DENTAL TRIBUNE The World’s Dental Newspaper · Asia Paciﬁc Edition PUBLISHED IN HONG KONG www.dental-tribune.asia MAORI ON COCA-COLA New marketing ploy by Coca-Cola by labelling its products with Maori language has been criticized by the New Zealand Dental Association. ” Page 04 FDI WORLD DENTAL CONGRESS FDI will be putting special focus on China when its World Dental Congress is held in Shanghai in September 2020. ” Page 05 VOL. 18, NO. 06 CLEAR ALIGNER The Australian Health Practitioner Regulation Agency has launched investigations into four providers of clear aligner therapy due to breaching of advertising laws. ” Page 07 Rise of non-premium dental implants in Asia Pacific region By Jeremy Booth, Dental Tribune International BEIJING, China: Sales of dental im- plants are set to grow at a phenom- enal rate in the coming years in major dental markets in the Asia Pacific region. The value implant segment is driving volume growth, but still trailing behind the pre- mium segment when it comes to overall dollar value. International implant manufacturers are invest- ing in the value categor y, and cheaper solutions in implant ther- apy may be the key to boosting some of the region’s developing markets. The world’s population is grow- ing by an estimated 82 million peo- ple per year, but an increase in candidates for implant therapy is not the only factor driving growth in the dental implant category. The 2016 Global Burden of Disease Study underscored the prominence of the leading conditions behind edentu- lism. The study found that dental caries in permanent teeth was the most prevalent of the oral diseases that affected an estimated 3.58 bil- lion people globally—half of the world’s population—and estimated that severe periodontal disease was the 11th most prevalent disease on the planet. The category is seg- mented into dental implants, final abutments, instrument kits, plan- ning software and surgical guides. Other factors driving its growth in- clude an increasing incidence of sports-related injuries, ageing pop- ulations, rising demand for prosthe- ses and more dentists being trained to place implant restorations. >> Page 2 Market researcher iData says the Chinese and Indian dental implant markets are set to exhibit growth rates of over 20%. (Photograph: SnvvSnvvSnvv/Shutterstock) Singapore to ban advertisement of certain sugary drinks AD By DTI SINGAPORE: Excessive consumption of sugar-sweetened beverages (SSBs) can have a deleterious effect not just on oral health but on systemic health conditions, such as diabetes, as well. With this in mind, the Sin- gaporean government has an- nou nced that it w i l l ban the advertising of high-sugar drinks across all domestic mass media platforms. The move is in response to grow- ing global recognition of the con- tribution of excess sugar intake to a range of negative health outcomes. As Dental Tribune International has previously reported, the promotion of high-fat, high-salt or high-sugar food or drinks in traditional media and online media aimed at children has been banned in the UK, and the state government of Queensland in Australia has forbidden the ad- vertising of unhealthy food and drinks on the advertisement spaces that it owns. Singapore has one of the high- est rates of diabetes in the world, The Singaporean government has announced that it will ban the advertising of high-sugar drinks across all domestic mass media platforms. (Image: Trong Nguyen/Shutterstock) and 13.7% of its adult population has been diagnosed with the con- dition. This is commonly attributed to an ageing population and to the increasingly widespread adoption of a diet high in added sugar. Edwin Tong, the Senior Minis- ter of State for the Ministries of Health and Law in the country, stated that the advertising changes would only apply to those carbon- ated beverages and fruit juices that are deemed to be the unhealthiest. “We will introduce an advertis- ing prohibition of product adver- tisements for the least healthy SSBs on all local mass media platforms, including broadcast, print, out-of- home and online channels,” Tong said in a statement. It has been confirmed that con- sultations with consumers, drink producers and the advertising in- dustry will take place prior to mak- ing a decision on the specific date for the ban to be implemented. Distinguished by innovation Healthy teeth produce a radiant smile. We strive to achieve this goal on a daily basis. It inspires us to search for innovative, economic and esthetic solutions for direct ﬁlling procedures and the fabrication of indirect, ﬁxed or removable restorations, so that you have quality products at your disposal to help people regain a beautiful smile. www.ivoclarvivadent.com Ivoclar Vivadent AG Bendererstr. 2 | 9494 Schaan | Liechtenstein Tel. +423 235 35 35 | Fax +423 235 33 60
02 << Page 1 According to Global Market Insights (GMI), the global dental i m p l a n t m a r k e t w a s w o r t h U S $ 3 . 9 b i l l i o n l a s t y e a r . A compound annual growth rate (CAGR) of 5% will mean that the category increases in value by around one-third to be wor th US$5.4 billion (CNY 35.4 billion; JPY 542.2 billion) by 2025. In the Asia Pacific region—the fastest- growing area for dental implants— GMI forecasts a CAGR rate of 6.5% between 2019 and 2025. According to medical market research company iData Research, which published a new report this year on dental implants in the Asia Pacific region, the region is the third largest for dental implants and cur- rently accounts for 28.1% of the to- tal value of the global market. The market researcher revealed last year that implant sales in the region were expected to experience high levels of growth in the coming years, to be worth US$890 million by 2024, and that the region was transitioning towards inexpensive implant solutions. In 2018, according to iData, the region’s key dental markets, Aus- tralia, China, India, Japan and South Korea, had a near fifty–fifty split in terms of the market value for pre- mium versus non-premium dental implants. The non-premium seg- ment edged slightly ahead to ac- count for 51.2% of market value versus 48.8% for the premium seg- ment. Cheaper implant solutions are expected to hold a 55% share of total market value in the region by 2024, according to iData’s analysts. Are value implants set to trans- form Asia Pacific markets? Jeffrey Wong, Analyst Director at iData, says it is not that simple. The value segment in the region is expe- riencing a healthy growth rate and an increase in volume sold, but the contribution of cheaper implants, in dollar value, is much smaller when compared with that generated by the premium implant segment. This trend is expected to unfold in the burgeoning Chinese market and in the lesser-developed Indian market, and significant growth has been fore- cast for dental implants in both of these countries in the coming years. AD ASIA PACIFIC NEWS Dental Tribune Asia Paciﬁc Edition | 06/2019 Training and educational activities for dentists placing implant restorations will help to speed up growth in the region. (Photograph: Straumann Group) “Within the Asia Pacific region, both the Chinese and Indian dental implant markets are poised to ex- hibit year-on-year market growth rates of over 20%,” explains Wong. “In both countries, the value and discount segments will exhibit higher growth rates compared with the premium segment. However, the premium segments will be add- ing more to the overall value of the markets, despite the lower growth rates.” that the Chinese market is nearly four times the size of the Indian market.” Wong also points out that not all growth rates are created equal: “Even though both the Chinese and Indian markets are expected to experience similar rates in market growth, it is worth noting Despite a lower contribution to overall market value, an increasing prevalence of dental implants be- ing placed will boost visibility and acceptance of this form of dental therapy. “Even though both the Chinese and Indian markets are expected to experience similar rates in market growth, it is worth noting that the Chinese market is nearly four times the size of the Indian market.” Jeffrey Wong, iData Investment required on several fronts Implant manufacturers are plan- ning to do more business in the Asia Pacific region, and iData says the market landscape in the region is becoming increasingly competitive. Major implant manufacturers, such as the Straumann Group, have in- creased investment in their implant portfolios in key Asia Pacific mar- kets, particularly in the growing non-premium category. The Straumann Group acquired the popular Indian implant brand Equinox in 2016 and Anthogyr’s Chinese implant business. This year, the company’s acquisitions have continued. The company said in its 2019 half-yearly report that it was AO A NNUA L M E E T ING E VO LV IN G T E CHNO LO G I E S in Implant Dentistry March 18-21, 2020 Seattle, WA • osseo.org
Dental Tribune Asia Paciﬁc Edition | 06/2019 ASIA PACIFIC NEWS 03 investing in the South Korean com- pany Warantec to boost its pene- tration into the non-premium implant segment. Straumann said that it would provide a capital in- jection to bolster the established implant manufacturer’s production and international business and would gain in return a stake of just over one-third in the company and the exclusive rights to distribute War- antec implants outside of South Korea. Straumann said that the company’s Oneplant implant sys- tem offers affordability in the seg- ment and that product registrations had been obtained in China and in the leading dental implant regions, the US and Europe. The Asia Pacific region makes up 18% of the Straumann Group revenue and is the company’s fast- est-growing region. The company sa id i n its repor t t hat it had strengthened its foothold in pow- erhouse China’s non-premium im- plant segment by rolling out a fully tapered implant made by daughter company Anthogyr and that it had benefited from intensified training and educational activities in the country. “This is significant because only a very small proportion of the dentist population in China has re- ceived training in implant den- tistry,” the company stated. A key enabling factor in the suc- cess of companies like Straumann will be a greater investment by den- tists in the Asia Pacific region in offering implant-supported resto- rations. Of course, a vital part of the equation is that consumers are willing and able to invest in their oral health. In an April interview, Claire Li, Clinical and Scientific Manager at Dentsply Sirona Implants in China, commented that the dental implant market in the country was expand- ing quickly. “Different sources esti- mate a growth rate between 15 and 30% in the coming years, and the market is likely to exceed US$700 mil- lion by 2020.” She explained that the main drivers behind the rapid growth in numbers of implants placed in the country were an increasing familiar- ity with implant-supported resto- rations, more dental practices now offering implant dentistry, and eco- nomic factors that are making Chi- nese more willing to spend money on their oral health. Earlier this year in China, the Global Times quoted business news portal 21jingji.com as saying that “A full set of implanted teeth could cost as much as a brand-new BMW sedan.” The English-language daily tabloid reported that demand in China for oral treatments such as tooth replacement was surging, but that a lack of domestically made implants meant consumers were paying high prices in a market dom- inated by international dental com- panies. The newspaper said that calls have been made in China for the development of domestically manufactured dental implants in order to lower the costs of implant therapy for consumers. In the South Korean market, larger international dental compa- nies face stiff competition from domestic implant manufacturers, who have helped to transition the market towards more inexpensive implant solutions. But the situation in South Korea also reminds us that growth in the implant market re- quires investment from other par- ties. The country’s National Health Insurance Service lowered the age of eligibility for dental implant cov- erage to 65 from 70 in 2016, which iData says has helped to transform South Korea to the region’s most highly developed market for dental implants. “Calls have been made in China for the development of domestically manufactured dental implants in order to lower the costs of implant therapy for consumers.” Europe and the US dominate implant sales According to iData, Europe and the US still take the lion’s share of the global dental implants market. Europe accounts for 34.3% of the to- tal value of implants placed annu- ally and the US accounts for 29.5%. Together, these two regions hold al- most two thirds of the entire mar- ket. At 28.1%, the Asia Pacific region is currently the third most valuable for dental implants, followed by the Latin America region at 8.1%. AD Tetric® N-Line High-quality composites for esthetic anterior and posterior restorations High-quality composites for esthetic anterior and posterior restorations One efficient solution for all cavity classes MORE THAN MIO . s e r u g ﬁ l s e a s n o d e s a B * RESTORATIONS PLACED* Ivoclar Vivadent AG Bendererstr. 2 | 9494 Schaan | | Tel. +423 235 35 35 | Fax +423 235 33 60
04 ASIA PACIFIC NEWS Dental Tribune Asia Paciﬁc Edition | 06/2019 Coca-Cola criticised by NZDA for culturally appropriating Maori language. By DTI AUCKLAND, New Zealand: New Zea- land has an oral health problem. Expense is one of the main factors that prevent people from visiting the dentist, and this results, in some instances, in oral health conditions similar to those of developing coun- tries. However, sugar is another major issue, and in a recent state- ment, the New Zealand Dental As- sociation (NZDA), Te Ao M rama (the New Zealand Maori Dental As- AD REGISTER FOR FREE! DT Study Club – e-learning platform Join the largest educational network in dentistry! www.DTStudyClub.com Tribune Group GmbH is an ADA CERP Recognized Provider. ADA CERP is a service of the American Dental Association to assist dental professionals in identifying quality providers of continuing dental educa- tion. ADA CERP does not approve or endorse individual courses or instructors, nor does it imply acceptance of credit hours by boards of dentistry. Tribune Group GmbH designates this activity for one continuing education credit. sociation) and H pai te Hauora (Maori Public Health) have criticised the use of the Maori language on Coca-Cola products. The new marketing ploy by Co- ca-Cola focuses its sights directly on the New Zealand Maori popula- tion by labelling its products with slogans such as “Share a Coke with wh nau [family]” and “Share a Coke with kuia [grandma]”. “This has shades of the tobacco industry here—a subversive insidious way to connect with people who suffer a disproportionate amount of den- tal disease and harm from a public health perspective,” said NZDA sug- ary drink spokesperson Dr Rob Bea- glehole. A marketing ploy by Coca-Cola targets at-risk New Zealanders by culturally appropriating te reo M ori [the Maori language]. (Image: Twitter/@waikatoreo) According Dr Kirsten Robert- son, a senior lecturer in the Depart- ment of Marketing at the University of Otago, New Zealand has a signif- icant problem regarding the con- sumption of sugar-sweetened bev- erages (SSBs). As reported by Dental Tribune International, New Zealand is the third most overweight nation in the Organisation for Economic Co-operation and Development area, and 17% of adults’ total sugar intake comes from SSBs. “This corporation which cares nothing for our mokopuna [chil- dren], our kuia and kaum tua [se- niors], has appropriated our lan- guage to make a profit. Worse— they’ve singled out one of the worst areas of inequity in health out- comes—our wh nau’s oral health. They should be ashamed,” said H pai Te Hauora CEO Selah Hart. The introduction of a sugar tax is still to be debated in parliament, and direct action to protect some communities from persuasive mar- keting is also greatly needed. Ac- cording to the NZDA, 2017–2018 data shows Maori are 1.36 times more likely than non-Maori to have teeth removed as a result of dental caries. According to a 2018 Best Practice Advocacy Centre New Zea- land study, it was estimated that, in the Auckland region alone, over 40% of people of Maori, Pacific or Indian ethnicity aged 35–39 years have prediabetes.
Dental Tribune Asia Paciﬁc Edition | 06/2019 ASIA PACIFIC NEWS 05 FDI World Dental Congress 2020— China is shaping future of oral health By FDI World Dental Federation SHANGHAI, China: China is a pow- erful ally in achieving a global com- munity commitment to health. Recognising that health is funda- mentally linked to successful eco- nomic and social development, the Chinese government is making progress to protect and promote the health and well-being of its cit- izens. When its World Dental Con- gress is held in Shanghai from 1 to 4 September 2020, FDI will be put- ting special focus on the country. In China, significant differences exist between urban and rural pop- ulations in terms of oral hygiene practices and access to oral care. Results of a study published in the International Dental Journal in 2005 revealed that regular toothbrush- ing was three times more frequent in urban than in rural areas. There are also a limited number of oral health professionals to serve the population: the dentist to popula- tion ratio is 1:100,000. As might be expected, the use of oral health ser- vices is somewhat lower in rural than urban areas: significantly more rural residents in the study had never seen a dentist during their lifetime. Owing to the limited avail- ability of dentists, most people have a symptomatic, rather than preven- tive, approach to dental care. The most frequently cited reasons for dental visits are toothache, need for tooth extraction and prosthetic treatment. Dental care is offered on a fee- for-service basis that not everyone can afford: the fees for restorative services are approximately twice the cost of tooth extraction and are ten times higher than for preven- tive services. The 2005 study re- AD The World Dental Congress is a flagship event of FDI, strengthening ties and fostering collaboration within the global oral health community. (Image: FDI) ported that many people living in urban areas had at least part of their dental costs covered by their em- ployers, which was not the case in rural areas, keeping oral care in these areas even more out of reach. Healthy China 2030 The Healthy China 2030 initia- tive is an ambitious vision to incor- porate health into all policies and engage the whole of government in health. Healthy China 2030 in- cludes special provisions to improve oral health. As part of its vision, Healthy China 2030 implements special campaigns to raise aware- ness of oral diseases, among other health concerns. FDI congratulates the Chinese government for ensur- ing that oral health is recognised as being integral to overall health and well-being and is grateful that the policy landscape provides such a welcoming setting for the 2020 FDI World Dental Congress. FDI and Chinese Stomatological Association join forces for better oral health outcomes habits in China’s rural areas, most notably through the Smile Around the World initiative. Smile Around the World aims to introduce the importance of oral health through a series of educational workshops that will help children establish good oral health habits from a young age. The latest initiative was imple- mented earlier this year in three elementary schools in the cities of Pingxiang and Ganzhou in Jiangxi province. FDI and the Chinese Stomato- logical Association (CSA) have worked side by side to increase access to oral care and improve oral hygiene The 2020 FDI World Dental Congress, which is being co-hosted by the CSA, shows a joint commit- ment to continue strengthening this partnership to improve the oral health of populations. By work- ing together to build the scientific programme, the goal is to give global relevance to local research and learning, as well as share best practices on how to address the oral health challenges that are common to all geographical set- tings. Attendees will also learn more about the Healthy China 2030 initiative and how this translates globally. The congress will offer hundreds of continuing education opportunities and cover hot topics in clinical practice, research and public health and will feature nu- merous hands-on workshops. PRINT EVENTS EDUCATION DIGITAL Dental Tribune International The World's SERVICES Largest Dental Marketplace www.dental-tribune.com
06 ASIA PACIFIC NEWS Dental Tribune Asia Paciﬁc Edition | 06/2019 Improved instrumentation to reduce endodontic complications By DTI BUSAN, South Korea: Reducing com- plications in root canal therapy is in the best interests of dentists as well as patients. To improve the clinical performance of endodontic files, a research team led by Dr Sang Won Kwak from Pusan National University tested instruments with specially designed rotary motion. Over the years, root canal prepa- ration has been improved by the use of engine-driven NiTi files. AD Compared with stainless-steel man- ual files, NiTi instruments offer better flexibility and cutting effi- ciency in addition to reduced iat- rogenic errors. However, the NiTi files may have cyclic fatigue and torsional failure problems during root canal preparation. To reduce the risk of file fracture, Kwak and his team tested heat-treated NiTi alloy files with specially designed rotary motion. A study suggests that adaptive motion of NiTi files improves the success rate of root canal therapy by lowering the torque generation of the instruments. A lower torque will help reduce the risk of tooth damage and file fracture. (Photograph: alleemate/Shutterstock) The scientists tested three com- binations of instruments and mo- tions for root canal preparation. These were the K3XF rotary system with continuous rotary motion, the K3XF rotary system with adaptive motion and the Twisted File system with adaptive motion (TFA), all from the endodontic product manufac- turer Kerr Endodontics. Adaptive motion combines continuous and reciprocating motion, rotating 600° and stopping when the file is ex- posed to minimal or no load. “Adap- tive movement helps to reduce torque generation during instru- mentation with NiTi rotary files,” said Kwak. Torque generation oc- curs while removing root dentine by engine-driven NiTi files. The generated torque indicates the en- ergy required to cut the root den- tine, but also represents the reac- tion stress on NiTi files as well as the root dentine. To ensure consistent test con- ditions, endodontic training resin blocks were used. Each block con- tained an S-shaped artificial canal, with a working length of 16 mm. The instrumentation was performed for a total of 45 tests (15 per instru- ment) by a single experienced en- dodontist in order to reduce oper- ator errors. The researchers found that TFA generated the lowest torque. Kwak and his colleagues thus concluded that the adaptive motion for NiTi files may reduce torque generation without increasing preparation time. Kwak also suggested that the “torque generation is more likely to be affected by the cross-sectional area rather than the movement of the file system”. A smaller cross-sec- tional area may account for the lower torque generation by the TFA file system.
Dental Tribune Asia Paciﬁc Edition | 06/2019 ASIA PACIFIC NEWS 07 Australian agency has launched investigations into clear aligner providers By DTI Promoting clear aligners on social media without disclosing payments is a breach of Australian law. (Image: Edwardolive/Shutterstock) SYDNEY, Australia: The Australian Health Practitioner Regulation Agency (AHPRA) has launched investigations into four providers of clear aligner therapy amid claims of hushed in- centives being provided to dentists and the breaching of advertising laws. AHPRA has launched investiga- tions into market leader Invisalign and the teledentistry providers Smile- DirectClub, EZ Smile and Wonder- Smile. According to the Sydney Morn- ing Herald, the four separate investi- gations are following up on complaints from within the dental industry about the business and marketing practices of the companies. The c ompl a i nt s su r f a c e d through articles in The Age and the Herald and accused health regula- tors of failing to enforce the rules. The authors of the articles said that federal regulators had received complaints about social media in- fluencers promoting clear aligners without proper disclosure, which, if true, would be a breach of the law. The Therapeutic Goods Adver- tising Code stipulates that any pay- ments received for the advocacy of therapeutic goods—clear aligners, in this case—must be disclosed and a failure to do so carries a maximum fine of A$1.05 million (€649,000). Undisclosed promotion through so- cial media would also breach the Health Practitioner Regulation Na- tional Law, the authors pointed out, which attracts fines of A$5,000 per advertisement for individuals and double that for companies. “Nobody is even bothering to pretend to follow the law,” read one of the complaint letters from a den- tal industry insider, who believed that revealing his identity would cause him to lose his job. One letter from a Melbourne prosthetist said the undisclosed promotion presented a “clear and present danger to vulnerable health customers”. Industry insiders also com- plained to health regulators that Invisalign Australia was offering volume discounts to dentists. Based on the number of patients who or- dered the Invisalign cases, the dis- counts, it was claimed, provided an incentive to dentists and orthodon- tists to sell the company’s clear aligners and could result in patients being sold an unsuitable product. Invisalign Australia confirmed to the Herald that volume discounts were being offered to accredited dentists. The company said that such discounts are permitted under Australian law and common in the industry. In addition to the AHPRA inves- tigations, the Therapeutic Goods Ad- ministration confirmed to the Herald that it had opened investigations into potential breaches of its advertising code with respect to clear aligners. 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Special Care Dentistry Symposium Highlighting the treatment needs of patients with special needs, this full day forum is one of the first in Asia to focus on this niche topic in dentistry. W E N Trade Exhibition Discover the latest products and services in the dental industry and meet over 500 exhibitors at IDEM. Hands-On Workshops Hone your skills and learn new techniques at the limited attendance, hands-on workshops. SECURE YOUR PASSES ONLINE FOR IDEM 2020 Registration Connect with us Endorsed by Supported by Held in Organised by Koelnmesse Pte Ltd Ms. Isabel Shankar T: +65 6500 6700 E: firstname.lastname@example.org +65 9622 9782 IDEM Singapore IDEM Singapore idem.sg @IDEMSingapore Singapore Dental Association