N L Y A L S O N F E S SI O O R T A L P N E D PUBLISHED IN DUBAI ENDO TRIBUNE Bioceramic dispersion root filling www.dental-tribune.me January-February 2020 | No. 1, Vol. 10 LAB TRIBUNE The gold standard: IPS e.max Press – one material for virtually all indications?! IMPLANT TRIBUNE 3D digital dentistry imaging helps to push boundaries ORTHO TRIBUNE SureSmile learning app honored with AXIS award for learning technology HYGIENE TRIBUNE Dentaid – improving the world’s oral health ÿA1-2 ÿB1-2 ÿC1 ÿD1 ÿE1-2 "Clinical education is key to us. Providing dental professionals with essential knowledge is one of our main goals" By Dr. Dobrina Mollova DUBAI, UAE: Dental Tribune MEA had the pleasure to interview Don Casey, CEO of Dentsply Sirona and Walter Petersohn, CCO of Dentsply Sirona during their visit to Dubai recently. The interview took place at the beautiful Dentsply Sirona office in Business Bay which is equipped fully to provide outstanding training to dental professionals from around the Middle East region. Dr. Mollova - DTMEA: A warm wel- come to the Middle East. Is this your ﬁrst-time visiting Dubai, par- ticularly the Dentsply Sirona Ofﬁce – Middle East? Don Casey: Yes, this is my first visit to Dubai. The Dentsply Sirona office here is beautiful, showcasing our products and offering outstanding training facilities to our customers. We really appreciate the partnership that we have with CAPP in terms of focusing on clinical education. It is a team effort to help dental profes- sionals practice with new equipment in new ways. u Page 31 Dentsply Sirona CEO, Don Casey (right) and CCO, Walter Petersohn (left). AD Transforming treatment for the better with digital dentistry By 3D Systems Capabilities in dentistry have evolved at an astonishing rate over the past several years, and the transforma- tions are by no means slowing down. The introduction of synergistic tech- nologies such as intraoral 3D scan- ning, computer aided design (CAD) software, 3D printing, and materials science are creating new treatment and business opportunities for den- tal professionals with equally posi- tive impacts on patients. Offering unprecedented speed, accuracy and cost-effectiveness, the digital den- tistry workflow is not theoretical; it is in use in labs and clinics around the world, and it is gaining traction daily. Generally speaking, a complete digital dentistry workflow includes methods for digitizing patient infor- mation, precisely manipulating that digital information, and transferring digital information back into the physical world in a suitable material. Many dental offices have now adopt- ed intraoral 3D scanning, which satis- fies the first step of the workflow and gives patients a more comfortable al- ternative to traditional impressions. For the design and fabrication stages of the workflow, access points vary. Some dentists prefer to outsource these operations to a lab, where digital design and fabrication meth- ods are becoming an increasingly popular choice for fast, high qual- ity and cost-effective dental models and restorations. Other clinics find it more cost-effective, productive and valuable to have a complete digital workflow available for immediate use on site. For both labs and offices, digital production has become far more obtainable through the emer- gence of easy to operate dental 3D printers like the NextDent 5100, which offers high print speeds, a small footprint, and high material versatility. The NextDent portfolio includes 30 unique biocompatible and CE-certified materials, making it capable of addressing a broad range of clinical needs. u Page 27
4 NEWS Dental Tribune Middle East & Africa Edition | 1/2020 The 100k foot VALO™ curing light drop test: behind the scenes The True Story of One VALO Curing Light's Journey to Space By Daniel Lewis, USA There's a deflating helplessness all golfers know, when you take two shots to get the ball on the green, then another two, three, or four shots to reach the bottom of the cup. Those final few feet between tee box and pin routinely humble the most optimistic golfer. Ultradent teed-off on a celestial par- 5 when we launched a VALO Grand dental curing light into space in May of 2019. Our version of the putting green was a mountain covered in loose shale where the VALO Grand light landed. We eventually "sunk the put" by finding the curing light… but we took several attempts to do it. The Vision to Send a VALO Light to Space The 10thanniversary for a product like the VALO curing light can't be a simple wine and cheese party. The line has set the bar for curing lights for a decade—we had to set the bar with a celebration. "This is the kind of thing where I didn't ask a lot of per- mission," jokes Ultradent's Mike Sim- mons, a cornerstone architect of the VALO Light to Space initiative. Simmons brought the idea to the ta- ble, but he credits the inspiration to a friend. "He had two very sick daugh- ters with a rare immune deficiency. One of their brothers donated his bone marrow to his sister...and they had a hero party for him, where they sent a bobblehead of him to space on a weather balloon and captured it with GoPros." With this concept in mind, Simmons began formulating a plan to mark the VALO curing light's decade on the market with a true out-of-this- world event. His team eyed May 1, 2019 for liftoff—10 years to the day of the VALO curing light line's debut. They had roughly 90 days of runway to execute the mission and found the process of entering Earth's at- mosphere relatively uncomplicated. They devised a payload that would carry a VALO Grand curing light— along with a bobblehead of Ul- tradent Founder and CEO Dr. Dan Fischer—to 100 thousand feet of al- titude, while also filming every angle of the flight and fall. The cargo consisted of a Styrofoam box, four GoPro cameras, the VALO Grand curing light, and the Dr. Fis- cher bobblehead–all carried into space by a standard weather balloon purchased on Amazon. The heftiest complication came from the fuel needed to power the 100k foot journey. "We're in a nation- al helium shortage," says Simmons. Just finding a vendor who would sell helium became a difficult endeavor, but a supply was eventually secured. "We may have overpaid for that," he chuckles. Helium in tow, Simmons' team nar- rowed their focus on the May 1, 2019 sendoff. "The amount of preparation just for [launch day] was pretty crazy. I don't think either of us were breath- ing," jokes Oliver Brown, Ultradent's Brand Manager for the VALO cur- Logo and title excluded, the above is a non-doctored image of a VALO Grand curing light as it ascends through Earth's atmosphere. The VALO Light to Space payload box, prior to launch The predicted ﬂight path for the payload Moments prior to liftoff on Ultradent's lawn Successful launch Waiting for the GPS pings to start again Simmons ponders as he awaits a GPS ping The point on the left marks where the payload landed, roughly 70 miles from the anticipated landing spot of Flaming Gorge Reservoir. Ultradent's Mike Simmons packs cargo for the (ﬁrst) overnight trip into the Uinta mountains. ing light line. "People were saying 'what's gonna happen? What are you gonna do with this thing?' And I'm like, 'we're just...gonna...launch it,'" he adds with a shrug and a smile. Countdown Marketers don't tend to moonlight as physicists, but Simmons, Brown, and others involved in the launch ran countless simulations to predict the balloon's flight path and even- tual landing spot for the payload. Fortunately for the "mathematically limited" folks of the world, there are websites that do the heavy lifting on these calculations and limit the po- tential for human error. "We felt like we had a pretty good idea where it would come down," says Simmons. "All of the predictions we ran [. . .] told us we were going to pick it up at Flaming Gorge Reservoir, up over the Uinta [mountain range] and down around Flaming Gorge." When May 1 rolled around, weather was a large concern and the unpre- dictability of spring in Utah loomed over liftoff. Atmospheric conditions were favorable for the liftoff, despite frost on the ground the morning of the launch. Dr. Fischer emblazoned his signature across the VALO Grand dental curing light and the team attached it to the outside of the cargo box opposite the bobblehead, both in frame of their own GoPro. Handwarmers were add- ed to the payload to battle frigid at- mospheric temperatures that could derail video efforts. Ultradent's front lawn was converted to a launchpad and employees made up the peanut gallery. Dozens came out to watch the liftoff, accompa- nied by their own festive balloons to release alongside the main payload. Following a "10, 9, 8, 7…" countdown necessary for all space travel, the balloons were released, with the weather balloon and its cargo quick- ly ascending beyond its party-favor brethren. "We were on cloud nine as soon as we saw it go up into the sky," says Brown. "Now we know how NASA feels," adds a smirking Simmons. Up, Up and Away As the VALO Grand curing light climbed and slipped from view Sim- mons, Brown, and crew piled into a vehicle to trail the balloon. "We had the perfect day planned. We had this van, we had the video crew with us. We were going to follow the pings on our phones and laptops," Simmons says. "When we got in the minivan to start driving there, we were so excited, thrilled, anxious, just to get to Wyo- ming," Brown adds. The GPS pings were in line with the predicted flight path, and the team followed the digital footprints. "It was following the trajectory of the prediction calculator exactly. We were like, 'ok this might be too good to be true,'" says Simmons. "Then we lost it." The halt of pings didn't alarm the team – they anticipated losing com- munication with the payload when it reached 40–50 thousand feet of elevation. They expected to pick up the pings again once the balloon popped and the cargo descended back toward Earth. The crew pulled into a roadside diner and bunkered down, eating lunch to anxiously pass the time waiting for the next GPS ping. "We had lunch with our laptops open, thinking 'OK anytime now,'" Simmons recounts. "A couple hours later we're just sitting there, and there's nothing. We knew the total flight time would be somewhere between 2.5 and 3.5 hours. And we gave it...probably 4.5 hours, maybe 5 hours...just waiting, waiting, waiting. We ordered dessert, and still, noth- ing. We kinda just licked our wounds and went back to Ultradent." "There was a totally different feel in the van on the way back. Everybody was quiet, nobody was really talk- ing. People were making occasional jokes, trying to cheer each other up... but we were all just like 'ohhh nooo,'" says Brown. "Just a real quiet ride back. I think we stopped to film a train. Like, 'Oh that will make up for it, look at this train we saw.'" u Page 16
AEEDC Ultradent Booth 5C06 Come and visit us!
6 NEWS Dental Tribune Middle East & Africa Edition | 1/2020 Beverly Hills formula set to dazzle this 2020 By Beverly Hills Formula For Irish oral care brand, Beverly Hills Formula 2019 can be seen as their most successful year yet and the past twelve months will certainly prove difficult to beat. The brand saw their business grow phenomenally, particularly in Middle Eastern Mar- kets which boasts an extremely loyal following. The brand credit their 2019 success to a number of factors – their commitment to providing top- class at- home teeth whitening with formulations that are yet to be repli- cated, and their drive to bring first to market products that wow both con- sumers and dentists alike. The brand has always ensured that they stay well ahead of competitors and are certain that they will see even more success this coming year. If 2019 was anything to go by, this year is set to be monstrous for the brand. Not only are they entering the new year with a number of prestig- ious accolades under their belt, they will also be showcasing some of their most ground-breaking products yet, one of which is set to be released im- minently. This year, the ever-popular oral care brand will be exhibiting at the AEEDC Dental Exhibition in Dubai, which takes place from February 04- 06. The team are really excited to be heading back to what is seen as one of the most prestigious dental exhi- bitions worldwide. The exhibition offers Beverly Hills Formula the op- portunity to meet with dentists and suppliers who attend from countries all over the world, whilst also allow- ing the brand to showcase their lat- est products and innovations. Their stand, adorned in their trademark bold and daring colours, is always a must-visit for many attending over the weekend. The brand will be bringing along their most prestigious ranges, in- cluding the NEW Professional White Range and Perfect White Range. The Professional White Range, which was launched in 2019, consists of Ad- vanced Black Pearl whitening tooth- paste, Advanced Silver whitening toothpaste and Advanced Sensitive whitening toothpaste. As well as this, the brand will also be showcasing the ever popular and iconic Perfect White Range. The range consists of the first to market activated charcoal toothpaste, Per- fect White Black, as well as Perfect White Gold, Perfect White Black Sen- sitive and Perfect White Optic Blue. Two high performing gold and black mouthwashes also form part of the range which has soared in popularity and doesn’t look to be slowing down any time soon. This year, Beverly Hills Formula will ensure that all eyes are on them as they are set to launch their best ever whitening toothpaste. Set to join the Perfect White Family in 2020 is Per- fect White Extreme Whitening. Their latest product offers immediate op- tical whitening results and perfect stain removal whilst still being kind to teeth. The ground-breaking am- ethyst formula provides a whitening effect that is visible after just one use whilst hydrated silica and advanced pyrophosphates ensure excellent stain removal whilst working to light- en and brighten teeth. The product offers a first to market formulation which also works off light reflection to further enhance whitening results. Beverly Hills Formula are excited to embark on another ground-breaking and hugely successful year and look forward to kicking this off at the AEEDC Dental Exhibition. Be sure to check them out at stand SRD08 – there is truly something for every- one. DTI looks back on a successful 2019 By Dental Tribune International LEIPZIG, Germany: There is seldom a quiet news day in the dental industry and it has been a pleasure for the DTI team to bring you, throughout 2019, the stories that mattered as well as a suite of continuing education (CE) opportunities and events. As 2020 approaches, we look back on some of the milestones that DTI reached as a publisher and industry partner during the last twelve months, and we also look ahead excitedly at what promises to be another engaging and prosperous year in dentistry. Back in February, DTI shared with readers that the industry was in good shape. The global market for re- storative dentistry products was ex- periencing strong growth, driven by more dental implants being placed, a higher market penetration of CAD/ CAM-produced prostheses and final abutments, and thriving technologi- cal developments in segments such as intra-oral scanners and clear align- ers. Dental practices were report- ing smoother operations owing to advances in practice management, and the importance of oral care was increasingly being put in the inter- national spotlight. As DTI worked to bring these developments to you in print and digital media, we had some developments of our own. An expanding international network The thirty-eighth International Den- tal Show (IDS) took place in Cologne in March and DTI held its Annual Publishers’ Meeting in the scenic western German city during the build-up to the event. Over two days, 75 members of the DTI network had the opportunity to meet, share their successes and discuss the latest pro- jects being undertaken by the pub- lishing group. One of the highlights was an introduction to Dental Trib- une Algeria, a new licence partner and the first in North West Africa, led by Dr Ouahes Aziouez. In March, DT Algeria published the first of its quar- terly French-language Dental Trib- une Algeria Edition. The title focuses on the Maghreb region and the first issue was also the official newspaper of this year’s instalment of the Den- tex Algeria dental show. Something to Smyle about A completely new facet of DTI’s me- dia portfolio was also revealed at the publishers’ meeting: the glossy life- style-meets-prevention title, Smyle magazine. Published in collabora- tion with the Berlin-based Luna Me- dia Group, Smyle combines lifestyle, beauty and wellness with a patient- oriented focus on dentistry and oral health. Two issues of Smyle have already landed in dental offices throughout Germany, Austria and Switzerland. The next issue will hit the shelves in early 2020 and plans are being final- ised for an English-language interna- tional edition. E-learning remains a talk- ing point The online e-learning platform DT Study Club was a hive of activity throughout 2019 and this format of free and easily accessible online CE opportunities for dental profession- als remains one of our fastest grow- ing platforms. In the e-learning space, DTI also continued to work closely with dental companies on bespoke edu- cational projects and a number of Campuses—customised e-learning platforms—were developed. A good example of developments in this segment was DTI’s work with the Straumann Group: in October, the company expanded its global edu- cational online platform, the Strau- mann Campus. The website now offers up to 60 webinars per year, in five languages, to its international users. The webinars are free of charge and the overall aim of the platform is to build a true global e-learning com- munity. Another obvious highlight from DTI's work in e-learning was the world’s first 24-hour webinar in den- tistry. Deriving from the EMS Swiss Dental Academy Campus, the we- binar included 31 speakers from 16 countries and attracted over 15,000 participants. In the mix at dental trade fairs As is the case every two years, IDS dominated conversations among dental professionals in 2019—in all dental markets. Official figures released after the event confirmed its international relevance: 73% of exhibitors and 62% of visitors came from overseas, and 166 foreign countries were represented in the halls. Over the course of the show, the OEMUS MEDIA and DTI media lounge was the scene of a number of social occasions attended by key opinion leaders, including one that honoured a man who has dedicated his life to advancing dentistry. The Channel3 Evening was attended by more than 80 industry profession- als and the P-I Brånemark Award for Lifetime Achievement in Dentistry was presented for the fifth time. This year, it was awarded to Prof. Jörg Strub of the University of Freiburg in Germany. Dr Kenneth Malament ac- cepted the accolade on behalf of the esteemed professor and he remind- ed the gathering of Strub’s friends and colleagues that “[He] is an in- dividual who has put his whole life into dentistry—there is simply no one like him”. Malament continued, “He is the best of his generation.” Be- ing part of this recognition of Strub’s achievements was a clear highlight of 2019 for the DTI team. IDS aside, readers will agree that the wider dental trade fair calendar did not disappoint. DTI helped to keep scores of visitors and exhibitors in- formed with the more than 65 today show daily newspapers that were published by the DTI network dur- ing the year. Available in print and digital editions, today show dailies joined CE magazines to keep you in- formed. DTI’s CE magazine archive grew to include 50 different titles during the year. CAD/CAM -- international mag- azine of dental laboratories evolved into a magazine dedicated to dental laboratories, and the title digital -- in- ternational magazine of digital den- tistry will focus specifically on the topic of digital dentistry next year. DTI held its 15th Annual Publishers’ Meeting from 10-11 March in Cologne. (Image: Tom Carvalho, DTI) DDS.WORLD: the new digi- tal marketplace One of the most exciting develop- ments of 2019 came in the third quarter when DTI expanded into the dental marketplace with its new on- line sales platform, DDS.WORLD. DDS.WORLD has been designed to meet the needs of the entire dental team by simplifying access to the products, equipment and supplies that keep dental practices running. The portal also gives manufacturers and dealers the opportunity to list their products in a highly targeted environment and to communicate discounts and promotions to dental professionals. Roll on 2020 One of the things that we are particu- larly excited about in 2020 is our ex- pansion into the Scandinavian den- tal media market. From January, the new licence partner DentaNet will provide dental professionals in Den- mark and Norway with local editions of Dental Tribune and much more. Various digital and print products— such as webinars on DT Study Club in English, Danish and Norwegian— will help to tailor CE opportunities to dental professionals in both coun- tries and the regional Dental Tribune websites in Danish and Norwegian have already been launched. There are a number of projects yet to be revealed, so stay tuned for an even greater focus on e-learning and other educational opportunities. ROOTS Summit 2020 is taking place in Prague from 21–24 May and the line-up of speakers, workshops, and opportunities to engage with new equipment and protocols looks very Dr Kenneth Malament (left) accepted the P-I Brånemark Award for Lifetime Achieve- ment in Dentistry on behalf of Prof. Jörg R Strub, with Mark Ferber (middle), founder of Channel3, and DTI CEO Torsten Oemus. (Photo: Luke Gribble, DTI) promising. The event will bring endo- dontists and general dentists togeth- er and registrations are open—see the event's website for information on the programme and registrations. DTI will be on-site at all of the ma- jor dental events next year, and our today show dailies will keep you informed at leading events, including AEEDC Dubai 2020 (tak- ing place from 4–6 February at the Dubai International Convention and Exhibition Centre); IDEM 2020 in Singapore (taking place from 24–26 April at Suntec Singapore Conven- tion and Exhibition Centre); and the FDI World Dental Congress 2020 in Shanghai (taking place from 1–4 Sep- tember at the National Exhibition and Convention Centre). As we stand on the threshold of a new decade, it is exciting to imagine what the '20s could hold in store for dental practice, international dental markets, dental technologies, and oral care. The DTI team would like to take this opportunity to thank all of our readers and industry part- ners for their continued support. We wish you and your families a happy and safe holiday season, and a “good slide” into the new year, as the saying goes in Germany.
8 RESTORATIVE Dental Tribune Middle East & Africa Edition | 1/2020 Midline diastema closure using the front wing technique By Dr. Walter Devoto, Italy About the Case A 35-year-old female patient expressed a de- sire to optimize existing composite restora- tions on her maxillary central incisors, which had been placed 15 years previously to close her diastema. Then, a silicone key had been used for guidance. No tooth preparation was carried out, as the composite was bonded to the tooth structure. ishing. The shape of the teeth was acceptable, but not perfect. A decision was made to retreat her in a non-prep, single-shade approach. The main goal was to create a more natural shape. The front wing technique invented by the StyleItaliano team was used. This approach involved freehand modeling of the vestibular part of the tooth, which was easily accessible. Afterward, material was added to the palatal side, and anatomical matrices were employed for shape optimization. Challenge The surface of the restorations showed slight discolorations which were removable by pol- Outcome The technique worked beautifully to close the diastema. Despite freehand modeling, it was much easier and more precise than us- ing a palatal silicone index. In addition to the natural shapes that were achieved, 3M Filtek Universal Restorative blended well with the surrounding dentition, making the restora- tive work indistinguishable. About the author Dr. Walter Devoto graduated with honors in den- tistry and dental prosthesis in 1991 at the Univer- sity of Genoa, Italy. He is particularly interested in the ﬁelds of conservative dentistry and esthetic dentistry and runs his own private practices in Sestri Levante and Portoﬁno. In addition, he is col- laborating with diverse prestigious dental ofﬁces throughout Europe, which specialize in esthetic dentistry. He has worked as a teacher and dem- onstrator at the University of Genoa and as a lecturer at the universities of Siena and Madrid. Now, he is a lecturer at the International Univer- sity of Catalonia, Barcelona, Spain, and visiting professor at the Aix-Marseille University in Mar- seille, France. Case Overview INITIAL SITUATION: 15 years after the initial non-prep treatment, the restorations were still intact, but there was room for improvement in regard to shape, espe- cially in debri the vestibular area. To ensure esthetic results and create favorable con- ditions for bonding, surfaces were roughened and discloration and debris removed with 3M™ Sof-Lex™ Extra-Thin Finishing and Polishing Discs. The surface was cleaned and slightly roughened for etching and bonding. The selected treatment ap- proach worked without tooth preparation. Enamel was etched with 3M™ Scotchbond™ Univer- sal Etchant. After 15 seconds, etchant was removed by rinsing with water, and 3M™ Scotchbond™ Univer- sal Adhesive was applied. The preferred material for the single-shade technique was 3M™ Filtek Universal Restorative ™ shade A1. The composite has a universal opacity and lending a cha- meleon effect. After application of the ﬁrst layer of composite, the diastema was closed from the vestibular surface. Ves- tibular wing was ﬁlled and cured on the palatal side. Two anatomical matrices were used to close the dias- tema, create natural shape and ensure tight contact between central incisors. Matrices in contrasting colors were used. A drop of uncured ﬂowable composite between each matrix and tooth helped hold matrix in place. Composite material was applied to ﬁll space between each incisor and adjacent matrix. Matrix shape helped establish tight contact points and desired anatomical form. After light curing, composite was added from the palatal side. First matrix on right central incisor was removed. Removal of second matrix revealed a natural shape. Composite excess was easily removed from the incisal edge. Restoration surface was polished with 3M™ Sof-Lex™ Pre-Polishing Spiral (beige) of the 3M™ Sof-Lex™ Dia- mond Polishing System. Restorations received ﬁnal polish with 3M™ Sof-Lex™ Diamond Polishing Spiral (pink) of 3M™ Sof-Lex™ Dia- mond Polishing System. New composite restorations blended well with natu- ral surface of central incisors. FINAL RESULTS: Anterior restorations were naturally shaped and virtually indistinguishable from natural tooth structure. The composite blended in perfectly with the color of the surrounding teeth. Refer to Instructions for Use (IFU) for complete prod- uct information.
10 RESTORATIVE Dental Tribune Middle East & Africa Edition | 1/2020 Mastering black holes with premium endo-brands By Coltene COLTENE is a global leader in the develop- ment, manufacture and sale of consumables and small equipment for endodontic treat- ment applications. The comprehensive port- folio of endodontic systems includes root canal preparation with files and rinsing solu- tions, obturation and post systems. As the inventor of controlled memory files with the launch of HyFlex CM in 2011, COLTENE has taken a lead in innovative products for mod- ern endodontics treatments. Additionally, the COLTENE Dental Group of- fers a wide range of products, encompassing three segments. This results in solutions for almost all dental treatments ranging from infection control to tooth preservation and treatment efficiency. The COLTENE Group strengthened its position in the Endo-Seg- ment with the acquisition of the French ex- pert MicroMega. The now combined product portfolio offers an even more customized range of files and endodontic equipment. Product range for new endodontic dimen- sions: • HyFlex EDM and CM, MicroMega One Curve and MicroMega 2Shape NiTi file sys- tems, allowing the fast and safe instrumen- tation of the various root canal anatomies according to the preferences of the user. • HyFlex paper and guttapercha points, which perfectly match to the HyFlex CM and HyFlex EDM NiTi file system. • Well proven CanalPro and MicroMega Dual Move endo motors, completed by CanalPro and Dual Pex Apex Locators for working length measurement. • Innovative modular CanalPro rinsing so- lution system and MicroMega EndoUltra for ultrasonic activation to ensure an opti- mized disinfection and long-term success- ful treatment. • Bioactive GuttaFlow obturation mate- rial, which combines free-flow gutta-percha with a sealer and bio ceramic at room tem- perature and actively supports regenera- tion in the root canal. • Complete range of ParaPost systems, de- signed for perfect retention with superior strength and excellent radiopacity for de- finitive restoration. • Upcoming product innovation in 2020: new fully automatic endo motor CanalPro Jeni, which will be launched in the next few months. New SmartLite Pro – more than just a curing light By Dentsply Sirona Primarily, a curing light is a device to polymer- ize restorative materials. But it can be so much more, as shown by the new SmartLite Pro from Dentsply Sirona. It is an outstanding tool that allows for cutting-edge curing performance. In addition, it features a forward-thinking modu- lar concept with quick-connect tips for a vari- ety of clinical indications. Last but not least it exhibits an extraordinary design combining high-tech elements and robustness with a lightweight pen-style look-and-feel. The SmartLite Pro is a unique modular curing device in a remarkable, all-metal housing. Designed to perform Once you have taken the new curing light into your hands you will immediately feel a lightweight and well-balanced pen-style de- sign which is beautiful in each of its details. The SmartLite Pro’s housing is fabricated of medical-grade stainless steel and anodized al- uminium providing for robust durability and elegant simplicity. The user will love the easy and intuitive opera- tion with only one single button. Feedback is Fig. 1: Ergonomic, pure and elegant: the new curing light SmartLite Pro by Dentsply Sirona. facilitated by precise audible and tactile sig- nals. Its clinical performance in everyday prac- tice is unarguable. of the mouth. The dentist experiences excel- lent intraoral control and will easily maintain a steady hand at the proper angle. Top of the class in curing SmartLite Pro features newly engineered state-of-the-art optics to provide a homoge- neous beam profile for a uniform curing per- formance. Unlike many conventional lights the new device has an even and focused light distribution over the whole curing area. More- over, the SmartLite Pro features an active light output diameter of 10 millimeters. This en- sures that the beam completely encompasses even fillings with a large horizontal extension. The leading clinical performance is accom- panied by a comfortable handling. The 360 degree rotatable tips and the low-profile head with four high-performance LEDs guarantee easy clinical access even in hard-to-reach areas Constant availability thanks to in- novative battery management The futuristic multifunctional charging base features a built-in radiometer and room for extra tips. The intuitive battery management system comes with two quick-connect batter- ies for constant availability. Cutting-edge lith- ium iron phosphate cell technology ensures that the dentist may enjoy a full day of clinical operation with only one charge. Thinking ahead The modular versatility expands the options beyond the scope of a pure curing light and in- cludes various other indications. For example, the user may easily change from the curing tip to the transillumination tip. Within a few mo- ments he holds a diagnostic aid for the visu- alization of interproximal caries and cracked teeth in his hand. And in the area of root canal treatment this tip will provide for endo access illumination. But the best news is: The platform technology of the SmartLite Pro offers a forward-thinking system, which gives way to numerous future upgrades and will open up new worlds of indi- cations and applications. The SmartLite Pro is one of the most versatile dental instruments because it features leading quality of cure, and yet is so much more than just a curing light. Dental study of ancient chewing gum informs about oral microbiomes of the past was found that she probably possessed dark skin, dark hair and blue eyes. Traces of hazelnut and duck DNA were also identified in the pitch, suggesting that these may have formed part of the individual’s diet. The researchers also successfully identified DNA fragments from several bacterial and viral taxa, including the Epstein–Barr virus, which can cause glandular fever. “[Syltholm] is the biggest Stone Age site in Denmark and the archaeological finds sug- gest that the people who occupied the site were heavily exploiting wild resources well into the Neolithic, which is the period when farming and domesticated animals were first introduced into southern Scandinavia,” said Dr Theis Jensen, a postdoctoral student at the University of Copenhagen’s Globe Institute and a co-author of the study. “We managed to extract many different bac- terial species that are characteristic of an oral microbiome,” added Dr Hannes Schroeder, as- sociate professor at the Globe Institute. “Our ancestors lived in a different environ- ment and had a different lifestyle and diet, and it is therefore interesting to find out how this is reflected in their microbiome,” he con- tinued. Though still a relatively new form of analy- sis, DNA sequencing from birch bark pitch is growing in popularity, in part owing to its po- tential to be a good proxy for human bones in archaeogenetic studies. As reported by Dental Tribune International last year, Scandinavian researchers have previously used pitch to se- quence DNA from the first humans who set- tled in the region some 10,000 years ago. Though a considerable amount of informa- tion can be uncovered through the DNA sequencing of pitch, several questions still remain—including the question of what the purpose of chewing it was. Some research- ers have suggested that it may have been a method for making the pitch more pliable for further toolmaking purposes, while medicinal and hunger-suppressing uses have also been put forward for consideration. The study, titled “A 5700 year-old human genome and oral microbiome from chewed birch pitch”, was published on 17 December 2019 in Nature Communications.. An artistic reconstruction of what "Lola", the woman who chewed the birch bark pitch, may have looked like. (Image: Tom Björklund) By Dental Tribune International COPENHAGEN, Denmark: Though its popular- ity and constituent ingredients have changed over time, chewing gum has been used by humans for thousands of years. A new study out of Denmark that analysed a 5,700-year-old piece of chewing gum made from birch bark pitch has succeeded in extracting a complete human genome from the pitch, demonstrat- ing its potential as a new source of ancient DNA. The pitch was found during archaeological ex- cavations carried out by the Museum Lolland- Falster at Syltholm in southern Denmark, and subsequent analysis was conducted by re- searchers at the University of Copenhagen. Ra- diocarbon dating of the pitch helped to place it as a specimen from the early Neolithic period in Denmark, while DNA sequencing revealed that it was chewed by a female who was more closely genetically related to the hunter-gath- erers of mainland Europe than to those who populated central Scandinavia at the time. It
12 RESTORATIVE Dental Tribune Middle East & Africa Edition | 1/2020 Perform at your best in diagnostic and restorative Reduce glare and create beautiful restorations By Hu-Friedy Having a clear and precise diagnosis is needed in order to correctly plan the necessary treat- ment and sight is the first sense that every cli- nician uses, therefore having the best possible vision is crucial. With this in mind, Hu-Friedy, the global leader in dental instrument manufacturing and in- fection prevention solutions, leveraged the success of HD Mirrors, Blackline and XTS prod- uct lines, to create HD Black Line Mirrors. This innovation was engineered to optimize clini- cal outcomes by delivering superior visibility throughout any dental procedure. Designed for enhanced performance, Hu- Friedy’s HD Black Line Mirrors have a Dia- mond Like Carbon (DLC) coating, which reduc- es glare up to 80%** compared to a standard metal mirror heads and handles. This helps to reduce strain and fatigue, creating a more er- gonomic mirror, as the user does not need to adapt their viewing position due to unwanted shine produced by traditional metal mirror handles or frames. Additionally, the black matte finish provides enhanced contrast and visual acuity within the oral cavity. This creates a distinct contrast between the instrument, the tooth and/or the surrounding tissue allowing for easy identifi- cation intraorally. So, the DLC coating in combination with the superior brilliance and color of Hu-Friedy’s proprietary HD Mirror glass facilitates quicker and more accurate visibility of the mouth. Tami Wanless, RDH, MED, from USA, states about the product: “I wear loupes with a LED light and noticed a significant difference in the amount of glare reflecting back into my field of vision during patient care, allowing me to see more detail. I realized, at the end of my clinical day, I had less eye strain when I used the HD Black Line Mirrors.” (Fig. 1). strokes as they create superfine details during biomimetic restorative dentistry,” said Jen- nifer Nemeth, Senior Product Manager at Hu- Friedy. “By introducing NiTi into the design, we were able to create an extraordinarily flex- ible, wafer-thin composite instrument unlike anything we currently offer. We are beyond excited for clinicians to experience the flex of Akro-Flex™!”. Akro-Flex™, is an innovative, incredibly flex- ible spatula for restorative dentistry. The unique composite instrument features hyper- thin working ends made from Nickel-Titani- um (NiTi) – an alloy known for its super elastic- ity. The thin, ductile instrument fits easily into narrow interproximal spaces allow for better visibility as compared to traditional compos- ite instruments. (Fig.3). The resilient working ends rebound back to its original shape after use and are excellent for creating fine anatomical detail with delicate, artistic strokes during aesthetic restorations (Fig.4). In addition to its slender profile and innova- tive NiTi working ends, the handle of the Akro- Flex™ composite instrument was designed with the clinician in mind. The sleek, smooth finish prevents buildup of excess composite material while the lightweight, ergonomic design allows for an enhanced grip with less hand fatigue. To learn more about HD Black Line Mirrors and Akro-Flex™ visit www.hu-friedy.eu or contact our local distributors. Fig. 1 Fig. 2 Fig. 4 eas, it is often necessary to retract the tongue. Unfortunately, our usual retractor, the dental mirror, has a metal reflective back surface, which is not ideal for light reflection; scan- ning may be interrupted or get distorted. By using Hu-Friedy’s new HD Black Line Mirror I definitely solved the light reflection issues.” he quoted (Fig.2). Beautiful smile is what patients demand to clinicians every day and therefore highly aes- thetic restorations are the standard request in each practice. Fig. 3 Dr. Carlo Poggio, from Italy, is also using HD Black Line Mirrors in his digital dentistry cases: “A very simple “digital dentistry” issue: when dealing with intraoral scans in the posterior ar- “In looking to enhance our product offer- ing for aesthetic dentistry, we identified the need for a resilient composite instrument which would allow clinicians to use brush-like Follow us on: @HuFriedyEU @hu_friedy_europe @Hu-Friedy Mfg. Co., LLC.EU Radical oral intervention not necessary before stem cell transplants, study says By Dental Tribune International BASEL, Switzerland/HELSINKI, Finland: Hae- matopoietic stem cell transplantation is used to treat cancers and severe blood and auto- immune diseases. Owing to slow immune system recovery after the transplantation, patients have a heightened risk of infection. However, a recent study has reported that the presence of acute or chronic oral foci of infec- tion before the transplantation does not affect the patient’s survival rate within six months of the procedure. The study was conducted by the University of Helsinki, the Helsinki University Hospital, the University of Basel, and the University Hos- pital Basel. It involved patients who had been treated at the University Hospital Basel, of whom 341 had received an allogeneic stem cell transplantation and 125, an autologous stem cell transplantation. The procedures were carried out between 2008 and 2016. Before the transplantation, all patients underwent a clinical and radio- graphic dental examination to identify any potential foci of infection and the number of missing and filled teeth. A total of 51 stem cell transplant patients died within six months of the procedure. However, the data showed that the foci of infection, the number of missing or filled teeth, and the cases of periodontitis identified in the exami- nations were not associated with the patients’ lower survival rates. “Contrary to our assumptions, untreated oral infections had no connection with post-stem cell transplantation survival during the six- month follow-up period. Another surprise was that they had no link with any serious infec- tious complications occurring during the fol- low-up period,” said lead author Prof. Tuomas Waltimo, assistant lecturer in the Department of Biomedical Engineering at the University of Basel. “However, the patient’s health permitting, and if the wound has enough time to heal before chemotherapy, the radical treatment of such infections is justified. Other than that, con- servative, non-radical treatment that elimi- The results of a recent study have suggested that radical treatment of acute and chronic oral infections could be postponed until after haematopoietic stem cell transplantation. (Image: Vadym Wedmov/Shutterstock) nates the infection carried out by a dentist familiar with the case appears to be the lowest- risk option in terms of infectious and bleeding complications,” Waltimo noted. According to Waltimo, the study findings can- not be applied to any other patient groups, es- pecially not to patients suffering from cancer in the region of the head and neck, or those with a heart valve or a prosthetic joint. The study, “Associations of oral foci of infec- tions with infectious complications and sur- vival after hematopoietic stem cell transplan- tation,” was published on 18 December 2019 in PLOS ONE.
14 NEWS Dental Tribune Middle East & Africa Edition | 1/2020 2019 GNYDM highlights latest dental products and technologies The 2019 GNYDM attracted more than 52,000 attendees from all parts of the dental industry. (Images: Dental Tribune International). By Dental Tribune International NEW YORK, U.S.: Held from Nov. 29 to Dec. 4 at the Jacob K. Javits Con- vention Center, the 2019 Greater New York Dental Meeting (GNYDM) demonstrated once again why it is the country’s largest and most an- ticipated dental congress by offering an inviting mix of educational ses- sions, hands-on workshops, product launches and more. The 95th iteration of the free-to- attend annual event attracted more than 52,000 attendees from all parts of the dental industry. A large num- ber of these visitors were interna- tional. The German Pavilion featured a variety of companies displaying their wares under a “made in Ger- many” banner, while another area of the convention center showcased a broad range of Korean companies such as META BIOMED and DIGIRAY. More than 300 educational courses and events were conducted over the course of the 2019 GNYDM, covering topics as diverse as adhesive dentist- ry, guided implant surgery and early detection of oral cancer. A number of these courses were run entirely in Spanish, an inclusive choice that considered the approximately 41 million native Spanish speakers who currently reside in the United States. Live dentistry sessions were held each day in the convention center and proved to be a hit with audienc- es. Among these sessions were “Exe- cuting Accurate Aesthetic Dentistry,” in which Dr. Michael Apa discussed techniques for preparation, tempori- zation and the integration of digital technology, and “Modern Materials in a Digital Era,” a session presented by Dr. Justin Chi and sponsored by Glidewell Dental. The Utah-based startup company Weave was present at the 2019 GNYDM to publicly debut Weave Payments, a full-scale payment processing plat- form for small and medium-sized businesses, and 3DISC launched the latest version of the Heron IOS, its solution for intraoral scanning. The 2020 GNYDM will be held once again at the Jacob K. Javits Conven- tion Center from Nov. 27 to Dec. 4, 2020. AD
16 t Page 4 Waiting is the Hardest Part The next ping came in the middle of the night, nearly 12 hours after the team returned to Ultradent HQ. "About 8:30 the next morning I logged on and saw we got pings start- ing about 2 in the morning. But they were veryremote, and we wondered if it was right. The prediction calcu- lator said it was supposed to be by Flaming Gorge and this was in the middle of the Uintas," Simmons ex- claims. ideal—the payload The prognosis for recovery was far from landed deep in the mountains, not far from the second highest peak in Utah. "The forest service told us it's not accessible by car, it's 10–12 miles in from the trailhead and they were sit- ting around 90 inches of snow at the time," says Simmons. "We were like, OK, we need snowmobiles, snow- shoes, cross country skis [. . .] we're going to get this thing." "We knew we were going to go get it, go rescue it. We were making jokes like 'no VALO light left behind!' but that's when we realized there might be a real safety risk of getting stuck in the Uintas," Brown says. Reconnaissance missions got under- way while the team waited for the snow to melt, turning Brown into Ul- tradent's own Indiana Jones. "I would drive out to the trailhead, which is 15–18 miles on a dusty road, after a three-hour drive from Ultradent, and from the trailhead it was still 10 or so miles of hiking to where the pay- load landed. One Saturday I woke up early [. . .] figured I'd be fine because I had a Jeep Grand Cherokee," Brown says with a sarcastic grin. "I drove two miles on the dirt road and got stuck. I had to get pulled out by some mountain-dwelling locals. That was embarrassing. Then I got stuck again driving down the mountain and had to get pulled out...again." Ultradent videographer David Landeen succeeded where Brown's recon efforts fell short. He was able to get fairly close to the landing zone and returned with a realistic per- spective on what a retrieval mission would entail. "He came back and said, 'it's at least a two-day trip,'" Simmons says. Into the Wild Back at Ultradent, the team re- grouped and picked August 8, 2019 to set out and recover the payload. Horses were enlisted to help the would-be mountaineers trek through the wilderness. The venture into the backcountry began exactly 99 days after the launch. It was a rainy morning and they ar- rived at the trailhead to find a water- logged path. After a few soggy hours of riding, the team made it to their picturesque day-one destination. "We spent the night at a place called Dead Horse Lake in the middle of the NEWS Dental Tribune Middle East & Africa Edition | 1/2020 Simmons, Brown, and Ultradent's Martin Webb trek to Dead Horse Lake on horseback. Brown and Webb prep the drone to ﬂy over the landing zone. Simmons and Brown secure the payload. Brown and the payload box. Recovered GoPro footage showing the moment the weather bal- loon popped, sending the payload tumbling toward Earth. The team analyzing footage of the VALO Grand curing light de- taching from the payload. Uintas. Beautiful scenery," says Sim- mons. Tired, soaked, and sore, the crew set up their camp for the night. "Oliver AD bought a whole new hammock and chains, actual chains to hang it up, and a brand-new sleeping bag. But his sleeping bag didn't get packed, so he was up there without one," adds Simmons. "We had to find Oliver 'accommodations' so we flipped the horses' wool pads upside down in his hammock." "The wool pads from horses that had just ridden in the rain for 10 miles," Brown quickly "They smelled like butt." interjects. At sunrise the team awoke and launched a drone in hopes of spot- ting the payload box from above, but alas, no visual—for that, more hiking was in order. "I thought at that eleva- tion (roughly 12k feet) it would be all barren with just rocks," says Brown. "But it was like the Sound of Music set up there. Beautiful." The team searched and searched un- til a whistle pierced the stillness of the mountain air. "Mike got visual of the payload box and blew the whis- tle. And we started screaming, we ran over and it's in the middle of a hill of loose shale," Brown says. The team scampered to the payload, sliding around on the shale as they tried to stay upright, relieved and re- juvenated from finding the box. The jubilee was short lived, as they soon realized the VALO Grand curing light was no longer attached to the payload...nor was it anywhere in the vicinity. "We knew we had to head out of this area by noon, to get off the trail by dark, so we can get home without our families calling search and rescue," says Simmons. "Noon comes, and we didn't find the VALO light...we got completely dogged." After a few hours of searching, the team resigned to leaving without the curing light, but their spirits were nonetheless boosted from finding the payload. "We were all beat at the end of that day...but when we started charging the GoPros in the car and started seeing the footage, it was re- ally exciting," says Brown. Video evidence in tow, the team re- turned—without the VALO light for the second time—to Ultradent HQ. CSI – Crash Site Investiga- tion The video investigation got under- way immediately, with all five cam- era angles providing clues to the po- tential whereabouts of the missing VALO Grand curing light. The foot- age became Ultradent's version of the Zapruder film. "We started to dig into the videos, seeing the footage, and started de- termining that where the VALO light went down was not the final resting place of the payload box," says Sim- mons. "We put everything in slow motion, all angles from the cameras, sleuthing around. We saw the VALO light detach right when the payload touched down." Frame by frame, the footage was examined and the team developed theories for where the VALO curing light came to rest. They didn't know exactly where it was, but they knew they needed to go back to the land- ing zone to find it. "There was basical- ly a 75-yard section of steep embank- ment, a 200-foot cliff, and 300–400 yards of very steep shale that we needed to search," Simmons says. "No VALO light left behind," right? Return to the Wild Powered by dedication and persis- tence (and a desire to spend addition- al days in the woods instead of the of- fice) the search party–now including Ultradent's Katie Loyola–returned to the trailhead once more and began their journey toward Dead Horse Lake and the landing zone for the payload. They reached the campsite and bedded down to prepare for an- other day of scouring the shale-cov- ered slopes. Brown even managed to pack a sleeping bag this time. "I had a metal detector, and we were really concerned that we were going to have to scan all this shale with it," Brown says. Search number two got underway at sunrise, with the team determined to track down the missing VALO cur- ing light more than 17 weeks after it was launched. u Page 18
18 t Page 16 "When I saw photos of it I didn't real- ize how large it is," says Loyola of the landing zone. "You see these boul- ders on the top of the mountain and think 'they aren't so big' then you get up to them and they're the size of a school bus." The hunt was physically taxing but it soon provided hope—they found batteries that had been inside the payload box, but still no VALO cur- ing light. "We also found a bell from a goat that's probably long since been dead. A relic, it'll be in the Smithso- nian later," Brown recalls, smiling. After several hours of searching with only batteries and a goat's bell to show for their efforts, the team threw in the towel for the day with- out securing the VALO Grand cur- ing light. They returned to camp to spend another night at Dead Horse Lake with one final day of searching ahead of them. Spotting the VALO Curing Light The next morning it was déjà vu at 12k feet as the crew hiked to the land- ing zone for the third time. When the batteries were found, the team had been searching the lower "bowl" section of the landing zone. Now they had to canvas the upper rim and slope. "When you're down in the lower part of the valley and you're looking at the upper shelf, you don't realize how steep it is," Simmons says, eyes wide. "The enormity of it was so weird. When you'd look at it, you'd get this vertigo type feeling like from a Hitchcock movie," says Brown. "It was so steep, we were thinking, 'can you even walk on that? Should we have brought rope to harness in?' It took 40 minutes just to hike to the top," Simmons sighs. "We went to the very end of the cliff face and started to zig zag back and forth...and...it was...horrible." Fortunately for the crew, they soon caught their biggest break yet. "Probably 15 minutes after we hiked up, I look down and 20–25 feet away from me, I see this metallic signa- ture. I don't see the VALO light, I see Dan Fischer's signature," Simmons says with a visible glow. He enthu- siastically blew his whistle and the crew scampered over to his location. NEWS Dental Tribune Middle East & Africa Edition | 1/2020 The Dr. Fischer bobblehead, ﬂoating tens-of-thousands of feet above Earth's surface. The daunting hill of shale. Ultradent's Katie Loyola balances on a downed log to cross a creek. Brown and Loyola hunt for the VALO Grand light on a mountain of loose shale. A needle in a haystack may have been simpler to track down than a VALO Grand curing light on a mountainside of shale. The VALO Grand curing light, resting where it was spotted by Simmons. AD Brown and Loyola hear the VALO Grand curing light's BEEP. The LED of the VALO curing light ﬁring up after a trip to space and 126 days in the elements. Legend says Brown's shrieks still echo in the valley below. The VALO Grand dental curing light overlooking the valley. With the slog now finished, a victo- rious search team retreated from the landing zone for the final time, to proudly return the fully func- tional VALO Grand curing light to Ultradent HQ 126 days after it left. AEEDC Ultradent Booth 5C06 Come and visit us! Brown grabbed the VALO Grand cur- ing light and as soon as he put batter- ies in, it gave off a BEEP, signaling it still worked. That seemingly innocuous BEEP cascaded unfiltered elation over the search crew as pride in the cur- ing light's durability flooded through them. "I was yelling so loud, somebody else came over from a different moun- tain range thinking I was hurt. Full throated bellows," Brown recounts, visibly relieved by the successful mission.
20 RESTORATIVE Dental Tribune Middle East & Africa Edition | 1/2020 Smile rejuvenation with Biosmart restoratives Dr. Hussein Naama Alghadeer Center, Iraq Introduction Dentists today are spoilt for choice with a va- riety of direct and indirect treatment options for aesthetic restorations in the anterior zone. We are often challenged to create restorations that mimic natural teeth or enhance smiles to meet patient desires and expectations. I have recently adopted the Minimal Invasive Cos- metic Dentistry (MiCD) concept introduced by Dr. Sushil Koirala which is based on a ho- listic patient-centric treatment approach that integrates minimally invasive treatment tech- niques with aesthetic dentistry to enhance the smile while taking into consideration the psychology, health, function and aesthetics of the patient. Diastema or space between the teeth is a com- mon dental condition that can create cosmetic issues in adults and often corrected with or- thodontic treatment or indirect veneers. The clinical case below highlights a different treatment approach where direct aesthetic restorations were selected after assessing the following 5 factors which we take into consid- eration when treatment planning in my prac- tice. 1-Treatment longevity, 2-Cost estimation, 3-Vitality of the tooth, 4-Biological cost, 5-Ex- pectation of the patient. To achieve predictable aesthetic outcomes when opting for diastema closure and smile rejuvenation with direct restorations, it is very important to understand the optical charac- teristics and properties of the composite ma- terial being used. For this clinical case I have used a BEAUTIFIL II LS bioactive, low shrinkage composite resin with life-like aesthetics and high polishability to mimic nature with long- term predictability. (Fig 1a &1b) Patient Case A 28 years old female patient visited our clinic requesting for a beautiful smile with less tooth destruction at a reasonable cost as the gap between her front teeth had affected her confidence to smile for a long time (Fig. 2). Other dentists had suggested orthodontic treatment with indirect veneers which she had refused and was in search of an alternate option that would meet her needs. Treatment Plan The smile defects were determined upon careful clinical examination. The patient pre- sented with reverse smile line and median diastema that needed cosmetic correction. A direct mock-up was planned as an initial step to help evaluate the patient perception and visual interpretation of the expected final out- come as there were limitations in the selected direct restorative approach to rejuvenate the patient’s smile. (Fig. 1) Materials Used After careful examination the following ma- terials and Composite shades were selected • Tooth preparation Fine Diamond points (Red band on the shank) and Super-Snap Violet Disk • Etching and Bonding – 37% Phosphoric acid and FL-Bond II • Composite materials - Palatal Shell - Beautifil II Enamel shade T - First Dentin layer - Beautifil II LS opaque shade A2O - Second Dentin layer - Beautifil II LS shade A2 - Enamel Layer - Beautifil II Enamel shade HVT (High Value Translucent) • Finishing & Polishing - Fine Diamond Points, Super-Snap X-treme Kit • Super Polishing for high gloss – DirectDia polishing paste with Buff disk Restorative Approach Direct Mock-up and Shade Selec- tion Composite mock-up can be used as an aid in both diagnostic and aesthetic evaluation. In this instance, a prepless direct mock-up tech- nique was selected with the aim of motivat- ing the patient, evaluation of patient expec- tations by directly checking the smile design and to create the silicone index for fabrication of the palatal shell in the final restorations . (Fig 3). During the direct mock-up, composite material was added to the distal side of the left lateral incisor tooth to enhance the overall ap- pearance while preserving tooth structure as per the MICD approach. (Fig. 4) Clinical Tip: It is important to check occlusion and identify the high points using articulating paper to ensure that an accurate silicone index can be created for the palatal shell. (Fig. 5) There are many different methods used for shade selection to achieve an accurate shade match with the natural tooth. In my practice, we prefer to use the direct technique for shade selection, where the enamel and dentin shades of composite materials are placed directly on the tooth surface and compared with the shade of the natural tooth. Shade selection procedure is completed with digital photog- raphy taking into consideration the 3 dimen- sions of color with “Hue, Value and Chroma” (Fig. 6). A composite recipe is identified for build-up of each restoration. u Page 22 Fig 1a & 1b. Before and After smile rejuvenation with BioSmart restorative materials Fig 2. Pre-operative diastema between upper cen- tral incisors Fig.3 after prepless direct mock up Fig 4. Patient smile after direct mock-up Fig 5. Occlusion and high points checked with ar- ticulating paper Fig 6. Direct shade selection with Beautiﬁl II LS enamel and dentin shades Fig 7. Preparation of enamel surface with Super- Snap Violet disk Fig 8. Selective etching of the enamel surface with Phosphoric Acid Fig 9. Application of FL-Bond II bonding agent Fig 10. Palatal shell created with Beautiﬁl II Enamel shade T and incisal edge with Beautiﬁl II LS opaque shade A2O Fig 11. Diastema closure with Beautiﬁl II LS shade A2 and Beautiﬁl II Enamel shade HVT Fig 12. Build-up of incisal area of central inci- sors with Beautiﬁl II LS shade A2 and Beautiﬁl II Enamel shade HVT Fig 13. Restored central incisors before ﬁnishing and polishing Fig 14. Gross ﬁnishing with Fine Diamond Point (Red Band on the shank) at very low speed with no water Fig 15. Marking of mesial line angle and macro anatomy
22 RESTORATIVE Dental Tribune Middle East & Africa Edition | 1/2020 Fig 16. Anatomical contouring of Mesial Line An- gles with Fine Diamond Point Fig 17. Anatomical contouring of labial grooves with Fine Diamond Point Fig 18. Smoothening of the labial grooves with Dura Green Stone Fig 19. Polishing of the restorative surface with Super-Snap X-Treme Green and Red Disks t Page 20 and polishing of the final restoration. Tooth Preparation - Rubber dam was placed from premolar to pre- molar to help isolate the teeth to enhance vis- ibility and eliminate contamination with sul- cular fluid. The labial enamel surface of both central incisors were minimally prepared us- ing Super-Snap Violet disk to seamlessly blend the restoration margins on both labial and pal- atal sides. (Fig 7). Before proceeding with the adhesive step, it was important to protect the adjacent lateral incisor teeth with Teflon tape. Composite Build-up After selective etching of the restorative enam- el surface with Phosphoric acid (Fig.8), FL-Bond II, a 6th generation 2-step adhesive system was selected. First the Primer was applied, left for 10 seconds and air dried; followed by the appli- cation of bonding agent which was light cured for 10 seconds. (Fig. 9) . The palatal shell was created with the silicone index using Beautifil II Enamel shade T. Beautifil II LS opaque shade A2O was placed on the incisal edge to achieve a natural halo effect for enhanced aesthetics. (Fig. 10) Clinical Tip: Palatal shells technique helps to prevent over build-up of composite on the palatal surface resulting in efficient finishing Diastema closure between central incisors was completed using the naturomimetic lay- ering technique with incremental build-up and 10 second light-cure. The dentin layer was created using Beautifil II A2 followed by Beau- tifil II enamel high value translucent shade HVT. (Fig 11). For the incisal surface build-up, a thin layer of Beautifil II LS shade A2 was used followed by Beautifil II enamel shade HVT. (Fig 12). The restored central incisors af- ter composite build-up demonstrated that life-like aesthetics had been achieved success- fully. (Fig 13) . Clinical Tip: Spend time to achieve the accurate shade match and tooth anatomy during the composite build-up phase to save chair time Finishing and Polishing Protocol Selection of the right tools for finishing and polishing of direct composite restorations to a high gloss, still remains a challenge for many clinicians. It is always helpful to identify a pre- dictable finishing and polishing protocol for your composite material, that would help to achieve the desired final surface lustre while saving valuable chair time. For this case, after final light-cure and rubber dam removal, the gross finishing was done using a Fine Dia- Fig 20-21. Rejuvenated smile achieved with MICD restorative approach mond point (Red band on the shank) at very low speed with no water to smoothen the re- storative surface.(Fig. 14). The mesial line an- gles and macro anatomy was marked using a lead pencil. (Fig 15) The anatomical contouring of line angles and labial grooves were com- pleted using a tapered fissure Fine Diamond Point (Red band on the shank) with intermit- tent water spray (Fig 16, 17). Dura Green stone was used to smoothen the labial grooves. (Fig 18) Polishing of the restoration was completed using Super-Snap X-Treme Green and then Red Disks. The restoration was super-polished to high gloss natural enamel-like lustre with DirectDia diamond polishing paste and a buff disk. (Fig 19) Conclusion The above clinical case illustrates that optimal life-like restorations can be achieved using Bi- oSmart composite material with predictable aesthetics and function. By adopting the Mini- mally Invasive Cosmetic Dentistry (MiCD) con- cept and treatment protocols, we have been able to provide patients with direct restorative treatment options that exceeds their expecta- tions while preserving natural tooth structure. The inclusion of Beautifil II LS and Beautifil II Enamel range of composites with a predictable finishing and polishing protocol has helped to minimize armamentarium and meet patient’s aesthetic demands more efficiently in my daily clinical practice. (Fig 20,21). Get started in bone surgery with PIEZOSURGERY white By mectron s.p.a. When Mectron introduced PIEZOSURGERY in 2001, the technology was revolutionary for bone surgery: a device providing precision, safety, perfect er- gonomics and the highest quality to surgeons all around the world. The new technology immediately became state-of-the-art for bone surgery devices. Having set this benchmark, we improved the technology in the following years - with a strong focus on ergonomics. 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24 NEWS Dental Tribune Middle East & Africa Edition | 1/2020 Oral-B IO unveiled at consumer electronics show, marking the brand’s most innovative power toothbrush to date A CES Innovation Award 2020 honoree, the new Oral-B iO reimagines brushing from the inside out, delivering superior design, performance and experience for a professional clean feeling every day users to brush in the optimal pres- sure range. The Sensor features a variable-speed smart drive that adjusts frequency to protect gums and enamel. • Smart Display with Personalized Brushing Modes: an intuitive in- terface that greets users, while also providing coaching and motiva- tion throughout the cleaning pro- cess. Features up to seven brush modes for a highly personalized experience. • Artificial Intelligence Tracking via the Oral-B iO App: provides real-time individual tracking and coaching, thanks to artificial intel- ligence informed by thousands of u Page 27 AD By Oral-B Oral-B, the industry leader in oral care innovation, today unveiled the most revolutionary technology in its history with the Oral-B iO. Intro- duced at a press conference hosted by parent company Procter & Gam- ble during the Consumer Electronics Show (CES) in Las Vegas, the Oral-B iO signals the latest addition to the brand’s impressive line of power toothbrushes. Further validating the product’s exemplary design and engineering, the Oral-B iO was given the distinction of being one of this year’s CES Innovation Award Hono- rees, an annual accolade that recog- nizes outstanding new consumer technology products. Oral-B iO is a new power toothbrush series that has been reimagined and redesigned from the inside out, combining best-ever clinical perfor- mance with a superior user experi- ence, making it one of the industry’s most advanced brushing products. Oral-B iO was designed as a result of insights collected from more than six years of product research and development and over 250 patents from around the world. Oral-B iO uniquely features a frictionless mag- netic drive, which distributes energy more efficiently to the tips of the bristles, resulting in a smooth, quiet, sensational cleaning experience. The new magnetic drive delivers cleaning energy to the redesigned iO brush head, which has been engineered to combine oscillating and rotating cleaning motions with micro-vibra- tions for a professional clean feel. “There is nothing like the Oral-B iO. It introduces a new era in brushing and is a monumental leap in inno- vative oral care technology,” said Steve Bishop, P&G Health Care CEO. “The result of years of expert devel- opment, Oral-B iO strikes the right balance between effectiveness and experience and reimagines how a brush performs, cleans and feels. It is a brush that people will look forward to using and will deliver superior oral health.” As a result of input from more than 1,800 consumers, the Oral-B iO in- cludes five key pillars of design fea- tures and experience capabilities: • Linear Magnetic Drive: created from the need to deliver a more effective and enjoyable brushing routine. Producing controlled, harmonious movements, the quiet and frictionless linear drive system efficiently transfers more energy directly to the bristle tips. • Superior Cleaning Action and Re- designed Brush Head: Oral-B iO brush heads combine oscillating, rotating movements with micro- vibrations to ensure a deep clean that reaches every contour. The brush head has been redesigned with twisted bristles, and rein- forced with high-density tuft-in- tuft configuration, for a sensation- al brushing experience. • Bimodal Smart Pressure Sensor: an innovation that is the first of its kind to provide positive brushing feedback, identifying and guiding
26 INDUSTRY Dental Tribune Middle East & Africa Edition | 1/2020 Digital chairside dentistry. Redeﬁned. For CEREC users, it’s simple: CEREC makes even the best dentists better. By Dentsply Sirona CEREC users will tell you going digital was a great decision, but un- til they did it they too sometimes had doubts. Would everything go smoothly right away? No. Could they learn to handle the technology? Ab- solutely. What about the quality of restorations? Outstanding in every way. With a new, best-in-class milling unit and highly automated, intuitive soft- ware to go with the CEREC Primes- can, there’s never been a better time to future-proof your practice with CEREC. The all-new CEREC gives you the tools for superior digital chairside dentistry. The latest generation of our CEREC system sets new standards so you can offer patients an unmatched combination of single-visit dentistry and excellent quality. After 35 years of continuous optimization, CEREC gives you the options you need to treat multiple indications with the confidence that comes from out- standing results. A unique solution designed for su- perior digital dentistry. The CEREC system comprises world- class components that interact per- fectly ensuring seamless workflows. CEREC Primescan quickly delivers highly accurate scan data to the new CEREC Software 5, supporting you with patient-specific proposals based on the patented biojaw algorithm. But the powerhouse of the system is the new CEREC Primemill. With this state-of-the-art milling unit, digital chairside dentistry is faster, easier and more reliable than ever before. The all-new CEREC. Now is the time. The SphereTEC revolution continues… Introducing the complete Neo Spectra ST composite portfolio for efﬁcient esthetics. By Dentsply Sirona With the new Neo Spectra ST com- posite portfolio, dental professionals can now find the full range of han- dling preferences and esthetic needs covered by a single product line. Thanks to SphereTEC filler technol- ogy, the portfolio offers optimized performance in the areas that mat- ter most, helping clinians to achieve reliable, esthetic results efficiently. latest Dentsply Sirona’s innova- tion in composite filler technology, SphereTEC, was introduced to den- tistry in 2015. SphereTEC fillers are spherical-shaped, pre-polymerised fillers created from sub-micron bari- um glass. Their morphology, particle size distribution, and surface micro- structure deliver the benefits that matter most to dentists. Over 24 mil- lion restorations after the new tech- nology’s debut, Dentsply Sirona in- troduces an expanded portfolio with SphereTEC technology. Clinicians can now enjoy SphereTEC technol- ogy benefits in all composite cases with the comprehensive Neo Spec- tra ST portfolio. ‘Neo’, meaning ‘new’ or ‘revived’ emphasizes the mod- ern, cutting edge approach taken to optimize our composite portfolio. ‘Spectra ST’ explains the portfolio’s gether in a simplified layering tech- nique with Neo Spectra ST universal CLOUD shades. The simplified shade concept and layering technique re- sult in streamlined composite inven- tory while ensuring reliable, highly aesthetic clinical results. The unique structure of SphereTEC fillers also maximizes composite strength and durability, while their sub-micron primary particle size ensures excel- lent polishability. For further information about Neo Spectra ST composites available from Dentsply Sirona, please contact your local Dentsply Sirona repre- sentative or visit our website www. dentsplysirona.com 1 VITA® is not a registered trademark of Dentsply Sirona Inc. ML420155M (12-7-18) adapt, sculpt, and shape, and are re- sistant to slumping. For applications where higher flowability is preferred, the nanofillers in Neo Spectra ST flow help to create a versatile, thixotropic ‘flow on-demand’ handling that stays put until the user initiates the flow. Each of the three viscosities of- fers proven durability, excellent cha- meleon blending ability, high polish and stain resistance. Covering the Full Range of Esthetic Needs In addition to satisfying the range of handling preferences, the Neo Spectra ST composite portfolio makes it easy to achieve natural esthetic results with a streamlined shade inventory and simplified tech- niques. The unique construction of SphereTEC fillers creates an excel- lent chameleon shade blending ef- fect that enables five shades A1 to A4, called universal CLOUD shades, to cover the entire VITA1 Classic range, and satisfy the esthetic demands for the vast majority of cases with a single shade. One additional shade, BW (bleach white), is also available for restoration of bleached teeth. For esthetically demanding anterior cas- es, Neo Spectra ST Effects offers two opaque dentin shades and one trans- lucent enamel shade that work to- coverage of the full range or ‘Spectra’ of handling preferences and esthetic needs optimized with SphereTEC (ST) technology. Covering the Full Range of Han- dling Preferences Dentsply Sirona recognizes that every clinician is unique and when it comes to composites, so are their handling preferences. That’s why the Neo Spectra ST composite portfolio was designed to cover a full range of handling options, enabling clinicians to select their preferred viscosity for placement ease and efficiency. Neo Spectra ST High-Viscosity (HV) uni- versal composite has a firm, packable handling, while the Low-Viscosity (LV) option offers a creamy, spread- able handling. Thanks to SphereTEC technology, both the HV and LV universal composite viscosities are non-sticky to the instrument, easy to
27 AD Dental Tribune Middle East & Africa Edition | 1/2020 NEWS crease productivity to keep produc- tion volumes up, and small labora- tories are able to avoid backlogs to maintain availability to take on new jobs. Fast and highly accurate 3D printing also enables superior com- munication between dentists and laboratories to enable streamlined restoration fabrication and delivery and increased patient satisfaction. The expedient input to output loop created by the digital dentistry workflow is more comfortable and convenient to the patient than the traditional processes it replaces. Furthermore, digital precision at every stage gives care providers higher confidence in fit. The author of this piece has firsthand experi- ence to support these statements, as I was one of the first patients to receive a 3D printed restoration. I had a tooth replaced in 2016 using 3D printing, and it works and looks as great as it did on day one! As dentistry and 3D printing con- tinue to evolve and synergize, my experience is becoming less and less unique, which I view as a won- derful thing. From high production labs where large volumes of unique parts must be fabricated quickly, to private clinics where the provider wants to enhance patient experi- ence with high quality expedited treatment: 3D printing technology is leading a transformation in dental occupations that allows everybody to win. t Page 1 The reality is that digital dental technology has now become user- friendly and affordable enough to be adopted by anyone who wants to access its benefits. Clinics and labs of all sizes are unlocking substantial ef- ficiency and productivity gains with no compromise in quality. In fact, many digital workflow users’ credit digital dentistry tools with contribut- ing to improved quality in care due to the level of precision that is now possible, and the fidelity of planned versus actual outcomes. Digital scans and digital designs fuel accurate digital production that increasingly requires less and less post-processing before next steps can be taken. This is true for every- thing from prosthodontic models to long-term, full-arch dentures. These advancements are exciting and ben- eficial to everyone involved. Labs can handle higher volumes, practition- ers can expand in-house services, and patients can get precise treat- ment faster, with fewer visits. For instance, the new capabilities in 3D printing speed make it possible for clinicians to deliver complete res- torations within a same-day appoint- ment that have historically required multiple visits. On the NextDent 5100, for example, it is now possible to 3D print a full arch in half-an-hour or less. For practitioners, this means the ability to see more patients over time while offering a more conveni- ent, expedited treatment experience. For patients, the integration of this technology means fewer scheduling conflicts and life disruptions to ad- dress their concerns. For dental laboratories of all sizes, increases in digital production speeds are of tremendous value. Large laboratories are able to in- t Page 24 recorded brushing sessions. Oral-B iO has a simple and intuitive user interface that guides consumers through a two-minute brushing session with 3D teeth tracking to ensure a professional clean feeling every time. “Oral-B iO goes beyond being a new toothbrush – it is an innovative brushing technology with a truly sensorial experience that users will feel, hear and see, transforming the act of brushing teeth from some- thing they have to do into some- thing they actually want to do,” said Lisa Ernst, P&G VP Global Health Care R&D. “Six years of dedicated re- search were undertaken with dental professionals to discover a wholly original brushing experience.” In clinical tests, Oral-B iO provided a deeper cleaning of teeth and gums, allowing users to easily and effec- tively maintain oral health. When compared to manual toothbrushes, Oral-B iO users experienced: • 100 percent healthier gums in just one week • Six times more plaque removal along the gumline • 83 percent of gingivitis patients moved from unhealthy to healthy gums in eight weeks The new Oral-B iO will be available for purchase beginning in August 2020. For more information about Oral-B iO, visit oralb.io. To join the Oral-B iO waitlist and be among the first to receive it, visit oralb.io/sign- up.
28 SCIENTIFIC Dental Tribune Middle East & Africa Edition | 1/2020 The complete digital implant workﬂow By Drs Kirill Kostin, Mikhail Erohin, Oleg Ponomarev & Maxim Koz- hevin, Russia Planmeca is known for high-tech innovations and continuous prod- uct development. The company’s pow-erful Planmeca Romexis soft- ware platform allows all stages of the dental implant and aesthetic prosthodon-tic treatment to be com- pleted using one piece of soft-ware, from the computer-assisted design of patients’ smiles to the fabrication of surgical guides. The following clinical case, which I performed together with my col- leagues Dr Ponomarev, Dr Koz- hevin and Dr Yarokhin, illustrates how digital solutions can be used in prosthodontic treatment, implant placement and res-toration design. According to our experiences, digital CAD/CAM technologies enable max- imal functional and aesthetic results compared to traditional methods. Clinical case report The clinical case illustrates the ad- vantages of using Planmeca CAD/ CAM solutions in the digital plan- ning of an implant placement and surgical guide, as well as in the fabri- cation of a ceramic restoration. This arti-cle presents a clinical case in which the treatment was completed using the Planmeca Romexis 3D Implant Guide software, Planmeca PlanCAD Premium software and Planmeca PlanMill 40 milling unit. The clinical case features a female patient, who com-plained about missing tooth #22, as well as the shield-like shape of tooth #12 (Figs. 1 & 2). During the initial examination, the area around the missing tooth was estimated to be quite narrow for an implant. How-ever, the patient declined orthodontic preparation, as she had already previously had orthodontic treatment with ortho- dontic surgery. In this particular case, we started with an aesthetic analysis of the pa- tient’s CBCT data and concluded that a Straumann implant with a 2.9 mm diameter would fit in the area of tooth 22, if we used a surgical guide for maximum precision (Figs. 3–5). For tooth #12, we decided to fabri- cate a thin-walled IPS e.max ceramic restoration (Ivoclar Vivadent). Thanks to digital planning and a carefully fabricated surgical guide, the implant was placed successfully, even though the anatomical condi- tions appeared to be less than ad- vantageous. We achieved a torque of 30 Ncm and attached a healing abut- ment to the im-plant (Figs. 6 & 7). Three months after the implant placement operation, the osseoin- tegration of the implant fixture was com-pleted. A temporary crown was fabricated on the im-plant from a Figs. 1 & 2: The patient’s upper teeth before treatment. u Page 29 Fig. 2 Figs. 3 & 4: Digital implant and surgical guide planning in Planmeca Romexis software. Fig. 5: Surgical guide was fabricated for maximum precision. Fig. 4 Figs. 6 & 7: Successful placement of the implant. Fig. 7 Fig. 8 Fig. 9 Fig. 10 Fig. 11 Figs. 8–10: Temporary crown was installed to support the formation of soft tissues. Figs. 11–13: Crown lengthening was performed on tooth #12.
Dental Tribune Middle East & Africa Edition | 1/2020 SCIENTIFIC 29 t Page 28 VITA ENAMIC multiColor block to support the formation of soft tissues (Figs. 8–10). We improved the origi- nal design on the Straumann super- structure with gum contouring. On tooth #12, crown lengthen-ing was performed with an electrocoagula- tor (Figs. 11–13). Once the formation of the soft tis- sues was complete, tooth #12 was minimally prepared for the ceramic crown with the help of a surgical mi- croscope. After the preparation, the teeth were scanned in order to digi- tally design a custom abutment and crowns (Figs. 14–19). The final smile design was planned digitally together with the patient. For the implant structure, we chose an individual zirconium abutment screw with a ceramic facing and a fully anatomical Empress crown (Figs. 20 & 21). The ceramic facing concealed the excessive bright-ness of the zirconium, and we were able to achieve the desired colour. Thanks to the digital workflow, we man-aged to fulfil the wishes of the patient. (Figs. 22–24). Fig. 12 Fig. 13 Conclusion With digital technologies, the entire implant workflow can be completed in the dental clinic, from planning to fabrication of the restorations. Digi- tal planning in-creases the reliability of the implant treatment and helps the dentist to succeed in the opera- tion. Digital tools allow achieving the maximum functional and aesthetic result even in combined operations in which an i m- plant p lacement and ceramic restoration are per- formed simultaneously. Thanks to the development of mod- ern technologies, a 3D model of a patient’s set of teeth can now be ac- quired in only a few minutes, with- out infringing on the com-fort of the patient. At the same time, combin- ing a CBCT image with an intraoral scan enables the dentist to plan the implant placement and surgical guide accurately and with just a few mouse clicks. Finally, digital technologies also enable visualising the treatment outcome for the patient. Clear visu- alisations of the end result facilitate communication with the patient, which, in turn, can increase case ac- ceptance. About the author Dr Kirill Kostin graduated from Saint Petersburg State Medical Uni-versity in Russia in 2004. He became the co- founder of the PerfectSmile dental clinic and dental study centre in 2014. At his clinic in Saint Petersburg, Dr Ko- stin runs a private practice concentrat- ing on the aesthetic and functional rehabilitation of natural dentition and implants, applying various digital instruments as part of restorative pro- cedures (digital smile design, intraoral scanning, CAD/CAM milling, 3D print- ing, and guided surgical procedures). Using a dental microscope on a daily basis, Dr Kostin focuses on minimally invasive restorative procedures with di- rect and indirect restorations. This par- ticular case Kostin per-formed together with his colleagues Drs Mikhail Erohin, Oleg Ponomarev and Maxim Kozhevin. Fig. 14 Fig. 15 Fig. 16 Fig. 17 Fig. 18 Fig. 19 Figs. 14–19: The ﬁnal restorations were designed in Planmeca PlanCAD Premium. Fig. 20 Fig. 21 Figs. 20 & 21: Final restorations: Zirconium abutment screw with a ceramic facing and a fully anatomical Empress crown. Fig. 22 Fig. 23 Fig. 24 Figs. 22–24: Final outcome after the completion of the treatment.
31 AD Dental Tribune Middle East & Africa Edition | 1/2020 INTERVIEW learned a lot, and with Dr. Amro’s help, we have put together a magnifi- cent team and all the building blocks to accelerate growth. Compared to Europe or the U.S., there are different aspects in this market, and you need a leadership team that is aware of these elements. The formulation for success involves local partnerships, local involvement of trainers, cus- tomers and key opinion leaders. All that combined with a good portion of focus is really the basis for growth. The Middle East is complex, and a lot of countries fear the region, but we have a long history in the region and expertise. We have many people with over 20 years’ experience on our team, so we know how to grow u Page 32 The Dentsply Sirona MENA team with Don Casey and Walter Petersohn. t Page 1 I was a witness to the opening of the ﬁrst ever Sirona showroom of- ﬁce opening in Dubai, 10 years ago. Remembering Dr. Amro Adel, your General Manager for the MENA region, working countless hours, from making everything himself even the design and it was excel- lent. I am a witness of this long successful journey and to reach the success with Sirona here, now Dentsply Sirona, what is your ﬁrst impression of the Dentsply Sirona Middle East ofﬁce? Don Casey: The office is gorgeous and highly well-staffed, with the right equipment and great space. I would say this is one of our best training facilities in the world. Wal- ter Petersohn and I travel constantly, and I would put this office among the best. “The Dentsply Sirona ofﬁce here is beauti- ful, showcasing our products and offering outstanding training facilities to our cus- tomers.” – Don Casey, CEO, Dentsply Sirona. In February 2016, Dentsply and Sirona merged resulting in the largest dental manufacturing com- pany in the world in dental prod- ucts and technology. Currently the company has 15,000 employees so how have you managed to keep the company consistently strong in terms of strategy and culture? This question is in particular regarding the Middle East due to its multi- cultural environment, religions and most importantly crucial par- ties having different educational backgrounds. Don Casey: When trying to integrate companies, whether it is a homoge- nous market, like North America or a multicultural environment, like the Middle East, you have to start with a single goal: the customer. At Dent- sply Sirona, we are all unified around the idea that if we focus on helping the half million dental profession- als around the world and improve their practices, that’s what will create a united culture. Whether you are Egyptian, German or American, our goal is to help dentists deliver better oral care and smiles to their patients. That is what we do. The education here in the Middle East is the challenge especially due to the different educational back- grounds coming with different ap- proaches from different countries. This is very challenging, but I am certain we can manage well in the Middle East in terms of education. Don Casey: Clinical education is key to us. Providing dental professionals with essential knowledge is one of our main goals. One of the conversa- tions we’ve had with Dr. Amro Adel was this region has done an excep- tional job because of great partner- ships, like we have with you, in fo- cusing on clinical and lab education. We have to consider that we need to do things differently in Saudi Arabia compared to Egypt or Morocco. For example, how we teach Class II resto- ration or digital dentistry, when deal- ing with different backgrounds and the complexity of each region. How important is the Middle East dental market to Dentsply Sirona? And for which reasons? Walter Petersohn: Super important. This isn’t an easy market, but it is a growth market. Growth markets at- tract us. Over the last five years we’ve
32 t Page 31 the business, to build it, accelerate it, and we are excited. This is why we continue to invest in facilities here, and why we continue to grow the team and increasingly invest in clini- cal education. Which product line do you feel is best represented in the Middle East region and which ranges still require more awareness? What are some of the solutions dental pro- fessional can expect in the Middle East in the future? Walter Petersohn: First, it is impor- tant to understand that people know our brand. It is known through our presence, our innovation and how we remain active in certain seg- ments and fields. Clearly, everything that is digital, combining procedures into digital workflows, aligners, im- plants, restorative materials and the INTERVIEW Dental Tribune Middle East & Africa Edition | 1/2020 The Dentsply Sirona MENA team with Don Casey and Walter Petersohn. AD endo solution process, have become very popular. Our task is to make sure we stay with our strongholds and accelerate in these areas, and we continue to support dental profes- sionals with our innovations, both in the product and the procedure level, so they can be successful and help patients smile. Again, this means focus. Countries vary, hurdles vary, it is multidimensional but a big op- portunity. “Over the last ﬁve years we’ve learned a lot, and with Dr. Amro’s help, we have put together a mag- niﬁcent team and all the building blocks to accelerate growth.” – Walter Petersohn, CCO, Dentsply Sirona How far ahead down the years do you plan when it comes to inno- vation planning and introducing novelties in the Middle East? What is your forecast and vision? Don Casey: You will understand some we cannot talk about. We want to emphasize a number of different businesses, but I think Walter Pe- tersohn said it very well: we believe digital is the future. Whether that is the evolution of 2D to 3D, the migra- tion with CAD/CAM, chairside den- tistry or Primescan, it’s a substantial digital business. But there is also Orthodontics and the Implants busi- ness too. When we look at the region, our Endodontic business plays an important role. This is an area where we have a lot of history and tenure. We went from hand files to digital, to reciprocating files. And the Mid- dle East has played an important role in the growth and will continue to be a great emphasize here. In our mind, we look at different blocks of innovation, and digital will be one. We believe that we are at the begin- ning of what we think endodontics will be like over the next decade. We’re also excited about our implant business, which traditionally has not been a focus in the Middle East. But with someone like Dr. Amro, who has been making investment deci- sions in the region, we’re changing our direction and structure. Working closely with our customers in the re- gion, he’s able to inform us on what should be our focus. From our point of view, the implants business will be good opportunity over the long- u Page 33
Dental Tribune Middle East & Africa Edition | 1/2020 INTERVIEW 33 are new customers, usually not only from our database but from the region who are interested in education. It will be good in the fu- ture to process more webinars. Walter Petersohn: We always try to tailor our activities to the country and partner with institutions from other countries. Some countries are already advanced, so we try to team up with institutions and create part- nerships whenever it makes sense. This creates a win-win situation and the purpose of both organisations can overlap to combine forces. This is the international platform. These webinars are going to our 139 publishers in the world. From China to the States. States is a big partner. Middle East is the second largest after the United States. Don Casey: As you think about your platform, and it’s a conversa- tion we had today, we really heard a lot of buzz from Russia. I would love to see the development and recog- nition of more local KOLs. As we do webinars, let’s not make them the same way, with the same guys who always do them. I think people are doing great dentistry all over the world. One of the things I’d like for Dentsply Sirona to do is make our webinars and our dental education to reflect the style and culture of countries around the world, includ- ing local voices and faces. Two days ago, we were in the office in Mos- cow and the technique and work were probably better than anything I have ever seen. I would love the world to learn best practices from all over the globe. There’s not just one centre. The power sits in local- ising activities. We reduced the re- gional responsibilities to have our leaders be more engaged and in- volved with our customers, dealer partners and staff. The same is true for training. The more you can get local leaders involved in training and education, same country, same language, the faster you can con- vince local customers of the quality of products. How important are the dental deal- ers in Middle East for Dentsply Si- rona International.? Walter Petersohn: They’re very important, also because of the geo- graphic diversity. There’s no way we would ever be able to cover this gi- gantic region without the help of the dealers. But that means we also have to train the dealers on our products so they can train the dental profes- sionals. We usually bring together all the dealers, that’s what we do during our so-called Dealer days. One of the challenges, depending on the region, is how can we help them with credit. Economically, it’s a challenge when dealing with different parts of the world, and different economical situ- ations and so on. Ultimately, every day starts with us asking, how do we help our customers - and the dealers are a critical way for us to help. Do you have anything else to say to Dental Tribune Middle East read- ers? Don Casey: First, we’re excited about your presence and the excitement of all your readers in the field of den- tistry. We want your readers in the region to know that we mean it very serious. This is why we believe in a local footprint and local staff. As you know, we are not just in Dubai, we have our teams all over the Middle East and North Africa region. This is a significant commitment! By putting the focus on the right areas and grow- ing education, all of our customers and dental professionals around the region will see that, which will trans- late into new partnerships. AD t Page 32 term. At Dentsply Sirona, we used to think we have 10 digital businesses that all had to move at the exact same speed. But we’ve learned that it makes more sense combining sep- arate businesses to sensible product solutions and then sell the solution outside the box. I am very excited about the ad- vancements of digital dentistry and the digital workﬂow and with your new scanning system it can keep the data of the patient even after 10-20 years from now. We can see how important it is starting from the patient’s treatment plan to the production, to the scanning and diagnostic. I remember we talked about this at Dentsply Sirona World in Las Ve- gas last year. We are not sure where digital dentistry will lead us. Imag- ine if you had an impression of a patient’s mouth, and you as a den- tist could tell them that their teeth will get worse and a years later it re- ally does. I think the opportunity to show patients a coherent long-term treatment plan over several years is very important. I am excited about the early stages of digital dentistry. Who knows where we will be in five years? I don’t think we have figured it out yet. “Clearly, everything that is digital, com- bining procedures into digital workﬂows, aligners, implants, restorative materials and the endo solution process, have become very popular.” – Walter Petersohn, CCO, Dentsply Sirona It is good because we can keep data of the patient, even in inves- tigations, accidents, we will not search for the papers in the clinic. It’s just digital. What is the process of education at Dentsply Sirona starting from the product innova- tion down to educating the dental professional, dental technician, dental hygienist, dental assistant, even now, dental managers - the full circle? Walter Petersohn: As you men- tioned, it is a multi-element process. The one thing we can clearly state: the more, the better, the deeper we edu- cate and train, the more awareness about the product, the procedure and the solution we generate. This is why we invest in facilities like in Dubai, with training and lecture rooms, and not just here in Dubai, but in all ma- jor cities. As you may know, we have two big centres in Charlotte, North Carolina, and Bensheim, Germany, and we are constantly expanding our dental academy facilities because we realize this is the future. Given all the geographical diversity here in the Middle East but also the challenges- -i.e., people from country A cannot easily travel to country B-- we think increasing investments and activities in webinars can be a solution. The lo- cal team can train customers in India and in Morocco simultaneously, so training can be highly digital in the future for sure. We have a very huge platform with Dental Tribune International Study Club, recently opening our Middle East platform as well. We also produce a lot of webinars and its really working. Minimum number of delegates attending in our region is usually between 400 - 800 dental professionals. These
34 INTERNATIONAL NEWS Dental Tribune Middle East & Africa Edition | 1/2020 Cervitec liquid: new formula is a success! Cervitec liquid from Ivoclar Vivadent now features an enhanced formula. By Ivoclar Vivadent The composition of the mouth rinse has been further optimized to im- prove the product’s taste. The new delicate mint flavour has been well- received, even by very taste-sensitive individuals. Cervitec Liquid makes the oral hygiene routine a pleas- ant and refreshing experience. This has been confirmed in a recent sur- vey conducted by Ivoclar Vivadent amongst around 150 test subjects. Cervitec Liquid is a ready-to-use alcohol-free mouth rinse for profes- sional oral hygiene in the dental of- fice and at home. The new formula contains xylitol, the provitamin D- panthenol and 0.1 % chlorhexidine. Cervitec Liquid made an excellent first impression on the participants of the survey on the basis of its scent. Ninety-seven per cent of the re- spondents said that they liked it very much. They also gave the taste and feel of the liquid in the mouth a posi- tive review. Eighty-six per cent rated the mouth rinse as being very mild to mild. Nonetheless, 89% reported that their breath felt clean and fresh after rinsing. As a result, it is not surprising that around 90% of the respondents said that they would continue using Cervitec Liquid in the future and recommend the product to someone else. In fact, two thirds of the group already knew that they could buy Cervitec Liquid from phar- macies. Rinsing with Cervitec Liquid is rec- ommended for patients before and after implant, periodontal or ortho- dontic surgery in order to control bacteria in the oral cavity. It is also recommended for patients with a high caries risk, impaired oral hy- giene or bad breath. Children over the age of six years may use Cervitec Liquid. Cervitec® is a registered trademark of Ivoclar Vivadent AG. AD