© MIS Implants Technologies Ltd. All rights reserved. © MIS Implants Technologies Ltd. All rights reserved. IT'S SIMPLE IT'S SIMPLE TO FIND YOUR TO FIND YOUR ZEN ZENZEN ZEN ® PEACE OF MIND WITH PERSONALIZED DIGITAL DENTISTRY. MAKE IT SIMPLE The MGUIDE system features user friendly software to ensure accurate planning and an open design template that allows for a greater field-of-view and irrigation for easier implant placement. Learn more about the MGUIDE and MIS at: www.mis-implants.com

| content editorial Signs of recovery Dr Scott D. Ganz 03 practice management The COVID-19 practice manager 2021: Four steps to confidence—Part 4 06 Chris Barrow Teledentistry: A bridge between present and future Dr Carlo Fornaini 10 page 06 page 36 page 56 Cover image courtesy of Frunze Anton Nikolaevich/Shutterstock.com issn 2193-4673 • Vol. 2 • Issue 4/2021 4/21 digital international magazine of digital dentistry interview “Digital technologies are fundamentally changing the dynamics of our industry” case report Restorative simplicity for a challenging case industry Extension of Ceramill CAD/CAM workflow 04 4 2021 interview “Digital technologies are fundamentally changing the dynamics of our industry” 12 An interview with master dental technician Stephan Kreimer Amann Girrbach goes “shareside” An interview with Dr Wolfgang Reim, CEO of Amann Girrbach 16 case report Full-arch rehabilitation with lithium disilicate secondary crowns 18 luted on to the primary framework Joaquín García Arranz (Quini), Dr Ramón Asensio Acevedo & Oscar Jiménez Rodríguez The use of autologous tooth structure as adjunct grafting modality for full-arch dental implant rehabilitation Drs Scott D. Ganz & Isaac Tawil Delayed immediate implant placement and direct soft-tissue management 30 Dr Haki Tekyatan Restorative simplicity for a challenging case with limited space Dr Fernando Rojas-Vizcaya & Jose de San Jose Gonzalez 24 36 feature “It was easy to turn off the pain”— Patient receives dental implant under self-hypnosis Franziska Beier 38 news Study highlights how artificial intelligence can be used for detection of caries 42 Brendan Day Apple’s iOS 14 shakes up digital dental brands Jeremy Booth 44 industry 3Shape Unite—the platform connecting the digital dots in dental clinics 46 Claudia Duschek MODJAW: A next-generation digital dentistry solution Extension of Ceramill CAD/CAM workflow—digital solutions lead the way into the dental practice Clinical advantages of KATANA Zirconia YML as related to an external organisation’s test results 48 50 52 meetings DS World 2021: Latest innovations, product launches and partnership announcements Iveta Ramonaite Registration for 2022 Midwinter Meeting is now open International events about the publisher submission guidelines international imprint 56 58 60 61 62

m o c . k c o t s r e t t u h S / s n e v N y e g r e S © i | practice management Time management—there simply do not seem to be enough hours in your day. The COVID-19 practice manager 2021: Four steps to confi dence—Part 4 Chris Barrow, UK In the first part of this series, we looked at the charac- teristics of great leadership and how this applies in the role of practice manager. In the second part, we looked at management and the checklist of systems required to run a modern-day dental business. In the third part, we talked about teamwork: what makes an ideal team player and an ideal team, and how does the practice manager keep the right people? In the concluding part of this series, I will be looking at extreme self-care, making sure that the best possible ver- sion of you can turn up for work (and arrive home again!). I set the scene by running through what has inevitably become a series of present-day challenges: – time management—there simply do not seem to be enough hours in your day; – task management—when you get to the end of the day, you rarely get to the end of the list; – energy management—you are living in what seems to be a perpetual state of exhaustion; – attention management—everyone wants a piece of you and a variety of digital channels are used to try and grab your attention. Sound familiar? I want to share some insights about each of these challenges that have helped me (and those I care for) to navigate the pandemic. Time management It has been suggested that time management is a myth, that we all have 24 hours in the day and the choice as to what we do with them. That sounds very harsh when you have a family to raise and bills to pay. I am lucky to be at an age when my five children have left the nest, and believe me, I recognise my good fortune (if you see what I mean), but I also remember long years of 06 4 2021

| practice management reasonably can and accept that what is left over will either get done by somebody else or never get done. You cannot work eight days a week or 27 hours a day. Task management is another myth—there is only priority management. One of the first modern-day books on time management, The Time Trap by Alec MacKenzie, suggested the following: – Make a list every day. – A, B, C the list. – Do the As first. Simple enough but profound and timeless. I am a list person—my life is a list—and I keep that list nowadays on the cloud and synced to every device I own. Do not try managing your list; simply manage your pri- orities (and often other people’s—that can be the hard part)—back again to strong boundaries and saying NO. Energy management I use a simple mnemonic with my clients, SNEF: – Sleep. Read Matthew Walker’s book Why We Sleep. I did in 2019, and it changed my approach to the subject. Without adequate and appropriate sleep, we cannot function at high revs for any sustainable period. – Nutrition. I do not do diets and am a happy carnivore, but I do ensure that my nutrition is healthy and bal- anced. COVID-19 introduced me and my wife to meal kit company HelloFresh, and we remain committed clients. – Exercise. Aerobic exercise has been a backbone of my life since the mid-1990s. Nowadays, I am a retired marathon runner after countless injuries, but I have taken up cycling and taken to it, both indoors and outdoors. Having two hunt, point and retrieve dogs helps as well. – Fun. Despite everything the world throws at us, I have always regarded a healthy sense of humour as being a prerequisite of happiness (and the best version of that is the ability to laugh at oneself—which I do most days). Fun can be quality entertainment, great company or a mini-adventure. Attention management This is a modern-day phenomenon that seems to have crept up on us in the Internet age. There is a lot of online talk at the moment of the difference between synchro- nous and asynchronous communication. Synchronous communication happens when messages can only be exchanged in real time. It requires that the transmitter and receiver are present in the same time and/or space. Examples of synchronous communication are phone calls or video meetings via platforms like Zoom and Microsoft Teams. Another example of synchronous communication is that tap on the door (or the shoulder), followed by “I know you said not to be interrupted, but...”. In this case, the transmitter is someone who wants your help (or to dump his or her load) and the receiver is you. Attention management—everyone wants a piece of you and a variety of digital channels are used to try and grab your attention. m o c . k c o t s r e t t u h S / r d n a s k a i l A o k r a M © 08 4 2021

| practice management Teledentistry: A bridge between present and future present and future By Dr Carlo Fornaini, France and Italy The COVID-19 pandemic has dramatically and totally changed all medical clinical practices. The aims of limiting physician–patient contact and reducing hospitalisation have become major concerns, pushing researchers to find novel ways to perform medical care.1 The new field called “telemedicine” has achieved great importance, and today it can be used in several medi- cal specialties: – Store-and-forward telemedicine, common in the med- ical fields of dermatology, radiology and pathology, makes it unnecessary for the medical practitioner to meet in person with a patient because patient informa- tion such as medical images or biosignals can be sent to the specialist as needed after it has been acquired from the patient.2 – Remote monitoring, also known as self-monitoring or self-testing and extensively used in the management of chronic diseases such as cardiovascular disease, diabetes mellitus and asthma, uses a range of tech- nological devices to monitor the health and clinical symptoms of a patient remotely.3 – Real-time interactive services can provide immediate advice to patients who require medical attention, utilising for this purpose several media, including the phone and the Internet, followed by an assessment similar to one conducted during face-to-face appointments.4 The term “teledentistry”, first used in 1997 when Cook defined it as “... the practice of using videoconferencing technologies to diagnose and provide advice about treatment over a distance,”5 is a new area of dentistry that integrates electronic health records, telecommunications technology, digital imaging and the Internet, in order to improve access to care for patients in remote settings. It allows specialists located many miles away to make a diagnosis and recommend treatment options and/or referral for patients who, otherwise, would find it difficult to see them.6 In the field of oral and maxillofacial surgery, it has been reported that diagnostic evaluation of impacted teeth using teledentistry is as efficient as real-time patient as- sessment. Similarly, it has been shown that screening for dental caries in children using teledentistry is comparable with traditional techniques such as tactile and visual den- tal examinations. In the field of endodontics, teledentistry has been successfully used to identify root canal orifices and periapical lesions of anterior teeth.7 10 4 2021

| interview 1 “Digital technologies are fundamentally changing the dynamics of our industry” An interview with master dental technician Stephan Kreimer By Iveta Ramonaite, Dental Tribune International Stephan Kreimer is a master dental technician who runs a dental laboratory in Warendorf in Germany. Since he developed an interest in technology early on, Kreimer was always eager to integrate dental technologies into his workflow. Now, more than a decade later, innova- tive technologies such as CAD/CAM, CNC milling and 3D printing are shaping his work and offer increased effi- ciency. In this interview with Dental Tribune International, Kreimer shares his journey from a conventional to a digi- tal laboratory and weighs up the advantages of investing in an in-house 3D printer. Mr Kreimer, when did you first start working in the dental field, and what led you to a career in dentistry? Technology has always been an interest of mine. Since 2009, I have been able to combine this interest in tech- nology with dentistry through my education in dental technology. At the time, my parents were operating a conventional dental laboratory in Germany that made little use of digital technologies such as CAD/CAM. After completing my master’s in dental technology, I took over as managing director of our family laboratory. 12 4 2021

| interview 3 Fig. 3: 3D-printed dental appliances. (All images: © Stephan Kreimer) and the manufacturers. Dentistry is at the intersection of multiple disciplines, and we need to have good commu- nication to make progress. The rate of innovation in digital dentistry is extremely high. We now see manufacturers coordinating much better and creating more accessible ecosystems that are much “We are undergoing a paradigm shift in dentistry because digital technologies are fundamentally changing the dynamics of our industry.” easier to use. At the same time, most of the potential is still untapped and will become apparent as we undergo significant transformations within our industry. Having worked with digital technology for over a decade now, what benefits do you see of using den- tal technology, especially 3D printing, in a dental laboratory? To me, dental technology is about combining the best of two worlds: analogue and digital. We still need and will continue to need traditional craftsmanship to meet the high requirements for individualised aesthetics in complex cases. At the same time, the holistic digital workflow works well in an increasing number of areas, enabling significant increases in efficiency while main- taining or improving overall quality. Digital fabrication in particular enhances production speed and repro- ducibility. Dentistry is constantly evolving. What lies ahead for dentistry, and what dental technology is most likely to shape its future? In my view, we are now at a point where most of the industry understands and embraces the vast potential of digital technologies. At the same time, we are just about to move from an early adopter stage to the early majority stage when it comes to the adoption of digital technologies. In Germany, for example, only 15% of dental practices are using intra-oral scanners, much less than in the US. However, the trend towards digital impressions is accel- erating fast! We are undergoing a paradigm shift in dentistry because digital technologies are fundamentally changing the dy- namics of our industry. We will see entirely new business models, and together we will establish new standards of care. It is an exciting time, and for those who embrace this change, there will be many opportunities. 14 4 2021

| interview Amann Girrbach goes “shareside” By Jeremy Booth, Dental Tribune International Going digital in dentistry is now more important than ever. CAD/CAM pioneer Amann Girrbach has a long history of developing workflow solutions for dental clinics and laboratories. “We’re experts on both sides,” said CEO Dr Wolfgang Reim, who spoke in this inter- view about the company’s new modular Ceramill Direct Dr Wolfgang Reim has been the CEO of Amann Girrbach since 2020. (All images: © Amann Girrbach) 16 4 2021 Restoration Solution (DRS) and the communication and case management platform AG.Live. Dr Reim, what is new regarding Amann Girrbach’s approach to the overall digital workflow? The traditional approach to chairside workflows cuts off the competence of the laboratory from that of the den- tal technician. This is what we want to avoid. We have learned a great deal about the challenges at the inter- disciplinary interface and have focused on the develop- ment of Ceramill DRS in order to offer added value to all stakeholders. With our new software platform AG.Live, in combination with the modular DRS, we have combined clinical and laboratory workflows, thus closing the gap between the dental practice and the laboratory. As a result of this process, professionals have more choices and instant modes of communication, and both sides can contribute their core competencies in order to pro- vide patients with the best possible restorations. This is what we call “shareside”—Amann Girrbach’s specific concept of chairside. There are two core elements to the new and fully in- tegrated workflow. Firstly, can you tell us more about the Ceramill DRS? Ceramill DRS offers dentists and laboratories fully inte- grated and validated workflows with consistent highest- quality restorations and full flexibility. Depending on the type of collaboration desired, three team workflows are available in combination with the corresponding Ceramill DRS modules. The Ceramill DRS Connection Kit integrates digital im- pressions taken by the dentist into the digital laboratory workflow. It consists of a high-performance intra-oral scanner, the Ceramill Map DRS, and scan software. It includes a connection to AG.Live, through which all case data is shared seamlessly and in real time with the laboratory of choice, and further communication directly linked to the case can be done online or offline. This elim- inates the need for handwritten job sheets and phone calls and enables same day dentistry for certain resto- rations with a fast laboratory process. Users can upgrade to the Ceramill Motion DRS produc- tion module, and restorations can be designed either on-site or with the support of the laboratory via AG.Live. In combination with the Ceramill Therm DRS speed

| case report Full-arch rehabilitation with lithium disilicate secondary crowns luted on to the primary framework Joaquín García Arranz (Quini), Dr Ramón Asensio Acevedo & Oscar Jiménez Rodríguez, Spain 1a 1b 2 Figs. 1a & b: Digital mock-up. Fig. 2: Digital design of the gingiva. Introduction Dealing with implant restoration is challenging, and this process would be impossible if we could not communi- cate freely between the clinic and laboratory. At the start, we do not know what type of framework design we will have to make, nor what the pink and white proportions will be. The starting point is working as a team, maintain- ing constant communication through emerging technolo- gies in photography or digital smile design. In a treatment protocol for complete edentulism with digital design in- formation, we transfer the ratios of white and pink aes- thetics to the scanner, turning it into an analogue test for a first analysis inside the mouth via CAM. When we know how far we need to go with the case, we select the type of material that will result in the best outcome, com- bining materials with appropriate techniques as required throughout the treatment. The patient’s needs are always taken into account in pursuit of greater durability of our prostheses over time. Case presentation A patient with inadequate crown and bridgework at- tended the clinic because several abutment teeth had failed. Owing to the Class III occlusal pattern and the small number of remaining teeth with a good long-term prognosis, we decided on an implant-supported res- toration in the maxilla and a combined tooth–implant restoration in the mandible. 3 4a 4b Fig. 3: Mock-up in PMMA with pink and white aesthetics. Figs. 4a & b: Evaluating the integration of the mock-up in the patient’s mouth. 18 4 2021

| case report 12a 12b 12c 12d 12e 12f 12g Figs. 12a–g: Light dynamics of natural teeth in direct and indirect light. consistently before we can continue with the treatment. All necessary changes were made to clear any doubts until we achieved the desired integration of the mock-up into the patient’s mouth and face (Figs. 4a & b). During the treatment protocol for edentulous patients, we take the time to evaluate the aesthetic mock-up to verify what the best obtainable result would be and which material would be ideal for the definitive restoration: a conventional porcelain-fused-to-metal (PFM) restoration or a white material, such as zirconia, combined with metal interfaces (Figs. 5a–d). For this type of design, there are many elements that we have to take into account: the length from the implant to the incisal edge, implant– restoration ratio, widths of the design, occlusion, etc. We take great care to ensure that every patient has a prosthesis customised to his or needs. The restoration 13a 13b 14a 14b 14c Figs. 13a & b: Light dynamics of natural teeth under fluorescent light. Figs. 14a–c: Layering with GC Initial LiSi. 20 4 2021

| case report 20 21 Fig. 20: Frontal view after treatment. Fig. 21: Radiograph after treatment. LiSi Press is available in degrees of translucency, from the most opaque to the most translucent (MO, LT, MT and HT). Cementation and bonding protocol The anterior area is the most aesthetically demanding area and was veneered using the polychromatic layering technique using GC Initial LiSi veneering ceramic. This ceramic is exactly matched to the lithium disilicate frame- work and ensures a perfect fusion (Figs. 14a–c). Once the macro- and microtexture surfaces have been fin- ished, we mechanically polish the restoration for perfect integration with the pink aesthetics. The bonding protocol to cement the LiSi Press restorations on to the surface of the ceramic-covered dies starts by ap- plying hydrofluoric acid to both ceramic surfaces and leaving it on for 20 seconds. After rinsing and drying, GC CERAMIC PRIMER II or G-Multi PRIMER (GC) is applied (Fig. 15). Shade A2 of G-CEM Veneer (GC) was selected, verified with G-CEM try-in paste (GC) to check the shade and used to cement the restorations (Fig. 16). The cement was tack- 22 24 23 25 26a 26b Fig. 22: Engineering of the micro- and microtexture of the surface. Fig. 23: Application of the GC Initial Spectrum Stains. Fig. 24: Fitting the GC Initial LiSi Press restoration on to the zirconia framework. Fig. 25: Highly fluid GC Initial LiSi ceramic is applied to the zirconia framework. Figs. 26a & b: Multi-chromatic layering of gingival structures. 22 4 2021

| case report The use of autologous tooth structure as adjunct grafting modality for full-arch dental implant rehabilitation Drs Scott D. Ganz & Isaac Tawil, USA 1 2 Fig. 1: CBCT imaging showing volumetric reconstruction, axial, panoramic and sagittal views. Fig. 2: Panoramic reconstructed view revealing fractured teeth, residual root tips and failing dentition. Introduction Full-arch dental implant rehabilitation is a viable treat- ment choice for patients who are edentulous or who have teeth that are compromised and in need of extraction. Regardless of a freehand or fully guided surgical protocol, treatment outcomes for full-arch implant-supported resto- rations have helped patients regain proper function, aes- thetics and quality of life.1–3 Additionally, the ability to place implants immediately after tooth extraction has become a viable treatment modality which can often reduce the time to delivery of functional restorations.4 However, the residual alveolar ridge may require grafting to fill defects left by extraction sockets, or pre-existing concavities.5, 6 It is well understood that substantial bone resorption and loss of bone volume can occur when extraction sites are not grafted.7, 8 Avila-Ortiz et al. concluded that “alveolar ridge preservation is an effective therapy to attenuate the dimensional reduction of the alveolar ridge that normally takes place after tooth extraction”.9 The gold standard has always been autologous tissue harvested from the patient, but it is not always easy to harvest or readily accessible. Therefore, most clinicians currently utilise bone and mem- branes available through tissue banks. However, current innovations have fortunately provided a new, previously untapped source of this autologous tissue: the extracted 3a 3b Figs. 3a & b: Six implants planned for maxillary arch fixed restoration (a). Five simulated implants with two tilted to avoid the inferior alveolar nerves in the mandibular arch (b). 24 4 2021

| case report 6a 6d 8a 6b 7a 8b 6c 7b 9 Figs. 6a–d: 3D volumetric reconstruction of the maxilla and mandible (a). The isolated mandibular arch (b). STL surface model merged with DICOM data with virtual posterior teeth (c). Yellow abutment projections representing screw access channels (d). Figs. 7a & b: Bone reduction guide design (a). Reduced mandible, nerves and simulated implants with selective transparency (b). Figs. 8a & b: Transparent reduced mandible, five implants and yellow abutment projections (a). Transparent STL model and virtual teeth (b). Fig. 9: Osteotomy drilling guide seated on the mandible. When assessing the potential mandibular implant recep- tor sites, the buccal and lingual cortical plates appeared to be well defined. However, careful inspection revealed a deficient density within the intermedullary bone. Yellow abutment projections represented simulated abutment trajectories helpful in the determination of screw access channels within the transitional and definitive prostheses. It was also possible to place realistic simulated abutments based on the desired angulation and tissue cuff height chosen from the implant library within the software. The planning continued with the examination and manipu- lation of the 3D reconstructed volume of the mandible and maxilla (Fig. 6a). Using the isolate function within the Blue Sky Plan software, the mandibular arch was sepa- rated from the maxillary arch, which with the merging of the intra-oral scanning data helped with the restoratively driven planning and refinement of implant positioning (Figs. 6b & c). The implants were then planned with precise regard for the emergence of the screw access channels represented by the yellow abutment projec- tions which extended above the occlusal plane (Fig. 6d). Once each of the implant receptor sites and the vertical positions had been validated, the amount of alveolar re- duction (after tooth extraction) was determined. A bone reduction guide was then designed with four anchor pins for stable fixation to the mandible (Fig. 7a). The various components of the diagnostic progress can be better appreciated using selective transparency to visualise structures based on their density (Fig. 7b). Selective trans- parency was again utilised to visualise the final location of the three central straight implants and the two angled im- plants, clearly indicating the safe proximity to the bilateral inferior alveolar nerves (Fig. 8a). The translucent STL model of the mandibular teeth and virtual teeth helped relate the implant positions to the restorative plan (Fig. 8b). The sequential osteotomy drilling guide was designed based upon the parameters of the implant system and guided drilling kit utilised. The osteotomy drilling guide was to be secured to the mandible with the same fixation pins as used for the bone reduction guide (Fig. 9). Clinical procedure The patient presented with a collapsed bite due to miss- ing, mobile and fractured teeth, which severely affected her ability to masticate food, resulting in embarrassment and a diminished quality of life (Fig. 10). After a thorough review of the diagnostic process, the treatment plan was presented and accepted by the patient for maxillary and mandibular implant-supported fixed restorations. At the request of the patient, one long procedure was scheduled to be completed under sedation administered by a dental 10 11 Fig. 10: Pre-op retracted view. Fig. 11: Mandibular extractions. 26 4 2021

| case report 16 17 18 Fig. 16: Surgical guide fixated to the maxillary arch for guided drilling protocols. Fig. 17: Implant delivered through the guide. Fig. 18: Fully template-guided implants were placed. noted during the diagnostic phase. Each implant was then objectively tested for stability using resonance fre- quency analysis, and implant stability quotient (ISQ) val- ues were recorded (Osstell IDx, Osstell). The ISQ values confirmed the initial CBCT assessment of the mandibu- lar bone, and a decision was made to bury the implants and leave them covered for approximately 2–3 months to provide sufficient opportunity and time for the implants to fully integrate within the mandibular bone prior to load- ing. Each subcrestally placed implant received a 2 mm cap screw to fill the coronal osteotomy site. All the re- sidual tooth sockets and any defects or concave areas were then filled with the dentine grafting material (Fig. 15). Two 20 × 30 mm collagen membranes (MaxxMem, Com- munity Tissue Services) were then draped over the grafted site and stabilised with deep horizontal mattress sutures. Closure was then achieved with continuous and interrupted sutures using #4/0 thread (VICRYL, Ethicon). A similar procedure was completed for the maxillary arch. After local infiltration of anaesthetic agents, all remaining root tips and teeth were atraumatically extracted and all sockets thoroughly debrided. A full-thickness mucoperi- osteal flap was elevated from approximately the area of tooth #16 to tooth #26 to expose the residual alveolar ridge. Once the bone had been reduced, an osteotomy drilling guide was fixated to the maxillary arch (Fig. 16). Osteo- tomies were then prepared, and six Helix Grand Morse implants were placed through the guide (Figs. 17 & 18). The stability of each implant was objectively measured, and the ISQ values were found to be below the threshold for immediate loading. Therefore, the maxillary implants were buried in a two-stage protocol. To preserve the width and height of the residual alveolar ridge, the extraction sites were all filled with the grafting material gleaned from the teeth extracted from the mandibular arch (Fig. 19a) and covered with large 20 × 30 mm collagen membranes (Fig. 19b). The immediate postoperative panoramic radio- graph showed the placement of five implants for the man- dibular arch and six for the maxillary arch (Fig. 20). The classic radiolucent appearance of fresh extraction sites was not evident, as each had been filled with the dentine grafting material. Small, round radiolucent holes could be visualised in the mandibular arch from the four fixation screws. The 2D panoramic reconstructed view is some- what distorted and thus the true trajectory of each implant cannot be accurately appreciated. It was the original plan that the right and left most distal tilted implants would receive 30° angulated multi-unit abutments at the appro- priate tissue cuff height once the implants had been un- covered and after osseointegration had been confirmed. The patient was then brought out of sedation and allowed to recover until she was fully coherent and ambulatory. Immediate complete dentures were then delivered to the patient after soft-tissue relining had been accomplished to improve fit. Postoperative instructions were provided to the patient orally and in writing. The procedure was well tolerated, and the patient was subsequently followed for suture removal and healing progress. Discussion When full-arch implant restoration is contemplated for patients who are partially dentate, immediate extractions will be required. Many will require extractions of perfectly intact teeth and roots, which can provide an excellent source of autologous grafting material. These extraction sockets may leave significant voids in the bony archi- tecture of the remaining alveolar ridge. As it is recom- mended that implants should be planned with 3D imag- ing acquired through CBCT scans, the diagnosis should also include an assessment of where the teeth will be extracted and what type of bony defects will be left af- ter extraction. When implants are planned to be placed directly within fresh extraction sockets, often there is a gap on the buccal wall, which can be filled with grafting material to help preserve the bony housing. In other areas, the entire sockets can be filled to reduce potential for volumetric shrinkage of the ridge over time. The current case presentation illustrated the effectiveness of utilising an innovative device to grind extracted teeth to pro- duce sufficient graft volumes required during the surgical phase of full-arch implant rehabilitation. Calvo-Guirado et al. found that, after processing with the Smart Dentin Grinder, “0.25 gr of human teeth produced 1.0 cc of biomaterial” and that the “chemical composition of the particulate was clearly similar to natural bone”.13 The pres- ent case illustrated immediate extraction and immediate implant placement for a delayed loading protocol with 28 4 2021

| case report 1 3 Delayed immediate implant placement and direct soft-tissue management Dr Haki Tekyatan, Germany were able to show in a systematic review that six months after extraction there is a horizontal bone loss of 29–63% and a vertical bone loss of 11–22%. The transverse bone loss was found to be higher than the vertical bone loss.12 This was also confirmed by Araujo and Lindhe in their an- imal studies. They found that the greatest changes to the alveolar process in the area of the buccal wall occurred within three to six months after tooth extraction.2 In im- plant dentistry, these are limiting factors in daily practice. However, it is crucial to have sufficient hard and soft tis- sue both in quantity and in quality to achieve the goals of implant therapy.5 Preventive interventions can aid in counteracting bone loss and resorptive processes in order to preserve hard and soft tissue.7 In this regard, alveolar stabilisation is a method performed during or after tooth extraction to minimise external resorption of the alveolar process, pre- serve bone, and promote and support bone formation within the extraction socket.6 Various terms are used for this in the literature, such as alveolar ridge preservation (for three- or two-walled defects), socket preservation (for circularly intact alveoli), socket seal technique and alveolar preservation. The aim of these methods is to fill the fresh extraction socket with a bone grafting material and to achieve stabilisation of the alveolar walls.9 In this regard, the use of bone substitute materials biologised with platelet-rich plasma (I-PRF and A-PRF) is described in the literature as a successful means to preserve bone and soft tissue and to support the healing process.8, 11 In the following case report, socket preservation with CERASORB Foam (curasan) and I-PRF (IntraSpin, Bio- Horizons Camlog), obtained according to the Low Speed Centrifugation Concept (LSCC) of Prof. Shahram Ghanaati, was performed after extraction of tooth #12.15 Similar cases were reported by Palm et al. and Al-Nawas et al. in the past.13, 14 The implant was positioned and inserted six weeks later on the basis of external planning (DEDICAM, CAMLOG) and using a surgical guide with depth stop (CAMLOG Guide System). An intra-oral scan (Medit i500, Kulzer) was performed intra-operatively, and the first sur- gical phase concluded with submerged healing. During this period, a new type of healing abutment was fabri- cated entirely from PEEK material. After a healing pe- 2 4 Fig. 1: Initial clinical situation of tooth #12. Fig. 2: Radiograph of tooth #12 showing failed endodontic treatment with the dislocated post restoration and deep complicated fracture. Fig. 3: Gentle detachment of marginal gingiva and periodontal ligament fibres using periotomes. Fig. 4: Atraumatic extraction of the tooth and the fractured fragment. In the case of implant planning, the preservation of soft tissue and bone is essential for functional and aes- thetic long-term success. There are now various different techniques and materials available. The timing of implant insertion and soft-tissue shaping play a crucial role, as do the measures taken in advance of the planned ther- apy. A targeted strategy can generate favourable condi- tions before implant placement. In this context, the use of bone grafting materials in combination with intrave- nously collected autologous platelet concentrates (I-PRF and A-PRF) has become increasingly important in recent years. With this “biologisation” of specially developed bone grafting materials for alveolar management, stable preservation of the extraction socket and the bone can be expected while promoting wound healing. The great- est loss of bone and, as a result, soft tissue occurs in the first 12 months after tooth extraction. In the literature, loss rates of up to 60% are reported.3 In this regard, Tan et al. 30 4 2021

| case report 12 13 Fig. 12: Evaluation of 3D diagnostics showed sufficient stable bony conditions in all directions. Fig. 13: Clinical situation before implant placement. Figs. 14 & 15: Planning of the surgical guide (CAMLOG Guide), vertical and ventral views. 14 15 orovestibular directions, the CBCT/DICOM data sets were sent to an external planning centre (DEDICAM) via a secure channel and a surgical guide (CAMLOG Guide, SMOP, Swissmeda) was fabricated (Figs. 14 & 15). An implant (CAMLOG PROGRESSIVE-LINE, CAMLOG; diameter: 3.8 mm; length: 13.0 mm) was chosen which would ensure sufficient high primary stability owing to its progressive thread design. Six weeks after extraction and socket preservation, im- plant insertion in region #12 was performed under local anaesthesia. A crestal incision was made, and a flap was reflected in a minimally invasive manner. The surgical guide was put into position, and then the guide system and the 3.8 mm drill set (CAMLOG) were used to prepare the osteotomy in several steps to the planned length of 13 mm. Finally, guided implant placement was performed to a torque of 25 Ncm (Figs. 16–18). After final position- ing of the implant (Fig. 19), the insertion post was re- moved and a PEEK scan body (CAMLOG) with the same diameter of the implant (3.8 mm) was inserted (Fig. 20). The implant and the jaws were then scanned intra- operatively (Medit i500 and Medit Link software, Medit) to verify the position of the inserted implant (Figs. 21a & b). After scanning, the scan body was removed, the healing abutment was installed, the surgical site was tightly sutured for submerged healing and a dental panoramic tomogram (Orthophos XG 3D) was taken (Figs. 22a–c). During the healing phase of the implant, the scans were further processed for further planning (Fig. 23). The objective was to shape the soft tissue and to fabricate the definitive res- toration in as few steps and as effectively as possible. Experience has shown that it is important to minimise insertion and extraction torque in order to protect and stabilise the peri-implant hard and soft tissue. This is es- sential for achieving long-term implant success, which, in the present case, was realised on the basis of the treat- ment protocol followed. After an irritation-free healing phase of three months, the hard- and soft-tissue conditions were considered sta- ble, and therefore the implant was exposed under local anaesthesia. Since the soft-tissue situation was consid- ered quantitatively sufficient, the incision was made cre- stally. In collaboration with the external planning service centre (DEDICAM), a novel healing abutment was fabri- cated from PEEK during the healing phase and subse- quently inserted. This one-piece healing abutment does not require further processing, thereby minimising possi- ble sources of error and potential contamination (Fig. 24). The soft tissue was modelled in the coronal direc- tion by means of a suspension suture, and the wound margins were fixed to the adjacent teeth by means of vertically modified backsuture (Fig. 25). Finally, a con- 32 4 2021

| case report 23 24 25 26 27 28 29 Fig. 23: Dental panoramic tomogram after implant placement in region #12 and post-op control at three months. Fig. 24: Healing abutment made of PEEK. Fig. 25: Inserted individual healing abutment and fixation of the peri-implant mucosa. Fig. 26: Periapical radiograph for radiographic control of the implant in region #12. Fig. 27: Vertical view shows the individually shaped mucosa immediately before the installation of the definitive superstructure. Fig. 28: Buccal view of the definitive crown in region #12. Fig. 29: Radiographic control of the implant in region #12 after installation of the definitive crown. There was homogeneous and continuous bony healing of the implant site throughout (Fig. 26). After a healing period of nearly three months, the defin- itive restoration of the implant in region #12 was carried out. A fully-veneered zirconia crown was fabricated in a CAD/CAM procedure. The customised zirconia abutment was bonded to the titanium base. The crown was then cemented onto the abutment. Following the final resto- ration, a final radiographic control was taken. Since the crown was placed immediately after customisation, fur- ther aesthetic remodelling of the approximal peri-implant mucosa is to be expected over time. Overall, a non- irritant, aesthetically pleasing and satisfactory result was achieved (Figs. 27–29). trix (CERASORB Foam) biologised according to LSCC, delayed implant placement, as well as direct soft-tissue management after exposure using a prefabricated cus- tomised healing abutment. The case demonstrates how adequately sized and contoured hard and soft tissue for implant restoration in the aesthetically relevant zone can be achieved in preventive and efficient treatment steps that are kept as short as possible. Editorial note: This article was first published in implants—international magazine of oral implantology, Vol. 22, Issue 3/2021. Conclusion about Restoration in the anterior region is one of the greatest challenges in implant dentistry. The demands and ex- pectations of patients regarding the aesthetic zone are very high.4, 7, 10 In order to meet these expectations and to achieve an aesthetically predictable and prognostically reliable aesthetic long-term result, it is vital to ensure the preservation of the soft tissue. Extensive augmentation of the bone and soft tissue should be avoided if possible, and the tissue should not be put under stress after im- plant placement.1 Preventive, predictable and minimally invasive measures aid in preserving bone and soft tis- sue. In the present case, implant surgery in the aesthetic zone was successfully carried out by means of a gentle extraction technique, alveolar management adapted to the situation using -tricalcium phosphate collagen ma- contact Dr Haki Tekyatan Simmern, Germany info@dr-tekyatan.de www.dr-tekyatan.de Dr Haki Tekyatan is a Germany- based dentist who specialises in implant dentistry and maxillofacial surgery. He is currently in private practice in the German city of Simmern. 34 4 2021

| case report Restorative simplicity for a challenging case with limited space Dr Fernando Rojas-Vizcaya & Jose de San Jose Gonzalez, Spain & Germany 1 2 Initial situation and treatment planning Crown Abutment (Dentsply Sirona) was planned to be used to restore the appearance and function of the missing tooth. A 40-year-old male patient with a missing mandibular right lateral incisor and grafted area requested restoration with a dental implant. The challenge with this type of restoration is the limited space available and the proximity of the adjacent teeth. The clinical evaluation revealed the limited space (Fig. 1), and the periapical radiograph taken before the treatment showed both the grafted area into the bone and the limited space (Fig. 2). The treatment plan involved conventional implant placement using an OsseoSpeed EV implant (Dentsply Sirona) and im- mediate provisionalisation using a Temporary Abutment EV (Dentsply Sirona), and for the definitive restoration, an Atlantis Implant placement In the first step of implant placement, the biological aspects according to the 3A-2B rule were evaluated using a surgical guide (Fig. 3). The first drilling position was marked to ob- tain 2B and to create the osteotomy angulation using the Precision Drill EV (Dentsply Sirona). The angulation was con- firmed and the implant depth of the osteotomy was prepared with the Twist Drill EV (Dentsply Sirona; Fig. 4). The depth of the osteotomy was verified using the Implant Depth Gauge 4 8 3 7 36 4 2021 5 9 6 10

| feature 1 “It was easy to turn off the pain”— Patient receives dental implant under self-hypnosis By Franziska Beier, Dental Tribune International Physically lying in a dentist’s office but mentally walking barefoot through a mountain river—that is how a patient successfully received a dental implant under self-hypnosis without any anaesthesia. The patient, who underwent such a procedure for the first time under these conditions, was very satisfied with the result and reported that he felt hardly any pain during the procedure. It all started when the patient, Tomas Schröck, a hypno- therapist with his own practice in Leipzig, asked his den- tist, Dr Nico Lindemann, co-owner of a dental practice Dr Lindemann, Kurtz-Hoffmann and colleagues in Leipzig, whether he would be willing to support him in a self- experiment: an implant surgery performed under self- hypnosis without any analgesics or anaesthesia. 38 4 2021

| feature 3 Fig. 3: Before the operation, Tomas Schröck tested his pain sensation with the help of a vascular clamp. they function largely automatically and only a few stimuli from the consciousness are necessary. tive pain tend to be mutually exclusive in my world,” he explained. For his procedure, Schröck employed a memory of walking barefoot through an ice-cold mountain lake. “I chose this memory for two reasons. The feet are physically furthest away from the mouth and thus from the site of surgery, and I associate a strong feeling of euphoria with this memory. Euphoria and fear or nega- He continued: “The art of self-hypnosis is to consciously self-regulate oneself on one level in order to have un- conscious experiences on another level. That means you are not switched off or entirely passive in self-hypnosis. As soon as I became too aware of what was happen- ing in my mouth, I directed my attention back to my 4 Fig. 4: A single implant was placed in the mandible. 40 4 2021

| news Study highlights how artifi cial intelligence can be used for detection of caries By Brendan Day, Dental Tribune International A study from researchers at Charité—Universitätsmedizin Berlin has sought to measure the impact that artifi cial intelligence has on the ability of dentists to detect caries. Though artificial intelligence (AI) is being increasingly integrated into a variety of dental products and services, the body of literature evaluating its perceived benefits is scarce. To help rectify this, researchers from Charité— Universitätsmedizin Berlin have recently published the results of a randomised controlled trial they conducted. These results demonstrate that AI can increase the diagnostic accuracy of dentists. Artificial intelligence technologies are steadily being ad- opted by dental practices aiming to digitise and stream- line their workflows. From initial consultations, diagnosis and treatment planning through to surgical procedures and postoperative care, a range of dental tasks can now be augmented by the various AI solutions that have been developed in recent years. The performance of these AI-powered tools in medical and dental settings, however, has rarely been tested in clinical trials. As a result, the real impact of AI on the decision-making and diagnostics processes of dental practitioners remains somewhat unknown. This lack of clarity can carry over into decisions regarding available courses of treatment and their advantages. 42 4 2021

| news Apple’s iOS 14 shakes up digital dental brands Jeremy Booth, Dental Tribune International In the past, key steps in maintaining one’s privacy might have entailed drawing the curtains after dark, planting a hedge or shredding documents that contained personal information. Nowadays, in a world increasingly ruled by digital data, privacy begins with not opting in. Privacy changes in the 14th major release of Apple Inc.’s mobile operating system, iOS, have made it more difficult for companies to track users’ virtual activities and caused headaches for marketing departments—including those at leading digital dental brands. Apple’s iOS 14 has significantly raised the bar for Internet- browsing privacy. The tech giant’s new application tracking transparency (ATT) measures were launched with iOS update 14.5 and went live in April this year. Crucially, users are now required to actively opt in in order to share their device’s identifier for advertisers (IDFA)— a random identifier that Apple assigns to its products— with the websites and apps that they use. Before the update, users were required to actively opt out. Apple has effectively closed the faucet that allowed user-related data to flow freely to those who sold adverts online. The changes have hammered social media platforms such as Facebook (which commissioned academic research that found that they represented an “anti- competitive strategy disguised as a privacy-protecting measure”) and resulted in challenges for the scores of companies that rely heavily on online advertising to inform consum- ers about their products, including digital dental brands. But are Internet users opting in? This flow of data from IDFAs was sizable—picture Niagara Falls—and extremely lucrative for all parties, bar those to whom the data pertained. This fact was not lost on users, if current opt-in rates are anything to go by. US-based mobile apps analytics company Flurry surveyed user privacy choices from two billion mobile devices and found that users opted out in 96% of cases and that just a quarter of users had agreed when presented with an ATT opt-in prompt. The worldwide opt-in rate was 25% and the US rate was 17%, according to Flurry, whose data related to the period between April and August this year. When the data was published, around half of users 44 4 2021 © DANIEL CONSTANTE/Shutterstock.com

| industry With 3Shape Unite, dental professionals have the opportunity to harness the power of an app store and connect easily with world-leading companies and laboratories. 3Shape Unite—the platform connecting the digital dots in dental clinics By Claudia Duschek, Dental Tribune International In October, 3Shape launched 3Shape Unite. The new open platform brings world-leading dental companies, solutions and laboratories together and will allow dental professionals to manage all their cases seamlessly and efficiently. During the launch event, Dr Rune Fisker, senior vice president for product strategy at 3Shape, introduced the new platform, describing it as the greatest effort and investment in the company’s history. More than 100 people have been working on this project for the past three years. He explained that 3Shape had recognised that the main problem with digitised dentistry was that, although a wide range of tools were available, these remained rather isolated in use. 3Shape Unite aims to provide an unprecedented connection of digital tools, offering users freedom of choice, unrestricted access to their preferred prod- ucts and the flexibility to easily switch between different brands’ and manufacturers’ solutions. The main benefit of the new 3Shape Unite platform is its simplicity, providing an intuitive customer experience. (All images: © 3Shape) 46 4 2021

| industry 1 2 Fig. 1: MODJAW strongly believes that using 4D data from the Tech in Motion device brings more than just beautiful smiles. It brings, first and foremost, healthy and long-lasting ones. (All images: © MODJAW) MODJAW: A next-generation digital dentistry solution By MODJAW, France 4D dentistry is driven by the idea that both static and dynamic parameters should be considered in order to enable complete diagnostics and bespoke resto- rations. Having a 4D dentistry concept, French company MODJAW introduces a new way of entering patients’ reality using true jaw motion and dynamic occlusion, in addition to 3D modelling. MODJAW started to emerge on the digital dentistry scene in March 2019, when the company introduced a new digital dentistry solution for real-time jaw motion called MODJAW Tech in Motion. How does it work? Inspired by the animated movie industry, the device al- lows dentists and orthodontists to record the real-time jaw motion of their patients and to create their dynamic digital twin. MODJAW’s unique platform can aggregate

| industry Ceramill Direct Restoration Solution (DRS). The new digital workfl ow from Amann Girrbach has been designed to enable interdisciplinary future-oriented collaboration and streamlined production processes that enable same-day dentistry. (All images: © Amann Girrbach) Extension of Ceramill CAD/CAM workfl ow—digital solutions lead the way into the dental practice By Amann Girrbach, Austria With its Ceramill Direct Restoration Solution (DRS), Amann Girrbach has extended its integrated digital work- flow to the dentist and thus closed the communication gap that existed between the dental practice and the lab- oratory. The new digital workflow from Amann Girrbach has been designed to enable interdisciplinary future- oriented collaboration and streamlined production pro- cesses that enable same-day dentistry. In this process, both partners contribute their core compe- tencies in order to provide patients with definitive and func- tional prostheses in a more timely and less complicated way. The delivery of smaller units is possible on the same day, depending on the local distance between the two partners. Depending on the type of collaboration that is desired, three team workflows are available in combination with the corresponding Ceramill DRS Kits. In each case, the central basis of these workflows is AG.Live, a new digital platform that provides the infrastructure and patient case management procedures to support a level of consistency and efficiency that was previously unattainable. As such, AG.Live takes communication and collaboration between the practice and the laboratory to an entirely new level. Virtual platform AG.Live creates freedom, more effi cient processes and greater customer proximity With AG.Live, Amann Girrbach has started the largest digitisation offensive in the company’s history. This web- based portal for collaboration between laboratories and dentists offers comprehensive digital services at all lev- els. For example, AG.Live is a central tool for digital case management, networking, infrastructure, material man- agement and support services. It is also a knowledge database that will gradually replace the company’s pre- vious C3 customer portal. On the one hand, the platform networks machines and materials in the laboratory, thereby simplifying processes and increasing quality and reproducibility. On the other 50 4 2021

| industry Clinical advantages of KATANA Zirconia YML as related to an external organisation’s test results By Kuraray Noritake Dental, Japan 1 Introduction Kuraray Noritake Dental is a manufacturer with a long history and wealth of experience in the field of pro- ducing dental materials, including bonding agents, cements and ceramics. The all-ceramic restorations market, including that for zirconia products, has been growing rapidly around the world since the beginning of the 2000s. In response to this trend, we have es- tablished an integrated production system that can be used to manufacture a wide range of dental zirconia products in-house, from powder to discs. When we develop new zirconia products, we care- fully analyse the characteristics of dental zirconia that are actually demanded by users in the clinical setting, and based on the results of our analysis, we craft new products with these clinically needed characteristics. In our first efforts, we focused on developing a den- tal zirconia that would have a natural tooth colour af- ter sintering. We launched KATANA Zirconia, our first dental zirconia product to span all the VITA classical A1–D4 shades, in 2007, and in 2013, using our original manufacturing method, we launched KATANA Zirconia Multi Layered, a multilayered zirconia product that produces smooth colour gradations like those of nat- ural teeth, avoiding sharp colour transitions between layers. Then, in 2015, we released KATANA Zirconia Ultra Translucent Multi Layered and Super Translucent Multi Layered (STML). We are one of the pioneering 52 4 2021

| industry Multilayer gradation Kuraray Noritake Dental released our first multilayered zirconia product in 2013. Subsequently, the company launched zirconia products very much appreciated for their smooth colour gradation, much like that of natural teeth. We use our own innovative pressing method to manufacture YML. It smooths the change of colours between layers, which provides the de- sirable feature of a very smooth and natural colour transition. Reduced deformation after sintering In general, dental zirconia shrinks during the sintering process by about 20% in 2D (50% in volume). If shrinkage cannot be controlled adequately, it becomes difficult to fabricate restorations that fit precisely on to compli- cated abutments or into margin lines. The shrinkage of zirconia materials varies subtly from one production lot to another, even when the same raw material is used. We appropriate raw material control, such as raw ma- terial crushing, using different sintering shrinkage rates for different production lots. In view of the fact that the sintering shrinkage of zirconia materials requires delicate control, it is not difficult to understand that shrinkage control is even more difficult when different zirconia materials are combined into one disc. If the shrinkage rates of the layers of a zirconia disc differ, the restoration will necessarily be deformed during shrinkage. Many users voiced particular concerns about dimensional stability when they were asked about using zirconia “When we developed YML, Kuraray Noritake Dental kept in mind that the fabrication guide must be practical, as well as easy.” discs (which require high precision) for the fabrication of implants. Kuraray Noritake Dental has an integrated production system that is used to manufacture zirconia products in-house, from the design and manufacture of zirconia powder as a raw material to final products, thus making it possible for us to control the shrinkage rate of zirconia with great accuracy. For this reason, we are able to use zirconia materials with stably controlled shrinkage rates to manufacture YML, even though it consists of multilayers made up of different zirconia materials. This minimises deformation of restorations after shrinkage. Results of a verifi cation of the physical properties of YML and a review of its clinical advantages To verify the physical properties of YML, the translucence, mechanical strength and crystalline structure of YML and IPS e.max ZirCAD Prime (Ivoclar Vivadent) were analysed and compared with one another at the Tokyo Medical and Dental University. This paper focuses especially on data on the translucency and mechanical strength, among the physical properties examined, of each product. Data collected at Kuraray Noritake Dental on the relative translucency of YML and Prime Total light transmittance (illuminant: D65; test specimens with a diameter of 30 mm and a thickness of 1 mm) of raw material in YML’s enamel layer (no colouring agent) was 49%, and the same was found for Prime’s enamel layer. 2 3 54 4 2021

| meetings DS World 2021 had something to offer for everyone interested in endodontics, implantology and sustainable dentistry. DS World 2021: Latest innovations, product launches and partnership announcements By Iveta Ramonaite, Dental Tribune International From 23 to 25 September, dental professionals had the opportunity to immerse themselves in the world of dental technology and innovation, all thanks to this year’s Dentsply Sirona (DS) World, which took place in Las Vegas. As expected, the event attracted thousands of partic- ipants, both in person and online, and featured major announcements, product releases, informative continuing education sessions and innovative technologies. and included Don Casey, the CEO of Dentsply Sirona, Dr Terri Dolan, vice president and chief clinical officer at the company, as well as key dental experts Drs Dan Butterman, John West, and Shivi Gupta. During the conference, Gupta and Butterman gave presentations on the digital restorative workflow and the digital implant workflow, respectively, whereas West discussed new endodontic solutions and Dolan focused on sustainability. For the first time, visitors to DS World were able to join the hybrid event either on-site at Caesars Forum in Las Vegas or virtually via livestream and on demand. After each day full of educational opportunities, the attendees were also able to take some time out and enjoy musical and comedy performances. The event reached 7,000 registered participants in total. The attendees were offered over 150 hours of clinical education, and the topics were presented by more than 100 expert speakers from all around the globe. On Friday, 24 September, participants were able to join the DS World press conference, which was streamed live from Las Vegas Discussing this year’s developments, Casey reminded the attendees that Dentsply Sirona is the first digitally native implant company, and that “the future is digital for Dentsply Sirona”. He commented that the company has had many software enhancements throughout the year and is “on a new products’ roll”, in line with its mission to transform dentistry and empower dental professionals by offering innovative dental solutions. Key highlights During the event, the company announced the launch of DS PrimeTaper, an advanced implant system; ProTaper Ultimate 56 4 2021

| meetings Registration for 2022 Midwinter Meeting is now open By Dental Tribune International Like myriad other events, the 156th Midwinter Meeting was a virtual one. However, the Chicago Dental Society (CDS) has recently announced that its 157th Midwinter Meeting will return to an in-person format and that reg- istration for the February meeting is now open. The re- nowned dental meeting will be held at McCormick Place West in Chicago on 24–26 February. “The Midwinter Meeting has a rich tradition of debuting the latest scientific information and cutting-edge prod- ucts to dental professionals for more than 156 years,” CDS President-elect Dr Thomas Schneider said in a press release. “After more than a year of virtual meetings, events and social gatherings, we’re very excited to return to the traditional in-person format for the 2022 Midwinter Meeting, ‘A Dental Tradition.’ We deeply missed the camaraderie and reconnection with old friends and col- leagues and can’t wait to be back in person at McCormick Place,” he continued. The Midwinter Meeting is renowned for attracting the premier speakers in dentistry from across the country.

| meetings International events AEEDC—International Dental Conference and Arab Dental Exhibition 1–3 February 2022 Dubai, UAE https://aeedc.com 157th Chicago Dental Society Midwinter Meeting 24–26 February 2022 Chicago, USA www.cds.org/midwinter-meeting ICOI— Winter Implant Symposium 17–19 March 2022 Atlanta, USA www.icoi.org/events Dental Salon 2022 25–28 April 2022 Moscow, Russia https://en.dental-expo.com/ dental-salon-en The British Dental Conference & Dentistry Show 13–14 May 2022 Birmingham, UK https://birmingham.dentistryshow.co.uk EAS— The 2nd Spring Meeting May 2022 Oporto, Portugal www.eas-aligners.com BDIA—Dental Showcase 2022 17th IDEX Istanbul 2022 25–26 March 2022 London, UK www.dentalshowcase.com 26–29 May 2022 Istanbul, Turkey https://cnridex.com The 5th International Dental Symposium 16–17 April 2022 Tokyo, Japan https://www.gcdental.co.jp/ 100thsymposium AAID— Annual Conference 2022 21–24 September 2022 Dallas, USA www.aaid.com m o c . k c o t s r e t t u h S / o t o h p 6 0 © 60 4 2021

| international imprint Imprint Publisher and Chief Executive Officer Torsten R. Oemus t.oemus@dental-tribune.com Editor-in-Chief Dr Scott D. Ganz Managing Editor Magda Wojtkiewicz m.wojtkiewicz@dental-tribune.com Designer Franziska Schmid Copy Editors Sabrina Raaff Ann-Katrin Paulick Editorial Board Prof. Gerwin Arnetzl (Austria) Dr Christian Brenes (USA) Dr Ansgar Cheng (Singapore) Dr Scott D. Ganz (USA) Hans Geiselhöringer (Germany) Lars Hansson (USA) Uli Hauschild (Italy) Dr Stefan Holst (Germany) Prof. Albert Mehl (Switzerland) International Administration International Headquarters Dental Tribune International GmbH Holbeinstr. 29, 04229 Leipzig, Germany Tel.: +49 341 48474-302 Fax: +49 341 48474-173 General requests: info@dental-tribune.com Sales requests: mediasales@dental-tribune.com www.dental-tribune.com Printed by Löhnert Druck Handelsstraße 12 04420 Markranstädt, Germany Chief Financial Officer Dan Wunderlich Chief Content Officer Claudia Duschek Clinical Editors Nathalie Schüller Magda Wojtkiewicz Editors Franziska Beier Jeremy Booth Brendan Day Iveta Ramonaite Executive Producer Gernot Meyer Advertising Disposition Marius Mezger Art Director Alexander Jahn Copyright Regulations All rights reserved. © 2021 Dental Tribune International GmbH. Reproduction in any manner in any language, in whole or in part, without the prior written permission of Dental Tribune International GmbH is expressly prohibited. Dental Tribune International GmbH makes every effort to report clinical information and manufacturers’ product news accurately but cannot assume responsibility for the validity of product claims or for typographical errors. The publisher also does not assume responsibility for product names, claims or statements made by advertisers. Opinions expressed by authors are their own and may not reflect those of Dental Tribune International GmbH. 62 4 2021

d e v r e s e r s t h g i r l l A . a n o r i S y p s t n e D l 1 2 0 2 © 6 0 1 2 - X S U - 4 4 9 1 7 6 2 3 . ™ r o ® s l o b m y s e h t g n i s u t o n y b s k r a m e d a r t s t i o t t h g i r y n a e v i a w t o n s e o d a n o r i S y p s t n e D l Digital Implant Workflow Streamlined collaboration for your treatment team From data capturing, planning and guided surgery to the final restorative solutions, with the Digital Implant Workflow from Dentsply Sirona you have all the support you need to save time, deliver predictable results and provide your patients with the best possible care. www.dentsplysirona.com Follow Dentsply Sirona dentsplysirona.com