Dental Asia May/June 2020

www.dentalasia.net 

MAY / JUNE 2020 

A Visionary Leader: Dr. Paul Weigl 

Photo courtesy of exocad GmbH 

Correcting Excessive Overbites 

with V-Bend Activations of Super Elastic Wires 

An Exciting Change 

A Comparison of the IPS d.SIGN and 

IPS Style Ceramic Systems

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Contents 

Under the Spotlight 

18 A visionary leader 

24 How a medical-school reject builds a dental empire 

Dental Profile 

28 exocad: Unparalleled fl exibility and design freedom 

Clinical Feature 

32 Part I: Correcting Excessive Overbites with V-Bend Activations of Super 

Elastic Wires 

38 Guided Implantology: the SMART Guide 

44 An Update on SARS-CoV-2 and the Effect on Dental Practice based on 

WHO Guidelines 

User Report 

48 Fast, Simple and Highly Sensitive: Dental Diagnosis with Digital Intraoral 

X-ray Imaging 

Behind the Scenes 

50 An Exciting Change – A Comparison of the IPS d.SIGN and IPS Style 

Ceramic Systems 

54 The unsung heroes 

In Depth With 

57 Pressing and Veneering on a Whole New Level 

58 Smart CBCT system just got smarter 

60 Smart Solutions for a Predictable Restorative Outcome 

62 Learning in the time of COVID-19 

Show Preview 

70 2020 MIDEC 

72 Dentistry 2020 and Beyond 

Regulars 

4 First Words 

6 Dental Updates 

63 Product Highlights 

74 Giving Back to Society 

75 Events Calendar 

76 Advertiser’s Index 

18 

44 

50 

60 

24

NEW! 3Shape Online 

Learning Hub 

The safe and convenient way 

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Visit 3shape.com/learninghub and keep learning 

during these stay-at-home days

First Words 

A different world with COVID-19 

Pang Yanrong 

Senior Editor 

As COVID-19 connues to spread, countries across the world are implemenng 

measures such as a lockdown to slow the spread of the coronavirus. 

While this has made seeing paents in the dental industry, difficult, it has 

opened up a new form of communicaon without the need of physical contact. 

Teledenstry provides an easy alternave for paents to connect, receive 

mely help and professional advice. In fact, companies such as Carestream 

Dental (p.15) and Elite Dental Group (p.8) are working with plaorms such as 

MouthWatch and SmileMate to deliver an enhanced teledenstry soluon 

during Covid-19 pandemic. 

More than that, dental professionals are also pursuing further knowledge via 

online plaorms, which can be seen from the recording-breaking registraons of more than 10,000 

visitors for the virtual Nobel Biocare Global Symposium (p.12). Other conferences that have gone virtual 

too include Internaonal Expert Symposium 2020 from Ivoclar Vivadent (p.11) and IDEM 2020 (p.12). 

“This digital experience proves that implantology professionals are extremely keen to learn,” said 

Dr. Alessandro Pozzi, a speaker at Nobel Biocare’s virtual symposium. 

His senments are echoed by Dr. Paul Weigl, who reminds dental professionals not to be complacent 

(p.18), “The enemy of something good, is something beer. As we have beer therapy approaches, 

beer materials, and faster therapy, we must give general praconers, or even the specialists, an 

update.” 

And an update it is. Dental technicians are also now movated by the advancements in digital workflow. 

For instance, Dennis Goh shares how an implant surgical guide designed on soware, such as 3Shape’s 

Implant Studio can make a surgery more precise and accurate (p.54). “It is excing to be able to skip 

some steps, and shorten the process me with the design soware, although it took me to get used 

to viewing and analysing the model virtually on a screen.” 

For implantology, Dr. George Freedman and Dr. Mark Antal explain how a guided implantology can 

be adapted to most implant brands and types, hence, making implant surgery paent-centred rather 

than product-centred, more predictable, and more efficient (p.38). 

As the world connues to grapple with the COVID-19 pandemic, manufacturers of dental 3D printers 

are pooling their resources to help in the fight by repurposing available 3D printers in the fabricaon 

of personal protecve equipment for hospitals. These include Structo (p.6), 3D Systems (p.8) and BEGO 

(p.6). In addion, Dentsply Sirona’s Wellspect colleagues are also making a difference by manufacturing 

disinfectants for hospitals at their Mö lndal producon facility (p.10). 

It’s a challenging me right now, but remember, you are not alone in this fight. Do connue to pracce 

social distancing, wash your hands oen and stay safe. We will get through this. 

PABLO SINGAPORE 

Publisher 

Associate Publisher 

William Pang 

williampang@pabloasia.com 

Pamela Buckley 

pamela@pabloasia.com 

Publications Director Jamie Tan 

jamietan@pabloasia.com 

Senior Editor 

Editor 

Graphic Designers 

Circulation Manager 

PABLO BEIJING 

General Manager 

PABLO SHANGHAI 

Editor 

LET’S CONNECT! 

@dentalasia 

Pang Yanrong 

yanrong@pabloasia.com 

Qian Leung 

qianleung@pabloasia.com 

Liu Yu 

liuyu@pabloasia.com 

Shu Ai Ling 

circulation@pabloasia.com 

Ellen Gao 

pablobeijing@163.com 

Sharon Wu 

pabloshanghai@163.net 

HEAD OFFICE 

PABLO PUBLISHING SINGAPORE PTE LTD 

3 Ang Mo Kio Street 62 #01-23 

Link@AMK, Singapore 569139 

Tel: (65) 62665512 

Email: info@pabloasia.com 

Website: www.dentalasia.net 

Company Registration No.: 200001473N 

Singapore MICA (P) No. 075/05/2019 

Malaysia KDN: PPS1528/07/2013 (022978) 

REGIONAL OFFICE (CHINA) 

PABLO BEIJING 

Tel: +86-10-6509-7728 

Email: Pablobeijing@163.com 

REGIONAL OFFICE (CHINA) 

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Tel: +86-21-52389737 

Email: Pabloshanghai@163.com 

ADVISORY BOARD 

Dr William Cheung 

Dr Choo Teck Chuan 

Dr Chung Kong Mun 

Dr George Freedman 

Dr Fay Goldstep 

Dr Clarence Tam 

Prof Nigel M. King 

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Dr William O’Reilly 

Dr Wong Li Beng 

Dr Adrian U J Yap 

Dr Christopher Ho 

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Dr Derek Mahony 

Prof Alex Mersel 

4 

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Dental Updates 

BEGO takes action in the fight against COVID-19 

With COVID-19 pandemic being a major 

challenge for the society, German dental 

specialist BEGO is freely sharing its technical 

resources in 3D printing and CAD/CAM for 

the manufacture of utensils that can prevent 

infection. 

“It is very important to us to make a 

contribution to society, and to use our knowhow 

to help reduce the spread of the virus,” 

explained Christoph Weiss, managing partner 

of BEGO Group. 

BEGO’s anti-corona commitment essentially 

consists of three cornerstones: 

• Users of a BEGO Varseo S or Varseo L 

3D printer may download free design 

files for do-it-yourself 3D printing of 

useful utensils to prevent infection from 

the BEGO website. Customers can print 

modular frames for face shields 

or breathing mask brackets, as 

well as bring in ideas for other 

useful parts. 

• Components that are urgently 

needed by hospitals and other 

medical facilities are being 

produced at BEGO Medical’s 

high-tech production centre in 

Bremen free of charge. These 

include components made 

using the SLM process (cobaltchrome) 

or high-precision parts 

Christoph Weiss (left), managing partner of BEGO Group, 

presented 3D printed face masks to Martin Sztraka, chairman 

made of titanium, cobalt-chrome 

or PMMA in the milling process 

for manufacturers of medical 

devices. 

of the Board of the Dental Association in Bremen (KZV) on 3 rd 

April 2020 

Association of Statutory Health 

Insurance Dentists and distributed 

• Additionally, BEGO Implant Systems is 

manufacturing 3D printed protective 

glasses, which are donated to the 

by the latter to hospitals and medical 

practices in Bremen and the surrounding 

area. ■ 

Structo helps battle the coronavirus 

With help from investors such as Wavemaker; 

Enterprise Singapore; and EDB Investments, 

3D printer solution provider, Structo, has 

repurposed all available resources to focus 

on manufacturing various medical devices 

and PPE to help battle the coronavirus both 

in Singapore and globally. 

The Structo Nasopharyngeal 

Swab, which are manufactured 

in Structo’s ISO 13485-certified 

facilities in Singapore, have been 

filed and registered with the FDA 

(Class 1) (United States) and HSA 

(Class A) (Singapore). 

Structo nasopharyngeal swab 

To test for the presence of COVID-19, 

healthcare professionals place a 

nasopharyngeal swab into a patient’s nasal 

cavity to collect a sample. The rapidly rising 

number of suspected cases worldwide has 

driven the shortage of swabs to keep up 

with testing demands. “We have allocated 

all available 3D printers in their facilities to 

focus on manufacturing this medical device 

round-the-clock,” said Structo’s founder 

Huub van Esbroeck. 

3D-printed face shields 

Full-face shields are used as a 

supplementary device to help 

healthcare professionals stop the 

spread of COVID-19 in hospitals. 

With the global shortage of 

personal protective equipment 

(PPE) in healthcare institutions 

such as surgical masks and N95 

masks, these 3D-printed face 

shields may serve as another 

option. ■ 

Structo is working with institutions, researchers and government 

agencies to produce 3D-printed face shields in the fight against 

COVID-19 

Nasopharyngeal swabs are being printed round-the-clock on 

Structo printers 

6 


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3D Systems pledges support in fighting Covid-19 

The creation of the emergency ventilator mask was possible with the help of the above organisations 

3D printed Charlotte valve connects oxygen supply to a 

snorkelling mask, turning it into an emergency ventilator 

3D Systems, manufacturer of 3D printers 

for healthcare and dental applications, is 

connecting their users and hospitals to come 

up with new solutions to meet the demand for 

PPE such as ventilators. 

Italian research institute, ISINNOVA, was 

contacted by a former head physician of the 

Gardone Valtrompia Hospital to address the 

shortage of hospital C-PAP masks for subintensive 

therapy. The idea is to construct 

an emergency ventilator mask by adjusting 

a snorkelling mask already available on the 

market. 

To guarantee the connection to the ventilator, 

a new component, named Charlotte valve, 

was designed and 3D printed. Testing done 

in the hospital showed that the idea worked. 

ISINNOVA has also made the file for 3D 

printing the valve available. 

If owners of 3D printers are able to offer 

their engineering team’s time and expertise, 

or access to 3D printers, 3D Systems would 

greatly appreciate their support. Conversely, 

medical device manufacturer, hospital, or 

healthcare provider that needs help to bridge 

a supply chain gap are welcome to let 3D 

Systems know of their needs. ■ 

Elite Dental Group adopts SmileMate tele-dentistry 

Elite Dental Group has adopted a cuttingedge 

dental artificial intelligence (AI) 

technology called SmileMate. Created by 

Dental Monitoring, SmileMate addresses 

the needs of patients who have dental 

anxiety and dental professionals alike, for 

the provision of remote and virtual general 

dental consultation services to such patients. 

The process of having a SmileMate virtual 

dental consultation is as followed: 

Step 1 - The dental surgeon installs a 

SmileMate widget on his or her dental 

practice website. A patient takes five intraoral 

pictures on his or her smartphone and 

submits the dental images to the SmileMate 

AI Engine. 

SmileMate Virtual Consultation is a light version of SmileMate, 

simpler and more immediate to implement for these times – 

enabling rapid on-boarding and roll-out 

Step 2 - A comprehensive customised dental 

report is automatically generated within 10 

minutes by the SmileMate AI engine and sent 

to the attending dental surgeon. The 

SmileMate AI engine compares the 

submitted dental images with its 

internal database of millions of oral 

scans and images. 

Step 3 - The dental surgeon then 

has a look at the submitted intraoral 

images and AI generated dental 

report. Using his or her experience, 

an assessment can be made on the 

accuracy of the report. 

Step 4 - The dental surgeon then 

personalises the dental report with 

pertinent general dental information, and 

advises on the need for a proper professional 

dental appointment at a dental practice. ■ 

8 



Dentsply Sirona’s Wellspect colleagues make a difference 

the front lines, who are working long shifts 

trying to help those who have fallen ill, and 

may also be faced with the worry of bringing 

the virus back home to loved ones. 

Through producing disinfectants at their 

facility in Mö lndal, the team hopes to 

send their thoughts and wishes to their 

colleagues in the countries who have been 

heavily affected, and to thank all the medical 

professionals who are currently working hard 

to deal with this outbreak. 

Wellspect team in Mö lndal, Sweden 

To support healthcare professionals on the The fast setup has shown the team’s passion 

front lines of Covid-19, Dentsply Sirona’s in making a real difference to those who need 

colleagues at the Wellspect production Dentsply Sirona’s products and services, 

facility in Mö lndal, Sweden are producing especially in these challenging times. The 

disinfectants for hospitals. 

team empathises with healthcare workers on 

Wellspect is a part of Dentsply Sirona, the 

world’s largest manufacturer of professional 

dental solutions. Wellspect was formerly a 

dental and healthcare business known as 

Astra Tech. Upon acquisition by Dentsply 

International in 2011, its healthcare business 

became known as Wellspect, which carries 

the meaning of wellness and respect. The 

Sweden-based company has over 1100 

employees, operations in 18 countries, and 

distributors around the world. ■ 

International Expert Symposium 2020 goes virtual 

Ivoclar Vivadent is shifting its International 

Expert Symposium 2020 on 12 th and 13 th 

June to an online format under the motto, 

Succeeding Together in Tomorrow’s Dentistry, 

where opportunities and possibilities available 

for everyday work will be explored. 

CEO Diego Gabathuler, explained, “We’re 

convinced that this decision is the right path 

for us. As an innovative and reliable partner, 

we want to fulfil our philosophy and meet 

our customers’ needs in providing first-hand 

information about the latest trends and 

developments in the dental world, even in 

this challenging time.” 

In an online format, insight into the latest 

dental topics will be provided in an interactive 

Diego Gabathuler, CEO of Ivoclar Vivadent 

and entertaining way: Participants can expect 

new, exciting impressions, and inspiration 

and interesting facts – presented by dental 

experts from all over the world. For example, 

Prof. Dr. Ronaldo Hirata will 

share about modern composite 

resins in a lecture titled “Direct 

aesthetics in a digital world”. 

In another seminar, “Digital 

chairside: myths and reality”, 

the applications and limitations 

of digital systems in chairside 

dentistry will be discussed by 

Prof. Dr. Petra Gierthmühlen. 

“By hosting the IES 2020 as an 

online event, we are taking the 

current situation into consideration and at 

the same time providing our customers and 

partners with an attractive platform,” said 

Gabathuler. ■ 

10 


Mastering digital workflows 

Experienced practitioners and 3Shape’s own experts share their 

knowledge through webinars on 3Shape’s online learning hub 

3Shape’s online learning hub helps dental professionals build 

their knowledge the digital way, from home or office. Webinars 

provide inspiration on getting started with new CAD/CAM 

solutions, while online classes introduce ways to master digital 

workflows. A personalised session with a 3Shape training expert 

to address the specific needs of the clinic or lab may also be 

requested. 

Upcoming live webinars include “A beginner’s guide to Smile 

Design” by CDT Przemek Seweryniak, “How to set up the Control 

Panel – a Dental System Special” by CDT Marcus Marcussen, 

and “How clinics and laboratories can collaborate and offer a 

final or provisional treatment through guided prosthetic” by 

Dr. Jan Paulics. 

Other topics to look out for include “Getting started with digital 

indirect bonding” by CDT Rudy Labor, “How to design your 

first crown in just 30 minutes with 3Shape Dental System” by 

CDT Chris Adamus, and “Back in the dental practice after the 

lock down – our experiences” by Dr. Simon Kold and Dr. Martin 

Heiden. ■ 

MAY / JUNE 2020 DENTAL ASIA 11


Nobel Biocare Global Symposium virtual edition 

Through a virtual edition of Global Symposium, Nobel Biocare fulfils 

its mission of advancing side-by-side with dental professionals 

With a record-breaking registrations of more 

than 10,000 unique registrations, the online 

edition of Nobel Biocare Global Symposium 

by Envista was not only an extraordinary 

educational event, but also an example of 

how remote teams can quickly adapt to 

unprecedented circumstances. 

The previous Global Symposium was held 

last summer in Madrid with more than 

1,000 participants. For the 

2020 virtual edition, the 

programme was shortened 

and included seven live 

sessions and several ondemand 

webinars over two 

science-focus days. 

Participants had the 

opportunity to raise 

questions and further 

discuss with experts several 

topics including guided 

and navigated treatment 

planning, implant treatment success in the 

aesthetic area, soft tissue grafting, and 

management of treatment complications. 

Thanks to the on-demand viewing, more 

dental professionals and associates can 

benefit from these learnings. 

President of Nobel Biocare Systems, Patrik 

Eriksson, said, “I was looking forward to 

meeting our participants in person in Las 

Vegas, however, when the circumstances 

changed for all of us, it was more important 

than ever to turn obstacles into opportunities. 

I am incredibly grateful to our speakers, 

and impressed by our team who quickly 

transformed this year’s symposium into our 

most successful ever online event.” ■ 

“This digital experience proves that implantology professionals 

are extremely keen to learn,” said Dr. Alessandro Pozzi 

IDEM 2020 to be a digital experience 

In consideration of the latest 

advisory issued by Singapore’s 

Multi-Ministry Taskforce on 

COVID-19 for events and gatherings 

on 20 th March 2020, as well as 

the World Health Organisation’s 

declaration of COVID-19 as a 

pandemic, Koelnmesse and the 

Singapore Dental Association will 

shift IDEM International Dental 

Exhibition and Meeting 2020 to an 

all-digital format. 

Delegates will be able to learn 

remotely at their own pace, with 

a selection of live and on-demand 

lectures. Exhibitors will be provided with 

the opportunity to showcase their products 

and solutions and at the same time offer 

pre-recorded and live streamed conference 

The online edition for IDEM 2020 will enable participants from 

across the globe to safely connect, network and engage 

sessions. A virtual exhibit area where 

attendees and exhibitors can interact and 

conduct businesses safely over a virtual 

space is also being considered. 

President of the Singapore 

Dental Association, Dr. Lim Lii, 

said, “Despite the situation we 

have with a constantly evolving 

global pandemic, through IDEM 

2020 we still strive to connect 

with the dental community. With 

this adapted format, we remain 

committed to provide adequate 

courses in a safe and responsible 

manner and are confident that 

our attendees worldwide will 

be able to effectively engage, 

learn, gain valuable insights and 

qualify for CE points.” 

More details on the digital experience for 

IDEM 2020 will be published on the event 

website over the coming weeks. ■ 

12 


AEEDC Dubai 2021 – Education and 

Innovation Transfer 

Participants enjoy live entertainment and oriental cuisine with 

fellow dental professionals at a gala dinner 

The UAE International Dental Conference and Arab Dental Exhibition 

(AEEDC Dubai) is stepping into its 25 th year with the theme of 

Education and Innovation Transfer. 

Since its inception, AEEDC Dubai has been bringing the best minds 

and brands to the stage and floor. In the 2020 edition, the conference 

featured over 4,800 exhibiting companies representing more than 

4,000 brands, across 12 exhibition halls, including 15 national 

pavilions. Dentists, dental specialists, technicians, manufacturers 

and traders meet to learn more, network, and advance their 

knowledge and network with like-minded colleagues. 

Going beyond the 

usual approach 

to continuing 

education, AEEDC 

Dubai scientific 

activities feature 

pre-conference 

courses, hands-on 

workshops, student 

competition, poster 

presentations, 

Participants can gain valuable Continuing Medical and awards. 

Education (CME) points and return to their practices Ample time is also 

as better dental professionals and clinicians 

made available for 

networking with peers and colleagues, during the coffee breaks, 

luncheons, and the AEEDC Dubai Night activities. 

Webinars on topics such as “Digital applications in clinical 

prosthodontics: Technology meets Materials” by Dr. Ziad Salameh 

and “Equation of bone augmentation in implant dentistry” by 

Dr. Abdullah H. Janbi are also available on the event’s Facebook page. ■ 



The show must go on 

range of topics, such as “The art and science 

of dental laboratory photography” by Dr. 

Miles Cone and “Digital dentures your way 

– multiple options, premium results” by CDT 

Thomas Gienger. 

Other discussions include “Smile design 

your result – Uncertainty? A thing of the 

past” by CDT Alex Wünsche, “Prime time 

machine Ceramill Matik – faster full range 

lab production” by Stefany Dobrucki Bueno, 

as well as “From the preparation to the final 

restoration” by MDT Benni Votteler and Dr. 

Michael Fischer. 

As the coronavirus brings all trade fairs and 

congresses worldwide to a standstill, Amann 

Girrbach has set up a virtual exhibition stand 

with many extras for visitors. The event will 

be helmed by international specialists and 

trainers from Amann Girrbach, and can be 

visited in mid-May. 

A highlight at the stand will be webinars 

and online training courses covering a wide 

Novelties and the most important products 

of Amann Girrbach will also be on display at 

the electronic exhibition stand. The focus 

is on the entire integrated process chain 

from articulation, via CAD/CAM with the 

new Ceramill Matik, through to the material 

portfolio. ■ 

Planmeca Solanna Vision operating light wins Red Dot Award: Product Design 2020 

The intelligent Planmeca Solanna Vision 

dental operating light with integrated 4K 

cameras and microphones has convinced 

the jury of the renowned Red Dot design 

competition, which this year received 

more than 6,500 product entries from 

manufacturers all over the world. 

The operating light can be used for taking 

still images of the patient’s teeth or for 

recording dental procedures, among other 

things. The light opens up new possibilities 

for patient communication, consultation, 

documentation and dental education. Built 

on an evolving platform, Planmeca Solanna 

Vision will allow dental professionals to 

enjoy ground-breaking new features with 

software upgrades in the future as well. 

“The operating light is an important working 

tool for the dentist, since a big part of 

dental work is based on visual perception,” 

explained Planmeca’s senior industrial 

designer, Timo Silvonen. “Taking photos of 

the patient’s teeth is also an everyday task 

at a dental clinic. We decided to combine the 

patient light and camera into one product, 

which makes the clinical workflow much 

smoother. Receiving the Red Dot is a great 

recognition and really 

confirms that our focus 

on innovative design that 

improves the everyday life 

of dental professionals is 

the right approach.” ■ 

The Planmeca Solanna Vision 

operating light with integrated 

4K cameras has been awarded 

a Red Dot in this year’s Red 

Dot Award: Product Design 

competition 

14 



Carestream Dental and MouthWatch to deliver an enhanced teledentistry solution during 

COVID-19 pandemic 

Doctors who use Carestream Dental’s digital 

imaging and practice management solutions 

will soon have greater access to the TeleDent, 

the teledentistry platform from MouthWatch 

thanks to a new partnership. 

As seen in recent weeks, the coronavirus has 

made seeing patients physically extremely 

difficult. However, having the ability to 

connect remotely with patients is an ideal 

way to communicate without the close 

physical contact. Teledentistry provides an 

easy alternative for patients to connect and 

receive timely help and professional advice. 

The platform enables live streaming video 

consultations to facilitate remote treatment 

The TeleDent solution makes it possible for existing 

patients to contact the office if they have a question 

or dental emergency 

planning, supervision and collaboration 

in real-time and asynchronously at the 

provider’s convenience. 

“Carestream Dental is excited to be partnering 

with MouthWatch and their innovative 

TeleDent software,” said Dr. Ed Shellard, chief 

dental officer of Carestream Dental. “This 

partnership helps deliver a much-needed 

solution in light of the Covid-19 pandemic 

so practices can interact with patients 

remotely.” 

“At MouthWatch, we believe in providing 

market leading solutions,” said Brant 

Herman, founder and CEO of MouthWatch. 

“Collaborating with a partner, such as 

Carestream Dental, enables us to do just 

that. Their technological expertise aligns with 

our commitment to providing practices with 

turnkey teledentistry solutions.” ■ 



Converting posts into patients 

From patient care to bookkeeping, clinical 

tools to advertising, the digital age has 

brought paradigm shifts to all aspects of 

dentistry. In terms of locating potential 

patients, there are two clear front-runner 

favourites for dental practices: Facebook 

and Instagram. 

“If you’re willing to put money toward it, 

Facebook is a really good model,” said Adrian 

Lefler, co-founder of My Social Practice. 

Fellow co-founder Blake Hadley interjected, 

“Practices could spend US$50–100 per 

month and that’s a great place to start.” 

Instagram, on the other hand, has better 

organic reach for a business. 

Working with Instagram influencers on 

campaigns specifically designed around 

whitening treatments is another option. 

“More and more brands are moving toward 

working with nano and micro influencers 

instead of big influencers,” said Hadley. 

“With smaller followings of between 1,000 to 

15,000, these influencers usually have more 

personal relationships with their followers, 

and are trusted more.” 

Social media can be an effective avenue 

for educating patients about products 

and procedures through videos, linking 

to blogs, and other 

marketing materials. 

Posts should also 

address common patient 

objections such as price, 

complexity of procedure, 

and scheduling. “Dental 

offices should be posting 

something every day,” 

said Hadley. “The more you can post, the 

more Facebook and Instagram will pump your 

content out to the people on their platforms.” 

Turning social posts into real-world patients 

requires genuine content that entertains 

while it educates, targeting the right 

geographic audience, posting consistently, 

and understanding the nuances between 

platforms. ■ 

Are patient communications leading to the best treatment decisions? 

you have to say,” said 

Dr. McGraw. 

Dr. Harriet K. McGraw, who attended the 

Academy of Osseointegration’s inaugural 

Leadership Institute in 2019, discussed how 

labelling patients’ emotions can help dentists 

communicate more effectively. 

Drawing on insights from former FBI hostage 

negotiator, Chris Voss, and UCLA psychology 

professor, Matthew Lieberman, who found 

that labelling an emotion – applying words 

to a fear – disrupts its raw intensity, Dr. 

McGraw believes that labelling patients’ 

emotions, most often fears, can be a first 

step towards disarming their apprehensions 

toward treatment. 

Academy of Osseointegration 

Antonio Damasio 

Chris Voss 

“Simply telling the patient you understand 

they may be fearful can be very disarming, 

making them more receptive to what 

According to neuroscientist 

Antonio Damasio, people who 

had damage in the part of 

the brain where emotions are 

generated all had something in 

common: They couldn’t make 

decisions. In other words, while patients 

may use logic to reason themselves towards 

a decision, the actual decision making is 

governed by emotion. 

Though dental implants have been part of 

dentistry for decades, they are still new 

to many patients. Add to the fact that 

surgery is involved in their placement and 

patients can understandably be fearful 

or apprehensive about proceeding with 

treatment. “Addressing the technical aspects 

of a case will not be successful unless the 

emotional component is also addressed,” said 

Dr. McGraw. “Dentists need to communicate 

like an FBI hostage negotiator!” ■ 

16 



Goethe University Dental Clinic 

A visionary leader 

Dr. Paul Weigl is an inventor and an educator. In fact, one can call him an 

innovation champion. Here, he shares with publications director, Jamie Tan, 

what his passion stands for and his vision as a leader. 

Wh en he was an 

undergraduate in 

Munich, Germany, in 

1981, Dr. Paul Weigl saw 

how edentulous cases 

could be transformed with the help of 

prosthodontics. 

He thought to himself, “This is the future,” 

which sealed his decision to specialise in 

implants. 

Upon graduation, Dr. Weigl wanted to seek 

answers to issues that dental practitioners 

were facing, “When you work in a dental 

clinic, your focus is the patients and the 

economic situation. You’ll not have the time 

to develop new therapy concepts.” 

And so, he took the leap into academia, 

which today sees him as the head of 

Department of Postgraduate Education 

& programme director of Master in Oral 

Dr. Paul Weigl 

Implantology at Goethe Dental School in 

Frankfurt, Germany. 

Building a solid education 

As programme director of Master in Oral 

18 



“This is important because if your programme 

always stays the same, your content is no 

longer state-of-the-art,” he stated. 

Moreover, with the course being evidencebased 

and free from sponsorship from 

manufacturers, there is greater freedom in 

selecting the materials as students can use 

any implant, abutment, membrane, bone 

substitute material and planning software 

of their choice and decide what works best 

for them. 

As part of the Master in Oral Implantology, students learn how to identify and deal with errors 

in scientific publications 

Implantology at Goethe University, Dr. Weigl 

has to ensure that the strategic objectives 

are in placed to equip his students with 

the necessary skills and knowledge such 

as ensuring the course is patient-centric, 

providing evidence-based teaching, and 

ensuring it meets the relevant needs of the 

students, even taking in feedback from them. 

To ensure the course provides the relevant 

needs and knowledge for his students, 

Dr Weigl takes in their feedback with serious 

considerations. Through these feedback, the 

course has broadened to include CAD/CAM, 

guided surgery, soft-tissue management as 

well as bone management. 

Creating an international platform 

Dr. Weigl has always felt that language 

barriers should not stymie exchanges in 

education. “In the past, only a Chinese 

implantologist who can speak English would 

have the opportunity to study in Europe,” 

he said. 

To make the course attractive to international 

students such as the Chinese, Dr Weigl flew 

to Shanghai for 10 days with his faculty 

to give lectures, which were translated 

simultaneously into Mandarin. In fact, some 

of Dr. Weigl’s professor friends in Beijing 

were also roped in to help integrate the 

lessons seamlessly. 

For instance, students will hear an approach 

to soft-tissue management on one day, and 

a different one the next. 

“This is absolutely intentional. I want them 

to know that there is not just one approach,” 

he revealed. 

This is done so because, “If you’re an expert 

on the all-on-four treatment concept, which 

was originally designed for edentulous 

cases, and a patient comes in with some 

residual teeth with no indications for 

extraction, there are other therapy concepts 

such as implant bridges and crowns. But 

if you extract all the teeth just to adapt 

the patient to your therapy concept then 

something is very wrong here,” he explained. 



Besides hands-on sessions and lectures, each student also attends three implant surgeries by highly experienced surgeons to gain insights 

When the students in Shanghai have grown 

accustomed to the structure of the lectures, 

they then head over to Frankfurt where a 

programme manager takes care of their 

transport and accommodation. This is to 

prevent the students from getting lost in 

translation and to place their focus on the 

rest of the course, which will continue to be 

simultaneously interpreted. 

“It’s really amazing because even after the 

course ended, the Chinese students stay 

connected through a WeChat group. Beyond 

talking about implantology, they rely on 

one another on issues such as marketing 

or financing a dental office. If they are in 

different cities, they make the effort to fly 

over to meet one another. Now, they meet 

every year and have their own congress. 

It’s a close-knit family,” remarked Dr. Weigl. 

Championing innovation 

As an innovation champion, his passion goes 

back to 1996 when computers cost €60,000 

and graphics cards were not as powerful 

yet. Dr. Weigl was awarded a grant for a 

machine-learning approach to the building 

of a software that can produce a crown 

or bridge with the push of a button. And 

although CEREC was already in existence, 

it was not fully automated. 

When colleagues said, “The inlays don’t fit 

well,” or “It’s not good,” Dr. Weigl stressed 

that, “It’s not perfect but this is a start. You 

cannot stop.” 

His solution was to have a dental technician 

“teach” the software. After about 500 

iterations and with input from the dental 

technician, the software was able to calculate 

a crown or even a four-unit bridge, with good 

occlusal surface and function. 

However, there was limited accessibility to 

3D printers and five-axis machines which 

resulted in the cost of occlusal surface 

grinding being prohibitive. 

Today, 3D printers are able to print anything 

that is resin-based; from a temporary crown 

to a temporary abutment or a surgical 

guide. Milling machines have also become 

smaller and are able to fit in a dentist’s 

office. But printing of the final restoration 

in zirconia or glass ceramic is still under 

research, and crowns and abutments are 

unable to mill ready to be used – some postprocessing, 

whether it be cleaning, polishing 

or separating, is still required. 

20 



He therefore cautions his students against 

impulse purchases of the machines if they 

are only using it once a week, studying or 

have a mortgage. 

Still, he has not given up on his dream 

for full automation and explained what it 

would entail, “When the clinician pushes a 

button, the implant; abutment; and crown 

are designed by the machine in two or 

three seconds. He checks that everything 

is in place - the nerve is fine and there 

is no perforation - maybe makes a small 

adjustment, and pushes the next button to 

print the template and mill the abutment.” 

In fact, Dr Weigl has also appealed to 

Tillmann Steinbrecher, CEO of exocad, 

the global leader in the dental CAD/CAM 

software market, to build in more automation 

software, machine learning and artificial 

intelligence. 

With only 5% to 10% dental surgeons 

in Germany currently using navigated or 

guided surgery, he has also made a case 

with manufacturers to produce user-friendly 

implant planning software as the present 

user interface is designed mostly for dental 

technicians than clinicians. 

Since a clinician’s core competence is placing 

an implant, he should not spend half the day 

at the monitor with the patient’s digital twin, 

Dr Weigl explained. With that being said, he 

foresees that manufacturers will soon put 

together a box of what a clinician needs, 

such as template, implant, and abutment 

for a single-tooth restoration based on the 

intraoral and CBCT scans of a patient. The 

surgeon would only need to follow the steps 

indicated without going through a catalogue 

of 500 different instruments. 

“A surgeon who has had a thousand implants 

every year under his belt would be able to 

do fine, free-handed,” said Dr. Weigl. “But 

for someone who is not as experienced, the 

guided surgery will provide a safety net and 

allow him to help the increasing number 

of patients who only need a single-tooth 

restoration.” 

Despite championing for innovation, 

Dr. Weigl still believes in the human touch. 

Even with a push of a button in innovation, 

he stressed that the final decision lies with 

Once a year Dr. Weigl and Goethe University celebrate the graduation of the Master students in a festive ceremony 



the clinician and cautions against trusting 

machine over a human. 

For instance, “If we ask the artificial 

intelligence in dentistry today, ‘I don’t know 

if I should extract this tooth and replace it 

with an implant or if I should keep it; perhaps 

it has a good prognosis.’ 

“If a machine is educated by periodontists 

after reading thousands of x-rays, it may 

lean towards keeping the tooth since the 

periodontists have experience in salvaging 

it. But if the machine is conditioned by 

implantologists, given the same case, it may 

propose an extraction because from the 

experience of the implantologists, implant 

offers a good solution.” 

But with the human touch, a clinician can 

spot a nerve that the machine was not able 

to. And in this case, the clinician will have 

to make the decision that the implant has 

to be shorter or it would violate the nerve. 

“As long as we remember this, we will be 

safe,” he said. 

Cultivating future generations 

Going back to his job as head of the 

Department of Postgraduate Education 

& programme director of the Master in 

Oral Implantology, Dr Weigl stressed that 

continuing education is also the key to 

become a good dentist or surgeon. 

With science advancing at lightning speed, 

one of Dr. Weigl’s desires for his students is 

to ‘learn how to learn’. Learning should not 

stop after they have completed his course, in 

fact, he urged them to keep themselves up to 

date with the latest breakthroughs through 

reading scientific papers and attending 

congresses. 

Discernment is also important. “At any 

dental show, when they’re being shown new 

technology, they need to know when to say, 

‘This is good. It is honest and objective,’ or 

‘This is nonsense because they don’t have 

a good material method,’ or ‘This is just 

a selling show because they have a bad 

exclusive culture,’” he said. 

Bolstered by the positive feedback from his 

Chinese implantology students, Dr Weigl 

wants to reach out to other international 

students who are also affected by language 

barriers such as the Latin American 

implantologist. As a matter of fact, planning 

efforts are already currently underway. 

In addition, he would also like to train his 

students to think from the perspective of 

a ‘director’ and learn to take a holistic and 

multidisciplinary approach to their patients. 

Often, a specialist, no matter the field of 

study, will only see the problem from his 

own standpoint. A student who engages 

with a colleague outside of his own discipline 

may be able to avoid complications that he 

did not foresee. By working together as a 

team, there could be a viable solution or an 

alternative for a complex case that would not 

have been possible if they had worked alone. 

And this will be one of the focuses of his new 

post-graduate course in aesthetic dentistry. 

Besides the treatment and documentation of 20 patients in his home country, each student will also 

perform three implant treatments under the supervision of a tutor of Goethe University 

“When you see a patient getting better 

after two months, and how glad they are, 

it is tremendously rewarding,” Dr. Weigl 

commented. DA 

22 


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Dr. Ng Chin Siau 

How a medical-school reject 

builds a dental empire 

Funny, upbeat and approachable, these are some of the words to describe 

Dr. Ng Chin Siau, founder and CEO of Q & M Dental Group. But he is not one 

to mince his words when it comes to issues that he has a strong opinion on. 

Dr. Ng Chin Siau was 12 when 

he had a root canal treatment. 

It was there and then that he 

realised the profession helps to 

alleviate pain. 

“Also, my mum had to spend a lot of money,” 

he quipped. “I thought to myself, ‘That is 

good money!’” he laughed. 

But more than that, Dr. Ng believes that the 

profession is one that allows him to “take the 

edge off the patients’ pain and suffering.” 

Initially, he tried to apply for medicine 

believing it will help him to achieve that. 

Instead, he was rejected, which turned out 

to be a blessing in disguise. Today, Q & M has 

80 dental clinics (and five medical clinics) 

in Singapore and 33 in Malaysia. Together 

with associate company Aoxin, Q & M also 

runs 18 dental hospitals and clinics in China. 

The start of an empire 

Dr. Ng lives by the phrase, “ 

” (xiūshēn, qíjiā, zhìguó, píng 

tiānxià), which is taken from the teachings 

of Confucius, a famous Chinese philosopher 

from ancient China. The phrase means that 

in order to successfully govern a country 

() and bring peace to all () — or 

in Dr. Ng’s context, an organisation — one 

should learn to first govern one’s family 

(), and oneself (). 

In the last two decades, Q & M has achieved 

many successes which Dr. Ng credits to the 

full team – dentists, doctors, clinic support 

and administrative staff. 

Q & M (Quan Min) was founded in 1996; the 

name represents “for the people” which is Dr 

Ng’s aspiration to constantly lend a helping 

hand to people. 

In 1999, Q & M started expanding. “With 

every clinic, I’ve a new partner. When we had 

more than 30 clinics, we had a restructuring 

exercise and went IPO in 2009,” explained 

Dr. Ng. 

The various partner dentists at that time 

become shareholders of the holding 

company of Q & M – Quan Min Holdings. 

24 



Reinventing the wheel 

With modern dental facilities and the 

adoption of the latest dental innovations, Q 

& M offers a comprehensive range of primary 

care dental services as well as specialist 

services. 

“We started using CEREC back in 2009. So, 

we have more than 10 years of experience,” 

said Dr. Ng. 

In fact, the group produces its own zirconia 

blocks to be compatible with any milling 

machine. This is in addition to developing 

their own multi-plug software to sync across 

other software so as to achieve smooth 

integration across all platforms in the clinics. 

“Quan Min is made up of a group of key 

shareholders collectively owning about 57% 

of the Group’s shares,” revealed Dr. Ng. 

From the start, Dr. Ng already had a vision 

to unite a group of dentists under one 

roof to form the largest dental network in 

Singapore. 

He started to expand organically in 

Singapore and Malaysia before embarking 

on the IPO in 2009. 

With the proceeds, attempts were made 

to enter China, in cities such as Beijing 

and Nanjing. It was not until 2013 when 

Shenyang-based Dr. Shao Yongxin reached 

out that Q & M discovered the northeastern 

province. At that time, Dr. Shao 

was a hospital director and owner of a 

dental company, Aoxin. And together, they 

established Aoxin Q & M Dental Group, 

managing dental hospitals and polyclinics 

in 18 locations. These dental centres are 

equipped with the latest technology such as 

cone beam computed tomography (CBCT) 

scanners, intraoral scanners and CEREC, 

which are supported by their own dental 

laboratories. The dental centres also serve 

as a teaching base for dentistry students of 

Jinzhou Medical University. 

River Valley branch of Q & M 

“Each annual batch of 30 undergraduates, 

30 nurses, and 20 laboratory technicians 

will provide a ready talent pool to sustain 

Aoxin Q & M’s expansion plan, allowing it 

to grow organically,” explained Dr. Ng. “We 

regularly have exchange programmes for 

students, both in Singapore and China, to 

sharpen their skills.” 

Aoxin Q & M is equipped with its own 

dental laboratory 

“This will be the first of its kind in Singapore. 

And if it works for us, I’m sure it’ll work for 

others too,” Dr. Ng revealed. 

His support for artificial intelligence is 

also seen in Q & M’s usage to determine 

the vitality of a tooth; whether it is still 

sound and can be saved with a root canal 

treatment, or if it is beyond saving, in which 

case implant would be a better option. 

A dentist who has the patient’s best interests 

at heart will allow A.I. to help find the correct 

and most ethical dental treatment plan, he 

said. 

Grooming generations to come 

Fully equipped with the latest in dental 

technology, Q & M is a reflection of Dr. Ng’s 

strong belief in innovation. With this strong 

belief, he founded Q & M College of Dentistry, 

the first private dental school in Singapore 

to provide a platform for dentists to upgrade 

their skills and learn best practices in 

dentistry. 

He believes a solid education is crucial as 

it helps novice dentists to build confidence 

under the guidance of an experienced 

dentist while performing dental procedures. 

The courses are also done with the latest 



technology and materials so as to assist and 

facilitate dentists in their continuous efforts 

in keeping abreast with the latest technology 

and evidence-based practice. 

Indonesia; Vietnam; Cambodia; and China, 

Q & M College of Dentistry hopes to help 

more practitioners specialise and serve their 

communities better. 

be seen as making an impact on those who 

hitherto did not have access to quality dental 

care, and beyond that, to provide help to the 

communities. 

Sharing about his most memorable case 

in his long career, Dr. Ng said, “The most 

complicated is the first case because it 

took lot of courage for me to sink my first 

implant.” 

And if a dentist plans to run his own clinic 

one day, Dr. Ng explained that beyond 

surgical skills, patient management, and 

financial and legal knowledge will also be 

crucial. 

When COVID-19 hit Singapore earlier this 

year, it became a challenge for him to ensure 

the wellbeing of his staff. “My full-time job 

became acquiring the needed protective 

wear,” he said. 

It was under the tutelage of Dr. Dominic 

Leung that Dr. Ng sank his first implant and 

attested that practical provides the best 

experience along with proper structured 

courses. 

“He [Dr. Leung] held my hand to sink in 

the first implant and after that, I could 

confidently do it on my own,” he revealed. 

He also encouraged general practitioners to 

specialise so that they can better meet the 

needs of patients. By taking in practitioners 

from across the region such as Malaysia; 

“Dental school has taught all of us to be a 

dentist, but it did not teach us how to be a 

businessman,” Dr. Ng commented. “Dare 

to take risks and manage your people well. 

Besides learning what you can, you’ll also 

need to delegate, and rely on your finance 

and legal advisors, who will help you to 

maintain good numbers and stay profitable.” 

Taking on a pandemic 

“When I set up Quan Min, my aim was to 

provide quality dental services not only 

to everyone in Singapore, but also to the 

world,” said Dr. Ng. In fact, this could also 

“Today, we have enough protective gear 

(masks, gowns, surgical caps etc.) for our 

800 staff in Singapore, 200 in Malaysia, 

and 600 in China. When you come to Q & M 

clinics, you are actually in one of the safest 

places in Singapore. Our doctors, nurses, 

and admins are all protected.” 

He counts the coronavirus outbreak as a 

major challenge in his career. “On the fourth 

day of Chinese New Year, masks were out 

of stock everywhere in Singapore. Without 

masks, how are the nurses and doctors 

going to treat patients? I’ve over 800 people 

26 



to protect in Singapore, 200 in Malaysia, and 

600 in China. One supplier that I was on the 

line with initially said they had 700 boxes of 

masks left. When I called back a minute later, 

after checking with my team that the quality 

is good for us, they had only 50 boxes left. 

You could have heard the pounding of my 

heart!” Dr. Ng recalled. 

He eventually found supplies in Brazil, which 

arrived in Singapore after going through 

three flights. With more than enough to 

last his staff through the ordeal, he and his 

team of dentists donated 50,000 masks, 

personally delivering them to 17 charity 

organisations in Singapore. 

The group also recently invested S$3 

million to build COVID-19 test kits through 

a joint venture with Dr. Ong Siew Hwa, 

Ms. Zeng Weiyi, and Acumen Holdings, for a 

51% equity stake in JV company, Acumen 

Diagnostics Pte. Ltd. 

Acumen Diagnostics will be mainly involved 

in the manufacture, sale, and distribution 

of diagnostic test kits for viruses such as 

COVID-19, in Singapore and overseas. 

It is also in the midst of setting up a 

polymerase chain reaction (“PCR”)-based 

laboratory in Singapore to analyse test 

results. Additionally, it has plans to conduct 

clinical trials, as well as manufacture, sell 

and distribute vaccines, for viruses such as 

COVID-19. 

“The rapid escalation of the COVID-19 

pandemic has called for a stepped-up 

response from both the public and private 

sector. We believe it is important for Q & M 

to step in and help wherever we can, and 

through our joint venture, we hope to do so 

by ensuring the timely availability of good 

quality performing test kits. This is not just 

a business venture, but an opportunity to 

assist in providing an essential capability 

to Singapore in its continuous fight against 

COVID-19,” said Dr. Ng. 

Q & M has also indicated that it intends to 

work with various agencies to deploy its 

dentists in order to conduct COVID-19 tests 

as needed. The group has purchased 20,000 

Acu-Corona 2.0 % Tests for this purpose. 

From cultivating himself to managing an 

organisation and taking care of his staff, 

Dr. Ng has shown how Q & M is the result 

of a strong belief and everyone working 

towards the same goal. The group is seeking 

good working partners and opportunities in 

Southeast Asian countries such as Thailand, 

Cambodia, Myanmar and Vietnam. It would 

not be long before more communities will 

have access to the multi-disciplinary and 

holistic treatments that Q & M provides 

under the good hands of its team of 

specialists and dentists. DA 

The training room at Q & M Dental Centre in City Square Mall, Singapore, is equipped with 10 units of dental training simulators; 

each with a dummy head and a dental microscope 


exocad: 

Unparalleled flexibility and design freedom 

exocad Insights, which was supposed to take place in March this year, has been postponed to September due to the 

COVID-19 pandemic. Instead, the dental CAD technology provider held a press conference to keep the community 

updated on its latest news – an acquisition by Align Technology. Our publications director, Jamie Tan, was in exocad’s 

headquarters in Darmstadt to speak with Chief Executive Officer Tillmann Steinbrecher and Chief Commercial Officer 

Novica Savic to find out their thoughts on the dental CAD scene and why their open architecture remains 

non-negotiable. 

Mr. Savic, you began training as a dental technician in 1990, and 

was the best student of the year. What piqued your interest in 

dental technology? 

Mr. Savic: I’ll have to give the credit to my wife. Back when she 

was still my girlfriend, she already knew how much I enjoy doing 

handwork that requires high precision and creativity. 

She said, “Why don’t you consider becoming a dental technician?” I 

was surprised to hear that, but the more I read about it, the more it 

turned out to be exactly what I wanted. Its connection to medicine 

and the human body remains magical to me. 

When did you first start taking notice of dental design and 

planning software? 

Mr. Savic: It was in the early 90s when CEREC was first revealed by 

Siemens (present-day Sirona). 

Mr. Steinbrecher, your background was in hardware journalism 

and computer graphics research. How has your background 

influenced exocad? 

Mr. Steinbrecher: I’m actually an electrical engineer, but I’ve 

always had a passion for software. I always find it intellectually 

stimulating to find solutions to problems. The dentistry world 

is full of interesting problems that need solving; you’re dealing 

with various data sources and high precision requirements in a 

market which is shifting from analogue to digital technology. It’s 

captivating. 

Could you share some of the digital revolution you’ve witnessed 

through the years? 

Mr. Steinbrecher: Fourteen years ago, even milling a small bridge 

was considered innovative. Now, we’ve advanced from milling the 

simplest of restorations to digitally producing the most complex 

28 



ones. It has been an exciting path, and although not everything we 

tried, worked; some worked better than we expected. Ultimately, 

being agile – reacting quickly to the changing market requirements 

– has been one of the keys to our success. 

Mr. Savic: When zirconia came to the market, it was a cool material 

that technicians wanted to work with. Since there was no other way 

to work with it besides digital technology, the material became a 

major push for digital. Milling machines have also become small yet 

still extremely precise, and intraoral scanners have advanced; the 

next wave will be 3D printing. It’s a privilege to be a part of these 

innovations. 

Mr. Savic: Within dentistry, dentures are the last to be digitised. For 

the 95% of labs that are still producing them the analogue way, 

the potential to improve the process and save costs is huge. Also, 

today, when you print dentures, they look natural; the function and 

fit are also amazing. Minimal post-processing is needed – you just 

need to remove the supports, and glue and glaze them. 

Mr. Steinbrecher: We expect the adoption of CAD/CAM technology 

for removables to be much quicker than it was for fixed prosthetics, 

simply because scanners and 3D printers are already available in 

labs. Even if they aren’t, they are not nearly as expensive as the 

first milling machines, 15 years ago. 

The latest version of exocad, DentalCAD Plovdiv, has an 

enhanced FullDenture module that allows the designing of 

dentures in a guided digital workflow. How has the feedback 

been so far from users? 

Mr. Steinbrecher: It’s been very positive. Customers have been 

asking for the ability to produce dentures digitally for some 

time now. With the Plovdiv release, our customers have now the 

maximum choice of production methods. You could print or mill the 

base and teeth, use tooth cards, or combine these options. Another 

request is the ability to create single-arch dentures, which we have 

added in the Plovdiv release. For partial dentures, as opposed to 

just producing the framework, we are now also able to digitally 

produce the teeth and the gingiva. As well, the availability of tooth 

libraries has been greatly expanded. 

exocad is valued for its open platform and integration with 

scanners and CAM solutions. How did exocad identify this focus 

to help machines “talk to one another”? 

Mr. Steinbrecher: If you look at different markets, the more mature 

a technology market gets, the stronger the trend it goes in the 

direction of open architecture software. 

Let’s talk about home computers. In the 1980s, each computer 

manufacturer had their own operating systems. Today, with 

the exception of Apple, everything runs on Microsoft Windows. 

And if you look at cell phones, 10 years ago, companies like 

Nokia, Blackberry or Samsung had their own operating systems. 

Nowadays, again with the exception of Apple, everything runs on 

Android. So, we see this clear trend that in the more mature market, 

the open platform software solutions are those that prevail. 

Mr. Savic: It is a complex endeavour to integrate just one scanner 

or one milling machine with the software. But it is a completely 

different matter to integrate 20 different scanners with 10 different 

milling or printing machines. It is unique how the exocad team does 

this with the variety of scanners and production machines. 

Could you share some areas where you are most proud of 

overcoming - software, hardware, or material challenges - to 

achieve integrated workflows? 

Mr. Steinbrecher: I personally think that the most challenging 

integrations were the ones for clinical products. Compared to 

dental technicians, clinicians have even higher expectations for 

integration, simply because they just don’t want to deal with 

technical problems. 

Novica Savic 

This is why we spend a lot of time making sure that when we 

integrate an intraoral scanner, milling machine, or printer with our 

platform, the workflow is complete, smooth, and trouble-free. To 

be honest, that’s pretty challenging. Especially when you do it with 

such a great variety of products. But we’ve learned to be good at it. 



intraoral scanners, from all vendors that are keen to collaborate. 

At the same time, being backed by a larger organisation allows us 

and our products to have more impact in the future. 

exocad has the best-in-class products for CAD/CAM and 

implantology, and when it comes to digital orthodontics, there’s 

no way around Align for best-in-class. The two customer bases do 

not overlap. So the two companies truly complement each other 

ideally. If you look at digital dentistry, you have solutions for CAD/ 

CAM, implantology, and digital orthodontics, but cross-discipline 

workflows are still unnecessarily cumbersome. I’m enthusiastic 

about the ability to combine ortho-restorative treatments moving 

forward. 

Another thing I’ve noticed when working on previous projects with 

Align is that despite the difference in the size of the organisations, 

the culture is surprisingly similar. It’s innovation-driven and agile, 

with a fascination for technology that I truly appreciate. 

Tillmann Steinbrecher 

Mr. Savic: Also, sometimes it’s not just about the technical part. 

Each company has their own unique culture, and we’ve learned 

to make the best even of differences. It certainly didn’t happen 

overnight. 

exocad’s software is high-performance and runs robustly, even 

when dealing with large and complex cases. What motivates the 

exocad’s team of engineers to keep pushing the boundaries of 

digital dentistry? 

Mr. Savic: I think the motivation comes from being recognised by 

the exocad user community for what we do. Rather than being 

just customers, loyal exocad users who form their own groups on 

social media feel like a large family. Even when their feedback is 

disapproving, it is still important to us, because this is the only way 

to become better. 

Mr. Steinbrecher: We empower our engineers by giving them 

both the responsibility and freedom in their decisions in the 

technical side, as well as how they manage their projects. We have 

our engineers interact with customers directly so that they get 

unfiltered feedback, both positive and negative. They are starting 

to realise that they’re instrumental in changing the market. 

What’s the reaction to the acquisition been like from the exocad 

community? 

Mr. Savic: They are mainly asking questions like “Will we still get 

the software?” or “Will exocad remain independent as a company?” 

and I think by now most understand that we will continue today 

as we did in the past. Personally, the impression I received is it’s 

almost like we have fans who see themselves as part of the exocad 

team. So the thoughts of the exocad community are extremely 

important to us, not only now, but also in the future. 

Could you share a little about the upcoming exoplan 3.0 release, 

Galway? 

Mr. Steinbrecher: Galway is a beautiful town that is the European 

capital of culture in 2020. We are releasing our software this year 

as Galway, with exoplan 3.0 being the first in the cycle. All Galway 

releases will feature a completely overhauled user interface. The 

design concept revolves around making the software as simple to 

use as an app on a cell phone. We want to make it accessible to 

new users, while those who know and love exocad will still feel at 

home, with new and existing features in a freshened look. 

There is also quite a major update of exoplan, with a focus on drill 

guides for edentulous patients, dual-scan protocol, as well as 

greater automation in the guided workflow. 

With the acquisition by Align Technology of exocad, how will the 

development of exocad products change in the days to come? 

Mr. Steinbrecher: The key philosophy of exocad – its open 

architecture – is not going to change. We will keep building 

partnerships, integrating various types of hardware, such as 

In your opinion, what trends do you foresee in Asia? 

Mr. Steinbrecher: I think that some trends that exist worldwide 

will be particularly strong in Asia. Generally, in technology, there is 

a trend that mostly applies to emerging markets in Asia – certain 

steps are just skipped. In Europe or in the United States, people 

30 



went from having no telephones to installing landlines to owning 

cell phones. In many emerging markets, you have people going 

from not owning a telephone to owning a cell phone or even a 

smart phone. We might see the same with digital dentures. 

But we’ve taken the challenge. We’ve always tried to make our 

software not just easy to use, but even fun for someone who wants 

a more intuitive approach to using the product. And I think this has 

been a big part of our success. 

There are geographies in Asia where a large part of the population 

is simply not able to afford the traditional hand-made dentures. So 

digital dentures are going to be a huge game-changer. Not just for 

labs and dentists, but for the general population in Asia. 

In the area of hardware, Asian companies that domestically 

produce their own milling machines are becoming stronger and 

more competitive. Huge investments are also being made in China 

and Korea in the area of intraoral scanning technology. It’s a trend 

that I find very positive. 

How does exocad ensure that these new users get the most out 

of what exocad products have to offer? 

Mr. Savic: We have been approached by independent training 

centres in Asia that want to get certification for training users in 

exocad. There are already many such centres existing, and they’re 

growing. With the new certification programme, we ensure that the 

education level is as good as possible. 

What is your personal philosophy in life? 

Mr. Steinbrecher: I believe greatly in personal freedom – being 

able to try new things. I recommend the same to both our 

engineers and our users. The good thing about software is that you 

can just try stuff, and nothing is going to break. The worst thing 

that can happen is that you waste some time, but usually you learn 

something during that time. 

Engineer or exocad user – I encourage both to play with the code 

or the software, and try different things. If you get stuck, don’t 

hesitate to ask others. The culture in our office is such that if an 

engineer is stuck, he is free to just go to the next office and ask 

someone for help. Similarly, exocad users have a strong community 

on social media where they interact and support one another. There 

may be times when you want to do something that may not even be 

officially supported by the software or the reseller. You can always 

talk to other dental technicians who have experience. They may 

have already found a solution for whatever challenge you’re facing. 

Despite the advancements in digital dentistry, some dentists 

and dental technicians still prefer traditional or analogue 

methods. What are your views on this? 

Mr. Steinbrecher: The enchanting thing about our industry is 

that we’re dealing with extremely complex CAD technology, such 

as precision requirements of just a few microns and huge 

amounts of data. At the same time, we’re selling 

these products not to engineers, but to artists. 

It’s only natural that someone who has worked 

all his life with his hands would have some 

reservations when he is first introduced to 

digital technology. 

Mr. Savic: Always enjoy what you’re doing. You can’t be good if 

you don’t enjoy what you’re doing. The other thing is always be 

positive. Rather than focusing on the negatives, I tend to look for 

the positives. I’m a notorious optimist. DA 



Traditional techniques correcting Literature review 

overbite features in all Orthodontic literature had described 

malocclusions have been known myriad approaches for overbite correction. 

to be quite complicated, and 

challenging 

to orthodontists. Strong 

mechanical background, 

sophisticated appliance 

designs, diligent patient’s 

cooperation and multiple 

By Dr. Suhail Khouri and Dr. Derek Mahony 

adjustment visits over a long 

treatment time are crucial 

elements for successful 

treatment prognosis of this 

dento-alveolar deformity. 

Despite the overwhelming advances that Some approaches used fabricated loops, 

already modernised many orthodontic helices and springs made of stainlesssteel 

wires to create the bite-opening 

concepts, techniques, and practice, 

nonetheless modalities correcting overbites force system 3,10-14 . Others used functional 

did not witness significant advances. appliances with and without headgears 4,5 ; 

while severe skeletal cases were managed 

To date super elastic wires have only with surgical approaches 6-9 . 

been principally used in their straight 

prefabricated form for the sole purpose of Ever since the inception of their use in 

initial teeth levelling, until the Bendistal Pliers orthodontic practice, the impossibility 

demonstrated their unique ability to cinchback 

and bend NiTi wires, for the first time 1 . restricted orthodontists to use them only 

of bending super elastic archwires has 

The possibility of placing permanent V-bends in their prefabricated straight arch forms 

on super elastic archwires intraorally armed in initial teeth levelling. Subsequently they 

orthodontists with full control of super couldn’t use the superior elasticity of those 

elastic wires and resurrected their advanced wires in other orthodontic tooth moments. 

mechanical properties that were overlooked They could not even bend distal ends of 

after performing initial teeth alignment. By such wires without annealing that ruins 

providing light and consistent force, these the entire wire’s resiliency and defeats the 

bends could effectively move groups of only purpose of their use. Many researchers 

teeth in both transverse and vertical planes demonstrated the validity of using intrusion 

of space. 

appliances, helices and springs made of 

super elastic wires in their prefabricated 

Clinical application of this concept has forms 15-17 . Despite this success, however, 

resulted in evolution of new techniques that the inability to bend these wires made it 

showed efficiency in correcting a multitude of impossible to customise the costly intrusion 

major orthodontic dentoalveolar deformities appliances, and resulted in the limited use 

with unprecedented simplicity, convenience of prefabricated elastic appliances and even 

and time savings 2 . This article elaborates wires. 

on one new technique that corrects dental 

and skeletal deep overbite mostly featured Bending titanium wires without annealing 

in Class I and Class II malocclusions using or breakage requires specially designed 

simple routine wire adjustments during pliers. Khouri developed one such set of 

patient’s regular visits. 

pliers – Bendistal Pliers – and subsequently 

Part I: Correcting Excessive 

Overbites with V-Bend Activations 

of Super Elastic Wires 

This two-part article describes a simple, effective and clinically 

applicable alternative bite-opening technique using V-bends on 

super elastic wires that are created by new orthodontic pliers. 

showed how clinicians could use them 

for many intraoral sundry super elastic 

wire activations that moved segments of 

teeth and corrected overbites, crossbites, 

expanded and constricted 

dental arches, tip backs and 

rotate molars 2 . 

The mechanical principles 

underlying bite-opening 

techniques have been 

well established and 

appreciated in literature 3, 

16, 19, 20 

. Dake and Sinclair 13 

reported that intrusions 

and extrusions achieved by both Ricketts 

and modified Tweed techniques remained 

stable. Hans et al 18 compared the efficiency 

of the headgear and bionator with fixed 

appliances in bite opening and found that 

both approaches produced incisor intrusion 

combined with skeletal mandibular changes 

that contributed to the correction of deep 

overbites. Burstone 3 has advocated that not 

all patients with overbites require incisor 

intrusion exclusively; rather, some require 

posterior teeth extrusion to open their bite. 

He presented upright intrusion springs that 

intrude anterior teeth with minimal effect 

on posterior teeth. He recommended spring 

appliances with low load deflection rates 

to produce the optimal intrusive forces. 

Sander et al 16 described intrusion mechanics 

completed with NiTi uprighting springs with 

low load deflection rates that could intrude 

incisors a magnitude of 7mm. 

Shroff et al 11 found it difficult to correct 

deep overbites when accompanied with 

flared incisors by conventional orthodontic 

therapies. They subsequently recommended 

the Burstone segmented arch approach for 

achieving precise vertical and horizontal 

simultaneous moments of teeth. Davidovitch 

and Rebella 12 described an intrusion 

archwire that uses only tip back bends 

close to molars, to achieve bite opening. 

Nanda has also described appliance systems 

and biomechanical techniques for incisor 

32 



intrusion. Melsen et al 15 compared force 

systems generated by stainless steel and 

beta titanium cantilevers with helices 

and have demonstrated that quality of 

the wire influences the relative stiffness. 

They showed how various laboratory wire 

configurations could deliver predetermined 

horizontal and vertical forces. 

Using the V-bends in biteopening mechanics 

and other mass tooth moments is not new and 

was successfully used on manufacturer-bent 

super elastic wires by researchers 13,15,21,22 . 

What makes this technique more clinically 

applicable, however, is the orthodontist’s 

ability to customise the exact orientation, 

locations and easy placement of permanent 

V-bends intraorally on tied super elastic 

wires with the proper tool during their 

patient’s routine adjustment visits. 

Material and method 

The pliers used to place the intraoral 

V-bends on NiTi wires in this technique are 

new pliers called Bendistal Pliers (Fig. 1a-b). 

They are designed longer and thinner than 

conventional ones, for easier accessibility 

in the patient buccal sulcus. They are 

made in a set of two pliers – one for the 

archwire adjustments in maxillary right and 

mandibular left quadrants, while the other 

pair makes adjustments in maxillary left and 

mandibular right quadrants 

Fig. 1b: Close-up front view of their jaws 

A full squeeze of the plier jaws around the 

archwire creates a permanent sharp bend on 

most types and sizes of super elastic wires 

extraorally and intraorally without annealing 

or fracture (Fig. 2a-b). The resulting bend 

angle is slightly obtuse and ranges between 

100-110 degrees. The stability of the obtuse 

bend angle protects the titanium archwire 

against fatigue or fracture after tying, and 

maintains an efficient and consistent level 

of light force delivery. 

Placing such V-bends has expanded the 

scope of clinical usefulness of super elastic 

wires far beyond the preliminary alignment 

and rotational control of teeth they primarily 

do. They activate such wires to move single 

or whole segments of teeth in vertical and 

horizontal planes to correct many dentoalveolar 

deformities with unsurpassed 

simplicity and dispatch. This article is 

focused on the vertically oriented V-bends 

that help open severe overbites. 

Making the V-bends 

To place the bite opening V-bends on 

maxillary archwire, position the apex of 

gingival jaw of Bendistal Pliers above the 

archwire, with the occlusal jaw underneath it 

as shown in Fig. 2a. For bite opening V-bends 

on mandibular archwire, position the apex 

of the gingival jaw below the archwire 

and the occlusal jaw above the archwire 

as illustrated in Fig. 2b. Then make a firm 

squeeze in the recommended locations on 

the archwire. 

Before using the pliers, clinicians must be 

familiar with the most effective orientation, 

location, and direction of each V-bend 

on archwire that activate it to create the 

prescribed force system prescribed to elicit 

the planned teeth moment. Also the proper 

positioning of the plier jaws in relation to 

the archwire is equally critical to place the 

proper bends and to master the technique. 

Precision in orienting the apex of the V-bend 

on an archwire determines whether the teeth 

will intrude or extrude. To intrude maxillary 

incisors, place plier jaws as shown in Fig. 2a. 

To intrude lower incisors, place plier jaws as 

shown in Fig. 2b. 

Fig. 1a: The Bendistal pliers set (UL-LR for Upper Left 

and Lower Right, and UR-LL for upper Right-Lower 

Left quadrants), with the bends they can insert in 

super elastic wire. 

Fig. 2a: A Permanent 110-degree intrusive bends 

on a maxillary NiTi wire 0.016”X0.22” placed 

extraorally distal to canine’s areas 

Fig. 2b: Placing intrusive bend on mandibular 

archwire is done by reversing plier jaws 

Fig. 3a 

Fig. 3a illustrates the long range of wire 

activation after placing the V bends on 

0.016”X0.022” NiTi archwire. Those bends 

can be easily placed either extraorally or 

intraorally in the midway point between 

canine and first premolar brackets. Upon 

tying, the active wire will deliver a consistent 

intrusive force and moment on anterior 

teeth segment from canine to canine. The 

curvy shape of activated wire delineates the 

ultimate prospective incisor positions which 

the wire will intrude to. 



Rationale of the new technique 

This technique was actually inspired by the 

ability of Bendistal Pliers to place lasting 

bends and activate tied super elastic 

archwires intraorally. Resiliency of super 

elastic wires provided light force delivery 

and allowed bending tied archwires without 

breaking adjacent brackets. Also the stability 

of bends ensures consistency of force 

delivery over the long range of activation 

those wires are famous for. The key to the 

success of this technique is its simple clinical 

applicability, its convenience and time 

savings, besides enabling orthodontists to 

customise the number and locations of the 

intrusive V-bends on tied archwires. 

Mechanical considerations of the 

V-bends 

1. It is well known that a V-bend on any 

orthodontic wire creates two moments equal 

in magnitude and opposite in directions 

acting on teeth in both sides of that bend 

(Fig. 4a). The labially directed moment 

acting on teeth segment anterior to the 

V-bend is counteracted by an equal and 

posteriorly directed moment (side effect) 

on teeth segment posterior to that bend. 

Analysing those moments to the couple 

of forces causing them, we see intrusion 

of the furthest teeth on both sides of the 

V-bend, and extrusion of teeth closest to 

that bend (Fig. 4b). The intrusion effect and 

the extrusion side effect resulting from this 

V-bend technique work favourably to open 

the deep overbite. 

Fig. 4a: Diagram showing analysis of the force 

system created by V-bends located between 

canine and first premolar. To bring the system into 

equilibrium, anterior moment M1 must be equal to 

posterior moment M2 

Fig. 4b: Shows the intrusion and extrusion effects of 

both moments acting on tooth segments located on 

both sides of the bend 

2. The apically directed forces applied 

through facial brackets of anterior teeth 

intrude them and cause them to flare 

because the force line passes facial to 

their centre of resistance creating a labially 

directed moment. Such flaring can be 

controlled with elastomeric power chain 

extending from one upper molar to the other. 

3. In maxillary first premolar extraction 

patients, posterior segment consisting of 

first molars and second premolars provides 

an anchorage of eight roots, to intrude the 

six roots of the anterior teeth segment. 

Posterior teeth anchorage can be further 

strengthened by adding both maxillary 

second molars that increase number of 

anchor roots to 14, if minimal side effect 

is indicated. The anterior teeth intrusion is 

elicited by the vertical component of force of 

the anterior clockwise moment causing the 

bite to open. Clinician can decide whether to 

prevent or take advantage of the extrusive 

side effect on teeth close to both sides of the 

V-bend that help opening the deep overbite 

as well in Fig. 4. 

4. Although intrusion of the furthest molars 

of posterior segments may be an unwelcome 

side effect 23 , it is advantageous since the 

apically-directed force acting buccally to 

molar’s centre of resistance intrudes their 

buccal cusps and extrudes their lingual 

cusps. This very side effect becomes a 

favourable and indispensable step to 

disengage upper and lower molar cusps that 

simplifies cross-bite correction by routine 

bend adjustments. It actually constitutes the 

core of the rationale for another technique 

to correct cross bites. 

Clinical technique and wire sequence 

Traditional intrusive appliance designs 

and springs made of stainless-steel wires 

required long prefabrication time, frequent 

adjustments, and high patient cooperation 

over long treatment times. Although V-bends 

on stainless steel wires were already known 

to intrude teeth, their relative stiffness 

and short range of activation limited their 

efficiency and clinical application. 

Bendistal Pliers provides a clinically simple 

way of placing V-bends on titanium archwires 

to ensure light and consistent intrusive 

force delivery. To master this technique, 

orthodontists must have a good background 

in creating the bite opening force system 

through placing V-bends that incidentally 

conform to segmental formats. 

This technique can be started as early as 

when the initial small-sized 0.016” NiTi 

wire finishes its sole role in preliminary 

teeth alignment. Instead of discarding 

this wire, placing V-bends on it distal to 

both canines will rejuvenate this wire, 

Fig. 5a: Right intraoral view of 100% severe overbite 

before treatment 

Fig. 5b: During treatment with the intrusive V-Bends 

in both dental arches 

34 



Fig. 5c: Post-treatment result 

and take its performance to a much higher 

level as shown in Fig. 4. Once the bite 

opens enough to allow mandibular incisor 

bonding, a similar small-sized NiTi wire is 

tied in to align mandibular teeth and possibly 

start early intrusive bends on mandibular 

archwire. Then the light magnitude of 

the intrusive force on anterior teeth can 

be increased according to case severity, 

by upgrading the wire size to a thicker, 

rectangular one (Fig. 5). 

If overbites extend more that 100%, greater 

force is required to intrude anterior teeth. 

V-bends on larger-sized rectangular NiTi 

wires (0.016”X0.022”) deliver a relatively 

greater consistent force that is still tolerable 

by patients, yet not so stiff as to break the 

neighbouring tooth brackets 

As the mandibular teeth align and the 

mandibular curve of Spee starts to flatten, 

replace the initial wire with a 0.016”X0.022” 

NiTi archwire to get a greater force 

magnitude by placing similar V-bends in 

the same locations on it. Monitor the case 

for few months until the overbite opens. In 

cooperative patients, overbite is corrected 

in about six months. 

In later stages of treatment, if greater force 

is required, stainless steel rectangular wire 

may be used with similar V bends to maintain 

results. A very gentle or incomplete squeeze 

of the plier jaws is adequate to activate 

stainless steel wires to deliver a greater 

intrusive force without breaking adjacent 

brackets. 

Patients who display severe skeletal 

overbites (150% or more) will benefit from 

acrylic bite plates that will allow early and 

simultaneous mandibular incisor bonding 

and commencement of intrusion mechanics 

on both dental arches (Fig. 6). Simultaneous 

bonding both arches shortens bite opening 

time. The same wire sequence and activation 

is followed in mandibular arch as that in the 

maxillary. 

Fig. 6a: Intraoral right views before treatment 

showing severe overbite of Class II Division 2 

Fig. 6b: During treatment with the arrows pointing 

at locations of the intrusive disengaging V-bends 

Fig. 6c: Post-treatment after four-bicuspid extraction 

Once overbite opens enough to allow 

mandibular incisors bonding, remove the 

bite plate and leave the active wires for 

few more months until the normal 1-2mm 

overbite relation is restored. Intrusive wires 

should not be left in mouth unsupervised 

for long durations to avoid unnecessary 

over treatment. At this stage clinician can 

reposition mandibular incisor brackets 

more incisally where needed, especially 

in cases where the brackets were placed 

gingivally to avoid occlusal interference. 

This step flattens mandibular curve of Spee 

and facilitates restoring and maintaining 

the normal overbite relation with just tying 

a straight wire. Rectangular finishing NiTi 

or stainless steel archwires without bends 

are recommended for this purpose. Should 

the need for additional bite opening develop 

during the finishing stage, half-squeeze 

bends on stainless steel wires or full 

squeezes on finishing NiTi wires will allow 

additional correction. 

Fig. 7a: Before treatment of a complicated case 

and two upper unerupted canines, with initial 016” 

round NiTi archwires with multiple V-bends to 

disengage the interlocking incisors. Notice brackets 

were placed in any available areas to speed up the 

disengagement of incisors 

Fig. 7b: During treatment before erupting the canines 

Fig. 7c: Post-treatment front intraoral view 

Dealing with severe skeletal overbite that is 

complicated by excessive skeletal overjet in 

Class II Division 1 patients, there is usually 

an adequate space allowing mandibular 

incisors bonding with or sometimes, without 

bite plate. Despite the severity of such 

cases, simultaneous commencement of 

bite-opening mechanics on maxillary and 

mandibular arches along with maxillary 

anterior teeth retraction that should have 



been planned and executed concurrently 

bring about a fast treatment result (Fig. 7). 

Case 1i 

Case 1g-i: Post-treatment photograph during 

retention period with minimal relapse 

Case 1c 

Fig. 8a: Pre-treatment models showing excessive 

overbite in a Class II Division 2 patient 

Case 1a-c: Pre-treatment models of a Class II 

Division 1 patient with 100% overbite 

Fig. 8b: Orthodontic effect of V-bend’s biteopening 

mechanics in both arches. Note locations 

of additional V-bends distal to lateral incisors 

on maxillary and mandibular 0.016”X0.22” NiTi 

archwires (arrows) that brought about this effect 

Case 1d: Intraoral photograph showing that the 

V-bends have intruded the maxillary incisors enough 

to bond mandibular incisors 

Case 2a 

Fig. 8c: Post-treatment frontal intraoral photograph 

of the same patient 

Patient treatments 

The following are cases with severe overbites 

treated by this V-bend technique. DA 

Case 1e: Effect of simultaneous V-bends on a 

0.16”X0.022” NiTi mandibular archwire that over 

corrected the overbite 

Case 2b 

Case 1f: Last stage of treatment where normal 

overbite and overjet relation are restored 

Case 1a 

Case 1g 

Case 2c 

Case 2a-c: Pre-treatment models of a Class II 

Division 2 patient with severe overbite 

Case 1b 

Case 1h 

Case 2d 

36 



Case 2e 

Case 2f 

Case 2d-f: Post-treatment frontal intraoral 

photographs of the same patient treated by the 

V-bends technique for bite opening. Normal overbite 

and overjet relations were restored nicely, but the 

tooth size discrepancy did not allow normal canine 

relations to be achieved 

References 

1. Khouri, S.A., A solution for distal end 

bending of super elastic wires. Am J. 

Orthodon Dentofacial Orthop, 1998. 114: 

p. 675-676. 

2. Khouri, S.A., Using the bendistal pliers 

for the correction of common orthodontic 

problems. World J. Orthod, 2002. 3(2): 

p. 172-174. 

3. Burstone, C.R., Deep overbite correction 

by intrusion. Am J. Orthodon Dentofacial 

Orthop, 1977. 72(1): p. 1-22. 

4. Mahoney, D.R., Witzeg, J.A., A modification 

of the twin block technique for patients 

with a deep bite. Functional Orthodon, 

1999. 10(April-June): p. 4-8. 

5. Demisch, A., Ingervall, B, Thur, U., 

Mandibular displacement in Angle Class II 

division 2 malocclusions. Am J. Orthodon 

Dentofacial Orthop, 1992. 102(6): p. 

509-518. 

6. Delair, J., Sagittal splitting of the body of 

the mandible (Mehmet’s technique) for 

correction of open bite and deep over 

bite. J. Maxillofac Surg, 1977. 5(2): p. 

142-145. 

7. Hinkle, F.G., Surgical treatment of adult 

Class II division 2 malocclusion. Am J. 

Orthodon Dentofacial Orthop, 1989. 

95(3): p. 185-191. 

8. Piecuch, J.F., Tideman, H., Correction of 

deep bite by total mandibular osteotomy; 

report of a case. J Oral Surg., 1981. 39(8): 

p. 601-606. 

9. Bell, W.H., Jacobs, J.D., Legan, H.L., Am 

J. Orthodon Dentofacial Orthop, 1984. 

85(1): p. 1-20. 

10. Cooke, M.S., Wreakes, G., Upper torque/ 

intrusion mechanics in deep bite cases 

using the upper utility wire and directional 

headgear. Br. J. Orthod., 1979. 6(3): p. 

157-161. 

11. Shroff, B., Lindauer, S.J., Burstone, C.J., 

Leiss, J.B., Segmented approach to 

simultaneous intrusion and space closure: 

biomechanics of the three-piece base arch 

appliance. Am J. Orthodon Dentofacial 

Orthop, 1995. 107(2): p. 136-143. 

12. Davidovitch, M., Rebellato, J., Two-couple 

orthodontic appliance systems utility 

arches: a two-couple intrusion arch. 

Semin Orthod, 1995. 1(1): p. 25-30. 

13. Dake, M.L., A comparison of Ricketts and 

Tweed-type arch leveling techniques. Am 

J. Orthodon Dentofacial Orthop, 1989. 

95(1): p. 72-78. 

14. Nanda, R., Correction of deep bite in 

adults. Dent Clin North Am, 1997. 41(1): 

p. 67-87. 

15. Melsen, B., Konstantellos, V., Lagoudakis, 

M., Planet, J., Combined intrusion and 

retraction generated by cantilevers and 

helical coil. J Orofac Orthop., 1997. 58(4): 

p. 232-241. 

16. Sander, F.G., Wichelhaus, A. Scheimann, 

C., Intrusion mechanics according to 

Burstone with the NiTi-SE-steel uprighting 

spring. J Orofac Orthop., 1996. 57(4): p. 

210-223. 

17. Nanda, R., Marzban, R., Kulberg, A., The 

Connecticut Intrusion Arch. J Clin Orthod, 

1998. 32(12): p. 708-715. 

18. Molligan T F, Molar Control Part 1. J Clin. 

Orthod. 2002 Jan; 36 (1): 11-23 

19. Hans, G.M., Kishiyama, C., Parker, S.H., 

Wolf, G.R., Noachtar, R., Cephalometric 

evaluation of two treatment strategies for 

deep bite correction. Angle Orthod, 1994. 

64(4): p. 265-276. 

20. Parker, C.D., Nanda, R.S., Currier, C.F., 

Skeletal and dental changes associated 

with the treatment of deep bite 

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Orthop, 1995. 107(4): p. 382-393. 

21. Burstone, C.J., and Koenig, H.A. Creative 

wire-The force system from step and 

V-bends. Am J Orthod 1988; 93:59-67. 

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Bending characteristics of Nitinol wire. Am 

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theses 2004 

About the Authors 

Dr Suhail Khouri 

graduated from 

a postgraduate 

programme in 

orthodontics at 

the University of 

Connecticut in the 

United States in 1980. He taught 

and practiced orthodontics at Riyadh 

University’s dental college and King 

Faisal specialist hospital in Saudi 

Arabia until 1988. He became a 

Diplomat of the American Board of 

Orthodontics in 1988, and maintained 

an orthodontic private practice in 

Saint Louis, Missouri until 2015. His 

biomechanical clinical research had 

resulted in the development of the 

Bendistal Pliers in 1995, and Omni 

Pliers in 2015. 

Dr. Derek Mahony 

is a diplomate of the 

International Board 

of Orthodontics and 

a visiting clinical 

professor at the 

City of London 

Dental School in charge of their 

international orthodontic programme. 

He is a world-renowned specialist 

orthodontist who has spoken to 

thousands of practitioners about the 

benefits of interceptive orthodontic 

treatment. Dr. Mahony approaches 

his orthodontic diagnosis from a 

“facial profile” point of view. He sets 

his treatment goals to create not just 

straight teeth, but beautiful faces and 

healthy temporomandibular joints. 



Guided Implantology: 

the SMART Guide 

By Dr. George Freedman and Dr. Mark Antal 

The tremendous proliferation of 

implant services worldwide has 

created a need for simplified 

and more predictable treatment 

guidance modalities. There 

are currently a number of surgical guide 

platforms that are available, but most 

systems are strictly limited to specific 

implant catalogues, typically the products 

sold by the surgical guide sponsor. Other 

surgical guides are open systems and allow 

the practitioner to use any selected dental 

implant. The practitioner has the options 

of freehand, partially guided, and fully 

guided implant placement surgery. Guided 

surgery results in more accurate results than 

freehand surgery. Computerised treatment 

planning and guided surgery improve 

accuracy, predictability and patient care. 

Patient-centred treatment planning 

Given the wide selection of high-quality 

implants that can be utilised by the dental 

practitioner, it makes more sense to develop 

a treatment plan based on the patient’s 

needs and anatomic suitability rather 

than on a specific implant manufacturer’s 

product lines, due to the large variation in 

cost and the regional disparity in product 

access. Thus, the ideal guidance system can 

be adapted to a variety of implant brands 

and types, offering recommendations that 

are patient-centred rather than productcentred. 

The SMART Guide Technology System 

(dicomLAB Dental Ltd., Szeged, Hungary) 

provides a complete case analysis and 

preparation shortly after imaging, enabling 

immediate treatment planning for any type 

of implant placement; it is possible to set 

the implant length with 0.5mm increments 

and the diameter with 0.1mm accuracy. The 

surgical protocol of the system is entirely 

dependent on the properties of the implant 

which is selected by the practitioner. The 

shape of the implant is also at the discretion 

of the dentist – conical or parallel shapes 

can be selected. 

CBCT and intraoral impression 

The following presentation is a detailed, 

step-by-step presentation of a case 

where planning and surgery were both 

accomplished with the assistance of the 

SMART Guide system. 

Fig. 1: Panoramic radiograph 

Fig. 2: Virtual model of #24 fractured 

Fig. 3: Virtual model of #24 fractured with SMART 

Guide visualisation 

A 39-year-old female patient presented a 

broken left upper first bicuspid, tooth 24. 

The tooth has had endodontic treatment; 

a subsequent vertical fracture of the root 

and unrestorable coronal structures made 

the case for an implant treatment the best 

choice. 

The remaining dental structures of tooth 

24 were extracted. In order to avoid any 

complications due to residual bacteria or 

possible periapical or periradicular infection, 

a two-month healing time was mandated. 

After the initial healing step, a CBCT was 

taken, and an intraoral impression of the 

patient was made with a custom-made 

plastic impression tray and C-silicone. This 

is the SMART Guide Simple CBCT Protocol. 

This approach does have some limitations 

as the superimposition of the CBCT to the 

silicone impression requires the presence 

of a minimum of eight sound teeth to be 

present as reference points on the dental 

arch to be treated. The silicone impression 

must be scanned with an extraoral scanner 

38 



for the digital superimposition of the CBCT 

to the impression. Another option is to use 

an intraoral scanner. The same limitations 

regarding sound teeth apply, however. The 

reference teeth must be sound or restored 

with metal-free restorations; any metal 

restorative components, such as amalgam 

fillings, PFM crowns or bridges and/or 

metal posts interfere with the CBCT data 

acquisition. 

After the CBCT of the patient and the 

scanned impression were completed, both 

data sets were uploaded, without patient 

identifying information, to the SMART Cloud. 

Then the SMART Guide centre checked the 

quality of the pictures. 

In cases where the patient is completely 

edentulous or where there are not enough 

metal-free, sound or restored teeth to 

provide the required minimum eight reference 

points, the “Double CBCT” technique can be 

employed. This procedure consists of an 

initial impression of the patient. The radioopaque 

gutta percha markers are positioned 

on the tray. The patient then wears this tray 

intraorally during the second CBCT. Thus, 

there are two separate CBCTs, one of the 

gutta percha marked tray extraorally and 

one of the marked tray intraorally – hence 

“Double CBCT”. This process ensures a 

precise fit in those cases where the number 

of sound tooth reference points are limited. 

Fig. 4: Planned implant in OV view 

Fig. 5: Planned implant in OV and MD view 

Fig. 6: Panoramic view of the planned implant in 

the SMART Guide software 

In the current example, the replacement of 

the earlier extracted left upper first premolar 

with an implant and an implant-borne 

crown are demonstrated. The software 

makes it possible to visualise the bone, 

soft tissue, and intraoral impression taken 

of the patient. The software then suggests 

a crown shape, which assists with the 

planning of the implant angulation and the 

ideal emergence profile of the restorative 

crown. The recommended shape considers 

the anatomical properties of the adjacent 

and opposing teeth, and the soft tissue 

condition. In cases where screw-retained 

crowns are planned, this process is essential 

in ensuring the proper location for optimal 

angulation and access of the retention 

screw. 

Fig. 9: Digital tooth setup visualisation in the 

SMART Guide Software 

Assisted treatment planning 

Once the dicomLAB Dental SMART Guide 

centre has prepared the case, the operator 

receives a notification e-mail or text. This 

is typically within approximately four 

hours after successful data upload. The 

practitioner then downloads the patient’s 

data to the practice computer on which the 

Smart Guide software has previously been 

installed. It is now possible to plan the 

optimal positioning (location, angulation, 

depth, and diameter) of the implant, 

considering the implant properties (length, 

diameter, and shape) as indicated above. 

Fig. 7: Zoomed-in view of the planned implant in 

SMART Guide software 

Fig. 8: Zoomed-in view of the planned implant in 

SMART Guide software 

Fig. 10: Implant for fractured #24 planned 

Fig. 11: Planned implant in the 3D Visualisation in 

the SMART Guide Software 



Fig. 19: The surgical guide in the patient’s mouth 

Fig. 12: SMART Impression tray visualisation in the 

SMART Guide Software 

Once the planning phase is completed, it is 

possible to ask for a treatment plan review 

by a contracted expert implant specialist 

within the SMART Guide System who is able 

to mentor the practitioner. This approach 

offers confirmation of treatment approach 

and direction prior to beginning any surgical 

steps. For those who are less experienced in 

treatment planning, this is an invaluable and 

highly protective service. A comprehensive 

Preplan Service, which begins immediately 

after data uploading, is also available. 

Fig. 14: Second preview picture of the case in 

SMART Cloud 

Fig. 15: SMART 

Guide Surgical 

Protocol 

Fig. 20: Preparation 

Fig. 21: Start long drill 

In all cases, however, the final decisions 

are always in the operator’s hands. Further 

planning and modifications are always 

possible before the SMART Surgical Guide 

is ordered. 

Surgical guide and protocol 

A short time after it is ordered, the printed 

surgical guide arrives at the practice. It is 

a good idea to sterilise it in an autoclave. 

Along with the printed surgical guide, the 

operator is provided with a specific surgical 

protocol which matches the planned implant. 

Fig. 16: Abutment in the model 

Fig. 17: The surgical guide after arrival 

Fig. 22: The first drill goes in with the spoon to 

stabilise the drill 

Fig. 23: The first drill with its spoon 

Fig. 13: First preview picture of the case in SMART 

Cloud 

Fig. 18: The surgical guide after sterilisation 

Fig. 24: Inserting the first drill through the surgical 

guide after the start drill 

40 



During the actual implant placement 

surgery, the sequence that is suggested on 

the attached drilling protocol chart should 

be followed. The Surgical Kit of the SMART 

Guide System consists of 20mm, 24mm and 

28mm long, each with a diameter of 2.0; 2.5; 

3.0; and 3.5mm. 

Fig. 33 

Figs. 29-33: Implant insertion 

Fig. 28: After the preparation, use the implant 

drills up to the last drills needed 

Fig. 25: The second drill with its spoon 

Fig. 34: Checking vertical position through the 

surgical guide with depth control 

Fig. 29 

Fig. 35: Healing cap insertion 

Fig. 26: Inserting the second drill 

Fig. 30 

Fig. 36: Post-operative panoramic radiograph 

Fig. 27: The third drill with the corresponding 

spoon 

Fig. 31 

The final drilling step is done with the final 

core drill of the selected implant system at 

the proper depth and diameter to ensure 

perfect implant placement. The final implant 

drill can also be used without the surgical 

guide, since the direction and depth of 

the bone preparation are already preestablished 

with the SMART guide. The bony 

housing is already prepared to a size which 

almost matches that of the intended implant. 

Fig. 32 

Fig. 37 

Fig. 38 

Figs. 37-38: Healing 



Fig. 39: Implant is exposed 

Fig. 41: Abutment inserted 

Fig. 43: The missing #24 tooth replaced using 

SMART Guide 

Predictable and versatile 

The SMART Guide Technology offers a 

versatile implant placement guidance system 

that can be adapted to most implant brands 

and types, making implant surgery patientcentred 

rather than product-centred, more 

predictable, and more efficient. DA 

Fig. 40: Abutment 

Fig. 42: Before the final step 

About the authors 

Dr. George Freedman is a founder and past president of the American Academy of Cosmetic Dentistry. Besides 

being a co-founder of the Canadian Academy for Esthetic Dentistry, and the International Academy for Dental Facial 

Esthetics, he has also served as a diplomate and chair of the American Board of Aesthetic Dentistry. 

He is an adjunct professor of dental medicine at Western University in Pomona, California, and professor and 

programme director at BPP University in London for the master’s programme in clinical dentistry in restorative 

and cosmetic dentistry. 

Dr. Freedman has authored or co-authored 14 textbooks and more than 800 dental articles, and lectures 

internationally. He maintains a private practice limited to aesthetic dentistry in Toronto, Canada. 

Dr. Mark Antal is a senior lecturer at the Faculty of Dentistry at the University of Szeged in Hungary. After earning 

his Doctorate of Medicine in Dentistry, he specialised in operative dentistry and oral surgery, with internships in 

Martin-Luther University of Halle-Wittenberg in Germany, and Boston University and New York University in the 

United States. 

Besides being a member of the education committee at FDI World Dental Federation, Dr. Antal is also an honorary 

lifelong member of the International Association of Dental Students. His special research interests are in aesthetic 

dentistry, dental implantology, and tobacco cessation in preventive oral medicine. 

42 


A 

Bone Level 

REG & PX designs for 

biological integration 

With more than 30 years of experience 

in implantology, Anthogyr launched 

the Axiom® implant system 10 years 

ago to improve access to implantology 

by offering innovative and accessible 

solutions, a greater comfort for practitionners 

and performance in their 

everyday practice. 

www.anthogyr.com


The coronavirus has been 

affecting mankind since 2019 

with high morbidity and 

mortality rates. Up to 25 th 

April 2020, 2,830,082 people 

were infected worldwide and 197,245 

people have died from respiratory failure. 

The World Health Organisation has declared 

this a pandemic since 11 th March 2020, 

representing global public health concern. 

By Dr. Kevin Ng and Dato’ Dr. How Kim Chuan 

Organisation for Animal Health (OIE) and 

the Food and Agriculture Organisation of 

the United Nations (FAO). 

Health workers face high risks in treating 

patients, and need to protect themselves 

and staff, since social distancing is 

impossible to achieve especially with the 

presence of aerosol in dental office during 

treatments. The purpose of this article is 

An Update on SARS-CoV-2 and the 

Effect on Dental Practice based on 

WHO Guidelines 

Discussion 

The last time the WHO declared a pandemic 

was in 2009 for H1N1 influenza outbreak. 

Past examples include HIV, Swine Flu, and 

the 1918 Spanish Flu. Although there is 

no special threshold or set rules such as 

cases number and death, a pandemic means 

that there is widespread human-to-human 

transmission globally, with unknown cure 

strategy. The latest update from WHO 

(April, 2020) reported over 0.8 million 

people infected, with over 20,000 fatalities 

in different countries. The number is still 

increasing. The American government has 

predicted the death rate will be 10,000 – 

24,000 in America alone. 

Viruses, and the diseases they cause, 

often have different names. Viruses are 

named based on their genetic structure 

to facilitate the development of diagnostic 

tests, vaccines and medicines. Virologists 

and the wider scientific community do 

this work, so viruses are named by the 

International Committee on Taxonomy 

of Viruses (ICTV). Diseases are named 

to enable discussion on disease 

prevention, spread, transmissibility, 

severity and treatment. Human 

disease preparedness and response 

is WHO’s role, so diseases are officially 

named by WHO in the International 

Classification of Diseases (ICD). 

to report updated information available 

from the WHO, Centre of Disease Control 

(CDC) in the United States, and National 

Health Service (NHS) in the United Kingdom 

in order to make recommendations for 

practicing dentists to ensure safety to 

patients, the dental team and their families 1 . 

ICTV announced “severe acute 

respiratory syndrome coronavirus 2 

(SARS-CoV-2)” as the name of the 

new virus on 11 th February 2020. This 

name was chosen because the virus is 

genetically related to the coronavirus 

responsible for the SARS outbreak of 

2003. While related, the two viruses 

are different. 

WHO announced “COVID-19” as 

the name of this new disease on 11 

February 2020, following guidelines 

previously developed with the World 

Deaths from COVID-19 according to WHO on 25 th April 2020 

Cases of COVID-19 according to WHO on 25 th April 2020 

The coronavirus 

Virus are large pleomorphic spherical 

particles of about 120um in diameter, with 

bulbous projections on the outside. The viral 

envelop consists of a lipid bilayer where the 

Membrane (M), Envelop (E) and Spike (S) 

structural protein are anchored. A single 

stranded RNA genome in continue beads on 

string conformation form the nucleocapsid 

inside. The S protein from coronavirus 

44 


can bind to the receptors of the host to 

facilitate viral entry into target cells. The 

virus protein can be dissolved by detergent 

and alcohol disinfectant and cannot tolerate 

hot temperature over 25°C 2 . 

The novel β-coronavirus was named by 

WHO as COVID-2019. It can cause severe 

and even fatal pneumonia in human. The 

transmission routes of COVID-2019 can be 

by direct person-to-person transmission via 

coughing, sneezing, saliva, and inhalation of 

discharged droplet. Contact transmission is 

also common to oral, nasal, and eye mucous 

membranes after touching virus since it 

can survive on metal and plastic surfaces 

for hours 2 . 

Patients suffering from COVID-19 will 

experience mild to moderate respiratory 

illness. They may recover without special 

treatment. However, older people with 

chronic medical problems such as diabetes, 

Symptoms 

cancer and cardiovascular disease will 

develop serious pulmonary fibrosis and 

respiratory failure. The best way to prevent 

infection is to understand its cause and 

spread, and intercept. Social distancing, 

regular hands washing with alcohol rub 

and not touching one’s face are strongly 

recommended by CDC. 

In dental settings 

Face-to-face close communication in dental 

surgeries is unavoidable and the environment 

is exposed to saliva, blood, and other body 

fluids via aerosol generated by dental 

instrumentations. Dental profession workers 

are encountering high risk; therefore, a 

strict guideline is urgently needed to protect 

dentists, staff and patients. It was confirmed 

that those without symptoms can spread 

the virus 4,5 . 

The typical clinical symptoms of COVID-19 

pneumonia patients are fever, dry cough, 

coarse breathing sounds, 

and myalgia or fatigue with 

abnormal ground-glass chest 

X-ray. The less common 

symptoms are sputum 

production, loss of sense of 

smell, headache, haemoptysis, 

diarrhoea and lymphopenia. In 

severe cases, acute respiratory 

distress, RNAaemia and acute 

cardiac injury lead to death 8,9 . 

The patient sputum show 

positive real-time polymerase 

chain reaction that confirmed 

COVID-19 infection 10 . 

Laboratory studies show 

leucocytes 2.91x10^9 cells/L 

of which 70% are neutrophils. 

High erythrocytes count 

sedimentation rate and D-dimer 

are also observed 12 . While there 

is no specific antiviral drugs 

or vaccine for humans, broadspectrum 

antiviral drugs like 

nucleoside analogues and 

HIV-protease inhibitors could 

attenuate virus infection until specific 

antiviral drugs become available 11 . 

Being in close proximity to one another is 

unavoidable in dental settings 

Spread by airborne virus 

Aerosol transmission of COVID-2019 is of 

the most concern in dental settings since 

it is difficult to minimise the production of 

aerosol and droplets mixed with saliva and 

blood during operative procedures. Virus 

can stay airborne for a while in droplet 

particles and aerosols before they settle 

on surfaces or enter the respiratory tract. 

Dentists and their staff are constantly 

in contact directly with human fluids, 

patient exudates, and contaminated dental 

instruments and surfaces. 

An infected person who coughs can propel 

his droplets and aerosols a distance, causing 

infection if the virus comes into contact 

with another person’s eyes, nose, or mouth. 

This can happen even during conversation 

without a mask. An effective infection control 

system is needed to prevent the spread 

through this media 6,7 . 

Spread from contaminated surfaces 

COVID-19 can survive on metal, glass, and 

plastic surfaces for hours. It is a potential 

source of coronavirus transmission since 

contaminated surfaces in surgery are 



common and are in close contact with 

staff. Disinfection of the whole dental 

practice to eliminate any droplets and 

aerosols contamination are most essential. 

COVID-19 can cause infection after twohour 

exposures on surfaces and last for nine 

days, surviving at 50% relative humidity. 

Therefore, it is suggested that a clean and 

dry environment in the dental office would 

help decrease the persistence of the virus 1, 8, 9 . 

Infection control strategies 

In order to intercept the infection of 

COVID-2019, dentists should have a 

better understanding of the virus on its 

transmission routes, as well as the protocol 

to stopping its spread in the dental office 9 . 

1. Identify patients with possible 

COVID-2019 infection. 

2. All patients must record their body 

temperatures before entering treatment, 

and fill up a form on their past travel history. 

3. Extra protective measures should be 

applied to all dental operations. These 

include infection control measures that 

should be followed by all operators and 

staff. Our recommendations are based 

on the WHO, CDC Guideline for Infection 

Control and the Diagnosis and Treatment 

of Coronavirus. 

4. It is rare to encounter confirmed COVID-19 

patients in general dental offices, since most 

of these patients will be under hospital care 

until they are tested negative. For patients 

with symptoms, seeking dental treatment 

is not recommended. Analgesics to prevent 

severe pain seems to be the only available 

solution, until the patient has been tested 

negative. 

Non-urgent or elective dental procedures, 

particularly those which will generate 

aerosols, should be delayed. 

5. A 20-second pre-procedural mouth 

rinse with either of the following is also 

recommended: 

• 1% hydrogen peroxide 

• 0.2% povidone iodine 

• 0.2% chlorhexidine rinse (alcohol free) 

• an essential oil mouth rinse (alcohol free) 3 . 

6. The following websites are recommended 

by different well-known organisations for 

dental practitioners for references: 

I. WHO (2003a) Practical Guidelines for 

Infection Control in Health Care Facilities. 

Geneva, Switzerland: WHO. 

http://www.wpro.who.int/sars/docs/ 

practicalguidelines/practical_guidelines. 

pdf, accessed 2 August 2004. 

II. The concept of ‘Standard Precautions’ 

which, as defined by the CDC, are a set 

of safety measures designed to prevent 

transmission of blood-borne infectious 

agents, human immunodeficiency virus 

(HIV) and hepatitis B virus (HBV). CDC 

(2003a) Guidelines for infection control in 

dental healthcare settings - 2003. MMWR 

52 (No. RR-17). 

ADA Interim Guidance for Minimising Risk of 

COVID19 Transmission 

https://www.ada.org.au/Campaign/ 

COVID-19 

https://www.ada.org/en/publications/adanews/2020-archive/february/ada-releasescoronavirus-handout-for-dentists-basedon-cdc-guidelines 

https://www.cdc.gov/coronavirus/2019- 

ncov/infection-control/controlrecommendations.html?CDC_AA_ 

refVal=https%3A%2F%2Fwww. 

cdc.gov%2Fcoronavirus%2F2019- 

ncov%2Fhcp%2Finfection-control.html 

III. United Kingdom Department of Health. 

NHS HTM 01-05: Decontamination in 

primary care dental practices. 2013 Version. 

https://www.chp.gov.hk/files/pdf/the_ 

basic_protocol_ic_guidelines_for_the_ 

dental_service_dh.pdf 

Personal Protective Equipment (PPE) 

The operator and staff should be well 

protected with surgical mask or N95, face 

shields, disposable gowns, surgical gloves 

and hair covers for all dental procedures 

according to the guidelines listed by CDC. 

In this era of panic and fear, there are 

a lot of confusions and misconceptions 

existing regarding the use of mask, not only 

among the layperson, but also among the 

healthcare providers. 

On the one hand, masks are not available 

for the group at risk, while on the other 

hand, those who are not at risk are spending 

unnecessary money and energy to procure 

these masks. 

The difference between a mask and a 

respirator is that a mask has a loose fit, 

which does not seal the nose and mouth 

snugly, while a respirator has a tight seal, 

and most of the time, air passes only through 

its material after filtration. Examples of 

respirators are: 

N-95 - capable of trapping 95% of particles 

N-99 - capable of trapping 99% of particles 

N-100 - capable of trapping 100% of 

particles 

Respirators are graded according to their 

filtration efficiency according to the used 

filter type, materials used and additional 

features. 

Respirators can also be graded in filtration 

efficiency as: 

P1 (FFP1) - 80% 

P2 (FFP2) - 95% 

P3 (FFP3) - 99.95% 

The oil resistance of respirator can be 

further graded as N, R, or P and is usually 

46 



printed over the respirator: 

N - not oil proof 

R - oil resistant 

P - oil proof 

Some respirators have a built-in valve 

which functions as a simple exhalation port 

with one-way valve mechanism. It reduces 

expiration effort, reduces heat inside the 

mask, dissipates humidity and reduces the 

level of carbon dioxide within the mask. 

To ensure the quality of mask, we should use 

a mask which is certified by: 

NIOSH (National institute for occupational 

safety and health) or 

NPPTL (National personal protective 

technology laboratory) 

WHO recommendations for using masks are: 

• For the normal population, any type 

of mask is not required, maintaining 

the social distance and hand hygiene 

are enough. 

• A sick person should wear a surgical 

mask. 

• Any person who is taking care of a sick 

person should also wear a surgical 

mask. 

• An N95 mask should be used by 

a person who might be exposed 

to the respiratory secretions of 

an infected patient, for example, 

during endotracheal intubation, 

cardiopulmonary resuscitation, 

ventilation, bronchoscopy, and 

tracheostomy. 

The only additional thing to remember is that 

the recommended wear time for N95 masks 

is four hours. 

Conclusion 

Since 2020, COVID-19 information had been 

widely disseminated in social media related 

to dentistry. McGrath from the University of 

Hong Kong analysed the content of postings 

on 687 anonymous Facebook accounts and 

screened by PRISMA framework. He found 

over 50% posted by dental professionals 

with background information and 61% 

on prevention, while 49.4% were posted 

with guidelines, with only 7.2% on how to 

diagnosis the virus. In a summary listed by 

the Health Authorities, an evidence-based 

prevention protocol is recommended for 

effective prevention in dental setting: 

1. The mandatory patient triages include 

temperature taking, travel and contact 

history, signs and symptoms must be 

reported honestly by each patient. 

2. Restrict all aerosol procedures to pain 

relieve and infection control. 

3. Cease elective procedures such as 

scaling and cosmetic procedures. 

4. Use of rubber dam. 

5. Use of mouth rinse. 

6. Use high volume intra or extra-oral 

suctions. 

7. Use Class B autoclave to sterilise all 

instrument including high-speed hand 

pieces with spore test at least weekly. 

8. Anti-retraction high-speed dental 

handpiece can reduce the backflow 2 . 

9. Any confirmed or suspected cases 

should not be treated and refer to 

special clinics for management and 

report to Health Authority immediately. 

10. Treat all patients with high alert as 

signs and symptoms may not appear 

in infected cases in early stages. DA 

References 

1. https://www.who.int/emergencies/diseases/ 

novel-coronavirus-2019/technical-guidance/ 

naming-the-coronavirus-disease-(covid- 

2019)-and-the-virus-that-causes-it 

2. Peng X, Xu X, Li Y, Cheng L, Zhou X and Ren B. 

Transmission routes of 2019-nCoV and controls 

in dental practice. International Journal of Oral 

Science 12:9 2020. 

3. https://www.ada.org/en/publications/adanews/2020-archive/february/ada-releasescoronavirus-handout-for-dentists-based-oncdc-guidelines 

4. https://www.ada.org.au/Campaign/COVID-19 

5. Huang, C. et al. Clinical features of patients 

infected with 2019 novel coronavirus in Wuhan, 

China. Lancet 395, 497–506 (2020). 

6. Cleveland, J. L. et al. Transmission of bloodborne 

pathogens in US dental health care 

settings: 2016 update. J. Am. Dent. Assoc. 

(1939) 147, 729–738 (2016). 

7. Wei, J. & Li, Y. Airborne spread of infectious 

agents in the indoor environment. Am. J. Infect. 

Control 44, S102–S108 (2016). 

8. Otter, J. A. et al. Transmission of SARS and 

MERS coronaviruses and influenza virus in 

healthcare settings: the possible role of dry 

surface contamination. J. Hosp. Infect. 92, 

235–250 (2016). 

9. 9. Li Q, Guan X, Wu P, Wang X, Zhou L, Tong 

Y et al. 

Early transmission dynamics in Wuhan, 

China, of novel coronavirus-infected 

pneumonia N Eng J Med 10.1056/ 

NEJMMoa2001316GoogleScholar (2020). 

10. Carlos WG, Dela Cruz CS, Cao B Pasnick S, Jamil 

S. Novel Wuhan (2019-nCoV) coronavirus. Am 

J Respir Crit Care Med 2019(4) pp7-8 2020. 

11. Lei J, Li J,Li X, Qi X. CT imaging of 2019 novel 

coronavirus (2019-nCoV) pneumonia. Radiology, 

p.200236 10.1148/radiol.2020200236 Google 

Scholar (2020). 

12. Lu H. Drug treatment options for 2019-new 

coronavirus (2019-nCoV). Biosci. Trend (2020) 

10.5582/bst.2020.01020GoogleScholar. 

13. Hantak, M. P., Qing, E., Earnest, J. T. & Gallagher, 

T. Tetraspanins: architects of viral entry and exit 

platforms. J. Virol. 93, e01429–e01417 (2019). 

About the Authors 

Dr. Kevin Ng has been 

a visiting lecturer on 

oral surgery and 

cariology at Hong 

Kong University 

since 1981. His 

post-graduate 

qualifications include Membership of the 

Faculty of Dental Surgery (MFDS) of The 

Royal College of Surgeons of Edinburgh. 

He runs a private practice in Hong Kong. 

After graduating from 

Singapore in 1991, 

Dr. How Kim Chuan 

went on to specialise 

in orthodontics in 

London in 1993. He 

has served as the 

president of the Malaysian Dental 

Association, and is a founding member of 

the Malaysian Oral Implant Association 

and the Malaysian ITI Association. His 

special interests in dentistry include 

oral surgery, implantology, laser, and 

aesthetic dentistry. 


User Report 

Fast, Simple and Highly Sensitive: 

Dental Diagnosis with Digital Intraoral X-ray Imaging 

Digital dentistry has become the standard for dental 

care in Norway. In 1996, Norwegian dentist, Jan 

Kirkedam, started using storage plate systems for 

digital intraoral imaging and since 2003, he has been 

working with intraoral sensors. Depending on the 

patient’s case, he relies on both Dentsply Sirona X-ray systems – 

the storage plates with the Xios Scan unit, as well as the Xios XG 

Supreme Sensors. 

with storage plates – within one minute instead of two to three 

minutes,” said Dr. Kirkedam. 

Today, his first choice for intraoral imaging is Dentsply Sirona’s 

Xios XG Supreme sensor. “For me, it was a major technological 

breakthrough when the Xios XG Supreme came on the market in 

2015. Its image quality in terms of resolution, sharpness and the 

density of information really convinced me,” he explained. 

Dr. Kirkedam recalled, “To be honest, my initial motivation for 

starting with digital X-ray imaging in the mid-1990s was pure 

curiosity, combined with my high interest in technology. I wanted to 

be part of the technological evolution. Of course, the new storage 

plate’s advantages, such as the significantly reduced development 

time and the easier handling, were additional arguments in favour 

of the new X-ray systems.” 

His first choice today: the Xios XG Supreme sensors 

In 2003, he started with intraoral sensors. “Besides the fact that 

there was again this new piece of technology to explore, I adopted 

the intraoral sensors for two main reasons: Sensors require a 

much lower X-ray dose and I can take an X-ray even faster than 

In addition to its high resolution of 33.3 lp/mm and a pixel size of 15 

μm, the XIOS XG Supreme sensor is equipped with a special Cesium 

Iodide scintillator material to provide images with low noise and 

high contrast. Thanks to a dynamic focus capability, the sensor’s 

sharpness can be configured in four different ways depending on 

the particular case. Today, each of the six treatment rooms in Jan 

Kirkedam’s practice is equipped with Dentsply Sirona’s Xios sensor 

system. Additionally, his team can use a centralised Xios Scan unit 

for storage plates. 

Plate or sensor? – criteria to consider 

At Dr. Kirkedam’s practice, each dentist has his own imaging 

preferences. In almost every case, Dr. Kirkedam opts for the Xios XG 

48 


User Report 

Supreme and its highest level of image quality, especially when he 

requires high-quality images immediately, such as for endodontic 

treatments or in implantology. There is an additional reason for his 

preference regarding sensors: The Xios XG Supreme sensors are 

integrated with Dentsply Sirona’s imaging software Sidexis 4. 

“Sidexis 4 includes a dedicated tool – a sharpness filter – to play 

with the image information and to adapt the signal/noise ratio. This 

is a true advantage when it comes to complex root canal treatments 

involving a tedious search for the tooth’s apex,” explained 

Dr. Kirkedam. In certain cases, however, the intraoral sensor is not 

a 100% fit to the particular treatment situation. 

“Sometimes the patient’s anatomy is too unfavourable when using 

a rather stiff sensor, although the Xios XG Supreme is available in 

three sizes. So, I need to go back to the softer storage plate. ” A 

second reason for using plates would be to overcome the challenge 

of the limited active area of the sensor. 

database where we also store other documents, such as intraoral 

photographs or scanned reports.” In this way, the practice can 

manage all patient-specific information within one system. 

In general, dentistry in Norway shows a high degree of digitisation. 

“I do not know any Norwegian dentist that does not use digital 

imaging systems,” said Dr. Kirkedam. “In the last years, intraoral 

sensors have become more and more common. While in the past 

the plate-to-sensor-ratio was about 90:10, that ratio has evened 

out, thanks to two changes in favour of the sensors – a tenfold 

increase in image quality, and a halving of the price.” 

Despite his long experience of about 25 years, he is still curious 

about the further development of imaging technologies. “I could 

imagine something like intraoral 3D imaging or the integration of 

other imaging techniques besides X-ray.” DA 

About the author 

Dr. Kirkedam has been following the evolution of image quality 

with the various intraoral X-ray systems he has used during his 

professional career. “I have one patient that I have X-rayed on an 

annual basis for the last 15 years in terms of regular check-ups. 

This series of images shows clearly how fast the X-ray technology 

has progressed.” 

Perfect fit for digital workflows 

Jan Kirkedam’s practice is entirely digitised. Thus, the digital 

intraoral X-ray systems fit perfectly to the practice’s workflows. 

“Our patient management system integrates with the Sidexis 

4 image database. The imaging software serves as our central 

Dr. Jan Kirkedam established his first 

dental practice in 1990. In 2003, he 

opened his new practice rooms in 

Arendal, Southern Norway, where he 

is still working today. He, along with 

his three colleagues, offers an entire 

range of dental services – from small 

fillings to major dental surgeries – 

right out from his own operating room. 

Dr. Kirkedam has always championed 

new technological developments in 

dentistry. For instance, his practice 

has been using digital imaging since 1995 and CAD/CAM 

systems since 2006. 



AN EXCITING CHANGE 

– A Comparison of the IPS d.SIGN and 

IPS Style Ceramic Systems 

By Velimir Žujić 

Change is exciting – also in day-to-day dental lab 

work. The author switched to using IPS Style layering 

ceramic some time ago. Before he started working 

with this ceramic system, he thoroughly tested the 

material and compared it to the product he had 

previously used. 

The main aim of switching to a new ceramic system is to improve 

the quality of one’s results. We regularly used the fluorapatiteleucite 

glass-ceramic IPS d.SIGN® in our laboratory. Then, one 

day, we asked ourselves the following question: Would IPS Style® 

(the first patented metal-ceramic material containing oxyapatite) 

offer a sound alternative to our accustomed product? We decided 

to test the new material on flat cobalt-chromium alloy samples. 

These test specimens enabled us to take a closer look at the 

layering ceramic. We used these base metal alloy samples (Colado 

CC) to examine and compare several properties of IPS d.SIGN and 

IPS Style: For example shade, brightness, shrinkage, fluorescence 

and dimensional stability. 

Conditioning and opaquer application 

One specimen was oxidised at 950°C with a holding time of one 

minute. The other sample was treated with a bonding agent. 

Two metal specimens with different bases were now sufficiently 

prepared for the application of the ceramic materials. Next, the 

samples were coated with IPS d.SIGN Paste Opaquer and IPS Style 

Ceram Powder Opaquer. The opaquer products of both systems 

have a smooth consistency. We had never used an opaquer 

in powder form before, so applying the IPS Style material was 

completely new to us. Nevertheless, we were impressed by its ease 

of application and the excellent results. 

Shrinkage behaviour and shade effect 

In the next step, we compared Dentin and Transpa T Neutral 

materials as well as the Opal Effect OE1 materials. Each of the 

ceramics was applied to one of the metal samples. A line was drawn 

down the middle of the sample with a spatula for the purpose of 

comparing the shrinkage behaviour. The two different ceramics 

showed the same colour after firing. It was interesting to note that 

IPS Style exhibited less horizontal shrinkage than IPS d.SIGN (Fig. 

1). The vertical shrinkage of both ceramics was almost identical. 

The samples were held next to each other and examined under 

a polarising light. IPS Style was shown to be somewhat brighter 

than IPS d.SIGN. Both materials exhibited almost the same level 

of fluorescence. In this comparison, IPS Style was at a slight 

advantage because its Transpa T Neutral and the Incisal materials 

displayed a more lifelike fluorescence. 

Dimensional stability and test results 

The dimensional stability of the ceramics was clearly visible after 

the first firing cycle. The IPS Style layers successfully maintained 

their shape after firing. In contrast, IPS d.SIGN did not retain its 

shape completely. After this test series, we felt that we had gained 

enough information about the new material for our purposes. Even 

though the tests were relatively simple, they provided us with 

valuable insights into the two ceramic systems. Now, we are ready 

to compare the two materials on the basis of an actual case study. 

Fig. 1: Test samples showing shrinkage behaviour. 

Left: Application of the ceramic on the metal 

sample. Centre: IPS d.SIGN Right: IPS Style 

50 DENTAL ASIA MAY / JUNE 2020


New tooth colour 

The patient was dissatisfied with the appearance of her upper teeth 

(Fig. 2). She wanted a new tooth colour, but wished the shape and 

position of her teeth to be maintained as best as possible. This 

simplified shade selection, since we merely had to select a slightly 

lighter tooth shade. Next, teeth 15 to 25 were prepared (Fig. 3). 

Then a digital impression of the situation was taken with an intraoral 

scanner. From the manufacturing centre we were able to order both 

printed models and selective laser melting (SLM) metal copings. 

Both the models and the copings were produced simultaneously. 

This allowed us to start with the ceramic application immediately 

(Fig. 4). The restorations were built up on the frameworks with 

the two ceramic materials so that we could compare IPS Style and 

IPS d.SIGN in the patient’s mouth. A detailed description of the 

procedure involving the two ceramics is provided below. 

Fig. 3: Teeth 15 to 25 were prepared 

Fig. 2: Initial situation. The patient wished to have 

the appearance of her upper teeth enhanced 

Fig. 4: Printed model with SLM metal copings 

Preparation of the copings 

First, the metal copings were oxidised according to the instructions 

of the manufacturer and then the opaquer was applied. The IPS 

d.SIGN Paste Opaquer and the IPS Style Ceram Powder Opaquer 

exhibited excellent flow and masking properties (Fig. 5). Two firing 

cycles were adequate for producing the desired masking effect. 

The opaquer in paste form was easy to apply since the material 

is supplied ready for use from the syringe. Depending on its 

application, the rather dense paste may have to be diluted with 

some Paste Opaquer Liquid. The IPS Style Ceram Powder Opaquer, 

however, is mixed to the desired consistency with a matching liquid 

component. 

The product is easy to apply with a brush or a glass-ceramic or 

ceramic instrument. Margin material was used to create a shoulder, 

thereby enhancing the aesthetic appearance of the restoration and 

establishing a tight seal to the gingiva. The Margin materials of 

the IPS Style and IPS d.SIGN systems helped to create a beautiful 

margin (Figs. 6 – 7). 

Fig. 5: Comparison of the opaquer 

(left: IPS d.SIGN; right: IPS Style) 

Figs. 6 – 7: Application of the ceramic margin using the Margin materials of 

the two ceramic systems (top: IPS d.SIGN; bottom: IPS Style) 

MAY / JUNE 2020 DENTAL ASIA 

51


First firing 

In order to make a visual comparison of the layers placed with the 

two ceramics, the materials were mixed with Liquid Visual Eyes 

(Harvest Dental). The Visual Eyes Liquid is a product that renders 

the colour of the fired ceramic visible before the material is actually 

fired (Figs. 8 – 9). The basic dentin layer was created with 25% 

Cervical Transpa orange-pink and 25% Cervical Transpa khaki 

mixed with 50% Dentin B2. Unmixed Dentin material was used 

in the central part. The incisal mamelons were produced with a 

mixture of 80% Dentin B2 and 20% Special Incisal grey. In the 

horizontal cut-back space, Effect material Inter Incisal white-blue 

was applied. The incisal margin was completed with Opal Effect 

OE 1 and Transpa materials (neutral, orange grey). The mamelons 

and internal characteristics were created with a fine separating 

instrument. After the first firing, the colours of IPS Style and IPS 

d.SIGN looked good and appeared almost identical (Fig. 10). IPS 

Style Ceram and IPS d.SIGN Transpa as well as Mamelon materials 

were used to make some slight adjustments to the shape of the 

anterior teeth. At this stage, a comparison showed that a few distal 

areas in the incisal edge of the IPS d.SIGN restoration were slightly 

more translucent. 

Customisation of the layers and second firing 

After the first corrective firing cycle, the teeth were customised 

with suitable IPS Ivocolor® stains. These materials are used to 

characterise restorations (e.g. mamelons), imitate enamel cracks 

and adjust the colour intensity and translucency of certain areas. 

Subsequently, the stains were fired. In this case, a reddish hue was 

imparted to the incisal edge with IPS Ivocolor Essence E21 basic 

red to achieve a “lip gloss infiltrated” effect in the dental enamel. 

For the second firing, the crowns were coated with Transpa Dentin, 

Transpa Incisal and Transpa Impulse (Figs. 11 – 13). 

Comparison of the results 

After the second corrective firing of the different IPS Style Ceram 

Transpa materials, we were convinced that the product fulfilled all 

our criteria: The dimensional and shade stability of the ceramic was 

impressive. We effectively controlled the brightness of the material 

by adding Transpa T neutral. All in all, we were completely satisfied 

with the result. The colours of IPS Style were lifelike and they were 

identical to those of IPS d.SIGN. A direct comparison clearly shows 

the excellent colour coordination of the different ceramic ranges 

(Figs. 14 – 15). Furthermore, the same shade system applies to 

the IPS e.max® all-ceramics and the SR Nexco® light-curing 

laboratory composite. 

Figs. 8 – 9: The ceramic materials were mixed with Liquid Visual Eyes for the purpose of visually 

comparing the two materials during the layering process 


Fig. 10: Comparison of the crowns 

after the first firing 


Fig. 11: Adjustment of the incisal teeth with 

Transpa and Mamelon materials 


Fig. 12: Application of Transpa Dentin, 

Transpa Incisal and Transpa Impulse for the 

corrective firing cycle 

Fig. 13: The two anterior 

crowns after the 

corrective firing 

(left: IPS d.SIGN; 

right: IPS Style) 

52 



Fig. 14: The final restoration (IPS d.SIGN) 

after the second corrective firing cycle 

Fig. 15: The final restoration (IPS Style) 

after the second corrective firing cycle 

Fig. 16: In terms of fluorescence, 

both materials met our criteria 

Fig. 17: The final choice fell on the IPS 

Style restorations: shown in the mouth 

Fig. 18: The seated restorations (layered with IPS Style) 

harmoniously blend into the overall natural oral environment 

Lifelike fluorescence 

IPS Style is definitely capable of replacing IPS d.SIGN, which we 

used in our laboratory for quite some time. It completely satisfied 

us in terms of its shade and dimensional stability and its high 

strength. This ceramic offers us incredible flexibility and satisfies 

all our demands. Moreover, the ceramic system is geared towards 

modern manufacturing techniques. 

At present, we use printed, milled and conventionally cast metal 

to fabricate the frameworks used in our laboratory. The different 

fabrication methods involve a wide range of CTEs. IPS Style 

accommodates this requirement and does not cause any problems 

related to fracture during firing. The ceramic is characterised by 

minimal shrinkage and high dimensional stability. IPS d.SIGN, 

however, shows less dimensional stability and therefore does 

not perform as well in interdental areas and deep fissures. In this 

respect, it is less predictable than IPS Style. Nevertheless, the 

shade stability of IPS d.SIGN is comparable to that of IPS Style. 

In terms of fluorescence, both materials equally meet our criteria 

(Fig. 16). IPS Style Ceram Incisal and IPS Style Ceram Transpa 

T Neutral have a slightly more lifelike fluorescence than the 

corresponding IPS d.SIGN materials. 

In the end, the IPS Style solution had a slight advantage. We chose 

it for the final restoration because of its beautiful tooth shapes and 

vital appearance in the mouth (Figs. 17 – 18). 

Acknowledgements 

I would like to thank Dr. Patricia Žujić for her collaboration on this 

case and Iris F., our patient, for her patience during this project. I 

would also like to thank all my colleagues and friends from the TTT 

Group at Ivoclar Vivadent in Vienna. This group provides us with 

incredible opportunities to exchange experiences and new ideas. DA 

Patricia Zujic 

Velimir Žujić 


53


The unsung heroes 

Is there anyone who has 

one day since time was of the 

influenced you in pursuing 

essence. 

dental technology? 

Dennis Goh has been in dental technology for 16 years. 

In our younger days, my 

Also, there was a young patient 

Today, the lab manager oversees a team of dental technicians 

cousin was a dentist in the 

who could not control his bite 

at Precision Dental Lab, which specialises in crowns, bridges 

Singapore Armed Forces. 

due to a nerve complication. 

and prostheses. He shares how dental technology first piqued 

As a forensic dentist, he 

To prevent him from chewing 

his interest, and his passion for it. 

sometimes appeared in the 

his own tongue, I fabricated a 

newspapers, and the stories that he revealed through human teeth splint using mouthguard material. This also protects his parents’ 

amazed me. I thought, “Perhaps dental prostheses could also help fingers from his bite. 

him solve mysteries. If I took up dental technology, one day we 

could be colleagues.” 

Looking back, I am thankful I was able to help them in their times 

of need. 

In 2001, I had the opportunity to visit National Dental Centre 

Singapore (NDCS), where dental technicians presented not 

just tremendously life-like crowns, bridges and dentures, but 

also prosthetic eyes, ears and noses, which are used in oral and 

maxillofacial surgeries. They left a deep impression on me, so I took 

up a course in dental technology with the Institute of Technical 

Education. 

Every prosthesis is a masterpiece by a 

dental technician, who mimics every detail 

of a tooth as closely as possible 

Mouthguard 

Dennis Goh with his cousin, a forensic dentist 

What would you consider your special interests in dental 

technology? Kindly share some of your most memorable cases. 

My interests are in removable prosthetics, i.e., dentures. 

Many years ago, when I was a technician at NDCS, the family 

members of a dying patient pleaded for a set of dentures. It would 

have normally taken two and a half days, but I pushed myself to 

complete it within one and a half day. 

On another occasion, an oral and maxillofacial surgeon needed a 

set of surgical arch bars for a patient who had an accident. It would 

help reposition and secure the jaw during the surgery. I rushed 

to complete the arch bars within three hours instead of the usual 

In the past, dentures were crafted from a mould of the patients’ 

teeth and processed to form the final acrylic denture for fitting 

by a dentist. How has the advancement of technology changed 

the way you make dentures? 

I am from the analogue-method generation, where injection 

moulding was the norm. Then came CAD/CAM, where denture 

bases are designed by 

software before being 

milled. Soon, the press 

system and milling will be 

replaced by 3D printing. 

When I was at the Great New 

York Dental meeting four 

year ago, there had already 

been great advancement in 

3D printing. I was amazed 

by the improved print times, 

as well as the things that 

could be done by different 

software such as Dental 

Dennis Goh keeps himself up to date with 

Wings, 3Shape and exocad. developments through dental shows 

54 DENTAL ASIA MAY / JUNE 2020


A collaboration with a software researcher on print removable 

partial dentures has also made me excited about the possibilities 

that are to come. 

When was the digital workflow implemented at Precision Dental 

Lab? How was the transition? 

Precision transitioned into a digital workflow in 2015. Initially, 

doing away with the physical model felt a little strange, as we are 

so used to have it on hand to study with. On one hand, it took time 

for us to get used to viewing and analysing the model virtually on a 

screen. On the other hand, it was exciting to be able to skip some 

steps and shorten 

the process time 

with the design 

software. 

An implant surgical 

guide designed on 

software, such as 

3Shape’s Implant 

Studio, can help 

make a surgery 

more precise and 

accurate. Focusing 

on benefits like 

this motivates us 

Viewing and analysing a model virtually 

to put in the time 

and effort to master new skills. Besides taking relevant courses 

and troubleshooting issues with colleagues, dental technicians 

should also give themselves time to play with the software. 

When purchasing a new technology from a supplier, what are 

your main considerations? 

Technical support is important, because we cannot afford the 

downtime when the equipment is not working. Time wasted would 

mean a delay in the delivery of our products to the clinician who 

needs them. 

Training from the vendor is also key. Not only will it help the 

dental technician, it could also be an avenue for the manufacturer 

to understand the difficulties that we face as end-users, and to 

incorporate that feedback in future releases. 

Despite the advancements in digital dentistry, some technicians 

still prefer traditional, or analogue, methods. What are your 

views on this? 

Being from an era where tradition meets digital, I can understand 

how these technicians feel. Over the years, analogue methods 

have shown excellent results, so some technicians may wonder 

why they should go digital, since excellent prostheses can still be 

made using traditional means. 

Also, for technicians who are in their silver years and about to 

retire, staying analogue would make more sense. 

Today, some dentists are printing their own restorations 

in-house. Is it feasible or would it better if an experienced 

technician did it at the lab? 

Dental technicians exist because we free up time for dentists to 

focus on their clinical work. It’s best if a dentist works together 

with a technician. Having said that, it is only when a dentist tries 

his hand at technical work that he gets a sense of the difficulties a 

technician faces. So it’s not necessarily a bad thing. 

Please tell us your thoughts on all-on-4 or immediate bridge 

implants. Will they one day take the place of dentures? 

There is no one-size-fits-all solution. It would depend on the 

treatment plan. For people who have a medical complication, 

dentures would remain essential. Also, those who have a medical 

history may not be suitable for implant treatment. 

What qualities in a dentist would allow the most fruitful working 

relationship? 

At Precision, we hold monthly luncheon talks with clinicians, 

where they describe clinical challenges, and we discuss issues in 

the manufacturing process. Through these interactions, we can 

help produce a better end product. Dentists are also free to speak 

directly to the technician on their requirements. 

Conversely, how do you do your best to understand what a 

dentist needs? 

I would visit the dentist in person. We look at the problems and 

find ways to solve them. If I can understand the clinical difficulties 

and communicate the technical difficulties, it would be a win-win 

situation for both the clinic and the lab. 

Is there still a shortage of dental technicians today? What do 

you think can encourage young talent to step into this field? 

Yes. Locally, there is a shortage of qualified dental technicians. 

Thankfully, we are in the era of advanced technology, with a 

proliferation of both software and hardware. Hopefully, tech-savvy 

youngsters will be drawn to our trade. 

Also, I hope that the transfer of knowledge and experience from 

this generation to the next will not be broken. 

What questions do you receive the most from less experienced 

dental technicians? 


55


They are often technical issues, which can be solved through 

demonstration by a mentor. An example is the setting of teeth, 

which can be agonising for a junior technician. 

Has there been any time in the past 16 years when you’d 

considered leaving the profession? 

That has never occurred to me at all. I am proud to be a dental 

technician, and of every prosthesis that I’ve made. Using the skills 

I’ve acquired, I’d been able to help people talk, eat and smile. 

Dental lab work takes up a tremendous amount of time and 

patience; it can also get frustrating at times. So seeing the 

change in a patient’s appearance and quality of life gives me great 

satisfaction. Even though not many know about the work that we 

do, I know the purpose of our existence. Dental technicians are, to 

me, the unsung heroes of the dental industry. 

Dennis Goh guiding a technician on a scanned model 

What is the attitude towards dental technology like in other 

countries? 

In Brisbane, where I spent two years pursuing a diploma in dental 

technology at the Southbank Institute of Technology, I got to 

know classmates from Taiwan, Korea and Japan, as well as further 

afield – Africa and South America. Everyone had a positive learning 

attitude, especially since the course was such an eye-opener. We 

were exposed to different methods of fabricating prostheses. 

For example, before the course, I’d usually take an hour or so to 

make one sports guard. After the course, I picked up some tips that 

enabled me to churn one out within 30 to 45 minutes. 

Dennis Goh 

What advice would you give aspiring dental technicians? 

Value what you do because it makes a difference for another human 

being. Strive to look for the best possible result. Keep up with new 

skills and technologies by reading up and going to conferences. 

Dennis Goh with Australian lecturers and schoolmates 

What is your philosophy in life? 

The sky is the limit. Even when you meet with failures, never give 

up. Keep practising, find the error, and solve the problem. I always 

tell myself to keep pushing on. DA 

56 


In Depth With 

Pressing and Veneering 

on a Whole New Level 

Shade. Pressed. Success. 

With VITA AMBRIA, dental technicians no 

longer have to compromise when pressing 

glass ceramics. The new generation of lowfusing 

press ceramics made of zirconiareinforced 

lithium disilicate addresses 

the issues of surface imperfections, fit 

problems and grey, lifeless aesthetics. 

It’s pressed glass ceramics, done differently: A 

minimised reaction layer with the investment 

material provides for excellent surface quality, 

efficient finishing and a precise fit. The innovative 

formula delivers both improved stability and captivating aesthetics. 

To achieve the perfect shade, VITA shade match formula is available. 

German master dental technician Jürgen Freitag, who has already 

used the new VITA AMBRIA press ceramic for more than 50 

restorations on 20 different patients, said, “I have never truly 

experienced this kind of modelling 

quality. Due to the particle size, 

the veneering materials can be 

modelled with a very gentle 

touch. In combination with the 

outstanding stability, I am able 

to achieve the shape faster with 

fewer adjustments. The cutback 

with VITA AMBRIA and the 

individualisation possible with 

VITA LUMEX AC makes it a 

true model of the future for 

me, helping me to achieve 

high aesthetics quickly and 

reliably.” 

The innovative formula delivers both improved stability 

and captivating aesthetics 

Easy veneering ceramic 

VITA LUMEX AC is a leucite-reinforced, glass-ceramic veneering 

system with a material formula that produces vivid and reliable 

results. The ultimate material for all-ceramics makes beautiful 

veneers easy, allowing a new level of ease and efficiency for every 

ceramic framework. From the novice technician to the experienced 

ceramicist, this easy-to-handle material brings out the best in 

individual craftsmanship. 

Thanks to its excellent light dynamics, the material enables the 

creation of a luminous dentin core, with well-balanced opacity and 

translucency. With its opalescence and fluorescence, VITA LUMEX AC 

provides quick, easy and natural-looking individualisation. Diverse 

aesthetics can be achieved with the classic standard layering, while 

reliable reproduction of tooth shade is ensured with VITA shade 

determination. Micro, partial and full veneering are possible. VITA 

LUMEX AC simplifies laboratory workflows with highly aesthetic, 

long-lasting stability. DA 

VITA LUMEX AC produces 

vivid and reliable results 

with shade accuracy 


In Depth With 

Smart CBCT system just got smarter 

CS 9600, the CBCT system from dental imaging 

solutions provider, Carestream, 

is now smarter and better with 

the introduction of its Scan 

Ceph module option. Scanning 

cephalometric imaging complements the 

existing functions of 2D panoramic imaging, 

CBCT imaging, 3D object and impression 

scanning, and face scanning option. The 5-in-1 

system also includes new intelligent features that 

reinforce the system’s design principle, Intelligence 

drives precision. 

Cephalometric imaging rounds out the CS 

9600’s modalities 

With its multiple fields of view (FOV) and 

advanced features, the CS 9600 

has been the ideal unit for 

specialists and multispecialty 

practices since 

its launch in 2018. From 

cranial options to its lowdose 

format, the new Scan 

Ceph module is an ideal 

choice for all orthodontic 

and oral maxillofacial clinical needs. 

CS 9600 with Scan Ceph module features 

the same speed that Carestream Dental’s 

cephalometric units have come to be known 

for – as low as three seconds for 18 x 24cm 

lateral image in fast scan mode 

Once a cephalometric image is captured, Carestream 

Dental’s industry-leading auto-tracing feature 

can save doctors valuable time by automatically 

recognising anatomical structures and tracing them 

in 10 seconds, as opposed to the five to 10 minutes 

other orthodontic software take. Ultimately, 

doctors gain back time that could be used for 

more in-depth diagnosis or personalised patient interaction. 

Data drives further innovation 

Software algorithms, smart technology and artificial intelligence (AI) 

combined in this latest update further enhance the CS 9600’s userfriendly 

features. Patient positioning powered by AI automatically 

detects and traces the Frankfort plane to achieve proper positioning 

effortlessly. When combined with video camera assistance and faceto-face 

positioning, this technology increases exam precision and 

reduces the risk of retakes. 

Smart features make the CS 9600 a Star 

The CS 9600 with Scan Ceph module features all the same smart 

technology that garnered it awards throughout 2019. Video cameras 

aid in patient positioning leading to first-time-right imaging, while the 

CS MAR option makes those images easier to interpret by reducing 

metal artifacts and starburst effects. Stellar technology combining 

a 120kV X-ray tube option with intelligent filtration reduces artifacts 

and improve contrasts, delivering outstanding image quality without 

increasing dose. For doctors looking to care for and manage their 

investment intelligently, the optional CS UpStream monitors the CS 

9600 and learns its behavior to reduce downtime. DA 

Short scan times reduce patient dose and the risk of 

motion blur for safer and sharper exams

In Depth With 

Smart Solutions for a 

Predictable Restorative Outcome 

The need for easier, simpler and faster workflow is critical 

in dentistry, now more than ever before. The primary goal of 

any restorative treatment is to re-establish natural aesthetics 

and function that improves quality of life and enhances the 

confidence of the patient. 

Revolutionize your daily workflow ... 

Simplify restorations, Boost efficiency and Save time 

Direct composite restorations 

are one of the most prevalent 

treatments provided on a daily 

basis. Despite aesthetic and 

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conventional composite restorations require 

time-consuming, incremental build-up 

technique to minimize polymerization 

shrinkage, linked to staining, micro-leakage 

and secondary caries. 

Restore 

Prepare 

Smart Solutions with 

Adoption of nanotechnology in the 

development of unique S-PRG fillers signals 

a new milestone in restorative dentistry with 

the introduction of the next-generation of 

universal bioactive injectable composites. 

Beautifil Injectable X has been designed to 

offer strength, durability, natural aesthetics 

with self-polishing capability and the unique 

“Inject as you Shape” convenience. Antiplaque 

and anti-caries benefits assure 

additional protection and longevity of the 

restoration. DA 

1. PREPARE: Precise, minimally invasive preparation with 

Diamond points 

2. INJECT & SHAPE: Fast & easy restorations with 

Universal Bioactive Beautifil Injectable X. Custom fit , disposable 

Barrier Sleeves provide additional cross-infection control 

3. FINISH: Shape & polish with 2-in-1 low speed One Gloss 

Smart polisher 

Finish 

60 


In Depth With 

Learning in the time of COVID-19 

Webinars from Zimmer Biomet discuss what to know and do today and tomorrow in order to thrive beyond COVID-19 

As the COVID-19 situation rapidly evolves around the 

world, clinicians everywhere are asking what they can 

do to survive this unprecedented crisis and emerge 

stronger beyond the pandemic. 

Zimmer Biomet’s recent webinar series “Today, Tomorrow and 

Beyond COVID-19” strikes a chord with many in the dental clinic 

business. In this series, a panel of leading industry experts share 

their insights on financial, practice management and patient safety 

in the current situation and how to thrive beyond COVID-19. 

Zimmer Biomet Dental’s associate director of Education, Amy Gan, 

said, “In a time of uncertainty, we seek clarity and guidance from 

the top experts. As a medical device company, we stand with our 

customers and our communities. Providing education that’s reliable 

and actionable is part of our company mission to alleviate pain and 

improve the quality of life for people around the world.” 

To provide exceptional education to dentists, accessibility and 

relevance of topics are key. Gan added, “Zimmer Biomet has been 

Each session includes a roundtable discussion with experienced clinicians 

famous for its state-of-the-art institutes around the globe, but we 

also noticed the growing trend of virtual learning. Clinicians live a 

busy life and need to be able to learn whenever they can. So we 

developed an app that allows learning anytime, anywhere, which 

is especially necessary in the current unique circumstances.” DA 

62 


Product Highlights 

Reprocessing as a capacity strategy 

W&H 

To address the shortage of disposable to verify the correct handling, loading and 

masks in the current health crisis, W&H process of sterilisation. 

tested the decontamination of filtering 

facepiece class 2 and class 3 masks (FFP2/ As high-end B type sterilisers, W&H sterilisers 

FFP3 masks) with W&H sterilisers in order use steam under pressure to sterilise 

contaminated items. While 

more commonly used for 

the reprocessing of medical 

devices, it is now proving 

a suitable approach for 

decontaminating masks 

which meet the conformity 

assessment standards of 

their country of origin. 

According to latest scientific 

recommendations and 

reports after reprocessing 

FFP2/FFP3 masks for 

single use, the filter effect 

and respiratory capacity 

should be maintained 

during steam sterilisation. 

FFP2/FFP3 masks can be reprocessed using W&H sterilisers This specified steam 

sterilisation process had been presented 

in a publication of the Delft University of 

Technology in Delft, Netherlands, official 

recommendations of Austrian Authorities 

and the Alberta Health Services. 

Steam sterilisation with 121°C cycle is 

suitable for FFP2/FFP3 masks with or 

without an exhalation valve. With optimal 

loading in a W&H Steriliser, approximately 

40 to 60 masks can be reprocessed per one 

sterilisation cycle, depending on masks, 

their size and loading scheme. ■ 

Safe and even more convenient: The new DAC Universal 

Dentsply Sirona 

Dentsply Sirona’s new DAC Universal has 

had a complete facelift and a few updates 

to further ensure all-round protection for 

dentists and patients. For instance, the 

water tank can now be removed and is easily 

accessible from the back. 

With the touch of a button, the DAC 

Universal can begin its fully automatic 

decontamination programme, eliminating 

the potential of handling errors while 

obtaining perfectly clean results. For 

example, the “Guided Check and Clean” 

programme guides the hygiene assistant 

safely through the cleaning and maintenance 

processes of the device. 

Switch off hygiene risks by switching on DAC 

Universal hygiene system 

In addition, up to six instruments can be 

cleaned and treated with its high-level 

disinfection in a fully automatic cycle. The 

process takes only 15 minutes including 

the cooling phase, and does not require any 

chemical cleaners or disinfectants, which 

has a positive effect on the instruments’ 

lifetime. 

The DAC Universal is available in two different 

lids. The blue lid is for straight and contraangle 

handpieces and turbines. The green 

lid is for ultrasonic handpieces, and tips and 

the nozzles of multi-functional syringes and 

powder jet devices. With the lids weighing 

less, handling them is now effortless. ■ 



Asiga 

Repeatable precision 

Asiga MAX UV offers consistency, accuracy, fast 

print speed and repeatability 

From removable die models, custom 

impression trays and surgical drill guides to 

splints, partial frameworks, crowns, bridges, 

inlays, onlays and even gingiva – a 

range of dental appliances can be 

fabricated on 3D printers from 

Sydney-based affordable desktop 

stereolithography leader, Asiga. 

As best-in-class for digital 

dentistry, Asiga 3D printers offer 

the highest accuracy of any 

commercial 3D printer. 3D scans 

of full-arch dental models printed 

in Asiga’s photopolymer resin 

DentaMODEL demonstrate over 

93% of data points are within 

50 microns of the original CAD file with a 

standard deviation of 31 microns. Dentists 

and technicians can also use resins from 

almost any vendor as Asiga has a completely 

open material system. 

To ensure every layer is formed accurately, 

positioning encoders in Asiga’s Smart 

Positioning System read the exact position 

of the build platform. Its end-user features, 

such as single point calibration in under 60 

seconds and material change-over in less 

than 30 seconds, make 3D printing intuitive 

and simple. A streamlined integration into 

a digital workflow, remote access and 

touch screen display offer greater user 

convenience. 

Nobel Biocare’s head of Advanced 

Technologies, Alex Pilet, said, “After 

extensive internal testing of a variety of 

3D printing systems, the Asiga MAX UV is 

clearly one of the best desktop 3D printers 

in terms of print quality and consistency for 

the tested dental indications.” ■ 

VOCO 

A temporary luting cement with stronger adhesion 

The low film thickness of Provicol QM Plus allows precise placement, while optimum flowability makes it an easy-to-use material 

Thanks to its enhanced strength, the new 

temporary luting cement Provicol QM Plus 

from German dental material manufacturer, 

VOCO, is ideal for application in clinical 

situations that require particularly high 

levels of adhesion. 

The cement is for the temporary luting of 

provisional and definitive restorations such 

as crowns, bridges, inlays and onlays. It can 

also be used for the temporary obturation 

of small, single-surface cavities. The use of 

calcium hydroxide promotes the formation 

of secondary dentine, while zinc oxide 

provides antibacterial properties. It is also 

eugenol-free. 

With its increased strength, self-curing 

Provicol QM Plus is ideal for use in clinical 

situations that require a particularly strong 

hold, for short or small tooth stumps, and 

where retention between the temporary 

restoration and the tooth stump is low. 

Clinicians can also use Provicol QM Plus 

together with Provicol QM for greater 

flexibility and security when dealing with all 

types of temporary luting. ■ 

64 


Busch 

Quick cutting of crowns 

For an economical cutting of veneer ceramic, a diamond instrument with 

coarse grit such as 34D, 36RD and 36RL is recommended 

Carbide crown cutters with diamond cut from dental bur 

manufacturer, Busch, supplemented an existing range for 

precious and non-precious metal alloys, ceramics, and zirconia. 

Now run by the third generation, Gert and Wolfgang Busch, the 

company uses advanced CAD technology in the production of 

instruments that help dentists and technicians efficiently and 

reliably, as well as be excellent masters at their tasks. 

Recommended for accurate work in intricate areas where 

accessibility is difficult with larger lab burs, the cutters are 

manufactured to high precision tolerances for consistent and 

even cuts, without chatter or drag. 

The new BUSCH carbide crown cutters with diamond are 

extremely durable, with remarkable cutting rates with 

crowns, bridges and models in gold, silver, chromium-cobalt, 

palladium and nickel-chromium alloys. They are available in 

short, medium-length, and long working parts in in cylindrical 

and conical shapes to meet the various needs of any dental 

practice. ■ 



GC 

High strength, high value with exceptional aesthetics 

Thanks to a unique technology – high density 

micronisation (HDM), lithium disilicate 

ceramic ingot Initial LiSi Press from dental 

care product manufacturer, GC, features 

natural, lifelike aesthetics. The result is a 

combination of aesthetics and strength, 

making GC Initial LiSi Press suitable for 

restorations of all levels of transparency. 

Instead of traditional larger size crystals 

that do not fully utilise the matrix structure, 

HDM uses equally dispersed lithium disilicate 

micro-crystals to fill the entire glass 

matrix. Additionally, HDM technology helps 

ensure the product remains stable, without 

distortion or drop in value, even after 

multiple firings. 

Some of GC Initial LiSi Press’s advantages 

include flexural strength, richer, warmer 

and brighter aesthetics with excellent 

fluorescence. Besides being antagonistfriendly 

and wear-resistant, the lower 

solubility allows for a permanent 

gloss. Cleaner presses are 

possible since there is 

almost no reaction layer 

when divested. 

Jordanian ceramicist, 

Firas Dahbour, said, “What 

I love in this material is the 

colour stability: no more grey 

appearances after several 

firings. The LiSi Press saves 

me a lot of working time and 

money because of the inexistence of 

the reaction layer. There are no alternative 

materials that can measure up to LiSi; the 

HDM technology makes this material unique 

in the physical, chemical and mechanical 

aspects.” ■ 

With fewer steps and a more flexible procedure, 

GC Initial LiSi Press allows time savings of at 

least 15 minutes per restoration 

DGSHAPE 

A System for Titanium Abutment Milling 

Provider of digital solutions for dental 

laboratory technicians, DGSHAPE, recently 

announced the release of the AK-1 titanium 

abutment milling system for DWX-42W wet 

milling machine. 

As dental laboratories are increasing 

the adoption of digital CAD/CAM milling 

systems in place of traditional casting 

methods, DWX series milling machines 

Attachment AK-1-GE is 

compatible with GeoMedi Geo 

CMFit series 

AK-1 abutment milling system 

specialise in the digital production of dental 

prosthesis such as copings, crowns, and 

bridges. Supported CAD software include 

3Shape, exocad, and Dental Wings. DWX 

series milling machines can process various 

dental materials such as Zirconia, Wax, 

PEEK, and PMMA. 

Custom milling 

The AK-1 abutment milling system is a 

series of attachments to the standard 

DWX-42W material holder that allows the 

custom milling of titanium abutments from 

popular manufacturers such as GeoMedi, 

MEDENTiKA, and NT-Trading, which support 

brands such as Nobel Biocare, Straumann, 

Dentsply and Zimmer. 

Features of the AK-1 abutment milling 

system 

1. Effortless milling of titanium custom 

abutments 

Simply attach the abutment adapter and 

change out the filtration tray and milling 

burs to begin milling custom titanium 

abutments in-house. 

2. New burs for milling titanium 

Specifically developed and optimised 

for milling titanium, the new milling burs 

provide stable and quality milling of custom 

abutments. ■ 

66 


HyFlex CM & EDM 

STAYS ON TRACK 

Safer use 

Preparation following the anatomy 

Regeneration for reuse 

004719 05.19 

www.coltene.com


exocad 

New full denture possibilities with exocad DentalCAD 2.4 Plovdiv 

exocad GmbH’s new software version, 

DentalCAD 2.4 Plovdiv, features a 

significantly enhanced FullDenture 

module, which now also allows 

the design of removable single jaw 

dentures in a guided digital workflow. 

With the new FullDenture module, 

practically all digital full denture 

production methods can be mapped. 

Whether printing or milling, readymade 

or individually designed teeth – with 

the new Plovdiv release, digital full 

dentures can be implemented more 

easily than before. 

CEO of exocad, Tillmann Steinbrecher, 

said, “Plovdiv is the second major 

release of DentalCAD in the last year. 

This release contains 64 new features 

and 45 extended functions that make our 

Besides improved partial CAD and thimble crown design, the 

FullDenture module in exocad DentalCAD 2.4 Plovdiv also offers new 

functions for bars, jaw motion and virtual articulator 

software even more attractive for every 

dental technician. This time, the focus of 

our innovation is on removable dentures 

and advanced implant-supported bridges.” 

The straightforward user guidance 

characterises the entire exocad 

software portfolio. The exocad 

wizard, tried and tested for years, 

also guides dental technicians step 

by step through the FullDenture 

module. 

Experts benefit from the unique 

flexibility of the software, which 

gives them maximum design 

freedom via the software’s expert 

mode. The prosthetic tooth library 

has been expanded to include wellknown 

manufacturers such as Vita, 

Dentsply Sirona and Ruthinium. With 

selected libraries it is even possible 

to scale and modify the existing 

shapes allowing users to manufacture their 

own denture teeth in a variety of production 

methods. ■ 

Shofu 

EyeSpecial C-III – A smart digital dental camera designed for 

the dental team 

Compact and ergonomic, smart dental 

camera EyeSpecial C-III captures clinical 

photographs easily for case documentation, 

Worry-free cross infection control – 

spray, wipe and disinfect 

diagnosis and treatment planning. The 

images can also be used in patient 

communication and education, medicolegal 

and insurance 

verification, dental lab 

collaboration, quality 

assurance of the dental 

treatment and follow-up. 

With an integrated autofocus 

system, EyeSpecial 

CIII guarantees 

precise and detailed 

photographs, with 

maximal depth of field 

and minimal risk of error. 

Benefits for the dental practice 

• Water, chemical and scratch resistant 

for critical cross-infection control 

• Easy Intuitive display with one-touch 

operation for gloved, single handed 

operation 

• Eight pre-set dental shooting modes 

• 12-megapixel CMOS sensor 

• Precise and detailed images with 

exceptional depth of field 

• Built-in double flash with intelligent 

FlashMatic system for true colour 

reproduction 

• Auto-cropping, smart focus and zoom 

• Lightweight at approximately 590 

grams 

• Wi-Fi memory card compatible ■ 

68 


Show Preview 

Dentistry 2020 

and Beyond 

To be held from 21 st – 23 rd August 2020 at the Hong 

Kong Convention and Exhibition Centre, the 9 th 

edition of Hong Kong International Dental Expo And 

Symposium (HKIDEAS) will feature topics such as 

implantology, endodontics, orthodontics, periodontics 

as well as best clinical practices. 

HKIDEAS will take place from 21 st – 23 rd August 2020 

Interdisciplinary approach 

One of the most influential dental congresses in the Asia-Pacific 

region, HKIDEAS has long been recognised as a platform for dental 

practitioners and researchers to exchange knowledge and skills in 

the field of dentistry. Its interdisciplinary approach and offering of 

multitude of tracks within each segment provide attendees with a 

unique opportunity to meet up with peers from the dental health 

scene, as well as the academia. 

Distinguished speakers 

Focusing on major breakthroughs and developments in the field of 

dentistry, more than 20 scientific lectures with hands-on workshops 

will be presented by internationally recognised guest speakers. 

Topics will cover the latest trends in the various specialties. 

The latest dentistry equipment and technology 

At the trade exhibition, visitors and exhibitors will meet key 

decision makers, strengthen valuable contacts with customers and 

Panel discussion at the 8 th edition of HKIDEAS 

More than 20 scientific lectures with hands-on workshops will be presented by 

internationally recognised guest speakers 

partners, and explore the potential of an exciting growth market. 

Renowned brands such as Colgate-Palmolive, Procter & Gamble, 

GlaxoSmithKline will also showcase their new products to the 

industry players. 

To take advantage of this golden opportunity for learning, 

collaborations, networking and relationship building among dental 

professionals, register on or before 15th June 2020 for early-bird 

rates. 

Early-bird rates (on or before 15 th June 2020): HK$3,400 

Standard (16 th June – 13 th August 2020): HK$3,900 

On-site (21 st – 23 rd August 2020): HK$4,400 

The rates for other dentistry professionals are HK$1,200, 

HK$1,400 and HK$1,700 for early-bird, standard, and on-site 

respectively. 

One-day lectures, which do not include hands-on workshops and 

social events, are priced at HK$1,600 and HK$1,900 for standard 

and on-site respectively. DA 

72 


Giving Back to Society 

Helping densts safely return to providing care 

(PPE) items; and by accessing resources for remote practice reopening 

services plus in-person emergency labour, and online 

training and safety protocols. 

Reconnect with Patients by receiving best practices for patient 

re-engagement through customised email and social media 

campaigns; and, for new customers, a three-month subscription 

to a patient communication system, plus guidance on setting up a 

virtual waiting room process for new or existing patients. 

Patient communication tools such as Dentrix G7 help 

dentists in re-engaging their patients 

To help dentists in the United States prepare for the re-opening 

of their practices, Henry Schein launched a practice recovery 

programme, centred on three steps. 

Prepare to Reopen by receiving a recovery kit that includes 

supplemental infection control and personal protective equipment 

Leverage Financial Solutions by completing an analysis to get 

practice financial health back on track; and using a practice 

recovery planner to help identify revenue lost due to the pandemic 

and develop customised strategies to recover. 

“We are dedicated to doing all we can to ensure that our customers 

emerge strong from this difficult situation,” said Jonathan Koch, 

chief executive officer of Henry Schein’s Global Dental Group. “We 

are here to help customers get back to doing what they do best: 

safeguarding the oral health, and overall health, of their patients.” DA 

IDDA: Turning interest into acon 

In an initiative to improve the production capabilities of medical 

services in general to save lives, UK-based International Digital 

Dental Academy (IDDA) is coordinating with its community of 

over 13,000 digital dentists and technicians who have 3D printing 

capabilities to produce parts for the front lines in the fight against 

COVID-19. 

These 3D printers can print in a wide range of materials - even 

biocompatible – to produce ventilators, intubators and general 

parts needed. The idea arose when IDDA board member, Prof. Adam 

Nulty, realised that the digital dentistry scene has possibly the 

largest variety and collection of 3D printers outside of engineers. 

Since then, IDDA has received a few hundred responses from 

individuals and companies including Asiga, 3D Systems and 

Formlabs who have the combined power to run several hundred 

printers and print thousands of parts a day. These include the 

Venturi valve that has been in great shortage in Europe, ventilator 

splitters, masks and visors. 

Digital dentists and technicians who wish to offer their help can 

find download links and STL files for 3D printing on the initiative’s 

webpage. Donations to finance the creation, purchase and shipping 

of 3D printed parts to healthcare providers are also welcome. DA 

74 


2020 Events Calendar 

JUNE 

SEPTEMBER 

5 – 7 SIDEX 2020 - The 17 th Seoul International Dental 

Exhibition & Scientific Congress 

Seoul, Korea 

Venue: Seoul Convention and Exhibition Center (COEX) 

eng.sidex.or.kr 

9 – 13 APDC 2020 - 42 nd Asia Pacific Dental Congress 

Colombo, Sri Lanka 

Venue: BMICH Convention Center 

www.apdc2020.com 

June - August 

IDEM Singapore 2020 - Digital 

JULY 

www.idem-singapore.com 

11 – 12 Delhi Dental Show 2020 

AUGUST 

New Delhi, India 

Venue: Pragati Maidan, Hall A3 

www.delhidentalshow.org.in 

21 – 23 HK IDEAS 2020 - Hong Kong International Dental Expo 

And Symposium 

Hong Kong 

Venue: Hong Kong Convention and Exhibition Centre 

www.hkideas.org 

28 - 30 MIDEC 2020 - Malaysia International Dental Exhibition 

and Conference 

Kuala Lumpur, Malaysia 

Venue: Kuala Lumpur Convention Center (KLCC) 

www.mda.org.my 

Mid-late August 

SINO-DENTAL 2020 - The 25 th China International 

Dental Exhibition and Scientific Conference 

Beijing, China 

Venue: China National Convention Centre (CNCC) 

www.sinodent.com.cn 

23 – 26 IFEA 2020 - 12 th World Endodontic Congress - Virtual 

OCTOBER 

www.ifea2020india.com 

1 – 3 Dentsply Sirona World 2020 

Las Vegas, USA 

Venue: Caesar’s Forum 

www.dentsplysirona.com/en-us/ds-world.html 

4 – 7 IOC 2020 - APOC 2020 - JOS 2020 - 9 th International 

Orthodontic Congress - 12 th Asian Pacific Orthodontic 

Conference - 79 th Annual Meeting of the Japanese 

Orthodontic Society 

Yokohama, Japan 

Venue: Pacifico Yokohama 

www.asianpacificortho.org/2020/01/05/the-9thinternational-orthodontic-congress-yokohama-japan 

23 – 25 14 th Asian Congress on Oral & Maxillofacial Surgery 

(ACOMS) 2020 Singapore 

Singapore, Singapore 

Venue: Marina Bay Sands Convention Centre 

www.acoms2020.sg 

28 – 31 DenTech China 2020 

November 

Shanghai, China 

Venue: Shanghai World Expo Exhibition and Convention Center 

www.dentech.com.cn/en-us/ 

27 November – 2 December 

Greater New York Dental Meeting 2020 (GNYDM) - 96 th 

Annual Session 

New York, USA 

Exhibition venue: Jacob K. Javits Convention Center 

www.gnydm.com 


www.dentalasia.net 

MARCH / APRIL 2020 

Advertisers’ Index 

COMPANY 

PAGE 

COMPANY 

PAGE 

3Shape A/S 3 

Ivoclar Vivadent AG 

Outside Back Cover 

Anthogyr France 43 

Mectron S.p.A 11, 65 

Bausch 15 

Malaysia-International Dental 

Exhibition And Conference 2020 

71 

Carestream 59 

Coltene Whaledent 67 

Dentsply Sirona 9 

exocad 23 

Fotona 7 

NSK Asia Inside Front Cover, 1 

Shofu Dental Asia-Pacific Pte. Ltd. 17, 61 

SIDEX 2020 69 

VITA 13 

VOCO 5 

Hong Kong International Dental 

Expo & Symposium 2020 

73 

W&H Dentalwerk 

Inside Back Cover 

Can’t travel? 

Get your 

brands out 

there through 

our media 

platforms.. 

Photo courtesy of Dr. Juergen Manhart 

 

Henning Müller shares Dentsply 

 

Sandblasting 

– An Alternative to Cutters or Burs 

Anterior Full Ceramic Crown 

After a Complicated Fracture of the Natural Tooth 

@dentalasia 

For information, visit us www.dentalasia.net or contact us at jamietan@pabloasia.com 

Company Registration No: 200001473N 

All rights reserved. Views of writers do not necessarily reflect the views of the Publisher. No part of this publication may be reproduced in any form or by any means, without prior permission in writing from the Publisher and 

copyright owner. Whilst every care is taken to ensure accuracy of the information in this publication, the Publisher accepts no liability for damages caused by misinterpretation of information, expressed or implied, within the 

pages of the magazine. All advertisements are accepted on the understanding that the Advertiser is authorised to publish the contents of the advertisements, and in this respect, the Advertiser shall indemnify the Publisher 

against all claims or suits for libel, violation of right of privacy and copyright infringements. Dental Asia is a controlled-circulation bi-monthly magazine. It is mailed free-of-charge to readers who meet a set of criteria. Paid 

subscription is available to those who do not fit our terms of control. Please refer to subscription form provided in the publication for more details. 

Printed by Times Printers Pte Ltd 

76 


#whdentalwerk 

wh.com 

Incredible 

inside & 

outside 

New Lisa sterilizers. Beyond expectations. 

The new Lisa sterilzers – built for highest demands: 

Incredibly user-friendly thanks to EliSense. Incredible 

complete traceability down to the single instrument or 

instrument-kit thanks to EliTrace. Incredibly efficient 

thanks to the patented Eco Dry + Technology.

Dental Asia May/June 2020

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