molars Cambodia. A portion of the
donation included proceeds collected during
a charitable T-shirt sales campaign held at the
exocad event Insights 2022 and donations
from exocad employees worldwide.
“This donation will help more than 600
children onto a healthier and happier path.”
Mini Molars began in 2015 with the goal
to help develop a sustainable oral health
programme in Cambodia, targeting
underprivileged children who live in Phnom
Penh and surrounding communities with the
greatest need.
exocad is proud to contribute to this endeavor.
“Young people are among the most vulnerable
populations suffering from oral health
disease,” said Novica Savic, CCO and general
manager of exocad. “We’re glad we can
support Mini Molars’ outreach to those who
have the greatest need for dental care.”
Mini Molars provides dental care at a pagoda
in Phnom Penh that hosts other aid projects
and serves children from schools. Mini Molars
workers also travel with mobile treatment
units to communities throughout Cambodia to
bring dental care to those in need. DA
Mini Molars representatives said the donation
will be used to support the organisation’s work
providing dental care to children in Cambodia
without regular access to dental care.
“We see many children who have been in
chronic pain and unable to attend school
because of dental problems,” said Dr. Ulf
Zuschlag, dentist and founder of Mini Molars.
12 DENTAL ASIA MARCH / APRIL 2023

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TRENDS
HKU Dentistry new jaw surgery
concept is effective in treating
moderate-to-severe obstructive
sleep apnoea
Obstructive sleep apnoea (OSA) is a condition
in which the airway is blocked during sleep. It
may cause multiple occurrences of hypopnea
or apnoea during sleep. If left untreated,
patients with OSA may experience reduced
quality of life and health problems in more
serious cases.
Patients with moderate-to-severe OSA, i.e.,
AHI (apnoea-hypopnoea index) of 15 events or
above per hour, may require surgery to enlarge
their airway if non-surgical treatment such as
the use of continuous positive air pressure
ventilator fails. Surgical treatment of OSA
involves the removal or repositioning of soft
tissues (e.g., tonsils) or advancing the jaw to
expand the upper airway, since patients with
OSA often have smaller or recessed jaws.
Jaw advancement surgery is an effective
treatment for OSA. However, it may change
the facial appearance and the bite, especially
among Eastern Asians who usually have more
protrusive lips than Caucasians. This makes
it harder to perform jaw advancement surgery
without compromising on facial aesthetics.
The research team in the Oral and Maxillofacial
Surgery (OMFS) of the Faculty of Dentistry at
the University of Hong Kong (HKU) recently
conducted a pilot study to measure if a newly
conceptualised jaw surgery technique could
help improve moderate-to-severe level OSA.
The findings of the paper entitled Segmental
mandibular advancement for moderate-tosevere
obstructive sleep apnoea: a pilot study,
now published in the International Journal of
Oral and Maxillofacial Surgery, indicate that
3D surgical planning of the SMA as part of the jaw advancement surgery for patients with severe
obstructive sleep apnoea
this surgery can significantly alleviate sleep
apnoea, and also maintain or even improve the
patient’s appearance.
All the patients involved in the study with
moderate-to-severe OSA showed a 50% or
more reduction in breathing disturbances at
night after the surgery, and 58% of the patients
were considered to be cured, showing no
signs of sleep apnoea.
The jaw surgery technique involves a multisegment
osteotomy of the lower jaw called
segmental mandibular advancement (SMA). It
is a combination of a procedure to upright the
anterior jaw segment to create space and a
procedure to advance the whole lower jaw.
The surgery is done to bring about significant
enlargement of the skeletal airway at the
base of the tongue, as well as an appealing
aesthetic of the face and functional outcome
in the bite.
The lead researcher of the team, Dr Mike YY
Leung, clinical associate professor in Oral and
Maxillofacial Surgery, expressed that this multisegment
jaw correction surgery as adopted
in SMA has been used to correct facial
deformities in Hong Kong for many years, but
their study takes it several steps forward.
“It was the first-ever study to prove that SMA
could also effectively bring improvement in
OSA. The uniqueness of facial features among
the Eastern Asian population was the reason to
use this method, which takes into consideration
the aesthetics and jaw function on top of the
significant airway expansion,” he said.
Twelve patients in Hong Kong with moderateto-severe
OSA, referred by different dentists,
14 DENTAL ASIA MARCH / APRIL 2023

TRENDS
general practitioners, and ENT specialists
were evaluated for this study. They received
SMA as a major part of their jaw advancement
surgery.
AHI, the diagnostic tool used for measuring
the presence and severity of OSA, can be
classified into three categories. Mild AHI
usually entails five to 15 apnoeic or hypopneic
events per hour. Moderate AHI sees 16 to
30 events per hour, while severe AHI records
more than 30 events per hour.
The study found that the surgery helped
improve pre-operative AHI from 42.4 events
per hour to nine events per hour on average in
one year post-operatively.
Surgical success, as defined by a reduction of
the initial AHI by 50% or more, was observed
in 11 out of 12 patients. This implies that
almost all the patients showed a 50% or more
reduction in breathing disturbances at night.
Surgical cure, as defined by an AHI of less
than five events per hour — was also observed
in seven out of 12 patients. Thus, 58% of the
patients were cured after the surgery, showing
no signs of sleep apnoea.
On average, the airway volume was also found
to have increased by 2.8 times after the surgery,
allowing patients to breathe better. These
figures remained constant during the one-year
study period.
There was no incidence of any major
complications in the surgery, thus showing
that SMA is potentially a safe and effective
procedure for patients with severe OSA.
Dr Joan CC Wan, co-investigator of the project,
said the findings of the study are encouraging
since they show significant improvement even
in severe OSA cases as well as consistent
results.
“We believe the pilot study has set a
cornerstone for a larger scale study that can
observe the long-term effects of this technique
and help us compare that with the other
treatment methods for OSA,” said Dr Wan. DA
Pre-operative
Post-operative
The pre-operative and post-operative airway
images, showing a significant increase in the
airway volume after SMA
Research team members (from left) Dr Keira Chen, Dr Jasmine Chung, Dr Mike Leung, Dr Joan Wan and Dr Isla Fu
DENTAL ASIA MARCH / APRIL 2023 15

TRENDS
Artificial intelligence
in dental practice
By Dr Kristina Bertl, PhD MSc MBA
Consistent and flawless home oral hygiene
is the most important element of periodontal
therapy. However, it is also one of the most
difficult aspects to effect positive change
and improve our patients’ behaviour and
attitude. With this in mind, why not try modern
technology?
A group of researchers from Taiwan has
tested the use of artificial intelligence in
periodontal therapy (Shen et al. 2022). As
part of a randomised, controlled clinical trial,
they recruited 53 stage III and IV periodontitis
patients. All patients were given non-surgical
periodontal treatment, the outcome of which
was assessed after three months. The
patients were divided into three groups:
• Control group: No further/additional
intervention
• Artificial intelligence group: For this group,
home oral hygiene was checked on a
weekly basis using a smartphone app and
standardised text messages sent to the
patient based on the result
• Artificial intelligence with personalised
advice group: For this group, home oral
hygiene was checked on a weekly basis
using a smartphone app, but the patient
was also given personalised tips from
a dental hygienist in addition to the
standardised text messages
Three months after non-surgical periodontal
therapy, there were significant differences
between the three groups:
• Both groups that used artificial intelligence
showed better results than the control
group for plaque values, probing depth and
clinical attachment level
• The personalised tips from a dental
hygienist led to even greater improvements
in probing depth and the clinical
attachment level
One weakness of this study was the high
rate of participants who did not complete the
study; only 38 of the 54 periodontitis patients
attended all appointments up to the threemonth
check. Nevertheless, these results
are very interesting, particularly for a modern
dental practice specialising in periodontology.
On the one hand, they demonstrated that
frequent (weekly) checks improves patient
compliance in terms of home oral hygiene
and that better clinical results could therefore
be achieved, but also that the importance of
personal commitment and personalised tips
should not be underestimated. DA
REFERENCE
Shen, K.-L., Huang, C.-L., Lin, Y.-C., Du, J.-K., Chen,
F.-L., Kabasawa, Y., Chen, C.-C., & Huang, H.-L.
(2022). Effects of artificial intelligence-assisted
dental monitoring intervention in patients with
periodontitis: A randomised controlled trial. Journal
of Clinical Periodontology, 49(10), 988–998.
ABOUT THE AUTHOR
Dr Kristina Bertl
graduated from the
Medical University of
Vienna (MUV) in 2010
and pursued MSc in
Periodontology in 2012.
She then achieved her
PhD degree in 2015 and docent status
in 2014. In 2018, she completed an MBA
degree in Healthcare Management. Dr Bertl
is a recognised specialist in periodontology
from Sweden (2021), and published about
80 papers in international, peer-reviewed
journals.

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UNDER THE SPOTLIGHT
Under one roof: A multidisciplinary,
patientcentric
model
The dental profession can be more than
simply providing treatment — it is also
fertile ground for enhancing holistic care
and wellness.
By Agatha Wong
One of Dr Samintharaj Kumar’s formative
childhood memories stemmed from an
emergency visit to a dental clinic when
his sister needed a filling to be done. On
watching the dentist single-handedly manage
the procedure without the help of a dental
assistant or clinic receptionist, the then-12-
year-old Dr Kumar was inspired by the dentist’s
skills and ability to ensure a safe and friendly
environment for his patients.
A few years later, whilst in his late teens, he
was given the opportunity to visit KK Women’s
and Children’s Hospital, where he saw firsthand
children with craniofacial deformities
such as cleft lips, palates, and misshapen
heads. This visit further prompted Dr Kumar’s
desire to make a difference in these patients’
lives through surgery, giving them functional,
normal lives.
And while the doctor eventually attended
dental school instead of medical school, he
was touched by Dr Malcolm Harris, the visiting
professor emeritus from University College
London, to pursue a career in dentistry and,
subsequently, a five-year medical degree at
Royal Free, University College London Medical
School.
Altogether, these experiences formed a vital
cornerstone in Dr Kumar’s path as a dental

UNDER THE SPOTLIGHT
surgeon. According to him, the reconstruction
and refinement of facial appearances provide
him with a great sense of fulfilment:
“I find that my greatest happiness is in
managing patients who are unhappy with
their appearance: they are unable to smile
or function normally or have a regular social
presence. They have poor self-confidence
when they are, for example, at the workplace.
By reconstructing smiles and teeth, I help them
regain confidence and most importantly, give
them a chance to look at themselves in the
mirror, and become truly proud of who they are.”
MORE THAN DELIVERING TREATMENT
Nuffield Dental, where Dr Kumar serves as its
founder and CEO, operates more than 10 clinics
in Singapore. The practices are centred around
delivering a holistic experience to patients,
underscored by a philosophy to “pursue
perfection with commitment to excellence”,
something which stems from Dr Kumar’s
personal work ethos.
“I’m obsessed with accuracy,” the doctor
admitted. “If there is any inaccuracy — whether
by myself or others — I’d want to unpick and
redo it until it becomes perfect. This may take
a bit more time but it is the commitment I give
to all my patients and they understand that my
treatment for them is not over in a single visit.
Until they are eating comfortably, or they are
confidently wearing their smile, then only is my
work considered done.”
joint) disorder, it isn’t sufficient to just give
patients a mouthguard. We seek to rehabilitate
a patient to his regular routine and enable him
to overcome social or psychological factors
that contributed to TMJ pain. At Nuffield Dental,
I have developed a holistic dental care regime
that comprises of physiotherapists/massage
therapists, cognitive behavioural therapists, and
wellness consultants.”
Another focal point of delivering a heightened
patient experience is the adoption of specific
technologies that enhance treatment
outcomes. To that end, Dr Kumar shared his
enthusiasm on using Osteopore on its own
rather than with both membrane and particulate
bone graft material — as part of a general trend
for more non-antigenic, -animal, or -human
materials that will reduce the possibility
of rejection and inflammation.
“I’ve used Osteopore in a patient’s
maxilla for reconstruction of atrophic
upper jaws. When we looked at
the final result of the patient on
the lateral profile view, it appeared
that Osteomesh had increased
the projection of the base of the
nose — which gave more fullness
to the upper lip. That was a very
welcomed advantage of using
Osteomesh in the reconstruction
of the atrophic maxilla during our
All-On-4 treatment, which strives to
give patients teeth in a single day.”
Indeed, for Dr Kumar, "good treatment" is
defined as completing the works which the
patient wants; "better", on the other hand, is
providing something beyond the patient’s
expectations. And the "best" is when the patient
feels that their lives have changed as a result of
the procedure.
A core component of the latter aspect is
ensuring patient well-being through a holistic
and customised treatment experience. On
Nuffield Dental’s website, a section for sedation
and relaxation techniques are explained to
patients who might struggle with pre-procedure
anxiety.
Beyond that, Dr Kumar also raised another
example where patient wellness is key: “To
manage pain due to TMJ (temporomandibular
DENTAL ASIA MARCH / APRIL 2023 19

and their brands through the services
they provide and the products they use.
Nuffield Dental is no exception. In this
regard, it is perhaps more prudent to
view the practice through a business
lens, and how they have approached the
needs of patients as consumers with
demands.
“I don’t just want to give a patient a
crown — it would not be satisfactory.
We only want to give our patients dental
laboratory products that are made in
Singapore. Hence, the crowns used are
designed and produced right here in
our own laboratory; it costs us a lot of
money to maintain but gives us a high
assurance of the quality of component
products used,” shared Dr Kumar.
AI AS AN ENHANCEMENT
When it comes to enhancing treatment
outcomes, artificial intelligence has
become a hot topic of discussion. And
on that front, Dr Kumar retains an open
mind towards the use of AI in the future
of dentistry. In his opinion, AI can be
tapped into for the provision of better
patient care, especially where dentists
might be limited in making further
diagnoses.
“For example, if you observe a lesion,
you take a photo and upload it to an
AI programme that can suggest what
type(s) of lesion it could be. Such packet
recognition of a huge database can help
clinicians derive a diagnosis. So yes, it is
important that dentists are well-trained
to make a spot diagnosis but if they
cannot do so, AI can help.”
He further added instances where AI
can lend a helping hand: in radiographs
and x-rays where hypocalcifications or
potential areas of decay can be identified;
to simple things like brushing, where
the amplitude of the swing and the
amount of pressure to be used can be
ascertained for a better cleaning cycle.
Further, with the advent of technology,
which has enabled the common man
access to an expansive library of
information, patients may also come
to the clinic with questions on esoteric
conditions that dentists might have
forgotten or not know about. The use
of AI can thus broaden the dentist’s
repertoire of knowledge, boosting
patient confidence. This forms part and
parcel of any dentist or clinician’s path
towards success, especially if they are
have just taken the first steps in their
career.
A STRONG PRESENCE BEYOND
PRACTICE
For the practice’s efforts, Nuffield Dental
has been ranked among Singapore’s
fastest growing companies from
2017 to 2020. This road to recognition
had not been easy — with intense
competition in the realm of cosmetic,
aligner, and implant dentistry, practices
are finding ways to define themselves
In addition, Dr Kumar highlighted the
importance of customer service. Though
it was initially a challenge introducing
hospitality to his staff, he stood firm
alongside what his personal interest, and
was able to shape a team that delivered
a cohesive experience for the brand and
its virtues.
Understanding the anxieties and needs
of patients due to the COVID-19
pandemic, Dr Kumar also launched the
ORASYL povidone-iodine mouthwash,
which contains 1% of the eponymous
chemical that reduces the viral burden in
the oropharyngeal region. Subsequently,
the SURGISYL line of surgical masks
was also created — first for clinicians,
then for their patients, and eventually for
the public. These developments which
tap into complementary markets have
allowed Dr Kumar and Nuffield Dental to
establish its presence in Singapore, and
possibly further into the region.
“In the next five to 10 years, I am looking
forward to achieving greater growth for
Nuffield Dental. We want to cater to
patients who seek access to premium
healthcare and technology; it will establish
us as a luxury brand in dental care. We
will take Nuffield Dental regionally and
set up flagship clinics in major cities
throughout South East Asia.” DA
20 DENTAL ASIA MARCH / APRIL 2023

DENTAL PROFILE
Optimising dental scanning
process with Scanningspray
Specialised in scanning sprays for 3D dentistry, Scanningspray aims to
contribute to higher scan quality and results with their products. But what
makes their scanning sprays effective? Dental Asia finds out more from
Prof Dr Sebastian Gell, co-founder of Scanningspray.
By Amira Yunos
The Scanningspray is a team of specialists with
backgrounds in 3D scanning sector and aerosol
development, aiming to simplify complex
digitalisation process. They offer a range of
solutions to make the scanning process easier
and more accurate.
objects or objects with deep pockets such as
telescopes, brackets or occlusal and dental
splints in the first place. Therefore, our selfcleaning
scanning spray can contribute to the
trend of digitalisation in the dental field in the
future.”
Bringing their specialisation to the dental
industry, the company launched the SCANTIST
3D product line developed for extraoral
applications in dental laboratories.
DENTAL SCANNING SPRAY SOLUTION
The SCANTIST 3D dental spray comes in both
vanishing and permanent sprays to address
varying needs of the user. The coating of the
spray improves the measurement properties
of tooth models, plaster casts, preparations,
stumps and impressions.
It forms a homogeneous and fine, white matting
layer on objects to avoid any reflection and
precisely scan the model — without affecting
the fine details in geometry and surface. Both
the vanishing and permanent sprays are free
Prof Dr
Sebastian Gell,
Scanningspray’s
co-founder
The Scantist 3D
vanishing single can
with nozzle
The Scantist 3D
permanent spray
of titanium dioxide (TiO2), which can cause
respiratory irritation.
Prof Dr Gell said: “Unlike all other sprays used
for matting glossy or reflective surfaces, our
vanishing spray disappears completely by itself
after application. This eliminates the need for
subsequent cleaning and is a significant step
towards a clean dental laboratory. We have
minimised the layer thickness so that dental
laboratories are able to generate reproducible
results in the 3D scan.”
In addition, SCANTIST 3D dental spray uses a
unique valve with a fine nozzle that is beneficial
for precise and efficient application to smallest
parts.
As the dental sector continues to be more
digitalised with integrated workflows, 3D
scanning and 3D printing will play an important
role for dental laboratories in the coming years,
according to Prof Dr Gell.
He said: “Scan sprays improve the scan quality,
and enable the scan of transparent, reflective
TAPPING ON GROWTH POTENTIAL
Scanningspray is poised to change and shape
the dental scanning spray industry in the dental
computer-aided design (CAD) / computer-aided
manufacturing (CAM) field while significantly
raising the quality level of scan sprays.
The 3D printing market will continue to grow in the
Asia-Pacific region. As Prof Dr Gell added: “The
APAC market has an extreme growth potential
and we want to participate in it. For us, trade
shows are important, but also the cooperation
with reliable, long-term oriented partners and
resellers who serve the local market for us.”
Today, the company has a network of 22
distributors and 106 resellers in different parts of
the world since its founding in 2019.
“Customers were convinced of the unique value
propositions of our products. This allowed us to
grow quickly and expand our reseller network,”
said Prof Dr Gell.
Five to 10 years down the road, Prof Dr Gell
hopes that their consumer products will become
the standard products in dental laboratories
worldwide. “SCANTIST 3D will have established
itself as a brand and become the market leader
for 3D scanning consumables in the dental field,”
he said. DA
DENTAL ASIA MARCH / APRIL 2023 21

DENTAL PROFILE
Same-day dentistry made
a reality by Ackuretta
With 3D printing, dental models, surgical guides, and even
dentures can now be fabricated faster than ever. By ensuring
consistency, accuracy, and quality in every print, dental
professionals can rely on Ackuretta to provide premium yet
accessible 3D printing solutions.
The Taiwan-based company Ackuretta
is a global manufacturer of 3D printing
solutions for dental professionals. Its
plug-and-play solutions bring the world
of additive manufacturing and sameday
dentistry to its global network.
But how do these technologies and
advancements become available on
the market? What happens behind the
scenes?
Thomas Wu, chief technology officer
(CTO) of Ackuretta, answers these
questions and elaborates on how 3D
printing has become what it is today.
What does your role of CTO entail?
Wu: My job is to understand and gather
as much information as possible on the
technology currently on the market, as
well as on consumers and end users.
Before we start to design a product,
the first step is to know what we are
going to deliver. For example, a cost
target and a time target. I am given
certain requirements, and then I have
to find suitable technologies. I must
then combine them and put all that
technology into our machine. And I must
make sure that the machine provides a
solution to our customer’s problems.
For the final product, the key is not
the design but how to integrate all the
necessary elements. The different
engineers are in different fields —
mechanical, firmware, and electrical.
They are focused on their field and I
have to connect them to give them a
suitable target based on our products.
If we need to add a motor to our printer,
for example, I have to study how many
kinds of motors are available, and what
each one can do. We could look at
performance, price, reliability, and more.
There are a lot of criteria, and I have
to make a decision based on certain
conditions.
Ackuretta is innovative — that is one
of the company’s core values. How do
you embody that from a technology
perspective?
Wu: With all products on the market,
roughly 80% of the technology is
comparable — all products have almost
the same function. But we put different
22 DENTAL ASIA MARCH / APRIL 2023

DENTAL PROFILE
details on it. Those details will make
those machines unique and different
from others. One of the things that set
us apart is the overengineering of our
products, for example with the z-axis.
I focus on our machine’s reliability
because it is for the dental industry.
If they have an urgent task and their
machine is broken, they will have trouble
and will lose their case. Long life and
reliability are unique features that set
us apart. To build this kind of machine,
we need to consider some technology
or details more than others. It is more
about engineering than technology —
but that is still my responsibility. I need
to ensure all the product quality is the
same.
Other than reliability, are there other
areas of focus that set Ackuretta apart?
Wu: We put a lot of effort into ensuring
that the accuracy is as high as possible.
With 3D technology, printing is the
goal — but from a dental perspective,
dimension accuracy is crucial. A
patient’s mouth is very sensitive. For
instance, if there is hair in your mouth,
you can feel it. And the size of a hair is
only 100 microns (0.1mm). So, we need
to make sure our product accuracy is
less than 100 microns. The size you
design and the size you come up with
must be very close — less than a 0.1mm
difference.
next products, we will consider those
requests.
How long does it usually take to
develop a new product?
Wu: Usually, from start to finish, we need
one year. But the loading throughout
the year varies greatly. The first three
to six months are the most important.
They are spent mostly on planning,
evaluating, designing, simulating,
coding, and more. In those first six
months, there is almost no output — but
the key here is not output, but rather
to ensure that we are not going or
choosing the wrong way; and come up
with a low-risk plan.
Part of the conceptualisation includes
looking two to three years ahead and
ensuring that our design will be suitable
then. We don’t want it to be irrelevant
to the market after a year. Hardware is
difficult to upgrade, whereas software
is much easier to upgrade. So, we must
ensure that the hardware will still be
suitable for the market. The last six
months are to run reliability tests, then
if we need to modify anything or make
adjustments, we can do that, and then
launch two to three months after that.
What has changed or progressed the
most in the past 10 years in terms of
technology?
Wu: The basic technology is no different
than what has originally developed 30
to 40 years ago when it was known as
prototyping. It was owned by global
companies that handled the basic
patent — which meant that no one
could make a 3D printer without being
licensed by the company’s patent.
Ten years ago, the patent expired,
and everyone started making their 3D
printers.
How do you incorporate customers’
feedback in designing and building a
product?
Wu: Our customer support team has
a very close relationship with our
customers. They help them if they have
any questions, and give them solutions
to their problems. Once a month,
we have a meeting with the support
team. They update a data sheet with
all the problems that customers have
had. Some problems are due to user
error, and some are due to machine
issues — they will discuss which
issues are most urgent or serious.
We will get new requests and new
specifications, and then when
we start to design or plan our
DENTAL ASIA MARCH / APRIL 2023 23

DENTAL PROFILE
At this time, business people were
very clever, they created a marketing
word called “3D printing”. The idea was
that people would easily understand
this term — “3D” meant a solid, not
just a flat shape; and “printer”, rather
than “machine”, was a familiar term.
Everyone knew how to set it up and
how to use it. People would therefore
think that 3D printing was something
easy to use, and would be easy to
create something. Since then, many
new printers have been designed and
sold. The most different element of 3D
printing today is engineering. There is
new technology and components for
the manufacturer to come up with —
they can make the components more
efficient and reliable — but 3D printing
remains, in essence, the same.
What can you share about AI
integration?
Wu: In 3D printing, a lot of knowledge
must be gained, such as model design,
software, set-up and orientation, and
post-processing. Users need to ensure
that each detail runs smoothly to get a
good result. Otherwise, they will have
a problem with the final output. So,
we try to minimise the learning curve
by incorporating AI. For instance, the
slicing software. If the users don’t
know how to orient the model or build
supports, the printer can still print, but
the result will have problems. So rather
than spend a lot of time educating them
on using the technology, we integrate AI.
For them, 3D printing is a tool. If it is too
complicated, they don’t want to try it.
What is your outlook on 3D printing in
the coming years?
Wu: I would say that 3D printing will
not see remarkable changes in the next
few years, but in the future, there will
be more and more areas in which 3D
printing can be used. And the key is
the material. If more materials come
out, which are at a lower cost and with
better material performance that can
compete with the current manufacturing
process, then 3D printing can be applied
in more fields. The resin is the key,
especially in dental applications, where
the final product goes into the patient’s
mouth. You want to make sure it will
not damage your health — there are lots
of certifications to make sure that it
will not harm the human body. The
resin development is therefore more
important than the machine.
To have a suitable dental product
from 3D printing, we have to handle
three things: machine, material and
software. Usually, the CEO or the
CTO will think of something more
high-end. But I feel that I cannot just
develop a product that I want, because
everything starts with the customer.
You can develop an excellent product,
but if many don’t need this kind of
product and the market doesn’t accept
it, then it’s nothing for the company.
There is no best technology, only the
most suitable. New technology does
not always equal the best. DA
24 DENTAL ASIA MARCH / APRIL 2023

Simplifying the complex challenge
Case Gallery
As of today, iTero TM scans have been used in more than 12.6 million restorative case scans, including crown, bridge
and custom implant cases*. iTero scanners have been helping to simplify the workflow of many complex cases.
In this edition of the Simplifying the complex challenge, we are showcasing complex restorative cases by
Dr Niraj Kinariwala (India).
Full mouth rehabilitation: Implant supported upper denture
Dr Niraj Kinnariwala
White Dental Lounge, India
Chief complaint
Patient complained of loose upper teeth and difficulty in chewing
Medical history
The patient had a history of cardiac arrest 10 years back and has hypertension
Patient was on anti-hypertensive drugs and blood thinners.
Pre-treatment antibiotic coverage was given and with consent of his physician, blood thinners were skipped for 2
days prior the treatment. Dental history- The lower denture was fabricated by his previous dentist 8 years ago and is
implant supported fixed prosthesis
Initial examinations and diagnosis
Chronic periodontitis leading to periodontally compromised upper teeth owing to multifactorial reasons such as age,
medication and traumatic occlusion owing to compromised teeth as a contributing factor
Treatment plan
Extraction of all upper periodontally compromised teeth and placement of 4
implants followed by delivery of implant supported denture.
Initial scan
Frontal view Right lateral Left lateral
Before restoration
After restoration
Treatment progress images
Digital mock-up Scanbody image
Scanbody scan
Treatment workflow
• [Initial consultation]
Following consultation, initial scan was taken with iTero TM
intraoral scanner and the posterior bite from the initial scan was
used to establish tentative vertical dimension on exocad TM
• [Extraction and implant placement]
Extraction of upper periodontally compromised teeth from 17 to
27 followed by immediate placement of 4 implants (All-on-4) with
multi-unit abutments was carried out.
• [Digital mock-up and Provisional]
Exocad software was used with iTero scan to create the digital
mock-up and it allowed patient to visualise the final outcome of
the restoration. The provisional was 3D printed and delivered
after 24 hours post minor adjustments, and the patient was
asked to wear the denture for the next 6 months to ensure
comfort before delivering the final denture.
• [Post osseointegration]
Post 6 months, the stability of the implant was ensured, and
intraoral scan bodies were screwed on and iTero scan was taken
for fabrication of implant-supported fixed denture
• [Final restoration]
Delivery of implant-supported fixed denture.
View more complex
restorative cases
Contact us for
more information
Conclusion
• Pre-treatment scan served as a communication starter during
the initial consultation appointment and helped explain the
patient the treatment plan.
• Occlusogram tool helped explain the patient understand existing
trauma from occlusion owing to upper compromised teeth acting
as a contributing factor and the need to replace periodontally
compromised teeth.
*Data on file at Align Technology, as of June 30, 2022.
Invisalign, the Invisalign logo, iTero, the iTero logo, among others, are trademarks and/or service marks of Align Technology, Inc.
or one of its subsidiaries or affiliated companies and may be registered in the U.S. and/or other countries.
© 2022 Align Technology, Inc. All rights reserved.

CLINICAL FEATURE
Next generation synthetic
graft materials: Clinical and
scientific review
Prof Dr Peter JM Fairbairn elaborates on the use of synthetic graft material in
dentoalveolar bone regeneration.
In the last 20 years, there has been a
dramatic increase in the use and research in
new synthetic or alloplastic particulate graft
materials (Fig. A) as seen in the author’s own 2
and other 1 research. Interest in synthetic
graft materials all started in 1892 when
Dreesman first used calcium sulphate (CS) in
femur fracture repair. This is where the bulk
of the work and research is still being done
today by our medical colleagues.
In this article, we will look at its dentoalveolar
use where the author has done over 7500
grafts in a 22-year period. There are many
different synthetic materials used as
particulates; initially CS was used but now
the most popular material is beta-tricalcium
phosphate (BTcP) with over 300 new papers
per annum in research. Whilst there are
many other materials such as hydroxyapatite
(HA), silicates and polylactides, most of the
work done by the author has been with the
first two materials i.e., CS and BTcP, which we
will concentrate on here.
effect. The CS then resorbs at three to four
weeks, and this creates space for further
neovascular ingrowth resulting in improved
angiogenesis. But the BTcP is the main
reason for the up-regulated host healing. The
shape size and porosity of the particles is of
great importance as seen in the work of De
Groot in 1985. This dramatic up-regulation
of host healing is noted by measuring
osteoprotegerin (OPG) in research 7 .
Our studies, both animal 5 and clinical 6 have
shown over 50% new bone at 10 weeks with
only 10-12% residual graft material. It is also
well documented that all calcium phosphate
materials have an osteoinductive potential
with BTcP showing greatest potential of
them all.
The stability given to the graft by the CS
element changing from a hemihydrate
to a dihydrate form enables it to be used
without membrane hence the term “true
bone regeneration”, optimising the immense
benefits of the periosteum, as well as the
blood supply it brings.
The next thing was to develop predictable
protocols for these materials to enable 99%
success in outcomes and to assess the longerterm
results which are again stable as the
material has been turned over to the host
bone. These materials are used in all aspects of
dentoalveolar surgery, socket grafting, buccal
defect repair, sinus augmentation, periodontal
bone repair, peri-implantitis bone repair, cyst
site repair and more.
In 2012, work was done on the development
of similar but improved material, EthOss
(65% BTcP and 35% CS) (EthOss Regeneration
Silsden, UK) which has better handling
properties. A 10-year study of 600 grafts
using these two materials was published in
2015 4 .
The key in both materials is the BTcP element
as the CS only provides a short transitory
role of stabilising the material and providing
the barrier function as well as improving the
soft tissue healing and having a bacteriostatic
Fig. A
26 DENTAL ASIA MARCH / APRIL 2023

CLINICAL FEATURE
CASE REPORT
A 55-year-old male, non-smoker, nondiabetic
who is a medico legal lawyer, was
referred for implant placement at the upper
left second premolar (25) site. The tooth was
very mobile and had severe periodontal bone
loss as well as suppuration on compression
(Fig. 1). A radiograph (Fig. 2) of the site
showed extensive bone loss and clearly the
tooth needed to be removed, which was
done easily under local anaesthetic (Figs. 3ab).
At this visit, a 4.3mm wide drill (Anyridge,
Busan Korea) was placed in the site to show
the extent of the bone loss (Fig. 4). The site
was then allowed to heal for four weeks
following the authors published protocol 4 , to
allow for soft tissue healing but prior to hard
tissue modelling.
Four weeks post extraction (Fig. 5), we now
see the soft tissue healing. We then raised a
flap, but as this case was done four years ago,
the protocol now is to extend the incision
to the adjacent papilla when bone is lost on
adjacent teeth. This is more of an issue on
tooth 26 as with bone loss on the molar, the
tissue is mobile. But we now see extensive
bone loss in both buccal and palatal, and the
granulation tissue is moved out of the socket
using a curette (Fig. 7). The granulation tissue
was left attached at the palatal side (Fig. 8).
The socket site was then further cleaned
with degranulation burs (EthOsS, Silsden,
UK) until clean and the bleeding bone is seen.
Then, a shallow osteotomy was made in the
optimal position for the future restoration,
thus not too palatal as the site will be grafted
(Fig. 9). This shallow osteotomy was dictated
by the reduced bone in the site which is
clearly seen on the radiograph (Fig. 10) which
also shows the bone loss on the adjacent
teeth.
The palatal defect site was then grafted
with a wetter mix (as per manufacturer’s
instructions) of EthOss, which was mixed in
the delivery syringe after half of the 0.5cc
was removed and put in a sterile bowl to be
Fig: 1: Periodontally involved tooth 25
Fig. 2: Radiograph
showing extensive
bone loss
Figs. 3a-b: Removal of the tooth and the socket site
Fig. 4: Radiograph
showing extent of the
bone loss
Fig. 5: Soft tissue healing four
weeks post extraction
Fig. 6: Flap raised exposing the buccal and
palatal defects
Fig. 7: Removal of granulation tissue by curette
Fig. 8: Granulation tissue removed but left
attached at palatal side
Fig. 9: Approximately 1-2mm osteotomy made to
floor of the sinus.
Fig. 10: Osteotomy shown on radiograph
DENTAL ASIA MARCH / APRIL 2023 27

CLINICAL FEATURE
used later. Into this wet mix, the Anyridge
3.5x11.5mm implant (Fig. 11) was then placed
with very low primary stability because
of the shallow osteotomy. The remaining
EthOss is then mixed with saline, but now
a minimum was used to create a “drier” mix
which is then applied over the site and a
dry gauze is placed over the material. Thus,
it was held by the assistant for 3-5 mins to
allow for the setting of the graft.
Once set, the granulation tissue was then
placed over the graft to improve soft tissue
healing (Fig. 12). The flap was sutured
closed using 4.0 PTFE, Coreflon (Coreflon
Poznan, Poland) suture. This procedure with
the granulation tissue is not the routine
protocol, but a one-off for this case and has
been used occasionally over the last 15 years.
Radiographically, the site looks well grafted
(Fig. 13) but remember as the CS element
resorbs, the x-ray will look less “white”.
Fig. 11: Insertion of Anyridge implant 3.5x11.5mm
into the “wet” EthOss
Fig. 12: Drier mix of EthOss, placed over the
implant and the granulation tissue placed over
the site
Ten weeks later and the site is now ready to
be restored. We see a healthy site, but we
have recession on tooth 26 (Fig. 14), possibly
a better flap design would have reduced
this. Radiographically, the material has
now turned over to host bone (Fig. 15) and
as stated, human bone does not show that
well radiographically especially on the early
phases as the organic component is not
radiopaque. Thus, it appears that the area
distal to the implant shows reduced bone
but in fact this will improve. A stock healing
cap was then fitted and a week later the site
was ready for an open tray impression (Fig.
16) with a restored profile.
Fig. 13: Radiograph showing implant in EthOss
grafted site
Fig. 14: Ten weeks post-op
One year later, we see the improved
outcome radiographically (Fig. 17). The distal
area is now looking well regenerated as the
new bone and periodontal ligament on the
first premolar. Clinically, the site is adequate
(Fig. 18) and will continue to be so. By now,
all the graft material would be resorbed, and
the new host bone will ensure good attached
host keratinised soft tissue. The site was
then scanned using a CBCT to assess the
area of teeth 26 and 27. At 18 months, we can
see bone regeneration both on the palatal
and buccal sides of the implant on tooth 25
(Fig. 19).
Fig. 15: Radiograph at 10 weeks post-op
Fig. 17-18: One year follow up showing good signs of healing
Fig. 16: Ready to load at 11 weeks
Fig. 19: CBCT scan at
18 months showing
new bone regeneration
28 DENTAL ASIA MARCH / APRIL 2023

CLINICAL FEATURE
Fig. 20: Three years follow up, tooth 26 was
removed showing mature bone at tooth 25 site
Fig. 21: Socket graft of the tooth 26 site
Fig. 22: New bone
At the three years follow-up, it was
decided to remove tooth 26. A flap was
raised showing the mature bone of the
grafted 25 site from the prior procedure
(Fig. 20). The site of tooth 26 was then
socket grafted, again with EthOss (Fig. 21)
for future placement of another implant.
At 10 weeks, the site had regenerated new
host bone (Fig. 22). An Anyridge implant
was then placed with a small internal
sinus augmentation (Figs. 23-24).
CONCLUSION
The ability to dispense the need of using
a membrane as well as the up-regulatory
effect of the synthetic particulate graft
materials enable the host to regenerate
host bone more effectively. This results
in improved outcomes faster and patient
pain reduced due to biocompatibility.
After over 22 years of daily usage of
the materials and surgical protocols,
there appears to be potential although
more research is needed to see how this
potential can be further enhanced. DA
REFERENCES:
1
Bohner M Bastien L et al B-Tricalcium
Phosphate for Bone substitution: Synthesis and
properties. Acta Biomateriala, 113 (2020) 23-41,
Elsevier.
2
Cheah CW, RamanR, Fairbairn P, Ngeow WC et
al., Synthetic Material for Bone m Periodontal
and Dental Tissue regeneration; Where are we
now and where are we heading next? Materials
(Basel). 2021 Oct15;14(20):6123. Dos: 10.3390/
ma14206123
Fig. 23-24: Implant placement and graft
3
Leventis M, Fairbairn P, et al., Biological
response to Beta-tricalcium Phosphate/
Calcium Sulphate synthetic graft material: an
Experimental study; Implant Dentistry, 2014 Feb
;23(1037-43. Dos 10.109/id. 0000000000030
PMID 24384743
4
Fairbairn P, Leventis M. Protocol for Bone
Augmentation with Simultaneous Early Implant
Placement: A Retrospective Multicenter Clinical
Study. Int J Dent. 2015, 2015, 589135
5
Leventis M, Fairbairn P et al., Bone healing
in Rabbit Calvaria Defects using a synthetic
Bone substitute : A histological and Micro CT
Comparative Study. Materials (Basel) 2018 Oct
17;11(10): 2004. Dos 10.3390/ma11102004
6
Fairbairn P, Leventis M, Mangham C et al.,
Aleolar ridge preservation using a Novel
Synthetic grafting material: A case with 2 year
follow up; Case Rep Dent.2018, 641280
7
Mohammed Ali Saleh et al., Biological Impact
of Alloplastic Bone Graft vs Bovine Xenograft
and allograft materials in Bone Healing; An
Experimental study, J of Contemporary Dent
Practice 2022-23(5) 482-491, 10.5005/jpjournals-10024-3337
ABOUT THE AUTHOR
Prof Dr Peter
JM Fairbairn is a
visiting professor
at the University of
Detroit Mercy school
of Dentistry and
has placed dental
implants for 33 years at the Scarsdale
Dental Clinic, Kensington, West
London. He is an honorary life member
and past director of the ADI (UK) as
well as past president of the London
Dental fellowship. He has worked
in the development and research in
synthetic graft particulates for over 20
years, publishing many articles as well
as chapters in three books and nine
PubMed publications. Dr Fairbairn has
lectured in over 50 countries and many
national podiums.
DENTAL ASIA MARCH / APRIL 2023 29

CLINICAL FEATURE
Using occlusion technology
to simplify and improve
functional risk assessment
Dr Lee Ann Brady discusses how dental occlusion technology provides insights
and data-driven results that can offer clinicians a more complete picture of a
patient’s temporomandibular joint and how it contributes to temporomandibular
disorders.
Occlusion is subject to scrutiny and
disagreement perhaps like no other facet of
dentistry. Historically, dentists typically have
not assessed occlusion risk at the front end
of treatment. Occlusal symptoms largely are
dealt with after patients have developed pain
or dysfunction for one reason or another.
Possible explanations for this can be
complex such as a lack of emphasis in
early training or dental school; difficulty in
visualising or predicting occlusal disease
and relationships to the temporomandibular
joint (TMJ); inadequate education or scarce
widespread acceptance in the dental
community; difficulty applying occlusal
tools; and determining which patients would
benefit most from occlusal interventions.
Currently, modern occlusal analysis
technology may be leveraged that not only
can transform patient care and improve
long-term dental health, but also enhance
the dentist’s professional satisfaction.
Occlusal analysis is a valuable tool that can
be implemented when dentistry does not
work as expected. If restoration fails for
no explicable reason, or a patient presents
with increasing discomfort and jaw pain
with no obvious contributors, the science
of “how teeth touch” becomes the pathway
to alleviating the patient’s pain and enabling
lasting dental function. Modern-day dental
occlusion technology includes innovative
tools such as joint vibration analysis (JVA),
digital articulating paper, digital articulators,
digital jaw tracking, intraoral scanning,
and others that are on the cutting edge of
dental science. Predictable success is more
achievable when dentists who are motivated
to use their skill in occlusion leverage the
right tools in the most appropriate situations
to improve their patient’s quality of life.
ANALYSIS OF TEMPOROMANDIBULAR
JOINT DISORDERS
Restorative dentistry allows dentists to
simultaneously elevate a patient’s oral
health along with aesthetics. This includes
the somewhat complicated endeavour of
evaluating and managing a patient’s occlusion.
Patients who display heavy wear on past
restorations may also feel emotional distress
related to physical discomfort, their past
experiences with dentistry, and how they
think they are viewed as a dental patient.
Patients may present having lived with
long-term discomfort and pain associated
with occlusion-related diseases and TMJ
dysfunction and a sense that their issues are
undetectable or untreatable. However, an
array of occlusion tools is available to guide
advanced patient care and improve outcomes.
Temporomandibular disorders (TMDs) are
characterised by reduced jaw movement
and hyperalgesia or clicking noises
regionalised to the jaw joint, specifically
the area near the external part of the ear
(Fig. 1). In evaluating the history and future
of TMD diagnosis, Ohrbach and Dworkin
noted the importance of considering the
biopsychosocial aspect of TMD disorders,
particularly how patients make sense of
and seek treatment for chronic pain 1 . They
also identified TMD as having a population
prevalence of 10-15% and explained that
it is often quite difficult to associate a
physical finding with the source of the
Fig. 1: Palpating the patient for joint sounds
indicating TMJ changes
30 DENTAL ASIA MARCH / APRIL 2023

CLINICAL FEATURE
pain. JVA is a tool used for the diagnosis of
TMJs that has advanced in its efficacy and
clinical reliability. JVA uses accelerometers
and amplifiers to assess the motion and
friction of joints and assumes that healthy
biomechanical relationships demonstrate
hardly any vibrations.
Due to the variability of TMJ sounds,
however, the validity of JVA has been called
into question. A 2017 study by Sharma et al.
analysed the reliability and diagnostic validity
of JVA for bilateral disc displacement by
comparing JVA output variables to magnetic
resonance imaging (MRI) evaluation with a
radiologist. From a group of 36 participants
with a mean age of 39.03 +/- 13.6 years
(21 with normal joints versus 15 having
disc displacement with reduction), the
researchers recorded maximum unassisted
openings and lateral deflections, as well as
the vibrations of the condyles as the mouth
opened and closed. These JVA tracings
were compared to previously recorded MRI
images by blinded clinical examiners. The
researchers concluded that a JVA composite
score could be used with “acceptable levels
of sensitivity and specificity” to differentiate
between normal and displaced discs.
JVA may soon face competition from
incoming dental ultrasonography (known
as “ultrasound”) technology, which was
recently patented and given FDA market
clearance as a class II medical device.
Significant challenges of implementing
ultrasound technology in the dental practice
include dentists’ unfamiliarity with reading
an ultrasound image and the digital interface
being made more amenable to diagnostic
interpretation. Ultrasound technology
is based on the principle of how fast an
ultrasound device emits high-frequency
pulses that allow clinicians to visualise
tissues safely and effectively. In dental
research, ultrasound has been tested for
purposes as wide ranging as the detection of
carious and soft-tissue lesions, the diagnosis
of TMDs, and assessment for implant
dentistry.
MRI is the current gold standard for
visualisation of inflammation in the TMJ
but is limited by factors such as cost, time,
the need for radiologist expertise, and
the inability to use it with patients who
have metallic elements in their bodies. In a
literature review, Marotti et al. determined
that TMD diagnosis had ultrasonography
accuracy of “54-100% for diagnosing disk
displacement, 56-93% for osteoarthrosis,
and 72-95% for joint effusion” with
operator-dependent results. The authors
indicated that operator training was the
most significant shortcoming. They also
noted that studies have analysed the use
of ultrasound for TMD injection guidance,
internal derangement detection, and
assessment of increased capsular width.
Greater frequencies may be necessary to
improve the accuracy and sensitivity of
ultrasound for dental purposes. Overall,
however, oral cavity soft-tissue imaging is
increasingly becoming a “simpler” reality.
Devices are being introduced that provide
ultrasound probes designed for the oral
environment, and new visualisation systems
are being used to guide new users in
diagnostics.
DIGITAL JAW TRACKING FOR
VISUALISATION OF TMJ MOTION
While occlusal diagnosis has benefited
from advances in imaging technology, a
related area of occlusion technology is also
improving digital jaw tracking or jaw motion
tracking (JMT). Applying information
related to the movement of the mandible
can simultaneously frustrate and delight
dentists who seek to bring their patients
into greater comfort through restorative
dentistry. By bridging the initial occlusal
diagnosis with the later application of
occlusal analysis via an articulator, digital
jaw tracking acts as the missing piece that
enables dentists to translate more accurate
information about the true hinge axis point
location to a virtual articulator than what is
usually possible with a traditional facebow
(Fig. 2).
In 2019, Kwon et al. described a digital
approach to jaw tracking using a 3D optical
scanner and target tracking system, which
merged cone-beam computed tomography
(CBCT) data for clearer simulation of the
TMJ and mandible4. The researchers
scanned the oral cavity in maximum
intercuspation with a structured-light 3D
facial scanner. The data captured from this
scan was then placed in alignment with
CBCT STL data and dental cast scan data
to provide a more realistic recreation of
the patient’s TMJ and mandible movement.
With this data, they were then able to use a
facial scanner again to track the movement
of the mandible in real time. This technique
was designed to use a target sticker placed
on an anterior tooth’s labial surface. Novel
digital methods like this one can vastly
improve hinge axis recording.
In their 2017 case report, Aslanidou et al.
used dynamic jaw tracking to fabricate
an occlusal splint for a patient with a
TMD. JMT that could capture the range
of mandibular movement was also
combined with CBCT data in this case, as
was information gained from an optical
impression. The researchers used a JMT
system that converts acoustic signals to
spatial information. The combined system
measures all mandibular movements,
including chewing, left and right
lateralisation, and more. This occlusal
analysis solution enables clinicians to
analyse limitations of dysfunction in the
movement of jaw and teeth and joint space
changes. Digital jaw tracking provides
the guidance and insight necessary for
clinicians to truly visualise a patient’s
anatomy in action.
Fig. 2: Measuring the maximum opening distance
to assess patient’s jaw range of motion
DENTAL ASIA MARCH / APRIL 2023 31

CLINICAL FEATURE
BRINGING DIGITAL ARTICULATOR
TECHNOLOGY TO OCCLUSAL
ANALYSIS
Occlusal analysis and restorative
dentistry are highly dependent on
mechanical articulators (Figs. 3-4).
But as digital dentistry becomes
more prolific and dental scanning
and milling easier to use, demand
for digital articulation systems
has grown. In a 2020 study, Yau
and colleagues noted the need
for improved virtual articulator
mathematical modelling and
verification of model accuracy. To
verify digital articulator accuracy,
they developed an optical tracking
method and analysed their digital
articulator system and found that
their device had sub-millimetre
control.
A technique published by Kim et
al. in 2020 used the patient’s CBCT
data for occlusal plane reproduction
alongside data gathered from a
digital articulator. They developed
this technique because of the
difficulty, patient discomfort, and
time-consuming nature involved in
a facebow transfer and stone cast
mounting to a mechanical articulator.
The researchers used an industrial
scanner to scan a mechanical
articulator, obtained CBCT data,
and then imported the two sets of
data together to assess a spatial
relationship between the articulator
and CBCT.
A 2014 review article on a virtual
articulator described the advantages
of the technology, including
optimised communication between
technician and dentist, static and
dynamic occlusion analysis, and
3D navigation, but also noted its
limitations, such as poor costeffectiveness
and inadequate
technical knowledge of the user.
These limitations result from the
complexity of the technology, which
requires navigation of scanners,
sensors, and software, sometimes
simultaneously. In their clinical
study in 2020, Úry and colleagues
tested the accuracy of virtual
dentistry applied to the indirect
digital workflow. Specifically, they
examined the result of transferring
analogue dental casts to a virtual
articulator, which involved indirect
scanning 18 mounted maxillary
and mandibular gypsum casts. The
authors measured the matching
analogue and virtual contact points
from an occlusal analysis and found
the results indicated that the indirect
digital method would be successful.
Examples like this show the benefit
of virtual articulators, which provide
the integration necessary for dentists
to fully digitise the occlusal diagnosis,
analysis, and treatment process.
THE AGE OF DIGITAL OCCLUSAL
CONTACT REPORTING
Digital occlusal contact reporting
is another recent innovation that
is transforming occlusal analysis.
Occlusal analysis systems are now
available that take what used to be
done with paper, ink, and wax (Figs.
5-6) and transform the technique
Fig. 3: Gathering data using a dentofacial analyser to mount upper
model on an analogue articulator
Fig. 4: Mounting models on an analogue articulator
Fig. 5: Equilibration
using traditional
articulating paper
to mark occlusal
contacts
Fig. 6: Marking
the incisal edge
position for
anterior guidance
with articulating
paper
32 DENTAL ASIA MARCH / APRIL 2023

CLINICAL FEATURE
of marking and adjusting occlusal
contacts into a precise estimation
of applied force. A skilled clinician
may require years of experience
to develop the ability to adjust a
patient’s restoration precisely so
that the patient experiences an
exceptionally comfortable bite and
touching of maxillary and mandibular
teeth. This is a truly impactful dental
treatment. With digital occlusal
analysis, dentists can go one step
further and gain an even clearer
picture of the patient’s bite.
Occlusal pressure surfaces can be
identified through digital occlusal
analysis systems. In their 2015 in vitro
study of one such system, Cerna et
al. found a “good level of reliability”.
The system provided relative bite
force values, including the timing
and distribution of the force. The
study authors concluded that in
comparing 18 sensors (including two
different series of the same type of
device), low validity was found in
the system’s ability to approximate
“total occlusal force under laboratory
conditions”, but that the sensors had
high reliability in the case of two
consecutive measurements. The
results of this study may indicate that
occlusal analysis systems at that point
in the technology’s design lacked
accuracy but provided consistent
data, which would make them useful
at the individual patient level for realtime
assessment of the location and
relative force of occlusal contacts.
More recently, a 2017 study of this
occlusal analysis system for patients
before and after orthognathic surgery
also found high levels of reliability.
Agbaje et al. tested how useful and
consistent the occlusal analysis
system was in recording information
like maximum intercuspation and
maximum bite force (preoperative
and postoperative) for 40 patients
in comparison to 30 patients with
healthy occlusion. The technology is
based on a “pressure sensitive bite
transducer embedded in a dental
arch-shaped recording sensor”. Twodimensional
and 3D image analyses
of patient ocular force distribution
were gathered, and the data was
analysed to assess the technology’s
efficacy. The researchers concluded
that the occlusal analysis system
offered a comprehensive number
of parameters for assessing
occlusion and could even be used
for faster detection of relapse.
The landscape of occlusal contact
analysis sensors and corresponding
software continues to broaden to
encompass complementary tools and
even replacements for traditional
articulating paper.
CONCLUSION
Occlusion is the lynchpin of a
healthy masticatory system and
crucial to a patient’s oral condition.
Occlusal analysis and treatment
tools are emerging like never before.
The state-of-the-art in occlusion
technology provides insights and
data-driven results through tools
such as joint vibration analysis,
digital articulating paper and occlusal
analysis systems, digital articulators,
digital jaw tracking, intraoral
scanning, and more. Although
dentists may feel overwhelmed by the
number and complexity of systems
available, especially when more
established techniques are already
functional or adequate, once they
have overcome an initial learning
curve, they stand to gain a more
thorough and clearer picture of a
patient’s TMJ and how it contributes
to TMDs. Knowing the benefits and
drawbacks of occlusion technology
can give dentists more options for
providing high-quality restorative
dentistry and pain management to
patients in need. DA
REFERENCES:
1
Ohrbach R, Dworkin SF. The evolution of
TMD diagnosis: past, present, future. J
Dent Res. 2016;95(10):1093-1101.
2
Sharma S, Crow HC, Kartha K, et al.
Reliability and diagnostic validity of a joint
vibration analysis device. BMC Oral Health.
2017;17(1):56.
3
Marotti J, Heger S, Tinschert J, et al.
Recent advances of ultrasound imaging
in dentistry – a review of the literature.
Oral Surg Oral Med Oral Pathol Oral Radiol.
2013;115(6):819-832.
4
Kwon JH, Im S, Chang M, et al. a digital
approach to dynamic jaw tracking using a
target tracking system and a structuredlight
three-dimensional scanner. J
Prosthodont Res. 2019;63(1):115-119.
5
Aslanidou K, Kau CH, Vlachos C, Saleh
TA. The fabrication of a customized
occlusal splint based on the merging
of dynamic jaw tracking records, cone
beam computed tomography, and caDcaM
digital impression. J Orthod Sci.
2017;6(3):104-109.
6
Yau HT, Liao SW, Chang CH. Modeling of
digital dental articulator and its accuracy
verification using optical measurement.
Comput Methods Programs Biomed.
2020;196:105646.
7
Kim JE, Kim SJ, Kwon DH, et al. Mounting
casts on a mechanical articulator
by using digital multisource data: a
dental technique. J Prosthet Dent.
2021;125(1):41-45.
8
Koralakunte PR, Aljanakh M. The role
of virtual articulator in prosthetic and
restorative dentistry. J Clin Diagn Res.
2014;8(7):ZE25-ZE28.
9
Úry E, Fornai C, Weber GW. Accuracy
of transferring analog dental casts to
a virtual articulator. J Prosthet Dent.
2020;123 (2):305-313.
10
Cerna M, Ferreira R, Zaror C, et al.
Validity and reliability of the T-scan® iii
for measuring force under laboratory
conditions. J Oral Rehabil. 2015;42(7):544-
551.
11
Agbaje JO, de Casteele EV, Salem
AS, et al. assessment of occlusion
with the T-scan system in patients
undergoing orthognathic surgery. Sci Rep.
2017;7(1):5356.
ABOUT THE AUTHOR
Dr Lee Ann Brady
began teaching
dental education
in 2005 when
she joined the
prestigious Pankey
Institute as a
member of the resident faculty and
clinical director. Dr Brady has been
recognised by Dental Products Report
each of the last six years as a Leader
in Dental Continuing Education.
DENTAL ASIA MARCH / APRIL 2023 33

CLINICAL FEATURE
Clinical management
of root resorption and
separated instruments
Despite advancements made in the metallurgy of Nickel titanium
(NiTi) rotary instruments, instrument separation or fracture remains
a major clinical concern as Dr Denzil Albuquerque, Dr Paras Kothari,
and Dr Jojo Kottoor discuss more.
Instrument separation or fracture is a
frustrating and distressing experience for
the clinician and the patient. A fractured
instrument hinders biomechanical
preparation of the root canal system,
reducing the efficacy of disinfection and
thus the ultimate success of endodontic
treatment.
The reported success rate for instrument
retrieval ranges from 55-79%. Over
the years, several techniques and kits
have been designed for retrieval of the
fractured instruments. The removal
of separated instruments from root
canals is complex, and requires specific
instruments and equipment along
with advanced operator skills.
External inflammatory cervical root
resorption (EICRR) is a pathologic
process that occurs after a range
of mechanical or chemical stimuli
such as infection, pressure, trauma,
or orthodontic tooth movement
that cause inflammation and loss
of the root protective barrier. It is
radiographically characterised by
radiolucent loss of tooth substance
along with a radiolucency involving
the adjacent periodontal ligament and
bone.
CASE REPORT
A 35-year-old male patient presented
with a complaint of persistent pain,
swelling, and a draining sinus with his
upper left front tooth for about five
months. He had initiated root canal
treatment for his upper left canine
with a general dentist but treatment
was incomplete with multiple
instrument separations within the
root canal. Another endodontist
attempted root canal treatment
unsuccessfully and a periodontist
opted for localised curettage of the
sinus. He was finally referred to the
practice for a consult and treatment.
Figs. 1a-b: Preoperative photo and radiograph
Fig. 2: CBCT analysis
34 DENTAL ASIA MARCH / APRIL 2023

CLINICAL FEATURE
Intraorally, a gingival sinus was
noted on the buccal aspect between
upper teeth 23 and 24, approximately
6-8mm apical to the marginal gingiva.
Tooth 23 was tender to percussion
and had a palatal temporary filling.
Radiographic periapical examination
revealed a 16mm long broken
instrument, extending from the
coronal third to 0.5mm beyond the
apex, along with an additional smaller
piece of separated file in the middle
third of the root canal (Fig. 2). A
radiolucency in the distal aspect of
the cervical third of the root with
adjacent localised bone loss was
noted — pathognomic of external
cervical root resorption. Radiographic
sinus tracing with gutta-percha
directed to this site of cervical root
resorption (Figs. 1a-b).
A low volume CBCT scan of the
area confirmed the clinical and
radiographic diagnosis and provided
an accurate assessment of the full
extent of the cervical resorption
defect and its boundaries. As the
lesion was not extending
circumferentially into the palatal
aspect of the root, the treatment
of the defect was planned to be
approached directly by surgery. The
scan also showed a single long canal
with minimal curvature, presenting a
favourable and predictable approach
for orthograde retreatment of the
root canal system. The prognosis
for endodontic retreatment was
favourable while long-term prognosis
for cervical root resorption was
guarded (Fig. 2).
wire inserted through a needle. Once
engaged under magnification using
a dental operating microscope, the
separated instrument was retrieved
after multiple firm tugs in different
directions. The second instrument
was then retrieved using ultrasonics
in a fluid-filled canal. Cleaning and
shaping were completed followed by
warm vertical compaction of guttapercha
and composite restoration in
a single visit (Figs. 3a-b).
For the surgical management of the
EICRR, a papilla preservation-full
thickness flap was raised to expose
the defect. The granulation tissue was
curetted using hand instruments and
ultrasonics with copious irrigation.
The root dentin was then cleaned
and prepared using ultrasonics
and surgical burs, and filled with
white mineral trioxide aggregate
(MTA) (Figs. 4a-b). The flap was then
repositioned and sutured using 6-0
sutures.
At the six months follow-up
appointment, the patient was
Figs. 3a-b: Instrument retrieval
completely asymptomatic. Clinical
and radiographic investigation
showed good signs of healing (Figs.
5a-b). The patient was recommended
a night guard and was referred for an
orthodontic consultation.
DISCUSSION
Factors attributed for instrument
fracture include repeated usage of
the instruments, instrument design,
sharp canal curvatures and operator’s
experience. When such multiple
factors coincide, the chances of
instrument separation increase
manifold.
Guidelines to minimise the risk of
fracture of rotary instruments:
• Completely de-roof the pulp
chamber and ensure straight line
access
• Prepare a glide path and patency
before rotary instrumentation
• Prefer martensitic, heat-treated
instruments or reciprocating files
• Sequential, crown-down
instrumentation without jumping
sizes
On the treatment aspect, after local
anaesthesia and rubber dam isolation,
the access cavity was modified to
remove all tooth decay. Coronal
radicular access was widened with
gates glidden drills and ultrasonics
to allow for the coronal end of the
separated instrument to be visualised
and engaged. A custom loop device
was fabricated using a thin gauge
Figs. 4a-b: Surgical MTA repair of EICRR
Figs. 5a-b: Postoperative photo and radiograph at six months
follow up
DENTAL ASIA MARCH / APRIL 2023 35

CLINICAL FEATURE
• Pecking motion, light touch, stable finger
rests
• Wipe the instrument clean of debris after
use in a canal
• Examine flutes and the file tip, preferably
under magnification.
• Copious irrigation for flushing debris
between instruments and the use of rotary
instruments with an irrigant filled canal
• Discard files regularly, especially after use
in calcified, narrow or curved canals.
• Familiarity and hands-on practice with the
instrumentation technique
Teeth presenting with concomitant periapical/
periradicular lesions and a fractured
instrument in the apical third are deemed
complex endodontic cases. When a patient
presents with a separated instrument, the
advantages and disadvantages of attempting
instrument retrieval should always be weighed.
The clinician’s skillset, clinical experience and
armamentarium available at his disposal play
an important part in conservative instrument
retrieval.
Retrieval of the separated instruments with least
removal of root dentin should be the highest
priority. Critical prognostic determinants for
instrument retrieval include the position of the
fractured instrument, length of the separated
instrument, canal curvature and visibility of
the coronal end of the instrument. Moreover,
canal anatomy, including the diameter, length
and level of curvature of the canal, as well as
the thickness of root dentin and the depth of
external concavities will influence the safe
removal of the separated instrument fragment.
The dentinal engagement of the separated
fragment at multiple sites cannot be efficiently
overcome by ultrasonics alone, especially
when the fragment length exceeds 3-4mm. A
lasso tool or loop device is then necessary for
predictable retrieval.
Other relevant clinical findings for this case
included heavy buttressing of alveolar bone
including the entire upper anterior area,
and an extremely deep anterior bite with
retroclined incisors. The four upper incisors
had a history of multiple repetitive nontraumatic
fractures treated by endodontics
and zirconia full coverage crowns pointing
to the absence of a mutually protective
occlusion. The patient had not received an
orthodontic or restorative treatment for
correction of his bite or occlusal overloads.
In this scenario, the long-term impact on
canines could account for localised trauma
and a probable cause for cervical root
resorption. The specific site of resorption,
the disto-labial root surface at the cervical
third could also correlate to this traumatic
bite. The follow-up radiograph at six months
showed complete healing but partial
replacement or resorption of the repair
material, MTA. This could be possibly caused
by the persistence of excessive occlusal
forces on the tooth, specific to the said area.
The patient has not initiated any orthodontic
treatment and is reluctant to do so. An
occlusal appliance like a splint could be
protective and thus useful in preventing or
minimising diurnal non-functional forces.
A single, localised and accessible site of
EICRR allowed for surgical direct access and
management. This allowed for immediate
intervention as well as predictability in
terms of direct visualisation and treatment.
MTA is a bioactive, sterile, radiopaque and
dimensionally stable material not sensitive
to moisture and blood contamination. MTA
provides an effective seal against dentin and
cementum and promotes biologic repair and
regeneration of the periodontal ligament and
bone, cementum and dentin. Other alternate
bioactive materials like bioceramics may also
be used.
Alternate treatment modalities for EICRR
include long-term calcium hydroxide
intracanal dressings alone or in conjunction
with corticosteroids. Although they may
attenuate the progression, they may not
predictably arrest resorption. Regenerative
endodontics and intentional replantation
procedures have also been used for the
management of EICRR.
CONCLUSION
Instrument retrieval and conservation of
root dentin are critical for the long-term
prognosis and predictable endodontic
outcome. The present case had an added
dimension of EICRR that was managed
via a surgical approach and restored with
a bioactive material, MTA. A six-month
follow-up demonstrated adequate clinical
and radiographic healing. The long-term
prognosis of the tooth would ultimately
depend on the removal or diminution of
multiple etiologic factors. DA
REFERENCES:
Terauchi Y et al. Present status and future
directions: Removal of fractured instruments. Int
Endod J. 2022 May; Suppl 3:685-709.
Abbott PV. Prevention and management of
external inflammatory resorption following trauma
to teeth. Aust Dent J. 2016 Mar; Suppl 1:82-94.
Saoud TM et al. Regeneration and Repair in
Endodontics-A Special Issue of the Regenerative
Endodontics-A New Era in Clinical Endodontics.
Dent J (Basel). 2016; 27:4(1):3.
ABOUT THE AUTHORS
Dr Denzil Albuquerque,
MDS, is a clinician
exclusive in microendodontics
and
advanced endodontics,
restorative and
cosmetic dentistry at his private practice
Dental Expert, Mumbai, India. He is an
invited speaker and conducts workshops,
has authored multiple publications and is
a peer-reviewer for distinguished journals.
Dr Paras Kothari, MDS,
is a micro-endodontist,
speaker and educator
associated with
international companies
and MUHS. He has a
microscope assisted
dental practice in Malad, Mumbai.
Dr Jojo Kottoor,
MDS, is a speaker,
academician, teacher
and professor at
Royal Dental College,
Kerala, India. He
runs a distinguished
private practice dedicated to microscope
assisted endodontics, and restorative and
cosmetic dentistry in Kochi, India.
36 DENTAL ASIA MARCH / APRIL 2023

USER REPORT
Mini Implants: Simplified
protocol for stabilising
removable dentures
Dr Francis Bailly shares his experience in using Anthogyr Mini
Implant System to restore the smile and function of his patient with
resorbed mandible.
The 55-year-old male patient presents with a particularly
degraded oral health status, requiring the extraction of all
remaining teeth and the fitting of two complete dentures.
Since retention of the mandibular denture is inadequate,
four Mini Implants will be placed seven months later in
order to stabilise it.
Surgical protocol:
Fig. 1: Initial dental status
Fig. 2: The degraded condition of the
patient’s teeth was indicated by his
expression
Fig. 3: The pre-operative panoramic x-ray shows terminal stage
periodontal disease, as well as limited bone volume in the posterior
region. Severe bone loss surrounding teeth 22 to 25 was noted
Fig. 4: The remaining teeth were extracted
38 DENTAL ASIA MARCH / APRIL 2023

USER REPORT
Fig. 6: Post-operative occlusal view. The sites were then filled and
sutured
Figs. 5a-d: Some teeth were cleaned, ground, and mixed with PRF to form a filling
Fig. 7: Two and a half months after surgery, two complete dentures
were made
Fig. 8a: Pre-operative smile
Fig. 8b: Smile with dentures. The patient’s
physiognomy was transformed. The
denture holds well to the maxilla, thanks to
some preserved topography, but this is not
the case with the mandible
Figs. 9a-b: Seven months later, four Mini Implants were placed to
stabilise the bottom denture. The diameter of the implants was
particularly suitable given the absence of a floor of the mouth as a
result of bone loss. The denture intrados was hollowed out in order
not to put any stress on the implants for two months
Figs. 10a-b: Six months after the implants were placed, gum and bone healing was very
satisfactory
DENTAL ASIA MARCH / APRIL 2023 39

USER REPORT
Fig. 11a: The new denture, created a few months beforehand, was customised
to allow it to be adjusted to the Optiloc connections of the Mini Implants.
A mounting ring was placed on each connection to protect the neck of the
implant from any resin or glue residue. A denture cap with a retention insert
was then put in position, in order to create compression between the ring
and the denture cap
Fig. 11b: The base of the denture was hollowed in the areas receiving the
denture caps, using a contra angle and a resin drill. A silicone impression was
then carried out in the mouth, in order to confirm that there is sufficient space
between the denture caps and the base of the denture
Fig. 12: Finished denture incorporating denture
caps prior to being put into the patient’s mouth
Fig. 11c: The denture recesses were prepared using
a (resin) monomer. The denture caps were then
polymerised in the denture using PMMA resin, and
acrylic resin was applied. The denture can then
be positioned in the mouth in occlusion while the
acrylic resin is curing
Fig. 14: Patient’s smile after the removable
mandibular denture was fitted
Fig. 11d. Following polymerisation of the
impression material, the Optiloc mounting rings
were removed. The denture was then cleaned and
finalised for placement in the mouth
CONCLUSION
Minimally invasive surgery made it possible
to restore the patient’s appearance and
above all the comfort of stable, functional
dentition. The strong retention of these
Mini Implants and their compact design are
the major advantages of the Anthogyr Mini
Implant system. DA
Fig. 13: X-ray taken after fitting the denture
ABOUT THE AUTHOR
Dr Francis Bailly
graduated with a degree
of doctor of dental
surgery from the Lyon
Faculty of Medicine
in France. A former
associate practitioner at Lyon hospitals,
he holds a university diploma in oral and
maxillofacial implantology and he is trained
in advanced surgery and bone grafting with
Pr Khoury in Schellenstein, Germany.
40 DENTAL ASIA MARCH / APRIL 2023

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USER REPORT
Innovative leap in glass
ceramics
Dr Ayupoon Opasakhun demonstrates the use of VITA SUPRINITY
PC in a digital workflow and shows how robust and highly aesthetic
posterior restorations can be achieved efficiently in just a single
session.
With the development of lithium
disilicate, glass ceramics were long
considered to have reached their limits
in terms of function and aesthetics.
This class of materials is essentially
comprised of a glass and crystalline
phase. For a long time, researchers
attempted to improve the material
properties of glass ceramics by
increasing the crystalline phase. With
the development of the formulation for
VITA SUPRINITY PC (VITA Zahnfabrik,
Bad Säckingen, Germany), scientists
from the Fraunhofer Institute for
Silicate Research ISC in Würzburg,
Germany, were able to strengthen the
glass phase with zirconia (10 wt.%).
Improved material properties: The
resulting lithium silicate that is
reinforced with zirconia (ZLS) (with
more than 500MPa), is considerably
more fracture resistant 1 and robust 2
than lithium disilicate (350MPa),
and through crystallisation firing,
has been proven to facilitate the
repair of microcracks that occur
during processing 3 . The fine-grained
and homogenous microstructure
also facilitates more precise milling
results 4 , easier polishing 5,6 , and
improved aesthetics, thanks to
translucency 7 and opalescence 8
similar to natural dentition and
better true-to-shade masking 9 .
More homogeneous microstructure:
Compared to conventional lithium
disilicate with its larger, more
needle-shaped crystalline structure,
the new glass ceramic formulation
of VITA SUPRINITY PC showed
significantly reduced abrasion 10 and
was also gentler on antagonists 11
in laboratory testing, due to its
more homogenous microstructure.
The zirconia-reinforced lithium
silicate is bio-compatible 12 , results
in less microbial biofilm 13 and offers
greater shade stability than lithium
disilicate 14 . After conditioning
with hydrofluoric acid etching
and silanisation, the fully adhesive
bond with composite cement
demonstrates proven reliability 15 .
Clinically impressive: In a metaanalysis
of several studies, the
clinical performance of VITA
SUPRINITY PC was shown to be
highly promising, offering a genuine
alternative to lithium disilicate 16 . In
a prospective study, restorations
Fig. 1: Condition of 15 and 16 after successful root canal treatment
Fig. 2: Supragingival overlay preparation was performed on the
enamel
42 DENTAL ASIA MARCH / APRIL 2023

USER REPORT
fabricated from the zirconiareinforced
lithium silicate achieved a
survival rate of 100% after two years
in situ 17 . The following clinical case
study demonstrates the use of VITA
SUPRINITY PC in a digital workflow.
CASE STUDY
A 38-year-old patient required root
canal treatments due to advanced
carious lesions on teeth 15 and 16.
Both teeth were then scheduled
to be prosthetically stabilised. The
young patient wanted a restoration
that would match the shape and
shade of his remaining natural
dentition. CAD/CAM-fabricated
overlays were selected, made from
the zirconia-reinforced lithium
silicate VITA SUPRINITY PC. The
robustness of the material was to
reliably stabilise the weakened teeth,
while the optical properties similar
to natural dentition and true-toshade
masking would meet the
aesthetic demands of the patient.
Clinical steps: Shoulder preparation
was carried out on both teeth. The
preparation margin was consistently
supragingival in order to be as
gentle on the tooth substance as
possible and to ensure clean and
safe, fully adhesive integration
under the rubber dam in the enamel
area. Preparation impressions were
taken using A-silicone and used as
a basis for fabricating the master
model, which was digitalised using
the Identica T500 (MEDIT, Seoul,
South Korea) laboratory scanner.
Both overlays were designed with
VITA SUPRINITY HT 2M2 using
exocad software (exocad, Darmstadt,
Germany). The restorations were
then machined using the DC1
(Dental Concept Systems, Wesertal,
Germany) milling unit. The block and
the machined object were separated
using fine diamond tools prior to
crystallization firing.
Finalisation and characterisation:
Once the fit had been verified
on the model, the overlays were
finished using the VITA SUPRINITY
Polishing Set. The fissures were
characterised using rust-red VITA
AKZENT Plus EFFECT STAINS 06
(ES 06). Intensification was carried
out towards the cervical area using
cream-coloured ES 02. White accents
were added using ES 01. After stain
firing, final glazing was performed
using VITA AKZENT Plus GLAZE LT.
During clinical try-in, both overlays
fitted precisely so that they were
ready for fully adhesive seating.
Conditioning and integration:
Following hydrofluoric acid etching
and silanisation of the restorations
Fig. 3: Both overlay designs on the digitalised master model
Fig. 4: The completed overlays following characterisation and
glazing
Fig. 5: The sandblasted preparations before fully adhesive seating
of the restorations
Fig. 6: Seating was performed in a completely dry environment
using a rubber dam
DENTAL ASIA MARCH / APRIL 2023 43

USER REPORT
on the lumen side, and after sandblasting
the preparations, it was possible to seat the
crowns fully adhesively using a rubber dam
to ensure a completely dry environment.
The Clearfil SE Bond adhesive system was
used with heated CLEARFIL-AP-X universal
composite in shade A2 (both from Kuraray
Noritake, Tokyo, Japan). Following the
removal of excess material and light curing,
verification of the occlusion showed that
the overlays had been fitted with absolute
precision and no corrective milling was
required.
MORE THAN VIABLE ALTERNATIVE TO
LITHIUM DISILICATE
The zirconia reinforced lithium silicate
allowed the dental treatment team to
follow an efficient and streamlined
workflow. Integration of the overlays
with the remaining natural dentition
was completely seamless. The patient
was completely satisfied with the fast
and aesthetic restoration that did not
require any protracted adjustments or
corrective milling. With its superior
material properties in terms of function and
aesthetics, VITA SUPRINITY PC is a very
viable alternative to lithium disilicate in the
digital workflow. DA
REFERENCES
1
Zarone F, Ruggiero G, Leone R, Breschi L, Leuci S,
Sorrentino R. Zirconia-reinforced lithium silicate
(ZLS) mechanical and biological properties: A
literature review. J Dent. 2021 Jun; 109: 103661.
2
Alves DM, Cadore-Rodrigues AC, Prochnow
C, Burgo TAL, Spazzin AO, Bacchi A, Valandro
LF, Rocha Pereira GK. Fatigue performance of
adhesively luted glass or polycrystalline CAD-
CAM monolithic crowns. J Prosthet Dent. 2021
Jul;126(1):119-127.
3
Belli R, Lohbauer U, Goetz-Neunhoeffer F, Hurle K.
Crack-healing during two-stage crystallization of
biomedical lithium (di)silicate glass-ceramics. Dent
Mater 14, 1 64-71 (1998) 2019 Aug; 35(8): 1130-1145.
4
Hasanzade M, Moharrami M, Alikhasi M. How
adjustment could affect internal and marginal
adaptation of CAD/CAM crowns made with
different materials. J Adv Prosthodont. 2020 Dec;
12(6): 344-350.
5
Abdalla MM, Ali IAA, Khan K, Mattheos N, Murbay
S, Matinlinna JP, Neelakantan P. The Influence of
Surface Roughening and Polishing on Microbial
Biofilm Development on Different Ceramic
Materials. J Prosthodont. 2021 Jun; 30(5): 447-
453.
6
Vichi A, Fabian Fonzar R, Goracci C, Carrabba
M, Ferrari M. Effect of Finishing and Polishing on
Roughness and Gloss of Lithium Disilicate and
Lithium Silicate Zirconia Reinforced Glass Ceramic
for CAD/CAM Systems. Oper Dent. 2018 Jan/Feb;
43(1): 90-100.
7
Sen N, Us YO. Mechanical and optical properties
of monolithic CAD-CAM restorative materials. J
Prosthet Dent. 2018 Apr; 119(4): 593-599.
8
Gunal B, Ulusoy MM. Optical properties of
contemporary monolithic CAD-CAM restorative
materials at different thicknesses. J Esthet Restor
Dent. 2018 Sep; 30(5): 434-441.
9
Alayad AS, Alqhatani A, Alkatheeri MS, Alshehri
M, AlQahtani MA, Osseil AEB, Almusallam RA.
Effects of CAD/CAM ceramics and thicknesses
on translucency and color masking of substrates.
Saudi Dent J. 2021 Nov; 33(7): 761-768.
10
Yilmaz EÇ. Investigation of two-body wear
behavior of zirconia-reinforced lithium silicate
glass-ceramic for biomedical applications; in vitro
chewing simulation. Comput Methods Biomech
Biomed Engin. 2020 Nov 30: 1-19.
11
Wille S, Sieper K, Kern M. Wear resistance of
crowns made from different CAM/CAD materials.
Dent Mater 14, 1 64-71 (1998) 2021 Jul; 37(7):
e407-e413.
12
Zarone F, Ruggiero G, Leone R, Breschi L, Leuci
S, Sorrentino R. Zirconia-reinforced lithium silicate
(ZLS) mechanical and biological properties: A
literature review. J Dent. 2021 Jun; 109: 103661.
e407-e413.
13
Abdalla MM, Ali IAA, Khan K, Mattheos N, Murbay
S, Matinlinna JP, Neelakantan P. The Influence of
Surface Roughening and Polishing on Microbial
Biofilm Development on Different Ceramic
Materials. J Prosthodont. 2021 Jun;30(5):447-453.
14
Ozen F, Demirkol N, Parlar Oz O. Effect of surface
finishing treatments on the color stability of CAD/
CAM materials. J Adv Prosthodont. 2020 Jun;
12(3): 150-156.
15
Ustun S, Ayaz EA. Effect of different cement
systems and aging on the bond strength of
chairside CAD-CAM ceramics. J Prosthet Dent.
2021 Feb; 125(2): -339.
16
Banh W, Hughes J, Sia A, Chien DCH,
Tadakamadla SK, Figueredo CM, Ahmed KE.
Longevity of Polymer-Infiltrated Ceramic
Network and Zirconia-Reinforced Lithium Silicate
Restorations: A Systematic Review and Meta-
Analysis. Materials (Basel). 2021 Sep 3; 14(17):
5058.
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Rinke S, Brandt A, Hausdoerfer T, Leha A, Ziebolz
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J Prosthodont Restor Dent. 2020 Feb 27; 28(1):
36-42.
Fig. 7: The final seated overlays fabricated using
VITA SUPRINITY PC (lingual view)
Fig. 9: No corrective milling was required following
fully adhesive seating
Fig. 8: The buccal view shows the harmonious
shading between the tooth and the restoration
Fig. 10: Both overlays were functionally and
aesthetically integrated within the natural hard
tooth substance
ABOUT THE AUTHOR
Dr Ayupoon Opasakhun
graduated from the
Faculty of Dentistry,
Khon Kaen University,
Thailand, in 2016. He
specialises in restorative
and biomimetic dentistry and was a course
director for Logic and tips for restorative
works (2020) and Biomimetic Dentistry
Academy: Ceramic Overlay 101, 202.
44 DENTAL ASIA MARCH / APRIL 2023

BEHIND THE SCENES
Heralding the era of digital
dental technicians
CAD/CAM dental technician Kristina Vaitelytė shares her influences in
pursuing a career in dental technology and gives a millennial’s view on
how digital workflows can attract more young people to the dental field.
By Caitlan Reeg
Kristina Vaitelyte is a firm believer that
digital tools in dentistry are the present
and the future — a way to connect
patients, dentists and technicians together,
ensuring a seamless workflow. Having
seen the dental industry adopting digital
workflows, the accuracy, predictability,
and repeatability offered by these new
techniques allow dentists, and technicians
the confidence to deliver the perfect
results, time after time.
Inspired by the new technologies arriving
on the dental scene, she strives to explore,
trial, and adopt the latest workflows and
techniques. She works daily with exocad’s
DentalCAD software and believes it is
the number one tool to deliver bespoke
digital designs for aesthetic and restorative
dentistry at Primo Dental and Primo Dental
Design Studio. Read on as she shares more.
First, tell us about yourself.
Vaitelyte: I am Lithuanian and currently live
in Chester, UK. I am a digital dental technician
at Primo Dental Studio who lives and breathes
dental technology. I am from a dental family
— my mom set a trend for everyone. She is
a dentist, my dad is a dental technician, my
brother is a prosthodontist and my sister is a
ceramist. How lucky am I! For me, my normal
childhood was playing with dental chairs,
stamping patient cards with dentist details,
and playing with impression plaster in the
dental practice where my mom was working
in the mid-1990s.
My family members are massive dental
fans. I grew up with dental catalogues on
the kitchen table. Believe it or not, even
our family holidays were always at the IDS
in Cologne, Germany, around my birthday.
It is weird how things change in life, I
never actually thought I’d go into dental
technology. When I looked at the analogue
approach, it all looked messy, and I am not
the biggest fan of the monomer smell either.
However, going to IDS in 2013 changed my
life. That year was quite a big dental CAD/
CAM exhibition, and I was intrigued. Seeing
new software and milling units looked like a
winning combination of both technology and
dentistry worlds colliding. It was a eureka
moment for me.
How did you get your start in CAD?
Vaitelyte: I kind of fell into this by accident.
My sister was a massive influence on me.
She was working in a newly established
digital dental laboratory way back in 2014,
and they didn’t have anyone to work with
the system. At that time, no roles like this
existed. My sister and I persuaded the
laboratory manager to give me a week. By the
end of that week, I was producing zirconia
copings, cutback crowns and bridges, and it
snowballed from there.
I applied to university to study dental
technology, and from there I had
opportunities to practice my studies first in
Tenerife where I built my knowledge about
immediate load cases, dental tourism, and,
of course, enjoyed the sun. Next, to the UK
where I originally planned to stay only for
three months, but we all know how “plans’’
work. I met amazing people, worked with
some of the greatest dentists in the UK, and
it grew from there exponentially. I have been
here ever since.
46 DENTAL ASIA MARCH / APRIL 2023

BEHIND THE SCENES
How challenging was the learning
process for CAD/CAM design?
Vaitelyte: That was a long time ago. Like
most things, the more time you spend,
the better you get. Every software is
unique, and it takes patience to master. It
is exciting to see new software releases
and learn new features and techniques.
I like the handy feature called exocad
wiki. If you need help while designing,
there is a trick. You can just press the
question mark at the top right corner,
and it takes you straight to relevant
information.
Do you like having more interaction
with the patients and the dentists
working in-house?
Vaitelyte: I love it. No more guesswork!
We can provide a much better patient
experience, and I can get instant
feedback from dentists. I know not
everyone has this opportunity and not all
our work is in-house.
We also work with external dentists,
and this is where exocad’s dentalshare
and webview are fantastic tools to
share, discuss and confirm designs with
clinicians and patients, and they don’t
need to be in the same building or city.
Just think how much chair time this
saves.
Some want the “Hollywood smile”. What
are your thoughts on this?
Vaitelyte: I know “Hollywood smile” is not
for everyone, but many who are not related
to dentistry want straight, white and shiny
smiles. Thanks to exocad’s Smile Creator,
I don’t need to read patients’ minds. I can
propose designs, overlay patients’ images
and ask their opinion. It helps to see how
digital wax-ups integrate with patients’
faces. I can design patients’ mock-ups
before appointments and confirm designs
while they are in the dental chair.
What do you like about exocad?
Vaitelyte: Everything — stability, flexibility,
and ease of use. I am obsessed with exocad’s
sculpting tools, the libraries, and with how
much better this software gets every year.
I thought that it would be hard to improve
on DentalCAD 3.0 Galway, but DentalCAD
3.1 Rijeka is even better — much smoother
model builds, a bigger variety of model
articulators and attachments, and easy-toreuse
digital wax-up set-ups. The cherry on
top is that I can change the implant library
without affecting the abutment or crown
design.
How does using exocad impact your job
satisfaction?
Vaitelyte: First of all, without exocad I
would not be a dental CAD technician.
It had a tremendous impact in my life. It
pushed me out of my comfort zone, changed
my career, and I moved to another country.
It was so worth it! I met amazing people,
created thousands of smiles and I found
my passion. I am so grateful for the exocad
community, and everyone that helped me on
my journey.
Do you think digital tools will help attract
more women to the field?
Vaitelyte: Of course! Dentistry is a maledominated
industry, and we need more
female professionals. It brings a different
perspective, different approach and different
skills. We have already begun to see the shift
in new talent. It is already changing. Digital
workflows remove the necessity of being
in the laboratory, allowing the flexibility to
juggle work-life balance.
Any insights for other lab techs that you’d
like to share?
Vaitelyte: Play, don’t be afraid to experiment.
Personally, what worked for me was dental
congresses, shows and training. The best way
to learn is from somebody else! The exocad
team offers training sessions you can easily
book them online and believe me it kickstarts
your career at any stage whether you are
a beginner or an expert. Last year was my
first exocad Insights event. It was great to
meet the exocad team, and other dental
professionals, and to learn all about the new
features. DA
DENTAL ASIA MARCH / APRIL 2023 47

BEHIND THE SCENES
Inside
story of press
technology
Thirty years ago, Nicola Pietrobon
experienced the development of press
technology. Here is his recollection of
this memorable time.
Nicola Pietrobon qualified as a dental
technician in 1985. As a young technician,
he participated in an advanced training
programme at the University of Zurich
between 1988 and 1990. This is where
he met a very special person: Arnold
Wohlwend.
“Arnold Wohlwend was the chief dental
technician at the University of Zurich.
During my studies, I worked with him
on a daily basis. He was busy developing
a process in which a viscous ceramic
material could be shaped as desired. Once
the shape is attained, the ceramic would
be hardened again. The idea as such
was brilliant and I was impressed with
how dedicated Arnold Wohlwend was in
trying to achieve this goal. His innovative
spirit was incredible as he undertook
one experiment after the other,” shared
Pietrobon.
Reinventing how dental restorations
are made also meant opening up
new aesthetic design opportunities.
Furthermore, at that time, the demand
for minimally invasive, metal-free
restorations, which would help conserve
healthy tooth structure, started to grow.
Pietrobon said: “It was a long journey,
which required much patience. The
equipment that was needed was as
yet unheard of in the dental industry.
Consequently, Arnold Wohlwend worked
with injection moulding equipment
and ceramic furnaces from other
industries. Countless attempts were
necessary before his vision of the press
technique as we know it today became
a reality with the introduction of the
first prototype. It was an incredible
experience to have shared in the
enormous joy and satisfaction of this
achievement.”
The Programat press furnace has formed a part of the standard equipment of the Pietrobon &
Michel Dental Laboratory for many years
In order to develop a reliable and
marketable product, the inventors
decided to look for a partner in the
dental industry who had the expertise
that they needed. Ivoclar was prepared
to provide the desired support and
helped drive the further development of
the product. The press technique was on
its way.
48 DENTAL ASIA MARCH / APRIL 2023

BEHIND THE SCENES
The breakthrough for this revolutionary
technique came in 1991 as a result of the
untiring innovation efforts of Arnold
Wohlwend and the Ivoclar development
team. From then on it was possible to
press viscous leucite ceramic materials
into a hollow mould using a specially
developed furnace (Programat). The
mould was made in the lost-wax
technique.
Thirty years have passed since the press
technique reached market maturity.
Pietrobon has been running his own
dental laboratory with his business
partner Reto Michel since 1998.
Together with one other staff member,
they specialise in dental aesthetics.
WELL-THOUGHT-OUT SYSTEM
Right from the beginning, Pietrobon said
that they decided that their laboratory
would focus on creating all-ceramic
restorations. Hence, the press technique
was indispensable to their work at that
time and continues to be so to this day.
“Naturally, every system has its pros and
cons. However, this is what makes our
work so exciting: Every case requires
a different solution, and it is our job to
find it. I have always enjoyed having a
craft as a profession. I love to see all
the individual steps come together and
culminate in a tangible outcome,” he
said.
Press technique has been able to hold
its own in modern dental laboratories,
attributed to its exceptional efficiency
and smart devices.
“I welcome smart devices as long as
they do not impede my work. I am not
interested in time-consuming gadgets
because time is always at a premium in
our business. Smart devices have to work
reliably, save time and they must sound
the alarm in case of an emergency. I do
not expect anything more or anything
less from smart solutions.
“Over the past few years, immense
progress has been made in the
development of the Programat ceramic
and press furnaces. Initially, we were
often faced with failures and we were
unsure about whether or not the
result would actually live up to our
expectations. Today, using the hotpressing
technique is a ‘no brainer’
— due to the numerous intelligent
features of the equipment, the excellent
performance of the materials and the
well-thought-out overall process,”
shared Pietrobon.
FUTURE PROOF
The press technique from Ivoclar has
established itself as the original press
method on the market. Its development
is regarded as a milestone in the history
of dentistry. The success achieved
by this technology over the past few
decades shows that it has found its
place in dental laboratories and firmly
convinced dental lab technicians.
Although practices are now going
digital, the conventional workflow
of press technique can be efficiently
supplemented by digital processes, such
as CAD/CAM milling and 3D printing.
Sample restoration fabricated by Pietrobon in collaboration with Dr med dent Stefan Paul in Zurich. Crowns
on canines for the re-establishment of proper canine guidance. Veneers on central and lateral incisors
(Material: IPS e.max Press)
Pietrobon in the training laboratory at the
University of Zurich while participating in an
advanced milling programme
Pietrobon said: “Young dentists
in particular make use of digital
technologies as a matter of course
and they expect us technicians to
do so too. Nevertheless, I think it
is important for dental technicians
to understand the manual aspects
of their craft first before they start
to make use of digital possibilities.
Digital workflows offer numerous
advantages and they undoubtedly
make our job easier. That said I like
to use conventional techniques in
certain cases — even though an
equivalent digital option is available.
We scan, mill and print — but at the
same time, we have great confidence
in the press technique.
“Furthermore, I still prefer to make
impressions by hand. I am quite
certain that the press technique
will continue to evolve. Now that
this conventional technique can be
combined with the printing process,
it has taken the first major step
towards digital transformation. The
main aim will always be to find new
ways of imitating natural teeth even
more successfully. In all fairness,
however, the quality and performance
of the press technique are already
extremely high.” DA
DENTAL ASIA MARCH / APRIL 2023 49

IN DEPTH WITH
Choosing the best loupes
Dr Jin Chang enumerates the wide range of loupes developed by SurgiTel to help
clinicians determine the best magnification products for them.
With the introduction of ErgoDeflection
loupes, SurgiTel now has four main
categories of ergonomic loupes:
ErgoDeflection through-the-lens (TTL);
Straight TTL; Frame mounted straight
front-lens-mounted (FLM) and Headbandmounted
straight FLM.
SurgiTel Loupe Categories
ErgoDeflection TTL Loupes
The ErgoDeflection line of TTL loupes allows
the most upright work posture. If you have
had neck surgery or have a condition where
you need to be in a very upright position,
these are going to be the best choice for
you. There are two key differences between
SurgiTel ErgoDeflection loupes and others
on the market.
First, ErgoDeflection loupes use new patent
pending prism which allow us to customise
the viewing angle to give you the right
amount of reach distance between you and
the patient. The second key feature is that
ErgoDeflection loupes use ergonomic frames
and pantoscopic tilt, which give you better
eye protection and more area below the
oculars to see your working area as you bring
a tool into your magnified vision.
declination angles to support the safe neck
posture of less than a 20-degree head/neck
tilt. The advantage of straight FLM loupes
on either a frame or headband is that you
can incrementally change your declination
angle to gradually go from your current
posture to a more upright position.
After years of working in a bad posture,
your spine and body may not be able to go
from a hunched-over posture directly to
an upright ergonomic posture. If you are
a clinician that is operating on patients at
different heights, FLM loupes also give you
the ability to adjust the vertical direction to
align with your operating area. Combining
this feature with working distance caps,
you can also change the distance that is
in focus. With customisable FLM loupes,
you can have the most flexibility and
customisation.
Straight TTL loupes vs. Deflection TTL
loupes
The main advantage of TTL loupes for both
straight and deflection is that they don’t
need to be adjusted. And since the oculars
go through the lens, they sit closer to your
eyes to provide a wider field of view from a
keyhole effect. If you have the capability to
adjust your patients’ positioning to meet your
optimal working posture, then TTL loupes
are a great choice.
The biggest difference between Straight
TTL/FLM loupes and ErgoDeflection loupes
is your line of sight to your operating area.
Straight loupes give you a more natural
direct line of sight to your hands. With
your peripheral vision on the outside of the
oculars, you are able to see the surrounding
work area. With ErgoDeflection loupes, you
look straight up to see the magnified area,
and you look down below the oculars to see
the work area and its surroundings with the
naked eye. Deflection TTL loupes will require
users to have a longer learning time.
SCOPE STYLE/OPTICAL DESIGN OPTIONS
SurgiTel offers three main optical styles:
Galilean loupes, Compact Prism loupes, and
Deflection loupes.
Galilean loupes
Galilean loupes use a simple design which
helps keep the cost down. These loupes
Straight FLM Loupes
FLM loupes are available either mounted
to a frame or headband. FLM loupes and
most SurgiTel TTL loupes can deliver any
Comparison of neck angles with competitor TTL Loupes vs SurgiTel Ergonomic Loupe Types
50 DENTAL ASIA MARCH / APRIL 2023

IN DEPTH WITH
Galilean Loupe magnifications
UltiView Lite 3.0 and UltiView Loupe magnifications
UltiView Pro Loupe magnifications
are ideal for low-power loupes (less than
3.0x). If you are not looking to increase
your magnification but to work in a more
upright ergonomic posture, SurgiTel
ergonomic Galilean loupes are the best
loupes option. SurgiTel Galilean loupes are
available in a standard size and a smaller
micro size.
Compact Prism loupes
The new UltiView Lite 3.0x magnification
prism loupes have been introduced as a
new beginner loupe. With the increase of
working distance for the average clinician,
2.5x loupes are no longer an effective
beginner magnification. The UltiView Lite
has the same design and advantages as
our compact prism loupes, but at a more
compact size and lighter weight. The
advantage over the 3.0x Galilean loupes
is that it has a wider field of view, longer
depth of field, and better edge-to-edge
clarity.
SurgiTel also offers the UltiView Pro line
of loupes, which is a wider version of
the UltiView loupes. With large objective
lens and patented compact design,
these loupes give you a wider field of
view and good depth of field. Currently,
magnifications go from 3.5x to 10.0x.
Another key feature of our prism loupes
is the patented working distance caps,
which not only help you save on longterm
maintenance costs from prescription
changes, but also allow you to easily
change your working distance for different
procedures. If you like the size and weight
of the UltiView Lite but are looking for an
increased magnification, the UltiView 3.5x
and 4.5x are right for you.
Deflection loupes
The newly released ErgoDeflection prism
loupes are based off the UltiView Lite and
UltiView in terms of lens sizes. They have the
same compact prism design with all the same
benefits but with the use of a patent pending
deflection prism instead of a prism which
rotates images. They are currently available
in 3.5x, 4.5x, 5.5x and 6.5x magnifications.
LOUPE MAGNIFICATION
For some clinicians, it all comes down to
loupe magnification and sharpness. SurgiTel
currently offers a full line of ergonomic
loupes with loupe magnifications of up to
10x and uses laser alignment to maintain the
binocular view of the object.
The clarity and sharpness of an object are
increased when both oculars and your eyes
are perfectly aligned onto an object. This
is especially important on higher-powered
magnifications; the loupes need to be aligned
precisely, otherwise the image and sharpness
will degrade. Choosing sturdy, rigid frames
is recommended to keep higher-power
magnifications aligned.
Choosing your ideal loupe magnification
depends mostly on these three factors: The
object you are working on; the age of your
eyes and your working distance.
Due to the distance effect, the longer your
working distance is, the more magnification
you need to see the same as those with a
shorter working distance. As you get older,
your eyes are less able to perceive details —
this is when it is time to increase your loupe
magnification. The more thoroughly you are
able to see small objects, the quicker and
more precisely you are able to work.
For some procedures that you may have
previously looked to use an operating
microscope, many can now be done with
10x-powered loupes. The advantages of loupes
over a microscope are flexibility in movement,
different points of view around the operating
area, and a more natural coaxial alignment
from your eyes to your hand. DA
2.5x
3.0x
3.5x
4.5x
Actual Size
5.5x 6.5x 8.0x 10.0x
ErgoDeflection Loupe magnifications
Loupe
magnifications
DENTAL ASIA MARCH / APRIL 2023 51

IN DEPTH WITH
Severe dental problems in children
on the rise: Finnish innovation
keeps tooth decay
at bay
Up to 20% of children have a virulent strain of
Streptococcus mutans (S. mutans) in their mouths,
which has a greater ability to cause severe tooth
decay. Finnish health technology company Koite
Health has launched Lumoral Junior, a method
for targeted removal of dental plaque to improve
children’s declining oral health.
Lumoral Junior is an anti-bacterial oral cleaning
method developed for children’s needs
Lumoral Junior is a technology for improved
oral health self-care developed to suit
children’s needs. It aims to improve children’s
oral care and provide a good starting point
for oral health in adulthood. The method was
developed by Finnish researchers with the
aim of eliminating harmful bacteria in the
mouth to treat and prevent oral diseases.
Dr Heikki Alapulli, paediatric dentist at New
Children’s Hospital of HUS
Oral diseases differ from other diseases in
that they are largely preventable. Despite
this, caries and gingivitis are very common
diseases in children. By influencing oral
conditions through diet, oral hygiene and
fluoride, children can be assured of good oral
health through simple daily activities.
Oral health is a balance between factors that
protect against disease and those that make it
possible to contract it. “Regular eating habits,
thorough mechanical brushing of teeth to
remove bacteria from the mouth and regular
use of fluoride all protect against tooth decay,”
said Dr Heikki Alapulli, paediatric dentist at
HUS New Children’s Hospital.
Frequent consumption of high-carbohydrate
foods or sugary drinks combined with poor
oral hygiene are factors that contribute to
dental and oral diseases.
KEEPING ORAL BACTERIA UNDER
CONTROL
S. mutans is one of the most common
bacterial species causing tooth decay. Good
oral hygiene is essential to prevent these
bacteria from multiplying and damaging a
child’s sensitive teeth. Careful mechanical
brushing of teeth and the use of fluoride
toothpaste are the foundation of children’s
oral hygiene. But even the most effective
mechanical brushing is not always enough.
Lumoral Junior is suitable for children who
are prone to caries, have incipient caries or
have a high S. mutans bacteria population in
the mouth.
In a Swedish study published in 2017, up
to 20% of children observed had a virulent
strain of S. mutans in their mouths 1 . This
increases the ability to attach to teeth
surfaces, to tolerate acidic conditions in
the mouth and cause more severe cases of
caries, and thus challenges traditional caries
methods.
“Antibacterial oral care does not replace
traditional oral self-care, such as brushing
with fluoride toothpaste and flossing,
but the approach can inspire and enable
children and parents to take better care of
their teeth,” said Dr Alapulli.
52 DENTAL ASIA MARCH / APRIL 2023

IN DEPTH WITH
“
Lumoral Junior improves children’s
self-care of teeth when traditional
methods are not enough or when an
existing oral disease requires more
than just mechanical brushing and
flossing.”
Dr Tommi Pätilä, Lumoral Junior’s developer
The main responsibility for keeping children’s
teeth clean always lies with the adults; at least
until the third grade of primary school, he
added.
oral health in the future. Studies show that
this protects the child also from developing
many chronic illnesses such as cardiovascular
disease in adulthood 2 .
cleaned thoroughly enough,” he said. “Poor
oral hygiene in childhood can be a step to
serious gum disease in adulthood, known as
periodontitis.”
As children’s hand motor skills develop,
the responsibility for cleaning their teeth
can gradually be transferred to them. But
the child’s oral hygiene must be monitored
throughout primary school, right up to ages
of 12-13.
ANTIBACTERIAL TREATMENT HELPS
Lumoral Junior reduces plaque formation
and can be used to prevent oral bacterial
diseases such as tooth decay and gingivitis. It
is recommended to use the device to prevent
tooth decay at least twice a week for children
over three to 12 years of age.
“Lumoral Junior improves children’s selfcare
of teeth when traditional methods are
not enough or when an existing oral disease
requires more than just mechanical brushing
and flossing,” said one of its developers,
Dr Tommi Pätilä, who is also a HUS New
Children’s Hospital surgeon.
While mechanical teeth cleaning methods
are key to good oral health, brushing only
removes 50-60% of plaque at best. This
antibacterial method is a gentle way of
removing plaque and slowing down the
formation of new plaque, he added.
GOOD ORAL HEALTH PROTECTS THE
HEART
If permanent teeth of a child develop without
having been infected by caries, it is likely
that the child will continue to have good
“The importance of good oral health in
managing the risk of heart disease cannot be
overemphasised,” said Dr Pätilä.
Dr Alapulli also added that many long-term
illnesses are associated with an increased risk
of oral diseases, and that most oral diseases
originate in dental biofilms. Dental biofilm
is where the antibacterial effect of Lumoral
Junior targets.
“In addition to tooth decay, gingivitis is
also common in children if teeth are not
Lumoral Junior is intended to be used in
combination with the light-activated Lumorinse
mouth rinse that attaches to the plaque of the teeth
Habits learnt early in life are more likely to
be maintained during adulthood. It is vital
to prevent dental diseases for children with
underlying health conditions. Children
with heart conditions are at a higher risk of
developing caries. Good oral hygiene is also
one of the most important steps in preventing
endocarditis, an inflammation of the inner
lining of the heart’s chambers and valves.
One of the advantages of antibacterial
treatment is that it is selective. Lumoral
Junior targets hidden plaque on the teeth
without disrupting normal oral flora
which differs from oral anti-inflammatory
antimicrobials such as chlorhexidine,
according to Dr Alapulli.
“Chemical mouthwashes also kill the good
bacteria in the mouth, and with prolonged
use, the mouth gets used to them,” he said.
The use of Lumoral Junior facilitates the
mechanical removal of biofilm in the child’s
mouth. It is thus a key component of a
thorough oral self-care routine to maintain
children’s oral health. DA
REFERENCES
1.
Streptococcus Mutans Adhesin biotypes that
match and predict individual caries development.
eBioMedicine.
2.
Association of childhood oral infections with
cardiovascular risk factors and subclinical
atherosclerosis in adulthood. JAMA Network.
DENTAL ASIA MARCH / APRIL 2023 53

PRODUCT HIGHLIGHTS
Renfert
New generation of steam cleaning unit
With the POWER steamer from Renfert,
dental laboratories can take steaming to
a new level. The steam cleaning unit with
its maintenance-free heating element and
intelligent engineering enhances laboratory
equipment with smart functions, attractive
design, and reliable steaming performance.
The heart of the unit is the boiler where the
heating element is cast inside the aluminum
floor. This is a real feat of engineering
that makes the heating element virtually
indestructible.
Another detail is the extra-large service
opening in the pressure tank ensuring
convenient rinsing and descaling. Full steam
ahead in daily laboratory routine as this
unit maintains full power. Thanks to the
robust heating element, only a short heating
interval is required, with fast and continuous
reheating too. What’s more, user-friendly
handling and the services that users expect
of Renfert have transformed a no-nonsense
piece of everyday equipment into a champion
performer that’s clever too.
POWER steamer can be visualised as a 3D
model in the dental laboratory by installing
the AR-app. Moreover, on the Renfert
website interested parties can find a virtual
3D model with clear product descriptions
and animations explaining how it works. DA
Coltene
Efficient dental dam placement
COLTENE has launched a black dental dam
with a printed tooth template for marking
holes, allowing dentists to achieve their
objective one step faster. The black colour
of the dental dam provides the ultimate
contrast for the working field and is therefore
ideally suited for taking photographs during
diagnosis and documentation.
With a powder-free latex quality, COLTENE
further optimises its globally popular range
of dental dams. HySolate Latex Dental
Dam is made of pure natural rubber latex,
is powder-free and low in protein. This
greatly lowers the burden with allergenic
proteins and reduces the risk of developing
a latex allergy. Furthermore, the latex
dental dam impresses with its customary
high resistance, tear strength and varied
selection of retraction thicknesses to suit the
treatment situation.
The new HySolate dental dam variants
are available in a variety of colours, sizes,
thicknesses and in the Fiesta variant with
flavour in well-stocked dental retailers.
“Our mission is to make the use of dental
dams as simple and safe as possible,”
said Gabriele Burkhardt, head of Product
Segment Treatment Auxiliaries at COLTENE.
“Reducing the number of work steps by using
pre-existing markings is one of the many
clever ideas that we have passed straight
from dental practice to our research and
development department. Quite literally, one
can see the advantage in black and white;
here we have anticipated at least two moves.”
The practical product range is complemented
by corresponding training material and the
online further education modules of the
COLTENE Dental Management Academy. DA
54 DENTAL ASIA MARCH / APRIL 2023

PRODUCT HIGHLIGHTS
VOCO
Durable and aesthetic material for splint
and night guard fabrication
VOCO has introduced V-Print Splint
Comfort, their new FDA 510k-cleared
biocompatible 3D printing resin for the
production of clear, strong thermo-flexible
therapeutic splints and night guards that
are durable and aesthetic.
BUSCH - if
quality is what
you are
looking for
V-Print Splint Comfort thermo-flexible
resin allows for a precise fit to the teeth
for optimal patient comfort. The high
flexural strength and excellent wear
resistance permits the fabrication of
devices as thin as 1mm. The easy-to-polish and is engineered to work with, as well as
V-Print Splint Comfort is clear, colourstable
and doorless. All V-Print resins are source 3D printers that include Asiga,
validated for, a growing number of open-
sedimentation-free and therefore do not Ackuretta, Dental Wings, RapidShape,
require shaking or “rolling” prior to use. Microlay, MiiCraft, Shera, Straumann
and Solflex. And like all V-Print resins, it
V-Print Splint is part of a large and growing is included in the design software from
line of 3D printer materials from VOCO, 3Shape and exocad. DA
Mectron
Piezoelectric levers for third molar extraction
Mectron has introduced the first
piezoelectric lever to facilitate the luxation
manoeuvre and even third molar root
extraction, especially when ankylosed. This
occurs when the manual force the operator
exerts on the handpiece is added to the
hammering action (typical of the Mectron
PIEZOSURGERY) which propagates from
the lever into the deep periodontium.
Additionally, proper use of the piezoelectric
lever can significantly reduce operating
time. The efficiency of these levers was
evaluated in a randomised, controlled study,
comparing them to manual levers, where
they showed the following benefits: better
visibility, maximum intraoperative control,
and faster third molar extraction. DA
Since 1905 we produce rotary
instruments for demanding
users in dentistry and
dental laboratory. We convince
through first-class quality and
a comprehensive product
range.
Made in Germany.
Visit us:
14.03.-18.03.23
hall 10.2
booth R010
More information:
www.busch.eu
There is no substitute for quality
Dental Asia EN 60x234 mm
DENTAL ASIA MARCH / APRIL 2023 55
Dental_allgemein_export_60x234_EN.indd 1 30.01.23 16:59

PRODUCT HIGHLIGHTS
Owandy Radiology
Simplify orthodontic diagnosis, simulate treatment plans and deliver predictable
patient outcomes
Available as an optional module to Owandy’s
I-Max Ceph panoramic digital radiography
unit, the AI-powered Ceph Analysis
Orthodontic Software is available in a
standard or advanced feature package. Both
packages include an artificial intelligence
(AI) engine to automate orthodontic
diagnosis and treatment planning for
predictable results.
Boris Loyez, general manager of Owandy
Radiology, said: “Our Ceph Analysis
Software was designed to simplify
orthodontic diagnosis, simulate treatment
plans and deliver predictable patient
outcomes. This is all possible thanks to
artificial intelligence.”
Owandy’s Ceph Analysis Orthodontic
Software includes the following features
and benefits:
• Fully automatic cephalometric tracing:
The tracing feature automatically finds
soft and hard tissue landmarks, planes, and
silhouettes on lateral or PA radiographs
within seconds
• Radiograph analysis and image
superimposition: Analysis and patient
images can be superimposed automatically
or manually. The operator can manage
how analysis is displayed, generate report
automatically and visualise growth and
treatment progress
• Visual growth projections: The skull
growth projection feature will track skull
tracing from current skeletal age to a
chosen skeletal age. Projections up to
maturity are possible
• Treatment plan simulations: Ceph Analysis
creates treatment plans by analysing
different stages of tissue softness and
rigidity to simulate orthodontic and/or
surgical treatment plans DA
3M
An easier way to handle class II correction
The Forsus Fatigue Resistant Device from
3M is the optimal solution for class II
correction — an automatic, hygienic and
comfortable way to continuously apply light
force.
Class II correction is a common orthodontic
case requirement. The options for class
II treatment have traditionally presented
a difficult decision. Choices were limited
to fixed intraoral devices with known
breakage concerns, or other appliances —
including headgear — that require patient
compliance.
The Forsus Fatigue Resistant Device, now
with more than 10 years of clinical use
and over one million patients treated,
overcomes these concerns and limitations.
The left and right sides are universal. It
is also used with the Forsus Wire Mount,
permitting installation without a molar
tube.
Forsus Fatigue Resistant Device EZ2
Module: The EZ2 module allows for more
consistent installation and automatically
prevents the spring from pivoting toward
the cheek. The EZ2 module can be used
only with an occlusal headgear tube and has
permanently marked indicators for the left
and right sides.
Clinicians benefit from increased versatility
with three installation options:
Forsus L-pin Module: The L-pin module
allows for more flexible installation options
and movement in the mouth. It can be used
with a gingival or occlusal headgear tube.
Forsus Wire Mount: The Forsus Wire Mount
slides onto the archwire and provides an
attachment option for the L-pin Spring
Module, thus eliminating the need for molar
bands and making it easier to incorporate
the Forsus Device mid-treatment. DA
56 DENTAL ASIA MARCH / APRIL 2023

PRODUCT HIGHLIGHTS
BISCO
Base and liner, the THERA way
BISCO has launched TheraBase, a dual-cure, calcium and
fluoride releasing, self-adhesive base/liner. Utilising the
THERA technology, TheraBase chemically bonds to tooth
structure, and releases and recharges calcium and fluoride
ions 1 . TheraBase’s calcium release generates an alkaline pH
which promotes pulp vitality 2 . It is a dual-cured material that
will polymerise even in deep restorations where light cannot
reach.
TITANUS ® LED
BRILLIANT
PERFORMANCE
TheraBase is stronger and more durable than other base
materials, glass ionomers and resin-modified glass ionomers*.
Additionally, it is radiopaque allowing for easy identification on
radiographs, providing a quick and effective diagnosis.
One 8g syringe of TheraBase provides approximately 27-29
base applications. Clinicians can simply dispense TheraBase,
and either light cure for 20 seconds or allow to self-cure, then
they can immediately proceed with finishing the restoration.
TheraBase has the strength, durability, and THERA technology
to provide the best foundation for each restoration. It contains
the adhesion promoting monomer MDP, ensuring a reliable and
optimal bond to dentin 3 . DA
REFERENCES:
*Data on file, BISCO Inc.
1
Gleave CM, Chen L, Suh BI. Calcium & fluoride recharge of resin cements.
Dent Mater. 2016 (32S):e26
2
T. Okabe, M. Sakamoto, H. Takeuchi, K. Matsushima. Effects of pH on
Mineralization Ability of Human Dental Pulp Cells.Journal of Endodontics.
Volume 32, Number 3, March 2006
TITANUS ® ELED/SLED ULTRASONIC SCALERS
SIMPLIFYING DENTAL MOTION
info@teknedental.com
www.teknedental.com
Visit us at Hall 11.2, Stand N41
DENTAL ASIA MARCH / APRIL 2023 57
Spazio pubblicitario Dental Asia 95x250_def.indd 1 30/01/23 11:45

100 YEARS OF IDS
Shaping the dental future
The International Dental Show (IDS) takes place in Cologne, Germany, every
two years and is organised by the GFDI Gesellschaft zur Förderung der Dental-
Industrie mbH, the commercial enterprise of the Association of German Dental
Manufacturers (VDDI), and staged by Koelnmesse GmbH, Cologne.
The hot phase of the final preparations for IDS 2023 were heralded in
a European Press Conference on 25 Jan 2023. The conference, in the
presence of around 50 trade journalists from Europe, gave an outlook of
the forthcoming IDS from 14-18 Mar 2023, which is also celebrating its
100th anniversary this year.
In his words of greeting, Mark Stephen Pace, chairman of the Executive
Board of the Association of the German Dental Industry, highlighted the
success story of IDS from its early days in Berlin in 1923 through the 40th
edition.
True to the motto, “100 Years IDS — Shaping the dental future“, attendees
can look forward to numerous new products, live demonstrations and
practical hands-on, from the key players in the industry. With around 1700
exhibitors, IDS 2023 will be staged in Halls 1, 2, 3, 4, 5, 10 and 11 of the
Cologne fair grounds.
workflow. Visitors will be given the opportunity
to experience this live on approximately
640sqm of exhibition space at IDS 2023. The
complete digital workflow as well as individual
product highlights and innovations will be made
tangible on site.
Veneering. They will also showcase variety of
individual solutions for holistic workflow.
3SHAPE
Hall 4.2 | Stand J098/K099
Visitors at the 3Shape booth will learn all
about the latest in digital dentistry. 3shape will
showcase their latest innovations and will hold
insightful lectures from intraoral scanning to
3Shape software and integrations. Visitors will
discover more about the trends for digital dental
labs in 2023, and can look forward to other
innovations that 3Shape will reveal at the event.
Visitors will be able to experience how digital
workflows can sustainably facilitate daily
routines in dental laboratories and dental
practices and thereby set new standards in
patient treatment. An exciting showcase,
together with the opportunity of experiencing
products live in action or to learn from
colleagues and product experts how the new
technologies can be optimally integrated into
the workflow, all make the abstract world of
digitisation tangible.
DENTSPLY SIRONA
Hall 11.2 | Stands K010 N019, K011, K011a,
K020 L029, K030 L049, K031, K050, K051
Attendees are invited to experience the digital
universe at Dentsply Sirona’s immersive
1,900sqm booth. The booth will feature the
company’s entire portfolio of products and
solutions, which visitors will be able to see in
action through product demonstrations and live
presentations. A key highlight on display will
be DS Core — an open, cloud-based platform
powered by a collaboration between Dentsply
Sirona and Google Cloud.
AMANN GIRRBACH
Hall 1.2 | Stands C040 D041, D040
“Connect to the (Work-)Flow”— with this motto,
Amann Girrbach summarises the essence of
the company’s strategy in its IDS campaign:
to connect treatment processes in dental
laboratories and dental practices intelligently,
simply and end-to-end in a perfect dental
BEGO
Hall 10.2 | Stands M-010 N-019, M020 N021
This year, BEGO is celebrating 30 years of
BEGO Implantology Solutions and visitors at
their booth can look forward to birthday offers
from their easy-to-use range of implants and
implant prosthetics. BEGO will also present
their Live Arena for the first time, where they
will take the visitors into the world of SMART
Dentsply Sirona will also implement a number of
sustainability measures to reduce its footprint
for the event, in line with the goals set out in
its BEYOND sustainability strategy. The booth
will be made mostly of reused furniture, while
European-based employees will be encouraged
to travel to IDS by train, local public transport or
do carpooling. The company will also prioritise
digital communications — adopting a paper-free
approach wherever possible, alongside other
measures and activities that customers can
learn more about at the IDS.
58 DENTAL ASIA MARCH / APRIL 2023

100 YEARS OF IDS
DR JEAN BAUSCH
Hall 10.1 | Stands G010 H011, H006
Dr Jean Bausch will celebrate their 70th anniversary
this year at IDS. They are launching new design
products, networking and uniting with their existing
and new clients from all over the world. Attendees are
invited to visit Bausch at the newly-designed booth
with the new “Work Bench-Zone” for the OccluSense
demonstrations.
→ DISCOVER PERFECTION
IN PROPHYLAXIS -
THE NEW COMBI touch
→ ultra-gentle prophylaxis
→ ergonomic handling
→ made in Italy
→ 40 years experience
DÜRR DENTAL
Hall 10.1 | Stands E008, E020 F029, F011
DÜRR DENTAL will present their highlights and
innovations, focusing on their motto: “The best, by
design — intelligent & sustainable solutions”. DÜRR
DENTAL‘s vision is to support dental practices with
intelligent and innovative solutions. At their stand,
visitors will discover how they can make their
everyday practice more efficient with their sustainable
products and AI-supported solutions.
exocad
Hall 1.2 | Stands A040 C041, A048 C049
exocad will showcase its newest series of 3.1 Rijeka
software releases and demonstrate planning, design,
and restoration workflows for dental technicians and
dentists. exocad plans a diverse programme at IDS
for attendees to experience and learn about its latest
releases. With a focus on patient experience and case
acceptance, exocad will run its live Smile Creator
→ www.mectron.com
DENTAL ASIA MARCH / APRIL 2023 59

100 YEARS OF IDS
Experience, a full smile design workshop that
demonstrates how Smile Creator can help
improve communication and predictability
along the restoration workflow.
More than two dozen top application
specialists will run 11 demo stations to
answer questions and present exocad’s most
recent software releases. Renowned dental
trailblazers Dr Gulshan Murgai and Prof Dr
Guilherme Saavedra will offer first-hand
experience on how to effectively implement
exocad software solutions into daily practice.
new product launches in all main product
categories: dental units, imaging, CAD/CAM
and software. Additionally, visitors at Planmeca
booth have the chance to discover HeySmile,
the recently launched clear aligner solution
powered by Planmeca.
In hands-on product demonstrations, visitors
will learn how Planmeca all-digital workflows
help dental professionals optimise their daily
work, improve customer experience, and achieve
predictable and precise treatment results every
time. In the centre of each workflow stands the
Planmeca Romexis all-in-one software platform,
which includes a selection of easy-to-use tools
and features for all needs and specialties. The
Planmeca booth also includes dedicated areas
for solutions specifically designed for the needs
of large group practices, dental universities, and
dental laboratories.
Dental Scan Spray. The product specialist will
present how the spray is optimised for minimal
layer thickness. Free samples of the product
will also be offered at the booth.
VITA ZAHNFABRIK
Hall 10.1 | Stands C008, C010 D019
Throughout the entire trade fair, visitors
to the VITA stand can look forward to
presentations by key opinion leaders, live
demonstrations and innovations from the
field of tooth shade determination and
digital prosthetics.
KOITE HEALTH
Hall 10.2 | Stand L071
Koite Health will present its Lumoral treatment
— a technology designed to enhance oral
home care for the prevention and treatment
of gum diseases and dental caries. Lumoral
team members, including Tero Pasanen, COO,
and the two scientists behind the Lumoral
innovation Koite Health, Sakari Nikinmaa,
CEO, and Dr Tommi Pätilä, researcher and
heart surgeon at HUS New Children’s Hospital,
will participate at the event. In February, the
company signed a distribution agreement with
white cross, a German distribution and training
company specialising in oral health prevention.
Visitors can also meet professionals from the
white cross team at the company’s booth.
RENFERT
Hall 10.1 | Stand B010 C019, Hall 1.2 | Stand
A055
True to their motto “making work easy”, Renfert
will be presenting new smart equipment,
useful devices, and premium quality materials
for dental laboratory and orthodontic clinics.
Visitors to the trade fair will discover the
SIMPLEX 3D printer, POWER steamer and many
more products live at the Renfert booths.
In addition, VITA will present the VITA
EXCELLENCE AWARD at the IDS for the first
time. The prize honours outstanding work
with the VITAPAN EXCELL anterior set. A
jury of four persons will use the following
criteria to evaluate the patient cases
that are submitted: aesthetics, function,
documentation and preparation work.
The award-winning patient case will be
presented to the specialist audience at the
VITA stand.
PLANMECA
Hall 1.2 | Stand A020 C029
Planmeca will showcase its complete product
portfolio. Product highlights will include
SCANNINGSPRAY
Hall 3.1 | Stand L071
Visitors in the Scanningspray booth will witness
the live product demonstration of SCANTIST 3D
W&H
Hall 10.1 | Stands A002, A020 B029
Featuring a climate-neutral trade fair booth,
visitors to the W&H booths will be able to
experience the W&H ProService live for
the first time, as well as numerous product
innovations such as Piezomed module,
Lara XL and Assistina One. W&H will also
be showcasing attractive special offers for
the trade fair, digital highlights, and product
presentations. DA
60 DENTAL ASIA MARCH / APRIL 2023

SHOW PREVIEW
Advertorial
Seven reasons to
attend the International
Osteology Symposium
Oral regeneration is your passion and
investing in continuing education
is important for you? Then you
should consider the following seven
reasons why you should attend the
International Osteology Symposium in
Barcelona on 27-29 Apr 2023.
1. Be up to date and learn from the
best: In Barcelona, the world’s experts
in oral tissue regeneration will meet,
share knowledge and exchange
ideas. Learn about the latest research
results, new practices and emerging
technologies and standards. Bringing
this knowledge into your daily practice
will definitely improve your clinical
results.
2. Sharpen surgical skills: A total of 14
workshops will be offered alongside
the symposium programme. Choose
one of these hands-on workshops and
refine your skills through practice and
feedback. Learning the right surgical
procedure step-by-step from an expert
will improve your daily work.
3. Meet experts face to face: Leading
experts will gather in Barcelona on
and off stage and will be accessible to
participants. Take the opportunity for
personal exchange and leave a lasting
impression — careers, collaborations
and friendships can emerge from
chance encounters.
4. Explore different career options:
The promotion of the next generations
is close to the hearts of many of
the renowned experts — whether in
research or clinical practice. Take the
chance to connect with them and learn
from their experience.
5. Gain new perspectives: The
symposium will cover all aspects of
oral regeneration and also address
perspectives on related disciplines.
Become inspired by the whole
conference package and maybe it will
guide you to new horizons in the world
of oral tissue regeneration.
6. Osteology is the place to be in oral
regeneration: Osteology Foundation is
the only global specialist organisation
in the field of oral-tissue regeneration.
There’s nothing like being in a room
“
of likeminded people and taking that
energy back to your workplace. Be part
of the community and connect with
your peers from near and far.
7. Have fun: Conferences are fun! Live
events with other people are fun! Enjoy
three days of learning in a pleasant
atmosphere with exciting formats, like
live surgeries, clinical round-tables and
battles of concepts. Don’t miss the
opportunity to combine meeting your
educational needs with inspiration and
fun! DA
There is nothing more inspiring than a
great conference to bring that motivation
back into your daily practice on a Monday
morning.”
Ronald E. Jung, member of the Osteology Foundation Board.
DENTAL ASIA MARCH / APRIL 2023 61

SHOW PREVIEW
Edentulism
2023: Glimpse
into the
speakers’
presentations
In the Canary Islands, Spain, on 4-6 May 2023, world-leading dentists treating
edentulous patients will disseminate their knowledge on treatment options
during the conference, Edentulism2023. This conference will provide networking
opportunities, spur research innovation, and bring old and new friends together.
Being the first of its kind, the ZAGA Centers
podcast series invited four of the upcoming
speakers to discuss the presentations they
prepared for this conference.
Dr Ana Ferro, Dr Fadi Yassmin, Dr Costa
Nicolopoulos and Dr Petros Yuvanoglu share
their insights into the need for research on
complications, the utility of having digital
workflows as approaches to dentistry, and
the usefulness of “smart concepts” that allow
patients to achieve aesthetic and functional
goals.
The surgeons interviewed on the ZAGA Centers
podcast, which can be found on Spotify and
Apple Podcast, unanimously agreed they
would attend Edentulism2023 even if they
had not been asked to share their experience.
Because each dentist has a different viewpoint
and role, there are differing preferences and
protocols. However, the shared dedication
to improving treatment options and clinical
outcomes has led to the gradual harmonisation
of knowledge in overcoming the challenges
in dentistry — such as the issue of reducing
long-term complications. The ZAGA network
and conferences such as Edentulism2023 are
therefore crucial for disseminating scientific
knowledge on rehabilitating edentulous patients.
Dr Ana Ferro, practicing in Portugal, stated
her focus in refining her method in treating
edentulous patients. Referring to her process
as “dynamic”, she continuously follows up
on complications and follows a “strict oral
hygiene regimen”. She said that throughout
the treatment, all roles involved, including the
He said: “That’s what I love with these cases
because we design it from start to finish, and
there is no compromise, to within the millimetre,
where you want to reach your pink and white
aesthetics, the shape, the vertical dimension, the
AP distribution, lip support — we just have so
many variables that we can control.”
patient, are equal and important.
Dr Costas Nikolopoulos and Dr Petros Yuvanoglu,
“I think the surgery is just the starting point. I tell
my patients that the moment I do the surgery it
is the moment we marry,” said Dr Ferro.
practicing in Dubai and Greece, gave credit to the
ZAGA method, created by Carlos Aparicio, for
helping them with issues of remote anchorage
using zygomatic implants in their practice.
Dr Fadi Yassmin, practicing in Sydney, Australia,
emphasised the use of digital workflows. By
refining a digital approach, he reassures his
patients that he can treat them as “blank
canvases”. By imagining what their smile would
look like if they had not succumbed to an
edentulous situation, he is then able to provide
“ideal aesthetic results”.
Given that many patients that are edentulous
have unsuccessfully tried and tested other
solutions, they said that it is important to educate
patients — and that’s where the ZAGA concept
really helped them a lot. In their presentation,
they will discuss 10 guidelines on how to
predictably and reproducibly be successful in
full arch treatment. DA
Dr Ana Ferro Dr Fadi Yassmin Dr Petros Yuvanoglu Dr Costa Nikolopoulos
62 DENTAL ASIA MARCH / APRIL 2023

Implant Solutions World
Summit: The latest innovations
and science transforming
implant dentistry
Registration is now open for Dentsply Sirona’s
Implant Solutions World Summit 2023, taking
place in Athens, Greece, from 8-10 Jun 2023.
The congress will feature more than 40
international speakers, with inspiring main
stage presentations, hands-on workshops, and
break-out tracks on topics such as aesthetics
and the digital dentistry ecosystem.
SHOW PREVIEW
The Implant Solutions World Summit brings
together professionals who are passionate
about elevating the dental industry and
improving the quality of implant treatments
and care for patients. Attendees will be able
to discover the latest innovations in implant
solutions, including the EV Implant family,
digital dentistry, and bone regeneration. The
congress will take place at the InterContinental
Athenaeum Athens hotel, close to Greece’s
famous Acropolis.
SCIENTIFIC PROGRAMME
The Implant Solutions World Summit will
feature presentations from more than 40
experts in implant dentistry, who will share
best practices, expertise, and insights.
Attendees will learn about managing implant
complications, the connections between
systemic and oral health, maximising
aesthetics, controlling risk factors, maintaining
peri-implant health, and more.
The programme is developed together with
the scientific chairs: Dr Tara Aghaloo (US) and
Dr Michael Norton (UK), and the programme
chairs: Steve Campbell (UK), Dr Malene Hallund
(DK), Dr Mark Ludlow (US), Dr Stijn Vervaeke,
(Belgium), and Dr Martin Wanendeya, (UK).
“Peer to peer education is vitally important
for our implant solutions community and we
are thrilled to bring implant professionals
together from around the world to explore the
latest innovations and science transforming
implant dentistry,” said Tony Susino, group
vice-president, Global Implant Solutions at
Dentsply Sirona. “The event promises to be
an inspirational opportunity for learning and
networking as we glimpse into the future of
implant dentistry and optimised patient care.”
INNOVATIVE IMPLANT SOLUTIONS
AND DIGITAL WORKFLOWS
Attendees at the Implant Solutions World
Summit 2023 will also be able to visit an
interactive exhibition and sign up for masterclass
workshops to learn more about Dentsply
Sirona’s products, solutions, and workflows,
including:
• Dentsply Sirona’s implant portfolio: DS Prime-
Taper Implant System, DS OmniTaper Implant
System and Astra Tech Implant System
• OSSIX regenerative solutions
• DS Signature Workflows for single-tooth,
partial and full-arch restorations
• The cloud-based DS Core platform for
improved practice efficiency
• Practice building and social media
Dr Marco Degidi, inventor of WeldOne and
Conometric concepts, will also be leading a
session on: Aesthetic Excellence Meets Digital
Connectivity using the Ankylos implant system.
“We are excited for the implant community
to experience the latest innovations first-hand
as we gather in Athens to learn from each
other and be inspired by the latest research
in implant dentistry,” said Dr Tara Aghaloo,
scientific chair of the Implant Solutions
World Summit and a professor in Oral and
Maxillofacial Surgery at the UCLA School of
Dentistry.
“Dentsply Sirona continues to lead the way
when it comes to implant dentistry, with
state-of-the-art implant systems and seamless
workflows,” added Dr Michael Norton, scientific
chair of the Implant Solutions World Summit
and adjunct clinical professor at the University
of Pennsylvania Dental School.
In addition to clinical education, attendees
at the Implant Solutions World Summit also
have the chance to network with peers for two
evening events — an opening night welcome
reception, as well as a networking dinner by the
Aegean Sea on Friday evening. DA
DENTAL ASIA MARCH / APRIL 2023 63

SHOW PREVIEW
Sino-Dental 2023:
All-in-one platform
Happening on 9-12 Jun 2023, this
year marks the 27th anniversary
of Sino-Dental. During 26 years of
development, Sino-Dental has become
one of the largest dental exhibitions in
China and the most influential dental
show in Asia-Pacific region.
Sino-Dental has strived to introduce
and promote advanced technologies
and products; to provide a platform
for national and international
dental companies; and to provide
opportunities for the exhibitors and
professionals to communicate and
exchange experiences.
As the flagship dental event in Asia-
Pacific region that presents one of the
largest and most fast-growing dental
market in the world, Sino-Dental invites
participants to:
• Establish business cooperation
• Expand potential market and seek
partners in the most dynamic dental
market
• Exchange of technology advances,
latest research, and market information
• Engage with peers, KOLs, leaders from
home and abroad, public and private
• Explore the excellent Chinese
products with competitive price and
quality
• Experience with cutting-edge
technology and innovation exhibition
zone
• Enhance professional skills via
top-level academic seminars and
workshop

SHOW PREVIEW
FACTS AND FIGURES
• Nearly 900 exhibitors are expected
to participate with over 100 new
products to debut in Chinese market
• Five national pavilions: Germany,
Switzerland, US, Japan, South Korea
• More than 140,000 visitors are
expected
• Over 100 top-level academic
seminars and workshops covering
over 400 topics will be held during
the exhibition period to introduce
the most updated academic and
technology development in the
dental field
SERVICE
International dealers
• International dealer’s lounge: private
space, free access, complimentary
snack and beverage
• Free interpretation service
(appointment requested)
• Complimentary accommodation
during exhibition period for whom
invite 10 or more dealers to Sino-
Dental
• Free information release service to
facilitate the matchmaking with local
partners and suppliers
Visitor online pre-registration
• No registration fee
• On-site quick pass counter for badge
claim
• Free catalogue, drinking water and
gift DA
DENTAL ASIA MARCH / APRIL 2023 65

AOSC celebrates
successful first
in-person edition
back out of the
pandemic
The Association of Orthodontists (Singapore)
Congress (AOSC) celebrated a successful
return to in-person events with its first physical
edition out of the pandemic. The congress
took place from 17-19 Feb 2023, followed by
post-congress workshops on 20 Feb 2023,
at the Sands Expo and Convention Centre
in Singapore. The congress drew a total of
707 attendees from 37 countries, once again
solidifying its reputation as the go-to event for
orthodontists in the Asia-Pacific.
Dr Koo Chieh Shen, chairperson of the
Association of Orthodontists (Singapore)
Congress 2023, said: “We are delighted with
the outcome of the AOSC 2023. The congress
was designed to provide delegates with
opportunities to learn, explore and network in
an enriching environment. As we look back at
the event’s success, we extend our gratitude
to all our attendees, speakers, sponsors,
and exhibitors and look forward to providing
more opportunities for dental professionals
to reconnect in the future. We are pleased to
know that the AOSC 2023 was an event worth
smiling over.”
The AOSC provided an excellent platform
for orthodontists, researchers, and industry
experts to learn from one another and to
share their expertise. The event included a
wide range of educational and enrichment
opportunities, including keynote speeches,
panel discussions, and scientific poster
presentations. The scientific conference
featured a total of 21 sessions including postcongress
workshops.
The AOSC scientific poster competition
was another highlight of the event, with 38
poster submissions accepted and 10 finalists
shortlisted for poster judging. Dr Mei H’uah
Chin was the research category winner
with her poster titled Efficacy of Mandibular
Advancement Appliances at Different
Mandibular Protrusions for Obstructive Sleep
Apnoea — A Randomised Controlled Trial. Dr
Pongsakorn Warin won best poster in the
case report category with his submission
An Overcoming of Class III Skeletal Anterior
Open Bite by Whole Arch Distalization and
Intrusion Using an Indirect Palatal Mini-screw
Anchorage and Distalization Appliance and
Buccal Shelf Mini-screws With Tongue Posture
Reprogramming Using Bonded Shark Tooth-Like
Spurs.
The trade exhibition was a thriving success,
with 17 exhibitors and over 100 exhibiting
brands showcasing the latest trends, clinical
products, and innovations in the orthodontic
industry. Attendees had the opportunity to
explore the latest technologies and tap on
existing knowledge, to update their clinical
practice.
“As an exhibitor at AOSC, we were thrilled
to see the return of in-person events and
the opportunity to connect with orthodontic
professionals from around the world,” said Vida
Lau, commercial director, SE Asia, Straumann
Group and ClearCorrect Singapore. “The
enthusiasm from attendees was infectious and
we were able to make valuable connections
while showcasing our latest products.”
Attendees of the AOSC were not only able to
attend informative sessions and engage with
exhibitors, but they were also able to participate
in fun and engaging social events. The AOSC
Welcome Reception was held at Hopscotch
Gardens by The Bay on the first night and the
AOSC Gardens by The Bay Run on the second
day morning were particularly popular, with all
slots fully subscribed. These events provided
ample opportunities for attendees to network
and socialise, rounding up their conference
experience with fond memories and new
connections.
Dr Bryce Lee, president of the AOSC,
added: “The AOSC was an excellent event
that provided a platform for the exchange
of ideas and knowledge amongst dental
professionals. We were thrilled to see the
high level of engagement and participation
from the delegates. This is a testament to the
importance of continuing dental education.
We also had a great opportunity to network
amongst fellow professionals, after a lapse
of four years. This event augurs well for our
profession and we look forward to the next
edition of the AOSC in 2025.” DA
66 DENTAL ASIA MARCH / APRIL 2023

EVENTS CALENDAR
MARCH
14 – 18 International Dental Show 2023
(IDS) 40th edition
Cologne, Germany
Venue: Cologne Fair Grounds
17 – 18 SIDO International Spring
Meeting
Rome, Italy
Venue: Rome Cavalieri Waldorf
Astoria
24 – 25 BDIA Dental Showcase
London, United Kingdom
Venue: ExCeL Exhibition Centre
APRIL
20 – 22 ITI Congress Argentina &
Uruguay
Buenos Aires, Argentina
Venue: Golden Center
21 – 24 American Association of
Orthodontists
Annual Session 2023
Chicago, IL, US
Venue: McCormick Place
Convention Center
27 – 29 International Osteology
Symposium
Barcelona, Spain
Venue: Barcelona International
Convention Center
MAY
4 – 6 Edentulism 2023
Canary Islands, Spain
Venue: ExpoMeloneras
4 – 7 IDENTEX 2023 - Oral and Dental
Health Exhibition
Antalya, Turkey
Venue: ANFAŞ Antalya
Expo Center
12 – 13 ITI Congress Germany & Austria
Dresden, Germany
Venue: Maritim Hotel &
International Congress Center
18 – 20 Expodental Meeting 2023
Rimini, Italy
Venue: Fiera di Rimini
25 – 28 Istanbul Dental Equipment and
Materials Exhibition (IDEX) 2023
Istanbul, Turkey
Venue: Istanbul Expo Center
26 – 28 Seoul International Dental
Exhibition and
Scientific Congress (SIDEX) 2023
Seoul, South Korea
Venue: COEX
JUNE
1 – 4 Morocco Dental Expo 2023
El Jadida, Morocco
Venue: Mohammed VI Exhibition
Center
2 – 4 FAMDENT Mumbai
Mumbai, India
Venue: Bombay Exhibition Center
8 – 10 Implant Solutions World
Summit 2023
Athens, Greece
Venue: InterContinental
Athenaeum
9 – 12 SinoDental 2023
Beijing, China
Venue: China National
Convention Center
11 – 15 European Orthodontic
Society Congress
Oslo, Norway
Venue: Oslo Spektrum
AUGUST
17 – 19 Vietnam International Dental
Exhibition & Congress
(VIDEC) 2023
Hanoi, Vietnam
Venue: Cultural Palace
24 – 26 ICDO 2023 - 8th Edition of
International Conference
on Dentistry and Oral Health
(Hyrid)
London, United Kingdom
SEPTEMBER
15 – 17 Indonesia Dental Exhibition &
Conference (IDEC) 2023
Jakarta, Indonesia
Venue: Jakarta Convention Center
21 – 23 CEDE 2023 Central European
Dental Exhibition
Łódź, Poland
Venue: Expo-Lodz Lodz Poland
24 – 27 FDI World Dental Congress
Sydney, Australia
Venue: International Convention
Centre Sydney
28 – 30 Berlin Reloaded: 30th EAO annual
scientific meeting,
37th DGI annual congress
Berlin, Germany
28 – 30 International Congress of Oral
Implantologists (ICOI)
World Congress 2023
Dallas, TX, US
OCTOBER
12 – 14 Dental World 2023
Budapest, Hungary
Venue: HUNGEXPO Budapest
Fair Center
14 – 17 DenTech China 2023
Shanghai, China
Venue: Shanghai World Expo
Exhibition and Convention Center
18 – 20 Central Asia Dental Expo
(CADEX) 2023 - 7th International
Dental Exhibition
Almaty, Kazakhstan
Venue: ATAKENT Expo 11th Pavilion
NOVEMBER
1 – 4 American Academy of
Implant Dentistry (AAID)
Annual Meeting
Las Vegas, NV, US
Venue: Caesars Palace
9 – 11 SIE National Congress 2023 -
38th Edition
Bologna, Italy
13 – 14 32nd American Dental Congress
San Francisco, US
24 – 29 Greater New York Dental Meeting
(GNYDM) 2023 - 99th Annual Session
New York, US
Venue: Jacob K. Javits
Convention Center
DENTAL ASIA MARCH / APRIL 2023 67

ADVERTISERS’ INDEX
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68 DENTAL ASIA MARCH / APRIL 2023

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