Dental Asia September/October 2022

www.dentalasia.net 

SEPTEMBER / OCTOBER 2022

16 18 22 

30 48 55 

CONTENTS 

TRENDS 

16 Online comments and reviews 

– how dental professionals can 

respond 

18 Pledge for sustainable dentistry 

20 Shapeshifting microrobots can 

brush and floss teeth 

UNDER THE SPOTLIGHT 

22 What it takes to be a dental 

influencer 

DENTAL PROFILE 

24 Transforming the future of implant 

dentistry 

26 Peek into the digital future 

30 The hundred years of Shofu 

CLINICAL FEATURE 

34 Effects of PBM on implant and bone 

grafting after sinus elevation 

38 Root coverage on a gingival 

recession type 2 

42 Endodontic perforation: The hole 

that pricks 

USER REPORT 

44 Biomimetic oral care: Preventing 

oral diseases with hydroxyapatite 

48 Alternative solution for managing 

implant failure 

BEHIND THE SCENES 

51 Indirect hybrid nano-ceramic 

adhesive restorations 

55 Emotional dentistry 

IN DEPTH WITH 

58 Increasing patient comfort with 

advanced technology 

59 Award-winning CAD software for 

single-visit dentistry 

60 Full range of oral surgery 

applications 

62 Discovering perfection in 

prophylaxis 

63 LED headlights as clinical 

illumination 

64 Precise, fast and clean 

– that’s Simplex 

SHOW PREVIEW 

66 IDEM 2022 returns with exciting, 

new programmes and initiatives 

75 exocad Insights 2022: Learn. 

Connect. Enjoy. 

SHOW REVIEW 

78 VOCO welcomes dentists 

from different countries to 

their International Fellowship 

Symposium 

REGULARS 

4 Editor’s note 

6 Dental Updates 

68 Product Highlights 

79 Events Calendar 

80 Advertisers’ Index 

2 

DENTAL ASIA SEPTEMBER / OCTOBER 2022

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EDITOR’S NOTE 

The digital future 

is bright 

PABLO SINGAPORE 

Publisher 

Publications Director 

Assistant Editor 

William Pang 

williampang@pabloasia.com 

Jamie Tan 

jamietan@pabloasia.com 

Czarmaine Masigla 

czarmaine@pabloasia.com 

Two years ago, it was unimaginable 

when will the battle with COVID-19 end. 

However, today, we are now seeing the 

end of the tunnel. 

For instance, after four years of hiatus, 

the much-awaited physical event of 

the International Dental Exhibition and 

Meeting (IDEM) finally returns. With the 

theme “Building resilience in dentistry”, 

participants can look forward to a series 

of lectures, face-to-face networking 

activities, and so much more (p.66). 

vice-president of Dentsply Sirona’s 

Global Implant Solutions, shared that 

the advances in technology have 

helped in increasing patients’ dental 

knowledge, hence, they were more 

accepting of treatment (p.24). 

Indeed, it pays to empower patients 

– as how Dr Kayla Teh, dentist and 

content creator, found online and 

real-life success by raising dental 

awareness and elevating the public’s 

perception of dental care (p.22). 

Graphic Designer 

Circulation Manager 

PABLO BEIJING 

General Manager 

PABLO SHANGHAI 

Senior Editor 

Cayla Ong 

cayla@pabloasia.com 

Shu Ai Ling 

circulation@pabloasia.com 

Ellen Gao 

pablobeijing@163.com 

Daisy Wang 

pabloshanghai@163.net 

Looking back, the dental industry rose 

beyond the challenges of the pandemic 

by tapping on modern technologies and 

innovative solutions. 

In fact, Rune Fisker, SVP of 3Shape, 

said that digital adoption was pushed 

forward by three to five years. With 

dental professionals benefitting 

from streamlined and more hygienic 

workflow, they managed to bounce back 

to practice quicker (p.26). 

What’s more, apart from optimised 

workflow, digital tools positively 

affected patients’ behaviour towards 

treatment too. As Tony Susino, group 

These recent developments in 

the industry have opened a lot of 

opportunities for market growth that 

we can expect to see in the years to 

come. Exciting times are ahead of us! 

Czarmaine Masigla 

Assistant Editor 

Scan for digital copy 

of Dental Asia 

HEAD OFFICE 

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ADVISORY BOARD 

Dr William Cheung 

Dr Choo Teck Chuan 

Dr Chung Kong Mun 

Dr George Freedman 

Dr Fay Goldstep 

Dr Clarence Tam 

Prof Nigel M. King 

Dr Anand Narvekar 

Dr Kevin Ng 

Dr William O’Reilly 

Dr Wong Li Beng 

Dr Adrian U J Yap 

Dr Christopher Ho 

Dr How Kim Chuan 

Dr Derek Mahony 

Prof Alex Mersel

DENTAL UPDATES 

Align Technology collaborates with the European Aligner Society 

Align Technology has collaborated with the 

European Aligner Society (EAS) at the Society’s 

Summer Meeting in Portugal held on 1-2 Jul 

2022. The Align EAS Collaboration is intended 

to elevate educational standards in orthodontic 

aligner therapy, which are consistent 

with the EAS/European Board of Aligner 

Orthodontics (EBAO) Clinical Excellence Master 

requirements. 

Align Education has developed orthodontic 

development programmes which includes 

advanced and masters plan programmes for 

continued learning in clear aligner therapy with 

Invisalign aligners. The EAS recognises these 

programmes are consistent with the EBAO 

clinical aims and objectives. 

Prof Tommaso Castroflorio commented: 

“EAS has established the EBAO to certify the 

expertise, skills, attributes, and comprehensive 

knowledge of orthodontics, with an emphasis 

on orthodontic aligner treatment, through 

certification and periodic re-evaluation, and by 

encouraging the achievement and maintenance 

of diplomate status. 

“A suitable candidate is to be committed to the 

advancement of orthodontic aligner treatment, 

to life-long learning and a lifetime of ethical 

practices. Furthermore, EBAO aims to dignify 

the art and science of orthodontics and elevate 

the quality of orthodontic care by promoting 

high standard evidence-based practice in 

orthodontic aligner treatment and encouraging 

research in this field. EBAO also collaborate 

with other entities and organisations to improve 

the whole profession of dentistry.” 

Now that it has established recognition of 

the educational programmes, Align will be 

advocating them as preparation for the EAS/ 

EBAO Clinical Excellence Master certification. 

During these development programmes, Align 

will share guidance on the five case submission 

required for the EBAO Clinical Programme 

examination. This will be positioned as 

aspiration and best practice within Align’s 

development programmes. 

By meeting the education standards, this 

collaboration will prepare orthodontists for the 

EBAO Clinical Excellence Master certification 

and recognise their expertise and experience in 

treating complex cases. ■ 

Amann Girrbach now offers in-house fabrication processes 

With its 4.2 upgrade of the Ceramill Mind and 

Ceramill Match software, Amann Girrbach 

now offers dentists and dental technicians 

new opportunities for the in-house fabrication 

of restorations while significantly reducing 

cost. For example, the new software features 

allow titanium materials to be machined with 

the Ceramill Matik milling unit. The in-house 

fabrication of titanium-based implant-supported 

restorations is associated with external cost 

savings of up to 40%. The entire milling unit 

can therefore be financed in full by even a small 

number of cases. Another new feature is the 

Speedlining mode: with the aid of specifically 

developed tools, users of the Ceramill Matik, 

Ceramill Motion 3 and Ceramill Motion 2 can 

cut-grind hard block materials at full speed. 

Dentists and dental technicians thus benefit 

from almost 50% faster production while 

maintaining restoration quality and reliability. 

Moreover, the planning of dentures can now be 

performed directly on the implant and without 

abutments – regardless of whether single 

crowns, multi-part bars and bridges or full dental 

arches are involved. This implant solution is 

the result of a cooperation between Amann 

Girrbach and Tri Dental Implants. With matrix, Tri 

Dental Implants has launched the first approved 

dental implant specifically designed for digital 

fabrication technologies such as CAD/CAM 

milling or 3D printers. With the matrix concept, 

Amann Girrbach now offers its customers a 

comprehensive CAD/CAM-compatible implant 

system in both a digital and validated workflow. 

Implant-based Zolid zirconia crowns can thus be 

produced in less than two hours in combination 

with the Therm DRS sintering furnace. 

In addition to the fully digital and validated 

Amann Girrbach workflow for printing 

implant models and laboratory analogues, 

the upgrade also offers numerous other CAD/ 

CAM functions. To give an example, these 

include the AI-assisted design of bridges using 

the Instant Anatomic Morphing feature or the 

implementation of the smile creator report in 

PDF format. This allows patients to see the 

expected result in advance in a before-and-after 

comparison and to participate in the planning 

process if they so wish. In addition, the upgrade 

also offers quick to perform quality checks with 

the aid of the new nesting visualisation: this 

makes it possible to repeatedly check whether a 

restoration can be milled successfully. Additional 

process reliability can thus be created with just 

a single click. However, as the digitisation of 

production increases, so does the output of 

milling units and 3D printers. To stay on top of 

things, the Ceramill System now enables milled 

and printed restorations to be marked with notes. 

“With the upgrade of our Ceramill Mind and 

Ceramill Match software to Version 4.2, we are yet 

again focusing on the core principles of in-house 

fabrication and by doing so, also on the vision of 

Amann Girrbach. We are delighted to have come 

a great deal closer to this vision now with the new 

features, improvements and functions,” explained 

Nikolaus Johannson, head of the Global Business 

Unit Lab CAD/CAM at Amann Girrbach. ■ 

6 DENTAL ASIA SEPTEMBER / OCTOBER 2022

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HKU Faculty of Dentistry utilises AI technology to automate the process of 

denture design and enhance treatment efficiency 

Researchers from the Faculty of Dentistry 

at the University of Hong Kong (HKU) and 

the Department of Computer Science of 

Chu Hai College of Higher Education, have 

collaborated to develop a new approach using 

artificial intelligence (AI) to automate the 

design of individualised dentures to enhance 

the treatment efficiency and improve patient 

experience. 

The AI technology used in the process 

was based on 3D Generative Adversarial 

Network (3D-GAN) algorithm and tested on 

175 participants recruited at HKU. The study 

shows that AI technology could reconstruct 

the shape of a natural healthy tooth and 

automate the process of false teeth design 

with high accuracy. 

“The 3D GAN algorithm was selected due 

to its superior performance on 3D object 

reconstruction compared to other AI 

algorithms. In the preliminary study, 3D 

GAN was able to rebuild similar shapes to 

the original teeth for 60% of the cases. It is 

expected to mature with more AI training 

data,” explained Dr Reinhard Chau, coinvestigator. 

The new approach only requires the digital 

model of a patient’s dentition to function. It can 

learn the features of an individual’s teeth from 

the rest of the dentition and generate a false 

tooth that looks like the missing tooth. 

“This will facilitate the treatment workflow for 

dentists in replacing a missing tooth, as the 

preparation and fitting process will require 

minimal time, and a patient will not need to stay 

at the clinic for long hours,” said Dr Walter Lam, 

principal investigator. 

The study entitled “Artificial intelligencedesigned 

single molar dental prostheses: A 

protocol of prospective experimental study” 

is published in the journal PLoS ONE. The 

preliminary results of the study were presented 

in the recent International Association of Dental 

Research (IADR) General Session. The study 

won the IADR Neal Garrett Clinical Research 

Prize and first runner-up in the 2022 IADR-SEA 

Hatton Award - Senior Category. ■ 

Henry Schein advances ESG stewardship 

Henry Schein has announced the publication 

of its 2021 Sustainability and Corporate 

Social Responsibility (CSR) report, titled 

“Bold Leadership for a Healthier World”. 

The company’s 2021 Sustainability and CSR 

report details work done over the past year 

to advance its environmental, social, and 

governance (ESG) stewardship, including 

expanded ESG disclosures, several distinct 

health equity initiatives, and continued 

collaborations with business partners and 

suppliers to help address climate change. 

As part of the company’s work to enhance 

its ESG transparency, Henry Schein reported 

for the first time on its sustainability efforts 

in 2021 in accordance with Sustainability 

Accounting Standards Board and Global 

Reporting Initiative Standards. The company 

also issued its first task force on Climate- 

Related Financial Disclosures report, 

outlining Henry Schein’s governance and 

related strategies to address climate risks 

and opportunities. 

“Our commitment to the success of our 

stakeholders – our customers, TSMs, supplier 

partners, shareholders, and society at large – 

has long been the foundation of our purposedriven 

approach to corporate citizenship and 

commercial engagement, and continues to 

inform our bold efforts to create a healthier 

world,” said Stanley M. Bergman, chairman of 

the board and chief executive officer of Henry 

Schein. “Throughout our 90 years in business, 

we’ve faced many challenges as an industry 

and a society, and Team Schein remains 

determined to support our customers and 

our business through our robust stakeholder 

engagement model. Henry Schein will continue 

to pursue our higher ambition as a socially 

responsible and sustainable organisation while 

giving back in times of crisis and doing our 

part to build a healthier future for all.” 

Over the past decade, Henry Schein has 

further invested in its commitment to a 

higher ambition model of “ethical capitalism”, 

formalising its ESG strategy into five focus 

areas: Empowering Team Schein, Advancing 

Health Equity, Accelerating Environmental 

Sustainability, Supply Chain Resilience, and 

Ethical Governance. The 2021 Sustainability 

and CSR report underscores the values 

instilled at the company’s founding and 

highlights how Henry Schein gives back to 

the professions and communities it serves. ■ 



DentalMonitoring launches DM 

Intelligent Platform 

DentalMonitoring has launched a new service for dental 

professionals and industry partners: the DM Intelligent Platform. It 

is the only digital workflow which can interface and integrate with all 

dental digital solutions available on the market today. 

This accomplishment reinforces DentalMonitoring’s vision of 

making dentistry smarter, helping improve clinical outcomes and 

patient experience and enabling practice growth and efficiency. 

Since 2014, DentalMonitoring has revolutionised the management 

of clinical care and practice workflows through its AI-powered 

solutions, championing the utilisation of data to improve the quality 

of care. 

The company’s patented platform will greatly increase the freedom 

to operate and choice of partners for all dental professionals, 

and allow digital solution providers the ability to leverage 

DentalMonitoring’s AI technology. 

The DM Intelligent Platform includes the following solutions: 

• DataHub, a data analytics tool enabling continuous and immediate 

feedback and information to doctors, practices and partners related 

to clinical efficacy and operational efficiency 

• Export of manufacture-ready STL files from monitoring scans 

without the need for an in-practice appointment* 

• API/SDK Interfaces enabling integration of the DM Intelligent 

Platform with any digital partners, including patient management 

systems, CRM systems, digital treatment planning systems for 

aligners, braces and any other dental appliances, as well as devices 

such as connected electric toothbrushes 

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“We’re excited that our unique technology trusted by thousands 

of doctors and more than 1.5m patients worldwide will now 

be available to enhance product capabilities, workflows and 

solutions throughout the dental world,” said Philippe Salah, CEO 

of DentalMonitoring. “We believe that our only truly open digital 

platform in dentistry today positions us well to continue to positively 

impact the sustainability of dental care and improve the lives 

of millions of patients. We invite all our doctors and partners to 

leverage our technology to its full potential and help us in our vision 

to make dentistry smarter.” ■ 

*Products availability, claims 

and regulatory status may differ 

across countries depending on 

local regulations. Contact your 

local representative for further 

information 

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DENTAL ASIA SEPTEMBER / OCTOBER 2022 9 

ad_PStouch_dental_asia_IDEM_95x250_en_220704.indd 1 04.07.22 12:11


Dentsply Sirona appoints Simon Campion as chief executive officer 

Dentsply Sirona 

has appointed 

Simon Campion 

president and chief 

executive officer 

and will join the 

company’s board of 

directors, effective 

12 Sep 2022. He 

succeeds John Groetelaars, who has served 

as interim chief executive officer since Apr 

2022. Groetelaars will continue to serve on 

the board. 

Campion joins Dentsply Sirona from Becton, 

Dickinson and Company (BD), where he 

most recently served as executive vicepresident 

and president of the medical 

segment and prior to that served as 

president of the interventional segment 

following BD’s acquisition of C. R. Bard. 

He previously held several leadership roles 

across the C. R. Bard organisation, including 

leading the surgery business unit. 

With the hiring of Campion, the board has 

requested a full review of the company’s 

business and operations including 

competitive positioning and portfolio, 

margin enhancement opportunities, and 

capital structure. 

Eric K. Brandt, chairman of the Dentsply 

Sirona Board, said: “Simon’s appointment 

follows a comprehensive search process to 

identify the right leader to help the company 

deliver on its strategic and financial goals. 

Simon is a high-integrity, transformational 

leader with a record of world-class 

operational expertise and sustainable 

growth. In his 25 years in the medical device 

industry, Simon has led global business 

units, driven commercial execution, and 

developed and executed strategies to expand 

innovation and generate revenue growth 

at scale. During his tenure at BD, Simon 

delivered above-market annualised revenue 

growth, accelerated the segments’ M&A 

activity, and expanded the organic innovation 

agenda. We believe Simon’s values and 

leadership, will be highly impactful in moving 

the company forward particularly as the 

company prepares to complete the ongoing 

audit committee review, improve operational 

rigor, and drive accountability.” 

Campion said: “It’s an honour to join 

Dentsply Sirona and have the opportunity to 

lead this great team. During my career, I’ve 

developed a clear understanding of what 

it takes for a global healthcare company 

to succeed, and I am confident that with 

its strong foundation of industry-leading 

products and patient-driven innovation, 

Dentsply Sirona is well-positioned to 

capitalise on the market opportunities ahead 

and deliver long-term growth and value 

creation.” 

Brandt continued: “The board is most grateful 

to the employees of Dentsply Sirona for their 

patience, resiliency, and commitment to our 

providers and patients during this time of 

uncertainty as the company prepares for 

completion of the ongoing audit committee 

review. Additionally, the board thanks John 

Groetelaars for his service as interim chief 

executive officer. During his tenure, John put 

in place management systems that are key 

to focusing and advancing the company’s top 

priorities and set an exemplary standard of 

integrity and accountability. We look forward 

to continuing to benefit from his expertise on 

the board.” 

Groetelaars said: “It has been a privilege 

to serve as Dentsply Sirona’s interim CEO. 

Over the last several months, I’ve gained 

deep insight into Dentsply Sirona’s business, 

operations, and opportunities. Dentsply 

Sirona has a solid strategy in place, and I am 

eager to apply the perspectives I’ve gained 

as I continue to support the company’s 

progress from the board.” ■ 

FDI and Lancet Migration launch joint policy brief 

on oral health for people on the move 

Globally, more than one billion people are on 

the move 1 due to forced global displacement. 

Unfortunately, vulnerable groups such as 

refugees, migrants, and other people on the 

move often face oral health inequalities and 

are at heightened risk of developing diseases. 

The current health systems must address this 

issue and increase access to oral healthcare 

for vulnerable groups through integration into 

general healthcare systems. 

To address the oral health needs for people on 

the move, FDI has joined forces with Lancet 

Migration to develop a policy brief aimed 

at policymakers, governments and health 

systems, non-governmental organisations 

and charities, and academics and research 

institutions. 

It sheds light on the urgent need for action 

to reduce oral health inequalities amongst 

this particular group and provides key 

recommendations through calls-to-action. 

World Refugee Day is the perfect occasion to 

launch this publication and incentivise all those 

who can help to raise awareness and to act on 

the recommendations made in the Oral Health 

for People on the Move policy brief. 

Emphasising that strong and coherent action is 

required to improve the oral health of people on 

the move through a comprehensive universal 

health system approach, the policy brief 

highlights the current gaps in the system. Its 

key calls-to-action include increasing adequate 

epidemiological surveillance systems, oral 

health education, access to care, access to 

digital technologies and many more. ■ 

1 

WHO Refugee and Migrant Health Fact Sheet, 

https://www.who.int/news-room/fact-sheets/ 

detail/refugee-and-migrant-he… 



exocad to host global CAD/CAM conference 

Insights 2022 in Palma de Mallorca 

exocad has announced that Insights 2022, 

the third edition of the company’s global 

community event for dental labs and 

dentists, will be held in Palma de Mallorca, 

Spain, on 3-4 Oct, under the motto “Learn. 

Connect. Enjoy.” Held every two years, 

Insights 2022 will include a full, two-day 

programme of lectures from top-tier dental 

speakers, break-out learning sessions, a 

comprehensive partner exhibition and an 

evening event. 

The agenda for Insights 2022 includes a 

diverse programme of dynamic lectures 

by international speakers, software 

sessions with exocad’s team of application 

specialists that will present highlights of 

the latest Rijeka 3.1 software releases, and 

presentations by 11 international companies 

on the latest CAD/CAM trends. Up to 800 

dental technicians and dentists from Europe, 

North and South America, Asia, Africa, and 

Australia are expected to attend the exclusive 

event. 

“Connection is one of our top priorities at 

exocad: connecting with our community, 

connecting through technology, and 

connecting to learn and educate about the 

latest advancements in digital dentistry,” 

said Tillmann Steinbrecher, CEO of exocad. 

“Insights is our main event to strengthen 

those connections, offer a platform for 

exchange and a vision of the future.” 

Insights 2022 will focus on the possibilities 

of digital dentistry using an open software 

platform. With exocad’s open architecture, 

digital technologies like DVT, milling machines, 

3D printers, intraoral scanners and desktop 

scanners can be connected on a single 

software platform, allowing dental technicians 

and dentists to easily collaborate with one 

another and implement treatment concepts more 

efficiently and predictably. Over the two days 

of Insights 2022, attendees will experience the 

variety of possible solutions for the CAD/CAMsupported 

manufacturing of dental restorations 

and how to create consistent digital workflows. 

They’ll hear from internationally renowned dental 

guest speakers Steven Campbell, Dr Christian 

Coachman, Dr Gulshan Murgai, Prof Dr Guilherme 

Saavedra, MDT Sascha Hein, Dr Diana Tadros, 

Dr Lori Trost and Waldo Zarco Nosti. 

Sessions will be held in English with simultaneous 

translations in German, Italian and Spanish, and 

will include CE credits for select countries. ■ 

HIGH-PERFORMANCE 

DYNAMIC INSTRUMENTS 

SIMPLIFYING DENTAL MOTION 

TeKne Dental srl – Italy 

info@teknedental.com www.teknedental.com 

DENTAL ASIA SEPTEMBER / OCTOBER 2022 11


Formlabs announces fifth annual User Summit 

Formlabs has announced the return of its 

global Formlabs User Summit, a free virtual 

event from 26-27 Oct 2022. The 3D printing 

user conference reconvenes for its fifth year 

to celebrate more than 100 million innovations 

printed on Formlabs 3D printers, the positive 

impacts of these designs and 3D printing 

applications. 

At the 2022 User Summit, Formlabs will 

unite users and enthusiasts to inspire the 

next generation of innovations. The event 

will feature discussions about extraordinary 

3D printing innovations, from generative and 

nature-inspired product design and hyperrealistic 

props and prosthetics from TV shows, 

to how access to additive manufacturing tools 

prepares students for future careers, and 

how in-house rapid tooling adds flexibility to 

manufacturing workflows. 

Formlabs has assembled an enticing speaker 

lineup for the User Summit, tapping thought 

leaders who are using Formlabs 3D printing 

in a variety of industries, including Sheri 

Thorn, aerospace engineer, NASA Goddard; 

Amy Alexander, unit head biomechanical 

development & applied computational 

engineering, Mayo Clinic; Dr Alejandro Pineda, 

director, Clinica Lhasa; Jessica Rosenkrantz 

and Jesse Louis-Rosenberg, co-founders, 

Nervous System; Ryan Mandell, director, 

Innovation Hub Makerspace, Penn State; and 

Jaco Snyman, founder and lead production 

designer, Dreamsmith. 

The Summit will offer sessions in eight 

languages, including a multi-level Formlabs 

University track that will help users boost 

their 3D printing skills, a User Talk Track 

highlighting case studies and applications 

across engineering, product design, 

manufacturing, education, entertainment, 

jewellery, automotive, aerospace, and more. 

Innovations in dental and medical industries 

will also be featured, including a womenled 

Medical Talk track that will address 

3D printing’s application in personalised 

healthcare. 

Formlabs co-founder and CEO Max Lobovsky 

said: “Each year, the Formlabs User Summit 

is an opportunity to celebrate everything 

that our community has accomplished and 

inspire future innovators. Our users achieved 

an amazing milestone, printing more than 

100 million parts with Formlabs printers. This 

year’s Summit and expanded Impact Awards 

will shine the spotlight on the many ways 

that their 3D printed designs, prototypes, and 

devices have made an impact on the medical, 

automotive, and entertainment industries, to 

name a few.” ■ 

Neocis announces FDA 510(k) clearance for YomiPlan Go workflow 

Neocis has announced that their latest 

software offering, YomiPlan Go, has received 

510(k) clearance from the US Food and Drug 

Administration (FDA) after the successful 

completion of a recent clinical study. This marks 

the 13th FDA clearance Neocis has received to 

date. 

Yomi, the first and only FDA-cleared robotic 

system for dental surgery, assists clinicians in 

both planning and operative phases of dental 

implant placement via interactive digital planning 

(using YomiPlan software) and robotic guidance 

of surgical instrumentation, respectively. 

YomiPlan Go, which is expected to be 

commercially available soon, is a softwarebased 

workflow that allows doctors to directly 

visualise a patient’s anatomy, set the desired 

location and angulation of an implant using 

their drill tip, and then perform an osteotomy 

under robotic guidance. This mode differs from 

the platform’s other workflow options (YomiPlan 

Complete and YomiPlan Dynamic) as it frees 

clinicians from having to take a CT scan for 

case planning in YomiPlan, allowing them to get 

underway with surgery faster. 

“This new FDA-cleared workflow demonstrates 

our commitment to continuous innovation,” said 

Alon Mozes, co-founder and CEO of Neocis. “We 

are dedicated to providing all of our partners 

with versatile solutions that allow them to use 

Yomi for the wide variety of clinical cases they 

take on every day.” 

YomiPlan Go’s fast, flexible workflow is 

similar to freehand surgery but offers the 

enhanced precision and repeatability of robotic 

assistance. In this mode, Yomi’s guide arm 

stabilises the drill, maintains positional and 

angular precision as the clinician changes 

bits, and prevents overdrilling. Users can also 

accurately parallelise multiple fixtures by using 

the initial implant as a reference point. 

“By combining the feel of freehand surgery with 

the advantages of haptic guidance, YomiPlan 

Go adds a human touch to robotic implant 

placement,” said Massachusetts-based general 

dentist Dr Sathish Palayam. “It’s as simple as 

point and place.” 

The growing YomiPlan software suite gives 

dental practices the flexibility to choose a robotic 

workflow that best fits their needs, so they can 

perform robot-assisted surgery with minimal 

disruption to their existing clinical processes and 

techniques. 

“We’re thrilled to introduce another innovation 

that directly resulted from our users’ input,” said 

Wayne Craig, chief commercial officer of Neocis. 

“I’ve never been with a company that so closely 

partners with and listens to its clients to develop 

innovative, solution-oriented offerings. We’re 

excited to provide freehand surgeons with a more 

precise and versatile alternative to this method, 

without sacrificing speed and clinical efficiency.” ■ 



Vivos Therapeutics announces multiple 

regulatory clearances in Australia for its entire 

line of oral appliances 

Vivos Therapeutics has received multiple 

Class I clearances by the Therapeutic Goods 

Administration for multiple indications 

to include the treatment of snoring and 

obstructive sleep apnoea (mild, moderate and 

severe) for both adults and children for its 

series of oral appliances. 

“These recent clearances provide further 

validation to our technology and extend the 

scope of our international market,” said Kirk 

Huntsman, co-founder and CEO of Vivos 

Therapeutics. “The Australian regulators 

recognised and accepted the clinical data 

we presented showing the clinical safety 

and efficacy of our technology regardless of 

age or the severity of the obstructive sleep 

apnoea (OSA). We are progressively moving 

forward with other domestic and international 

regulatory agencies with high expectations 

that our applications will be as well received 

as they have been in Australia. Poor sleep 

is a global epidemic. Vivos has developed a 

safe, comfortable, non-invasive, non-surgical 

solution, and we intend to offer it worldwide. 

We have already received clearances in the US 

and Canada, and now, Australia will become 

part of our expanding international network. 

We will continue to grow and spread into other 

parts of the world.” 

Australia follows the standards applied by the 

International Organization for Standardization 

(ISO), which is currently made up of 165 

members/countries. These new clearances will 

allow Vivos to share its innovative technology and 

distribute devices that will help not only adults, 

but also children who suffer from sleep breathing 

disorders. These latest clearances include all 

classes of OSA as defined by the newly received 

Global Medical Device Nomenclature (GMDN) 

Vivos has received in Australia. 

symptoms of OSA and mild, moderate and 

severe sleep-disordered breathing. 

• Class I device clearances for the DNA 

and Vivos Guide/Way for palate lifting (jaw 

expansion causing airway enhancement), 

repositioning/straightening teeth, and as 

an anti-snoring orthosis. These appliances 

can be used for the purposes of reducing 

night-time snoring, to encourage nasal 

breathing in adults and children (limiting 

oral breathing) and for OSA and sleepdisordered 

breathing in children and 

adults. This is an important new clearance 

for Vivos. 

Equivalent to the Food and Drug 

Administration (FDA) in the United States, 

the Therapeutic Goods Administration 

(TGA) regulates the manufacturing and 

distribution of therapeutic goods in 

Australia. These clearances allow Vivos 

Therapeutics to distribute its appliances 

for several approved indications inclusive 

of snoring, sleep-disordered breathing 

and obstructive sleep apnea within the 

Australian market. 

Members of the professional dental 

community are excited to introduce The 

Vivos Method into their practices. “After 

20 years of practicing airway breathing 

and dental sleep medicine, it excites me 

to find Vivos,” said Dr Mark Levi, who runs 

a predominantly airway dental practice 

in Sydney. “Vivos has changed the way I 

look at treating adults and allows me to 

improve the wellness of young children. 

I’m thrilled to be able to integrate Vivos 

into my practice.” ■ 

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Oral-B partners with the International Association 

of Disability and Oral Health 

Oral-B has partnered with the International 

Association of Disability and Oral Health (iADH) 

as part of the brand’s drive to make oral care 

more inclusive, accessible, and positive for 

people with disabilities, their caregivers, and 

everyone in between. 

Benjamin Binot, oral care senior vice-president 

at P&G Europe, said: “We recognise the 

importance of making oral care accessible 

to all – and continuously listen to people’s 

experiences with disabilities to understand how 

we can help them. Through this work, we have 

learned that oral health care struggles amongst 

this audience are most common because 

many haven’t been taught the skills, they need 

to brush their teeth effectively, they experience 

a sense of inevitability about their teeth 

deteriorating and may be especially anxious 

in the dentist’s chair. As a brand, we recognise 

our responsibility to help ensure that oral care 

is accessible to all and we are proud to partner 

with the iADH to work to improve the experience 

for people living with disabilities.” 

The first step of this partnership is to co-create 

a ‘Positive Practices’ training programme 

designed to train and educate dental practices 

on how to become more confident and 

inclusive when it comes to their patients. 

Alison Dougall, president of iADH, said: “We 

are delighted to be working alongside Oral-B to 

address the significant oral health inequalities 

experienced by people with disabilities in 

Europe, through innovation, education, research 

and advocacy. By working together, we aim 

to make a positive difference to the oral care 

experience for people living with visible and 

nonvisible disabilities. 

“iADH exists to improve desired oral health 

outcomes for people with disabilities and 

Oral-B exists to create the best oral care 

outcomes by providing the most rewarding and 

enjoyable oral care experiences for everyone, 

everyday – given our shared values, it felt like 

a very natural fit when Oral-B approached us to 

come together in partnership” 

Benjamin Binot, oral care senior vice-president 

at Procter & Gamble and Prof Alison Dougall, 

president of the International Association 

of Disability and Oral Health (iADH). Credit: 

Djibrann Hass 

The brand will also be present at this year’s 

Biennial iADH Congress 2022 in Paris to learn 

from the global members, who will be sharing 

their knowledge and experience to improve oral 

health outcomes for people with disabilities in 

a KOL workshop hosted by Oral-B. The findings 

gathered from the workshop will help to inform 

Positive Practices and ensure that the training 

programme is underpinned by insight to deliver 

the best outcome for change. ■ 

Roland DG Corporation announces planned 

relocation to a newly constructed headquarters 

Roland DG Corporation will be relocating 

to a newly constructed headquarters near 

its current facilities in Hamamatsu, Japan. 

The completion of Roland DG’s new nearly 

ZEB-certified building in the Miyakoda 

area of Kita-ku, Hamamatsu on Jul 2023 

will integrate the company’s factory and 

headquarters, which are currently located at 

two separate venues. 

ZEB certification is defined by four levels 

of achieving zero-energy construction by 

combining energy-saving technologies, 

such as the use of natural energy and 

efficient equipment systems, with energycreating 

technologies, such as solar power 

generation. Roland DG’s new building will 

achieve a primary energy consumption of 

75%+ through energy conservation (50%+) 

and energy creation. 

The new building will provide a space that 

creates new value by organically combining 

R&D, administration, and sales functions 

together in a single office area. All floors 

will have public areas, interaction areas, and 

creative areas designed to enable employees 

to freely change their work environment, 

generate ideas, and communicate with each 

other. 

Shizuoka Prefecture sets a seismic zone 

standard that is stricter than the national 

standard, and the new building to be 

constructed will be 1.5 times safer than 

the national standard. The new building 

will also be equipped with a solar power 

generation system on the rooftop, automatic 

lighting control and inverter airflow control 

for exhaust fans, and a top-class efficiency 

air conditioning system, all of which are 

consistent with global efforts to achieve 

carbon neutrality. 

The building will provide a comfortable 

workplace that accommodates a variety of 

work styles, including a deck terrace taking 

advantage of its location in front of Miyakodasogo 

Park, cafeteria lounge, training room, 

and showers. 

At a time when the role of an office building 

is rapidly changing due to the pandemic, the 

design takes into account a hybrid working 

style between office and telecommuting, 

considering the way of working in the future. 

The company aims to create an environment 

that facilitates communication and promotes 

team building to realise its slogan to “Inspire 

the Enjoyment of Creativity” and spark 

excitement. ■ 


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TRENDS 

Online comments and reviews 

– how dental professionals 

can respond 

With social media platforms as 

well as review and comparison 

sites, patients can easily post 

their feedback on the service 

rendered to them. Positive 

reviews are heartening to read, 

but how should the dental 

professionals handle the 

negative ones? 

By Dr Bobby Nicholas and Dr Louise Eggleton, 

medicolegal and dentolegal consultants at 

Medical Protection 

Feedback in general – good and bad – 

can be useful in helping a dentist make 

improvements to the service or treatment 

they provide. However, receiving negative 

comments can be challenging, even more 

so if unfair criticism has been published 

online, in full view of colleagues, patients 

and friends. It can also be particularly 

frustrating if it is felt that there is no right 

to reply. 

The language used on social media and 

review sites can often be emotive, 

confrontational, and not what we usually 

expect in the course of spoken dialogue. 

This, together with the fact that there are 

limited safeguards to prevent patients from 

making unpleasant or factually inaccurate 

posts and potentially impacting the professional 

reputation of the clinician or practice, makes 

it understandable as to why clinicians are 

becoming increasingly concerned. 

Dental Protection is often asked to provide 

support and advice for dental professionals 

who feel that they are being unfairly portrayed 

in online comments. 

How a dental professional respond to negative 

feedback can be an important factor in whether 

matters escalate. Some types of comments 

may warrant reporting to the website, although 

this does not prevent the person from simply 

posting the comments elsewhere. Of course, 

any abusive or threatening comments are 

completely unacceptable and should be reported 

to the online administrator. A decision then 

needs to be taken by the clinician or practice 

if they consider police involvement is also 

necessary. 

If the online comments can be considered a 

misrepresentation of facts, in the first instance, 

one may be able to contact the website 

administrator to request for the removal of the 

review or comment. 

Unfortunately, this may be quite challenging 

if the comment is deemed to be the personal 

opinion of an individual as it is difficult to argue 

against the patient in question feeling that they 

have had a particular experience. 

Dental professionals can sometimes feel that 

negative feedback amounts to a personal 

attack or defamation. Taking legal action 


TRENDS 

over a comment is an option but is something 

that needs to be considered very carefully, 

and the chances of success and indeed any 

benefits may well be far less than we might 

first consider. 

The defamatory nature of content is subjective, 

and a challenge of this nature can risk inviting 

further attention and publicity towards the 

unfavourable comments with possibly only a 

small chance of success for the clinician. 

Practitioners may wish to encourage other 

patients who have had a different experience 

at the practice to post reviews instead. This 

goes to demonstrate the majority of patients 

value and appreciate the service they have 

received whilst moving the negative review 

further down the postings, eventually making 

it less and less visible. 

When receiving negative feedback, it is 

tempting to defend one’s reputation by 

engaging in a war of words with the patient 

via the social media platform or website. 

However, dentists need to be mindful of 

their duty of confidentiality when 

responding to feedback on public 

forums. When writing in haste or 

a defensive manner, it is possible 

that comments may inadvertently 

breach patient confidentiality by 

revealing details of the treatment 

or person. It is essential that 

any response observes the data 

protection guidelines which govern 

our practice. 

We will go on to look at how to respond 

in these situations to help mitigate any 

potential escalations and reduce the 

risk of further challenge or disagreement with a 

patient being played out in a public forum. 

CALM AND PROFESSIONAL 

RESPONSE 

Dental professionals and practice staff need 

to be prepared to deal with negative online 

comments. A dental practice which is seen to 

engage with negative feedback can also use it 

as an opportunity to demonstrate all concerns 

are taken seriously and that they want to 

ensure the care which has been provided to all 

patients meets their expected standards. 

An effective response should express genuine 

disappointment that the patient did not have 

a positive experience, inviting the patient to 

discuss their concerns in more detail offline. 

If the patient does wish to engage with the 

practice and their complaint or query is 

subsequently resolved, the patient may perhaps 

choose to remove the comments themselves. 

Bear in mind that if you think a comment is 

unreasonable or unfair, others may see it that 

way too. Informal patients’ surveys in the US 

found that 65% of patients tended to ignore 

negative reviews that seemed unreasonable or 

exaggerated 1 . 

Similar US surveys found that almost one in 

five patients will disregard a negative review 

if the provider has responded in a thoughtful 

manner 2 . 

A calm and professional response will come 

across well to others. Here are four steps that 

will help you provide a good response: 

1. Although a prompt response is important, 

try to make sure the reply is calm, measured 

and not written in haste. It is helpful to have 

a named colleague at the practice regularly 

monitoring and managing all social media 

accounts the practice chooses to engage in. 

2. A simple and brief acknowledgement of 

the comments should be provided. Thank the 

patient for their feedback and acknowledge 

concerns they may have raised. 

3. Invite the patient to contact the practice 

directly in order to further discuss their 

experience. 

4. Bear in mind your duty of confidentiality and 

do not disclose any personal information. 

Finally, Dental Protection members can contact 

us for further advice if they are unsure of how 

to proceed upon receiving a negative online 

comment. DA 

REFERENCES: 

1. 

Software Advice: How patients use online reviews 

www.softwareadvice.com/resources/howpatients-use-online-reviews/. 

Accessed on 28 

June 2021. 

2. 

PatientPop: 3 ways to respond to negative online 

reviews. Available at: www.patientpop.com/ 

whitepapers/3-ways-to-respond-to-negativeonline-reviews/. 

Accessed on 28 June 2021. 


TRENDS 

Pledge for sustainable dentistry 

FDI World Dental 

Federation launches 

Consensus Statement 

on sustainable oral 

healthcare. 

FDI World Dental Federation (FDI) has launched 

its inaugural Consensus Statement on 

Environmentally Sustainable Oral Healthcare, 

aimed at moving the oral healthcare sector 

towards more environmentally friendly 

practices that ultimately reduce the carbon 

footprint of the profession. 

The Consensus Statement was released 

at a special summit organised by FDI that 

brought together a diverse range of influential 

stakeholders, including leading figures from 

industry as well as health professionals, 

academic experts, legislative authorities, and 

dental associations. 

“It will come as a surprise to many people that 

the healthcare sector is responsible for around 

5% of global greenhouse gas emissions, 

of which oral healthcare is an important 

contributor,” said Prof Ihsane Ben Yahya, FDI 

president and dean of the Faculty of Dentistry, 

Mohammed VI University of Health Sciences, 

Casablanca, Morocco. 

“The dental industry has a collective 

responsibility to reduce its environmental 

impact and today’s Consensus Statement 

is the first major step to achieving that. The 

Consensus Statement reflects the growing 

recognition within the oral healthcare 

community that we must strive to improve oral 

health in a sustainable manner in compliance 

with UN targets. Healthier mouths mean a 

healthier planet.” 

Oral healthcare contributes to the environmental 

burden through air pollution arising from the 

release of CO2 associated with travel and 

transport, incineration of waste, lack of 

recyclable packaging, the greenhouse gas 

impact of anaesthetic gases such as nitrous 

oxide, and the high consumption of water. 

The Consensus Statement identifies the 

complex drivers that underpin current 

behaviours and practices and recommends 

remediation strategies based on the four Rs: 

Reduce, Recycle, Reuse and Rethink. 

Whilst highlighting some of the unavoidable 

environmental impacts linked to providing 

accessible dental check-ups and treatments 

to facilitate good oral health and reduce 

inequalities in healthcare, it also makes the 

case for minimising avoidable oral healthcare. 

This is best achieved through both the delivery 

and maintenance of good oral healthcare, 

focused on prevention with the promotion of 

good oral hygiene, healthy low-sugar diets, and 

avoidance of tobacco. 

“Prevention is better than cure and it is the 

most impactful and practical way of reducing 

the need for clinical interventions and 

associated environmental impacts,” said Prof 

Nicolas Martin, chair of the FDI Sustainability 

in dentistry task team and clinical professor 

in restorative dentistry in the School of 

Clinical Dentistry at the University of Sheffield 

in the UK. 

“When treatment is required, oral healthcare 

should focus on the provision of durable 

fillings, using high-quality products and 

materials that will last longer and require 

fewer replacements.” DA 

This article was first published at the FDI 

World Dental Federation website. 


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TRENDS 

Shapeshifting microrobots 

can brush and floss teeth 

The technology, developed by a multidisciplinary team at the University of 

Pennsylvania, is poised to offer a new and automated way to perform the 

mundane but critical daily tasks of brushing and flossing. 

By Katherine Unger Baillie, senior science news officer, University Communications, University of Pennsylvania 

A shapeshifting robotic microswarm 

may one day act as a toothbrush, rinse, 

and dental floss in one. It is a system 

that could be particularly valuable for 

those who lack the manual dexterity to 

clean their teeth effectively themselves. 

The building blocks of these microrobots 

are iron oxide nanoparticles that have 

both catalytic and magnetic activity. 

Using a magnetic field, researchers could 

direct their motion and configuration to 

form either bristle-like structures that 

sweep away dental plaque from the 

broad surfaces of teeth, or elongated 

strings that can slip between teeth like 

a length of floss. In both instances, a 

catalytic reaction drives the nanoparticles 

to produce antimicrobials that kill harmful 

oral bacteria on site. 

Experiments using this system on mock 

and real human teeth showed that the 

robotic assemblies can conform to a 

variety of shapes to nearly eliminate the 

sticky biofilms that lead to cavities and 

gum disease. The Penn team shared 

their findings establishing a proof-ofconcept 

for the robotic system in the 

journal ACS Nano. 

The nanoparticles have both magnetic and catalytic properties; catalysed hydrogen 

peroxide produced free radicals that eliminated tooth decay-causing pathogens as well 

(Image: Minjun Oh/Penn Dental Medicine) 

Medicine and co-corresponding author 

on the study. “You have to brush your 

teeth, then floss your teeth, then rinse 

your mouth; it’s a manual, multistep 

process. The big innovation here is that 

the robotics system can do all three in 

a single, hands-free, automated way.” 

and forth across a space, much like 

flossing. The way it works is similar 

to how a robotic arm might reach 

out and clean a surface. The system 

can be programmed to do the 

nanoparticle assembly and motion 

control automatically.” 

“Routine oral care is cumbersome and 

can pose challenges for many people, 

especially those who have hard time 

cleaning their teeth,” said Hyun (Michel) 

Koo, a professor in the Department 

of Orthodontics and Divisions of 

Community Oral Health and Paediatric 

Dentistry in Penn’s School of Dental 

“Nanoparticles can be shaped and 

controlled with magnetic fields in 

surprising ways,” added Edward 

Steager, a senior research investigator 

in Penn’s School of Engineering and 

Applied Science and co-corresponding 

author. “We form bristles that can 

extend, sweep, and even transfer back 

DISRUPTING ORAL CARE 

TECHNOLOGY 

“The design of the toothbrush has 

remained relatively unchanged for 

millennia,” said Koo. While adding 

electric motors elevated the basic 

bristle-on-a-stick format, the 

fundamental concept has remained 


TRENDS 

the same. “It’s a technology that has 

not been disrupted in decades.” 

Several years ago, Penn researchers 

within the Center for Innovation and 

Precision Dentistry (CiPD), of which 

Koo is a co-director, took steps 

toward a major disruption, using this 

microrobotics system. 

Their innovation arose from a bit 

of serendipity. Research groups 

in both Penn Dental Medicine and 

Penn Engineering were interested in 

iron oxide nanoparticles but for very 

different reasons. Koo’s group was 

intrigued by the catalytic activity of 

the nanoparticles. They can activate 

hydrogen peroxide to release free 

radicals that can kill tooth decaycausing 

bacteria and degrade 

dental plaque biofilms. Meanwhile 

Steager and engineering colleagues, 

including Dean Vijay Kumar and Prof 

Kathleen Stebe, co-director of CiPD, 

were exploring these nanoparticles 

as building blocks of magnetically 

controlled microrobots. 

With support from Penn Health 

Tech and the National Institutes 

of Health’s National Institute of 

Dental and Craniofacial Research, 

the Penn collaborators married 

the two applications in the current 

work, constructing a platform to 

electromagnetically control the 

microrobots, enabling them to adopt 

different configurations and release 

antimicrobials on site to effectively 

treat and clean teeth. 

“It doesn’t matter if you have straight 

teeth or misaligned teeth, it will adapt 

to different surfaces,” said Koo. “The 

system can adjust to all the nooks and 

crannies in the oral cavity.” 

The researchers optimised the motions 

of the microrobots on a small slab of 

toothlike material. Next, they tested the 

microrobots’ performance adjusting 

to the complex topography of the 

tooth surface, interdental surfaces, 

and the gumline, using 3D-printed 

Magnetic and catalytic properties of the iron oxide nanoparticles and their assembly into bristle and floss-like 

forms (Image: Melissa Pappas/Penn Engineering) 

tooth models based on scans of human 

teeth from the dental clinic. Finally, they 

trialled the microrobots on real human 

teeth that were mounted in such a way 

as to mimic the position of teeth in the 

oral cavity. 

On these various surfaces, the researchers 

found that the microrobotics system 

could effectively eliminate biofilms, 

clearing them of all detectable pathogens. 

The iron oxide nanoparticles have been 

FDA approved for other uses, and tests 

of the bristle formations on an animal 

model showed that they did not harm the 

gum tissue. 

Indeed, the system is fully programmable; 

the team’s roboticists and engineers 

used variations in the magnetic field 

to precisely tune the motions of the 

microrobots as well as control bristle 

stiffness and length. The researchers 

found that the tips of the bristles could 

be made firm enough to remove biofilms 

but soft enough to avoid damage to 

the gums. 

The customisable nature of the system, 

the researchers said, could make it 

gentle enough for clinical use, but also 

personalised, able to adapt to the 

unique topographies of a patient’s 

oral cavity. 

To advance this innovation to the clinic, 

the Penn team is continuing to optimise 

the robots’ motions and considering 

different means of delivering the 

microrobots through mouth-fitting 

devices. They are eager to see their 

device help people in the clinic. 

“We have this technology that’s as or 

more effective as brushing and flossing 

your teeth but doesn’t require manual 

dexterity,” said Koo. “We’d love to see 

this helping the geriatric population and 

people with disabilities. We believe it will 

disrupt current modalities and majorly 

advance oral health care.” 

Koo and Steager’s co-authors on the 

paper are Penn Dental Medicine’s Min 

Jun Oh, Alaa Babeer, Yuan Liu, and Zhi 

Ren; and Penn Engineering’s Jingyu Wu, 

David A. Issadore, Kathleen J. Stebe, and 

Daeyeon Lee. 

This work was supported in part by 

the National Institute for Dental and 

Craniofacial Research (grants DE025848 

and DE029985), Procter & Gamble, and 

the Postdoctoral Research Programme 

of Sungkyunkwan University. DA 

This article was first published at Penn 

Today. 



What it takes to be 

a dental influencer 

Dentist, entrepreneur, content creator – how does one find the 

balance in juggling these roles? Dental Asia finds out more from 

Dr Kayla Teh. 

By Czarmaine Masigla 

Transforming smiles one tooth 

(and content) at a time, Dr Kayla 

Teh Khe Sin has over 79,000 

followers on Instagram, 27,000 

followers on Facebook, and 

33,000 subscribers on YouTube. 

Also known as Dr Kayla to her 

patients and followers, she has 

established her name not just in 

the online space but also as a 

friendly dentist to her patients. 

With her enthusiasm for raising 

oral health awareness as well 

as her passion for aesthetic 

dentistry, she founded Dr Kayla 

Dental Clinic and now leads 

a team of dental specialists 

providing comprehensive dental 

care. Read on as she shares her 

humble beginnings and how her 

persistence brought online and 

real-life success. 

What sparked your interest to 

become a content creator and 

at the same time specialise in 

aesthetic dentistry? 

Dr Kayla Teh: When I was 

a dental student, I joined a 

volunteering programme at 

a rural village in Malaysia. 

There, I met a young kid with a 

cleft lip who was all alone and 

none of the other kids wanted 

to be his friend because of 

his appearance. That could’ve been 

prevented if his parents were aware 

of bringing him to an oral surgeon to 

do repair surgery during the earlier 

years of his life. That was the moment 

when I realised how important dental 

awareness is. I started making videos 

on it, and that was back in 2018 when 

videos on social media were not such a 

common thing. 

Then, I began to have some patients 

walking in, telling me that they do not 

have the confidence to get a job, partner 

or simply smile in front of the camera. 

So, when I did my first smile makeover 

case with veneers, my patient regained 

her confidence and came back to tell 

me that she met a new partner in life. 

That was when I felt true happiness and 

realised my ability to help others as a 

dentist. This experience and more after 

inspired me to keep doing this every 

day and keep improving in the field of 

aesthetic dentistry. 

What are your aspirations as an oral 

health advocate and an influencer? 

Dr Kayla: It is important to uphold the 

standard of dentistry while having fun 

on social media. Whenever I create 

a piece of content on social media, 

I always have three goals in mind: 

educate, entertain and inspire. 

I love to educate the public on certain 

dental topics through videos or social 



media posts. I also like entertaining 

them from the point of view of a dentist 

because that shows them that dentists 

are human too and we just wanted to 

help with their dental problems. That 

can actually increase the patient’s 

acceptance of dental treatment, which 

in turn elevates public awareness of 

dental care. 

I hope to inspire the younger generation 

on the beautiful aspect of dentistry – 

which to me is an amazing field. I enjoy 

every moment of it, creating smiles and 

building connections with my patients 

which last for generations. I hope that 

more people can see and appreciate 

this aspect of dentistry as much as I do! 

Can you walk us through the 

conceptualisation of your dream clinic, 

and what is the significance of this 

milestone in your career as a dentist? 

Dr Kayla: I have always wanted to 

make people feel safe. But dentistry? 

Oh man, it can be scary to our patients. 

When I build my clinic, I want people 

to feel like they’re coming back home 

to a safe place where they can be 

comfortable and more relaxed to share 

their dental concerns. 

That is why my clinic is homey, it is 

also covered in a pastel pink tone – 

which is unconventional. But that’s 

the beauty of it. It doesn’t give off 

that tense, strict vibe. But rather, it 

makes you feel comfortable like you’re 

walking into an area where you can 

relax as well as enjoy the view. 

As a dentist, this is a huge milestone 

for me. It is a sign that I am no longer 

just a clinician, but an entrepreneur, 

marketer, manager, and so much more 

too. I have a bigger vision now, to not 

only excel in my clinical work but also 

to build a team of doctors who strive 

to achieve excellence in dentistry as 

well as patient management. And this 

is something we did not learn in dental 

school; this is the real world where 

we have to be independent, creative, 

caring and better than who we are 

yesterday. 

As a practitioner of digital dentistry, 

what are the must-have devices in your 

practice, and how do they help you 

enhance your service to your patients? 

Dr Kayla: Intraoral scanner (IOS), digital 

planning software and 3D printer are a 

necessity in my daily clinical workflow. 

IOS enables me to take dental record 

conveniently and comfortably, and helps 

in enhancing the communication among 

clinicians, dental technologist and 

ceramists. 

I am also using exocad software to 

plan out my cases, be it prosthodontics, 

restorative or orthodontics. It helps 

me to bring a more comprehensive 

approach to my case planning. 

For example, most of my patients 

who came to me for veneers often 

need orthodontics treatment. I will 

incorporate digital dentistry into their 

orthodontics treatment to measure 

the space distribution for their final 

veneers as well as monitor their 

treatment progress. This gives me more 

predictability and control in my clinical 

cases, which also gives my patients 

more confidence and reassurance. 

How do you envision your career as a 

dentist in the next five to 10 years, and 

what else are you looking forward to in 

the future? 

Dr Kayla: I look forward to creating more 

quality content in dentistry and inspiring 

more young dentists to do better in their 

clinical work. I hope to show people that 

just because you’re out there on social 

media, doesn’t mean that you’re all talk 

and cannot produce good clinical work. 

We are all clinicians and we are here 

to help our patients through the skills 

and experience we have. I also look 

forward to meeting and learning from 

more dentists across the globe, after all, 

learning never ends. 

How do you find the balance between 

your role as a dentist and content 

creator, and what advice would you like 

to give to dental practitioners who are 

keen to follow in your footsteps? 

Dr Kayla: It is difficult to maintain social 

media while upholding your clinical work 

standards — at least for me. I plan out 

my shooting time as well as clinical 

time, but that also means that I have to 

sacrifice my personal and family time. 

My advice to those who wanted to 

engage more patients online is to 

be yourself on social media. Many 

people think they have to pretend to be 

someone with “personality” to engage 

more audience but simply being yourself 

and showcasing your best sides are 

good enough. It also gives a sense of 

authenticity when a patient, or a fellow 

dentist finally meets you in person. After 

all, people love making friends with a 

person who is true to himself. DA 



Transforming the future 

of implant dentistry 

With innovation and technology, Dentsply Sirona ensures 

that clinicians can provide dental implant therapy for life-long 

function and aesthetics. Dental Asia speaks with Tony Susino, 

group vice-president of Global Implant Solutions, to find out 

the latest trends in implant dentistry and how the company 

shapes the digital future of the field. 


People and products — veteran business 

executive Tony Susino shared that this 

combination was the key factor when he 

joined Dentsply Sirona, one of the world’s 

largest manufacturers of dental products 

and technologies, this year as the group vicepresident 

of Global Implant Solutions. 

Having spent the last 15 years in the dental 

space, he has never been more optimistic 

about the opportunities Dentsply Sirona 

provides in terms of an ecosystem of products 

and digital solutions. 

“At Dentsply Sirona, the employees have a 

great passion to create a superior experience 

for our customers through optimised 

workflows. With our cutting-edge products and 

technologies, the company is uniquely suited 

to win in this space,” he shared. 

In today’s dental landscape, Susino said 

that dental implants are set to become the 

standard of care for tooth replacement and 

edentulism in the years to come. 

“Clinicians and their staff are more widely 

aware and promoting these therapies over 

traditional crown and bridge dentistry, and 

that will continue to drive the steady market 

growth. Dental disorders such as tooth decay 

and cavities, unfortunately, continue to be on 

the rise based on the availability of sugary 

foods and overall poor nutrition and hygiene 

choices,” he elaborated. 

The advances in technology and accessibility 

of treatment, Susino suggested, have 

increased patients’ dental knowledge 

too, thereby sustaining the momentum of 

industry growth. 

“As implant therapy becomes the more 

accepted gold standard, governmentled 

initiatives and public health dental 

programmes will also make implant surgery 

more easily available to those in need,” 

he continued. 

SEAMLESS SOLUTIONS 

Dentsply Sirona is poised to meet the 

rapidly growing dental implant 

demands with their offering 

of implant systems, 

digital planning 

platform, regenerative 

and restorative 

solutions and 

educational 

programmes. 

Susino 

highlighted that 

Dentsply Sirona’s 

dental implant 

systems are 

Tony Susino 



based on a solid scientific foundation with 

long-term clinical documentation. In fact, their 

products and solutions have been the subject 

of more than 2,900 scientific publications 

with data from 50,000 patients and 125,000 

implants. 

For instance, one of the company’s latest 

innovations, the DS PrimeTaper Implant 

System features a union of form and 

function. It has a thread design that enables 

it to quickly cut and engage with the bone, 

allowing for immediate function and shorter 

procedure times. 

And with the comprehensive restage of its 

implants business including three signature 

digital workflows, Dentsply Sirona provided 

dental professionals with an innovative way 

of practising implantology from scan to crown 

that meet expectations in efficiency, accuracy, 

aesthetics, longevity and simplicity. 

“Dentsply Sirona is committed to the 

advancement of our industry as evidenced by 

our significant investments in R&D and the 

recently built Innovation Center in Charlotte, 

NC (US). We also have various facilities 

globally that are on the forefront of clinical 

education to provide training and resources 

for clinicians to continually be on the cutting 

edge of their field,” he added. 

For practitioners who are just starting out 

with their digital implant journey, Susino 

recommended accessing the DS Academy’s 

Dental Implant Curriculum. 

He explained: “It contains interactive, 

procedure-based courses, designed by 

world-renowned clinicians such as Dr Lyndon 

F. Cooper and Dr Bryan Limmer. The virtual 

curriculum is comprehensive, tuition-free and 

aims to inspire dental professionals to build 

and develop their clinical knowledge and digital 

skills in implant dentistry, through eight levels 

each consisting of 24 courses. 

“Practitioners of all backgrounds and different 

levels of knowledge can access this course — 

from foundational to mastery. They can learn at 

their own pace and gain new skills that will help 

them give their patients the best possible care 

for improved oral health.” 

BEST WAY FORWARD 

Dentsply Sirona is committed to enabling 

clinicians, to focus on growth and enhance 

their service. Streamlining implant treatments 

equates to consistent patient satisfaction. 

“I’ve already met and gotten to know many of 

our practitioners. They are exceptional, care 

deeply about our products and believe — like 

I do — that their success is our success and 

vice versa,” shared Susino. 

To stay at the forefront of digital dentistry, 

Susino encourages dental practitioners to 

attend as many symposiums and events 

as possible. He believes that they can learn 

much from their peers, build professional 

networks, tap into each other’s knowledge, 

and create groups to discuss trends and 

what’s coming next. 

“Dentsply Sirona holds events such as 

Dentsply Sirona World every year that do 

exactly this. It draws in professionals from 

all over the world who come to see the 

latest in digital dentistry, hear from expert 

speakers and see our newest products in 

action,” he shared. 

On top of that, they have also set up a registry 

study which aims to involve more than 500 

clinicians and over 2,500 implants for longterm 

follow-up. 

Embracing and adopting digital dentistry is 

the best way forward according to Susino, 

who reassured dental professionals that 

Dentsply Sirona will be there for them at every 

step of their digital transformation: “We are 

shaping the technology behind our innovative 

solutions, conducting research, and creating 

resources to help practitioners expand their 

clinical knowledge and digital skills. That is 

where we are going, and we are leading the 

charge into the future. The future is now!” DA 



Peek 

into the 

digital 

future 

What trends will 

sustain the positive 

momentum of digital 

dentistry? Rune Fisker, 

SVP of 3Shape, shares 

his insights. 




The digital era is here. From artificial 

intelligence, automated processes, 

and so much more, an array of dental 

treatment options are now accessible 

at a practitioner’s fingertips. These 

technologies have elevated the standards 

of dental care to a new height which 

would not be otherwise possible. 

Leading this revolution is 3Shape, a 

developer and manufacturer of 3D 

scanners and CAD/CAM software for 

the dental and audio industries based 

in Copenhagen, Denmark. Since the 

launch of 3Shape’s first dental lab 

scanner software in 2005, the company 

has continuously innovated and 

reinvented their product solutions. 

Over the years, 3Shape has supported 

many dental professionals in embarking 

on their digital journey, even more 

so when facing the unprecedented 

challenges brought by the pandemic. 

According to Fisker, due to COVID-19, 

digital adoption was dramatically 

pushed forward by three to five years. 

What will continue driving its growth? 

He highlighted five major trends: 

Intraoral scanning will keep driving 

digitalisation. The use of intraoral 

scanners (IOS) in dental clinics has 

skyrocketed and already penetrated 

30-35% in the US and mature markets. 

A small, handheld device that builds a 

digital model of the teeth and surrounding 

structures, many clinicians consider IOS 

their entry point in digital workflow – 

streamlining the cumbersome procedure 

of taking an impression and sending it to 

the lab. 

Speaking with Prof Dr Lucio Lo Russo, 

an Italian dentist, regarding the hygiene 

aspect of digital pathways, Fisker 

shared that besides the time and money 

clinicians save using a digital workflow, 

another important aspect to consider 

was safety. 

Highlighting that digital workflow has 

become a means for professionals to 

avoid cross-contamination issues, 

he explained: “Remember, there is 

no impression material to handle 

or ship with a digital workflow. So 

aside from eliminating the possible 

breakage of models with all the 

handling, professionals no longer 

need to touch, share, or ship models 

back and forth. 

“All those objects which were in 

contact with the patient’s mouth are 

theoretically, potentially infected. 

If we are not transferring anything 

from the clinic to the lab, we are 

reducing and controlling any chance 

of infection.” 

Artificial intelligence (AI) is here. 

A field that combines computer 

science and robust datasets to enable 

problem-solving, AI has finally made 

its mark on CAD/CAM. This past year, 

Fisker shared that with the launch of 

3Shape Automate, scans can now be 

uploaded to the cloud, and practitioners 

can fully design a crown using AI. 



we live. Think Netflix or Spotify. With 

Unite, our goal is to deliver a similar and 

seamless service where professionals 

can pick and choose their treatment 

partner just like they would pick the next 

movie to watch.” 

SYNERGISTIC COLLABORATIONS 

As the technology for digital pathways 

continue to improve, Fisker is positive 

that more practitioners will embrace it in 

practice and put high appreciation for its 

potentials. 

“When it comes to introducing new 

solutions, it is one thing to have an idea, 

it is a whole other ball game to make it 

happen. That is where 3Shape’s huge 

brainpower trust, an army of engineers, 

and data comes in,” he said. 

3Shape has also utilised this technology 

in TRIOS intraoral scanner to allow user 

of any skill level to capture accurate 

digital intraoral impressions with greater 

ease in less time. 

“There will be much more to come as 

AI is making computers smarter and 

faster across all applications in digital 

dentistry,” he continued. 

Aligners and dentures are rapidly 

adapted. Fisker said that cosmetic 

dentistry and clear aligners will continue 

to push digitalisation forward, driven by 

consumer demand for aesthetics. 

While dentures remain the big missing 

indication, he noted that their stats show 

that this is changing fast with three-digit 

growth in digital denture cases. 

Considering Asia’s ageing population 

affecting the demands for tooth 

replacement, he said: “When treating 

older patients, digital dentistry delivers 

higher efficiency, better clinical results 

and an overall improved patient 

experience that further accelerates 

digital adoption.” 

3D printers are hot. A true game-changer 

will be 3D printing materials, Fisker 

emphasised, as new and improved 

materials are being released every day. 

He elaborated: “Driven by new printing 

materials, high-quality splints are a 

reality and I believe, 100% 3D printed 

final dentures will soon take off. 

Ultimately, all indications will have the 

potential to be 3D printed, which would 

make the major question being how 

deep will 3D printers penetrate the 

practice?” 

With strong technology development 

and approximately only 5% of the 

world’s dentures presently being 

manufactured digitally, Fisker foresees 

that the industry will witness a lot 

of growth in this area. As printing 

materials become better, he added, 

more and more types of restorations 

will be printed due to their affordability, 

speed, and practicality. 

The dental platform race has begun. 

3Shape is one of the key drivers of this 

trend globally and is playing a crucial 

role in its rapid adoption as reflected 

with the successful launch of their 

Unite platform. 

Fisker elaborated: “Like all industries, 

platforms have disrupted the way 

For instance, 3Shape has recently 

launched a Smart Phone App that enables 

dentists and labs to communicate and 

add pictures directly from the phone – 

anywhere, anytime. They have also 

released TRIOS Unite, which delivered 

significant improvements to the workflow 

and communications. 

He explained: “Little additions like 

enabling partners to chat, so they do not 

need to keep checking emails, creating 

a URL for the lab to share a case with a 

practice that may not be using 3Shape 

solutions, or DIY order forms for labs, 

these types of initiatives go a long way 

in making dental professionals and their 

workflows more efficient.” 

3Shape has also taken advantage 

of social media to stay close to 

dental professionals considering it 

as a learning and sharing platform. 

Fisker shared that on Facebook, 

there are two study groups focusing 

on 3Shape solutions, and combined 

they have nearly 45,000 members. He 

considers this as a great resource for 

understanding their customers. 

“That is a lot of people talking about 

digital workflows, tips and tricks and 

even complaining about something. 

But it gives us a direct and instant 



apartment to being a business leader and 

innovator across the globe. The cool thing 

though, is somehow we have managed to 

retain that entrepreneurial spirit of always 

wanting to get better, grow and be open to 

new ideas.” 

Fisker considers South East Asia (SEA) 

as a terrific market for digital dentistry 

as many of the countries are already 

electronically savvy that adopting new 

technology is second nature. In addition, 

digital pathways provide an opportunity 

to deliver more cost-effective treatments. 

connection to what is happening out 

there. I would quickly run out of fingers 

counting the amounts of times we have 

received a suggestion for a new feature 

from a study group and then made it 

happen in the next software update,” 

he commented. 

Fisker highlighted that working alongside 

dental professionals to translate their 

ideas into reality is the cornerstone of 

3Shape’s product development. 

SHAPING THE FUTURE 

Undoubtedly, 3Shape has become a 

major player in the dental industry 

shaping the future of digital dentistry. 

Being one of the pioneers in 3Shape 

– in fact, the third employee – Fisker 

himself was astonished as to how 

3Shape changed over the years as an 

organisation and a trailblazer the field. 

He shared: “What I have witnessed is us 

go from a little start-up in a Copenhagen 

He concluded: “In many of the rural areas, 

a digitally printed prosthesis may be the 

only affordable alternative for a person 

and could literally mean the difference 

between life and death for some patients. 

The more digital penetration in the SEA 

market, the more people will have access 

to dental treatment. 

“We see lots of innovative business 

models for selling intraoral scanners 

around the world, I think if entrepreneurs 

and even governments could get behind 

dental professionals and make them easier 

to purchase, it would be a tremendous 

benefit to millions of people.” DA 



The 

hundred 

years 

of Shofu 

Established on 15 May 1922 in Kyoto, Japan, 

Shofu is a global manufacturer deeply 

involved in the field of dentistry offering a 

wide range of dental materials, equipment 

and instruments. 


Over the years, the treatment 

philosophy in dentistry has shifted 

from invasive to a more conservative 

approach – with Shofu spearheading 

development of products and 

technologies, emphasising prevention 

and preservation of natural tooth 

structure. 

Commemorating their centennial 

anniversary, Mr Noriyuki Negoro, CEO 

and chairman of Shofu, takes a trip 

down memory lane with Dental Asia 

to ponder on the company’s founding 

years, and elaborates on how they will 

continue to revolutionise the dental 

industry in years to come. 

FOUNDING YEARS 

Mr Kajo Shofu III, the founder of 

Shofu, was involved in numerous 

businesses, including the export of 

ceramics, industrialisation of ceramic 

manufacturing, and the insulator 

business based on Kiyomizu-yaki 

porcelain technology, as Mr Negoro 

shared. 

In 1915, during a visit to North America 

to expand sales channels for the export 

of ceramics, the founder was advised by 

Dr Mitsuru Okada, MD (later professor 

of oral surgery at Keio University School 

of Medicine) on the need for domestic 

production of high-grade porcelain teeth. 



The journey was not a walk in the 

park – as it required identifying 

tooth shapes and sizes suitable 

for the Japanese people, sourcing 

biocompatible materials and 

appropriate manufacturing methods. 

Seven years later, after overcoming 

several challenges, Mr Shofu III 

realised his dream with the help 

and cooperation of many people to 

successfully manufacture the first 

high-grade porcelain teeth in Japan – 

laying the cornerstone for Shofu. 

In 1965, Shofu succeeded in 

developing the world’s first dental 

spherical amalgam, “Shofu Spherical 

Amalgam”, recognised by clinicians as 

a revolutionary product with excellent 

handling and mechanical properties, 

and was considered a breakthrough in 

the dental industry. 

the Japanese dental industry to be 

listed in the Osaka Stock Exchange 

and subsequently in the Tokyo Stock 

Exchange in 2007,” he added. 

Since then, the company has diversified 

its product range to include not only 

artificial teeth, but a wide variety of 

dental products, laboratory materials, 

preventive products, and materials for 

digital dentistry. Now an international 

enterprise, Shofu has subsidiaries and 

sales offices in the US, Germany, UK, 

Singapore, China and in recent years 

Italy, India, Brazil, the Middle East and 

Taiwan. 

Mr Negoro continued: “These 

developments aim to contribute towards 

improving the standards of dental care. 

The R&D-oriented and innovation-driven 

management approach adopted since 

the company’s founding is proof that our 

founder’s passion for ‘high aspirations 

and drive for achieving them’ lives on in 

our DNA.” 

COMMITMENT TO BETTER 

DENTISTRY 

According to the Global Burden 

of Disease study published by the 

World Health Organization (WHO) in 

2016, dental caries remains the most 

common disease in the world, despite 

regional disparities due to economic 

status and healthcare systems. The 

Lancet and Journal of Dental Research 

also reported that more than 30% of 

people have untreated dental caries. 

Hence, Shofu’s vision is to continue 

to provide proven products for better 

dentistry worldwide with a commitment 

to quality and excellence, emphasising 

that beautiful teeth are the symbol of 

health and happiness. 

Additionally, the company’s rotary 

instruments was well regarded, 

and the brand reputation of “Shofu 

Abrasives” was established not only 

in North America but also in the 

global market. 

Such innovation helped propel the 

company’s overseas expansion, 

leading to the establishment of sales 

offices in the US in 1971, Germany in 

1978 and Singapore in 1980. 

Mr Negoro also shared that during 

the 1980s when Shofu was under 

a crisis due to Japan’s healthcare 

reform, then President Kajo Shofu V, 

changed the company’s focus from 

quantity to quality and implemented 

management reforms to ensure the 

company’s survival, under the slogan 

of “Response to Change”. 

“The foresight of the president and 

commitment of the employees 

resulted in the development of a 

series of high-quality value-added 

products that helped transform the 

company into a highly profitable 

business. As a result, in 1989, Shofu 

became the first company from 

Mr Noriyuki Negoro, CEO & chairman of Shofu (Left) with Mr Tetsuo Takami, president & COO of Shofu (Right) 



With the dental field continuously 

evolving digitalisation, artificial 

intelligence (AI), and dental material 

science taking the centre stage in 

product innovation, Shofu maintains 

profitability and growth by identifying 

expansion opportunities. 

“As a company, we had focused our 

business activities mainly in Japan, 

a stable market with a generous 

national medical insurance system 

and successfully introduced many 

revolutionary products over the years 

contributing to the development 

of dentistry. Our success in the 

domestic market laid the foundation 

for international expansion, with more 

strategic business activities extended 

beyond Japan to capture the global 

market,” he explained. 

Based on their management philosophy 

and vision, Shofu is actively engaged 

in business activities to increase 

their global presence with continued 

efforts to provide evidence-based 

product innovations using cutting-edge 

technology with end-to-end solutions 

for the wider dental community. 

And although the company promotes 

globalisation in its business activities 

internally and externally, Mr Negoro 

highlighted that it is equally important 

for them to adapt to local needs across 

diverse markets. 

For instance, the Shofu Dental Asia- 

Pacific subsidiary has been a crucial 

part of Shofu’s global footprint looking 

S-PRG Technology 

after its growth in the Asia-Pacific and 

Middle-East markets. Recognising that 

the local treatment trends had shifted 

from aggressive to minimally invasive, 

Shofu has become the official partner 

of the Minimally Invasive Cosmetic 

Dentistry (MiCD) Global Network and its 

digital platforms. 

Mr Negoro shared: “Our team at Shofu 

Dental Asia-Pacific felt that the MiCD 

philosophy matched very well with 

the benefits of our range of bioactive 

products, hence we have worked closely 

with Dr Sushil Koirala and like-minded 

clinicians to establish the MiCD Concept 

and treatment protocol.” 

BRIGHT SMILES FOR THE NEXT 

CENTURY 

Commemorating their rich history and 

legacy of product innovations toward 

enhancing smiles, Shofu launched their 

100th-anniversary logo and slogan 

representing their commitment to 

contributing to the bright smiles of 

people globally for the next century. 

Mr Negoro noted that as the company 

values the tireless efforts of its people, 

the slogan was selected from the 

employee submissions: “The ‘0’ in the 

centre of the ‘100’ figure takes the form 

of a tooth and a face depicting a ‘bright 

smile’. The line extending from the roots 

of the tooth towards the Shofu logo 

indicates the progress of the company 

over the years from 1922 to 2022, and 

the journey ahead for the next 100 years.” 

Looking ahead, Mr Negoro foresees that 

public health focus would shift towards 

prevention and oral health education. 

He also predicts that AI-driven remote 

examination with digital diagnostic 

techniques and preventive treatment 

will be implemented in each generation, 

especially in the ageing population. 

He elaborated: “Adequate oral hygiene 

maintenance becomes more challenging 

in older age group due to chronic 

diseases such as diabetes, druginduced 

xerostomia and other medical 

conditions as they retain more teeth. 

Unlike in the past, implant-supported 

dentures and partial dentures are 

becoming more popular increasing the 

risk of oral disease.” 

Therefore, Shofu targets to expand 

their Giomer/S-PRG technology 

into various areas and to enrich the 

Giomer product tree, with a specific 

elder care product range that includes 

a homecare treatment regimen for 

exposed root surfaces and denturerelated 

products. 

“S-PRG fillers are incorporated into 

new bioactive materials based on 

our proprietary technology (PRG 

technology), and have been proven 

to provide bioactive benefits such 

as inhibiting bacterial growth and 

adhesion, reduction in plaque formation, 

acid neutralisation and increased acid 

resistance by strengthening the natural 

tooth structure,” he explained. 

A gateway to overall health, oral health 

is essential for people to lead rich 

and fulfilling lives. As the world enters 

the era of a 100-year human lifespan, 

Mr Negoro concluded that the role 

of dentistry will become increasingly 

important in extending people’s healthy 

life expectancy. 

“For the next 100 years, we will continue 

to contribute towards the advances in 

dentistry while embracing the challenge 

of creating bright smiles that improve 

the quality of life of people around 

the world. In the past 13 years, I have 

served as the president and CEO of the 

company and am proud to announce 

that Mr Tetsuo Takami has now 

become my successor as the president 

and COO effective 24 Jun 2022. 

“I will oversee the management of 

the company as CEO and chairman, 

while Mr Takami will be responsible for 

business execution. We will continue 

to focus on developing innovative 

solutions that meet the changing trends 

in dentistry and we are looking forward 

to the future growth of Shofu under the 

new management.” DA 



Effects of PBM on implant 

and bone grafting after 

sinus elevation 

Dr Kevin Ng and Dato’ Dr How Kim Chuan discuss the use 

of photobiomodulation (PBM) device with 42 LED cores 

producing 650nm wavelength light in shortening treatment 

time and improving surgical outcome. 

Maxillary bone resorption after 

extraction of posterior teeth could 

cause severe bone loss and greatly 

reduce bone height and volume at 

the sinus base if the edentulous 

sites were not loaded for a long 

period. It may not show apparent 

sign and symptoms and not cause 

any concerns to patient; however, 

the resorption process is irreversible 

unless treatment is performed. 

Eventually, it will become an 

obstacle in placing dental implants 

and the average treatment time to 

graft and gain bone is usually long 

to achieve satisfactory results. 

These factors have been bothering 

dentists and patients since 

treatment outcomes may not 

always be successful if implant 

stability is not achieved. To assist 

graft, bone healing and growth, 

and at the same time, enhance 

patient cooperation and compliance, 

photobiomodulation (PBM) can be 

utilised to reduce pain and shorten 

treatment time. 

Although different clinicians hold 

different views regarding to the 

application of PBM to influence bone 

regeneration and outcomes, the 

following case showed satisfactory 

patient feedback and acceptable 

clinical result. 

Fig. 1 

Fig. 2 

Fig. 3 

THE PBM DEVICE 

The bite plane device consists of 42 

LED cores and the power input is 

4.2V. The current of each LED core is 

7mA. The LED cores produce light of 

650nm wavelength to stimulate the 

target sites. The energy absorbed 

after six minutes stimulation per 

arch is about 306.5 joules (Figs. 1-3). 

The manufacturer claims that the 

science of PBM mechanism is to 

enhance the biological activities at 

cellular level of the treatment area 

and improve the healing of bone and 

soft tissues and further enhance 

bone growth and repairs. 



Figs. 4a 

Figs. 4b 

Figs. 4a-b: Pre-treatment (a) OPG planning and 4b CT view show only 2mm bony height (b) OPG planning for augmentation site 

Figs. 5a 

Figs. 5b 

Figs. 5a-b: Post-treatment (a) Bone graft after five weeks (b) Week 10 - implants ready to load 

Figs. 6a 

Figs. 6b 

CASE REPORT 

A 55-year-old male patient presented 

with severe bone loss at the upper 

right molar region (teeth 15, 16, 17 

area) with only 2-3mm remaining 

bone height (Figs. 4a-b). The patient 

had difficulty chewing on the right 

side and requested for dental 

implant. The medical history was 

clear and he had received implants 

before at teeth 45 and 46. 

Sinus floor elevation was performed 

by external window and 2cc of 

graft were placed with membrane 

protection. PBM was prescribed 

to patient for 5-6mins daily. Pain 

thresholds were recorded for two 

weeks post-operatively. Two dental 

implants were placed at teeth 15 and 

16 areas five weeks after the graft 

with insertion torques of 40N, that 

were achieved with ISQ 65, 68. PBM 

was continued for 5mins daily in 

another five weeks before ISQ 70 

were recorded for both implants 

and successfully loading with two 

splinted crowns restoration. 

The total treatment time was 10 

weeks, and the patient reported 

that the chewing function was 

satisfactory after the splinted 

crowns were constructed. The 

PBM device was utilised for 5mins 

daily and the patient was advised to 

return to clinic monthly to check 

stability of implant and ensure 

good oral hygiene. At the same 

time, the patient was also informed 

to record the degree of pain or 

discomfort in the given form during 

treatment. The feedback pain 

scores were two to three for the 

whole period. OPG was taken after 

treatment revealing uneventful 

healing with no sign of infection 

(Figs. 5a-b, 6a-b). 



Fig. 7a 

Figs. 7a-b: Energy of light is absorbed 

Fig. 7b 

were released in the gingival crevice and 

affect bone remodelling. PBM stimulations 

have increased the levels of IL-1β, IL-8, 

OPN, and PGE2 LLLT was statistically 

related to an increase of IL-1β levels. It was 

suggested cytochrome c oxidase present in 

mitochondria of cells can absorb photons 

and convert this EMF energy into chemical 

energy (ATP). Surgical manipulation causes 

wound tissue ischemic and hematopoietic. 

Precursor cells and fibroblasts decrease ATP 

and metabolism, PBM deliver energy to cells 

and increase ATP production which aids 

wound or tissue healing and bone formation 

with increased blood supply to the area 17 . 

Fig. 8a 

Figs. 8a-b: Implant healing process 

DISCUSSION 

Dentists routinely use external sinus lift 

technique for augmentation of maxillary 

sinus to increase bone height and volume, 

enhancing implant stability. The surgical 

procedure is complicated and involves 

buccal wall removal to place sufficient graft 

materials for maximum bone volume to grow. 

The post-operative pain and complications 

cause concerns to dentists and patients. 

With the usage of PBM devices in different 

specialties of dentistry in the past decade, 

Kau in 2013 assessed 73 patients and 17 

controls who were fitted with traditional 

orthodontic brackets and wires and treated 

with 850nm wavelength near-infrared light 

with a power density of 60mW/cm2 for 20- 

30mins per day. He observed PBM achieved 

clinically significant accelerated tooth 

movements as compared to control group. 

Lao proposed PBM is a non-invasive 

stimulation of the dentoalveolar complex 

with ATP production at the mitochondrial 

cells. Due to increased metabolic activity, 

ATP is increased at a localised level and 

cause remodelling process. Infrared 

light double cytochrome oxidase level 

which mediates ATP production. Higher 

Fig. 8b 

ATP availability accelerate cell turnover 

resulting faster remodelling process 

and tooth movement. A total of 1.12mm 

movement per week for PBM group were 

observed compared to 0.49mm in control 

group (Figs. 7a-b, 8a-b). 

The mechanism of PBM is due to certain 

biological wavelengths elicited by the 

LED cores that have therapeutic effects at 

cellular levels. The photon source after LED 

produced favourable effects both in animal 3 

and recently human clinical studies 12,14,15 . 

The early clinical trial started with pain 

control, tooth movement acceleration, and 

increase bone remodelling and quality. 

Recently, this therapeutic technology had 

success reports on the improvement in 

mini-screw stability, TMD disorders, root 

resorption, bone consolidation during 

maxillary expansion and distraction 

osteogenesis. It is easy to operate and 

non-invasive, the clinical use is wide. Shan 

et al. in 2021 found that PBM had promising 

effect on post-orthodontic root resorption 

rehabilitation 1 . 

Reis et al. in 2021 suggested during 

orthodontic tooth movement, cytokines 

Brawn et al. in 2017 investigated the use of 

Biolux light emitting diode phototherapy 

daily for 21 days on extracted socket with HA 

grafting. They found there was accelerated 

bone healing in the phototherapy-treated HA 

socket graft. This may provide faster implant 

osseointegration and healing compared to 

control group 17 . 

Ekizer et al. in 2016 studies found PBM had 

potential of accelerating tooth movement 

and had a positive effect on mini-screws 4,9 

and these results were agreed by Asparanin 

et al. in 2019. They found that there was 

statistically significant difference between 

PBM therapy compared to non-stimulated 

group with a mean difference of 0.59 8 . It 

was proposed that the action of LPT IL-1B 

attract leucocytes and stimulate fibroblasts, 

endothelial cells, osteoclasts cause the 

effects 9 . 

In another study, Ozturk in 2020 found PBM 

applications has showed inhibitory and 

reparative effects on OIIRR by modulating 

the RANKL and COX-2 expression levels, 

which include resorption lacunae volume (p 

& lt; 0.001), number of resorption lacunae (p 

& lt; 0.05), and percentage of the resorption 

(PR) lacunae (p & lt; 0.001). The levels 

decreased with PBM applications when 

compared with the positive control groups. 

They also found the effects of the different 

wavelengths were similar 7 . 

Sfondrini et al. in 2020 studied the pain 

experience on subjects with banded maxillary 



first molars. Each molar received one 

session of PBM treatment on two buccal and 

two palatal points. In the trial group, PBM 

treatment has shown to be an alternative 

to decrease pain sensation as compared to 

control group 11 . 

Reis et al. in 2021 suggested during 

orthodontic tooth movement, cytokines 

were released in the gingival crevice and 

affect bone remodelling. PBM stimulations 

have increased the levels of IL-1β, IL-8, OPN, 

and PGE2 LLLT was statistically related to an 

increase of IL-1β levels 10 . 

Abellán in 2021 use intraoral scanner and 

CBCT to study molar intrusion using mini 

screw as anchorage. Again, they found 

the technique is effective in accurately 

monitoring the intrusion distance 

(p > 0.05). CBCT records allowed volumetric 

evaluation of the root resorption process 

and found lesser in the PBM group. They 

also suggested: ‘’application of PBM may 

provide better periodontal records and 

lower progression of root resorption at the 

expense of little lower intrusion distance 

and velocity’’ 5 . 

Both Kwong in 2022 and Kulkarni in 2019 

reported several in vivo and in vitro studies, 

revealing that PBM improved bone wound 

repairs after surgery when compared with 

control groups. Dental implants stability 

were also improved with less pain 17,18 . 

Finally, Caccianiga in 2022 reported 30 

patients treated rapid palatal expansion. Pain 

was significantly lower in the experimental 

group 16 . PBM was used in orthodontics 

together with anchoring TAD micro-screws 

as stability. After 60 days post-treatment, 

significantly higher stability was noted in the 

PBM group, and the authors had concluded 

that application of the 808nM diode laser 

increased micro-implant stability clinically. 

PBM also decreased pain felt by patient 2 . 

CONCLUSION 

With the updated literature presented 

above, it is possible to apply PBM safely to 

assist sinus lifted patient and to improve 

treatment time and outcome for patients 

who have received implant treatments. 

The findings here suggest that intraoral 

PBM could be used to reduce pain and 

discomfort and improve quality of bone 

formation that could promote bone healing 

and osseointegration of dental Implants. 

The healing time and loading time had been 

reduced to half in this case. However, due 

to its research limitations, further extensive 

research by multi-centred, randomised 

clinical trial is suggested. DA 

REFERENCES 

1. 

Shan Z, Wong K, McGrath C et al (2021) 

Comprehensive Effects of Photobiomodulation 

Therapy as an Adjunct to Post-orthodontic 

Treatment Care: A Systematic Review. Oral Health 

& Preventive Dent 19:203-216 quintpub.com 2021 

2. 

Matys, J.; Jaszczak, E.; Flieger, R.; Kostrzewska- 

Kaminiarz, K.; Grzech-Leśniak, K.; Dominiak, 

M. Effect of ozone and diode laser (635 nm) in 

reducing orthodontic pain in the maxillary arch—a 

randomised clinical controlled trial. Lasers Med. 

Sci. 2020, 35, 487–496 

3. 

Melo Conti C, Suzuki H et al(2019) Effect of PBM 

on root resorption induced by orthodontic tooth 

movement and RANKL/OPG expression in rats. 

Photochemistry and Wiley Online Library 

4. 

Atsawasuwan P, Shirazi S (2018) Advances in 

orthodontic tooth movement: gene therapy and 

molecular biology aspect Current approaches in 

Orthodontics, pp 41-68 2018-books.google.com 

5. 

Abellan R, Gomez C, Palma J (2021) Effect of PBM 

on the Upper first molar intrusion movement using 

mini-screw anchorage: A randomised Controlled 

Trial Photobiomodulation, Photomedicine, and 

Laser Surgery Vol. 39, No. 8-liebertpub.com 

6. 

Kumar AN, Jadhav V et al ((2021) Light Emitting 

Diode Mediated PBM Therapy in Orthodontics-A 

Review of Contemporary Literature Journal of 

Evolution of Medical and Dental Sciences(Vol. 10, 

Issue 32) 

7. 

Ozturk T, Amuk GN (2020) Effect of PBM at 

different wavelengths on orthodontically induced 

root resorption In orthodontic retention period : a 

micro-CT and RT-PCR study. Lasers Med Sci 2020 

35: 1419-29 

8. 

AlShahrani I, Togoo RA Hosmani J (2019) 

PBM in acceleration of orthodontic tooth 

movement: A systemic review and meta analysis 

Complementary Therapies in medicine Vol 47 2019 

–Elsevier 

9. 

Ekizer A, Türker G, Uysal T, Güray E, Taşdemir 

Z (2016) Light emitting diode mediated 

photobiomodulation therapy improves orthodontic 

tooth movement and mini-screw stability: a 

randomized controlled clinical trial. Lasers Surg 

Med 48(10):936–943 

10. 

Reis C, Furtado T,Mendes W (2021) PBM impacts 

the levels of inflammatory mediators during 

orthodontic tooth movement? A Systemic review 

with meta-analysis Lasers in Medical Sc 2021 

Springer 

11. 

Sfondrini MF, Vitale M, Pinheiro ALB (2020) 

PBM and pain reduction in patients requiring 

orthodontic band application: randomized clinical 

trial BioMed res Int Article ID 7460938 2020 – 

hindawi.com 

12. 

Heravi F, Moradi A, and Ahrari F, (2014) The 

effect of low level laser therapy on the rate of 

tooth movement and pain perception during 

canine retraction Oral Health and Dental 

Management, vol. 13, no. 2, pp. 183–188 

13. 

Shaughnesy T, Kantarci A et al (2016) 

Intraoral photobiomodulation-induced 

orthodontic tooth alignment: a preliminary 

study, BMC Oral Health volume 16, Article 

number: 3 

14. 

Kau CH, Kantarci A, Shaughnessy T et 

al (2013) Photobiomodulation accelerates 

orthodontic alignment in the early phase of 

treatment Progress in Orthodontics volume 14, 

Article number: 30 

15. 

Deana NF, Zaror C, Sandoval P, Alves N 

(2017) Effectiveness of Low-Level Laser 

Therapy in Reducing Orthodontic Pain: A 

Systematic Review and Meta-Analysis. Pain 

Res Manag 

16. 

Caccianiga G et al (2022) Pain Reduction 

during Rapid Palatal Expansion Due to LED 

Photobiomodulation Irradiation: A Randomized 

Clinical Trial Life 2022, 12, 37. 17. Brawn P, 

Kwong A (2007) 

Histologic comparison of light emitting diode 

phototherapy-treated hydroxyapatite-grafted 

extraction sockets: a same-mouth case study 

Implant Dent 2007 Jun;16(2):204-11 

17. 

Kwong A, Kantarci A (2022) PBM Implant: 

Intraoral PBM Device Dental Asia May/June 

2022 pp34-36 

18. 

Kulkarni S, Meer M, George R (2019) Efficacy 

of photobiomodulation on accelerating bone 

healing after tooth extraction: a systemic 

review, Lasers Med Sci 34: 685-692 

ABOUT THE AUTHORS 

Dr Kevin Ng is 

a specialist in 

community dentistry, 

a visiting professor 

at Guangzhou 

Medical University, 

and was a Hon a/clinical professor at 

the University of Hong Kong from 2017 

to 2019. 

Dato’ Dr How 

Kim Chuan is the 

president of ICD 

Section XV and the 

Osseointegration 

Society of Malaysia, 

and a visiting 

professor at Zhejiang Chinese Medical 

University; a visiting associate professor 

at both the Air Force University and 

Hong Kong University. 



Root coverage on a 

gingival recession type 2 

Dr Francesca Daye See-Santos presents a coronally-advanced flap 

with subepithelial connective tissue graft to address periodontal 

attachment loss due to aggressive toothbrushing. 

A 45-year-old female came to the 

periodontics department of the 

University of the East-Manila, 

complaining about how her maxillary 

canines appear longer than before. 

The patient has an unremarkable past 

medical history and no known vices 

such as smoking or alcoholism. 

Upon intraoral examination, several 

dental caries and non-carious cervical 

lesions (NCCL) were observed. The 

patient was currently wearing upper 

removable prosthesis and admits 

of aggressive toothbrushing on her 

remaining natural teeth. 

Deep NCCL restorations have been 

done to some of her posterior 

teeth, while surgical root coverage 

procedure was discussed to be done 

on her maxillary canines. Patient’s 

labial probing depths in millimetres 

were 2, 2, 2 (distal to mesial) and 

gingival margins were +2, +5, +1 (distal 

to mesial). Clinical attachment loss 

computed was as 4mm on mesial, 

7mm at midroot and 3mm on distal. 

DIAGNOSIS 

As per gingival recession classification 

by Cairo et al., where interdental 

clinical attachment loss is measured, 

the patient’s gingival recession on 

the right maxillary canine is classified 

as Recession Type 2 (RT2). RT2 is 

characterised by the interproximal 

attachment loss being less than or 

equal to the buccal attachment loss 

(Figs. 1a-d). 

SURGICAL PROTOCOL 

After disinfection with chlorhexidine 

mouth rinse, supraperiosteal 

infiltration on labial and palatal was 

performed and the exposed root 

of tooth 13 was scaled and planed 

using 2R/2L universal curette. Local 

anaesthesia given was 2% Lidocaine 

HCl with 1:100,000 epinephrine. 

Fig. 1a 

Fig. 1b 

The recipient site was prepared 

by making a trapezoidal partialthickness 

flap with two vertical 

incisions mesiodistally with the use 

of a 15c blade (Fig. 2). A sterile strip of 

aluminium foil is used as a template 

for harvesting donor tissue and 

Fig. 1c Fig. 1d Fig. 2 

Figs. 1a-d: Pre-operative intraoral photos and radiograph (Tooth 13) 

Fig 2: Trapezoidal partial thickness flap (two releasing incisions) 



Fig. 3a Fig. 3b Fig. 3c 

Figs. 3a-c: Preparation of recipient site and application of root conditioner 


Figs. 4a-c: Pre-operative photos of harvesting of connective tissue graft on palate donor site. 

(a) Bleeding points noted (b) harvested palatal tissue with 3mm of keratinised mucosa (c) donor site 

bleeding points were done (Fig. 4a). 

The planned donor connective tissue 

was characterised by an epithelial cuff 

covering half of the harvested tissue 

and is to be placed coronally at the 

recipient site. 

Using a 15c blade, a partial thickness 

horizontal incision was made 6mm 

apical to the gingival margin in the 

palate, then another horizontal 

incision at full thickness was made 

3mm apical to the palatal gingival 

margin. It was followed by a full 

thickness vertical incision mesiodistally 

approximating the width and length of 

the necessary graft. 

A primary partial-thickness flap 

(1.5mm thick) was prepared toward 

the centre of the palate, parallel 

to the palatal gingiva so that the 

underlying connective tissue is 

exposed. The connective tissue 

graft was reflected, and was 

brought toward the centre of the 

palate and separated from the 

bone using a surgical blade 15. An 

absorbable haemostatic gel was 

placed on the palatal surgical site 

to control bleeding (Figs. 4a-c). 

At the recipient site, smear layer 

was removed on exposed root 

surface with tetracycline solution 

on a piece of cotton, left for three 

minutes, and washed thoroughly. 

The connective tissue graft was 

positioned at the recipient site with 

the thin border of epithelium coronal 

to cemento-enamel junction (CEJ). 

Interrupted sutures using Vicryl 

5-0, 3/8 reverse cutting 12mm needle 

was placed on the interdental papilla 

to secure the graft in place, followed 

by multiple periosteal sutures at the 

edges of the graft for stability. An 

interdental concavity suture was 

done to prevent dead space formation 

under the graft. The partial thickness 

flap was displaced coronally to 



Before any elective oral surgical procedures, 

systemic health, smoking and oral hygiene 

must be considered because healing of the 

surgical site may be compromised. For root 

coverage procedures, gingival recession 

classification should be taken into account 

for predictable outcomes. 

Fig. 5a 

Fig. 5b 

Fig. 5c Fig. 6 

Figs. 5a-c: (a) Connective tissue graft placement (shaded region shows keratinised mucosa) 

(b) subepithelial connective tissue graft secured with interdental concavity sutures and periosteal sutures 

(c)Partial thickness flap secured with interrupted sutures 

Fig. 6: Post-operative photo after seven days 

Miller classified gingival recessions into 4 

classes based on severity: 

A. Class I: Marginal tissue recession does not 

extend beyond the mucogingival junction 

(MGJ) and no loss of interproximal tissue. 

B. Class II: Marginal tissue recession 

extend to or beyond MGJ, with no loss of 

interproximal tissue. 

C. Class III: Marginal tissue recession 

extends to or beyond MGJ, with some loss 

of interproximal tissue or tooth rotation and 

interproximal bone is still coronal to the 

apical extent of the recession 

D. Class IV: Marginal tissue recession 

extends to or past the MGJ, with severe loss 

of interproximal tissue or tooth rotation. 

cover the graft as much as possible and is 

secured with sutures (Figs. 5a-c). Lastly, 

several interrupted sutures were placed 

on the palatal donor site to hold the blood 

clot as well as the haemostatic gel (Fig. 4c). 

Post-operative instructions for bleeding, 

wound care, diet and oral hygiene were 

given. Over-the-counter analgesics were 

prescribed and patient was dismissed 

with minimal bleeding on both surgical 

sites. Patient was instructed to avoid 

warm or hot food and beverages, place 

cold compress only 20 mins of every 

hour for the first day, avoid chewing at 

the surgical site, avoid brushing on the 

area for the first few days, have a cold, 

soft diet, drink plenty of fluids, and gently 

gargle 10ml of undiluted 0.12% Orahex 

Mouthrinse for 30 seconds, twice a day 

for two weeks. 

The patient was informed to come back 

for follow-up checkup after seven days 

for review and to remove necessary 

sutures if needed (Fig. 6). 

DISCUSSION 

Gingival recessions are seen as the 

displacement of the gingival margin 

apically, thereby exposing the tooth’s root 

surface to the oral environment. They may 

be accompanied with sensitivity, which 

is one of the most common reasons for 

a patient to seek treatment, along with 

patient’s aesthetic complaints (Chan et al., 

2015 and Douglas et al., 2013). Causative 

factors include low-level, long-lasting 

trauma, chronic inflammatory periodontal 

disease, periodontal treatment and 

occlusal trauma (Jati et al., 2016). 

As the patient disclosed, her aggressive 

toothbrushing habit caused chronic 

trauma to the delicate gingival tissues and 

consequently making her teeth appear 

longer. Cervical abrasions may be also 

observed in patient with inappropriate 

brushing techniques. Patients with bone 

dehiscence, tooth malposition, thin gingival 

tissue, inadequate attached gingiva and 

frenal pull can predispose the patient to 

receding gingival margins (Chan et al., 2015). 

Classes I and II expect 100% root coverage, 

Class II expects 70% root coverage and 

Class IV less than 50%. Limitations for this 

classification were noted such as difficulty 

of Class I and Class II identification and 

prognosis per classification no longer 

matches the predicted outcome when 

more advanced surgical techniques were 

performed (Pini-Prato, 2010). 

The patient has a dental history of tooth 

extractions notably adjacent to the maxillary 

canines, which hastened proximal bone loss. 

Interproximal and buccal clinical attachment 

level is suggested to have predictive value for 

root coverage procedures (Cairo et al., 2011). 

Written below is the modern, treatmentoriented 

classification of recession based on 

interdental clinical attachment level: 

A. Recession Type 1 (RT1): Gingival recession 

with no loss of interproximal attachment. 

Interproximal CEJ is clinically not detectable 

at both mesial and distal aspects of the 

tooth. 

B. Recession Type 2 (RT2): Gingival recession 

associated with loss of interproximal 

attachment. The amount of interproximal 



attachment loss (measured from the 

interproximal CEJ to the depth of the 

interproximal sulcus or pocket) is less than 

or equal to the buccal attachment loss 

(measured from the buccal CEJ to the apical 

end of the buccal sulcus or pocket). 

C. Recession Type 3 (RT3): Gingival recession 

associated with loss of interproximal 

attachment. The amount of interproximal 

attachment loss (measured from the 

interproximal CEJ to the apical end of the 

sulcus or pocket) is greater than the buccal 

attachment loss (measured from the buccal 

CEJ to the apical end of the buccal sulcus 

or pocket). 

Areas with Cairo RT1 (Miller Class I and 

Class II) that had undergone treatment is 

predicted to achieve 100% coverage. Teeth 

with Cairo RT2 (Miller Class III overlap) may 

be observed to have 100% root coverage 

with different root coverage techniques. In 

recessions classified as Cairo RT3 (Miller 

Class IV overlap), complete root coverage is 

not achievable. 

The patient reported here cannot be 

classified as Miller Class I, though recession 

does not go beyond MGJ, interproximal 

tissue is present. Therefore, Cairo RT2 is 

well-suited for this case, interproximal 

attachment loss is less than buccal 

attachment loss. 

Researches over the years have been made 

in order to forecast results of root coverage 

procedures. One stated that the final 

position of the new gingival margin following 

such procedures may be determined by 

the interdental papilla as stated in some 

researches (Zuchelli et al., 2010) because of 

the blood supply provided by the interdental 

soft tissue and stability it may provide 

during healing. Gingival recession with 

interproximal bone loss was reported to only 

achieve partial root coverage (Miller 1985). 

Coronally-advanced flaps (CAF) with 

connective tissue graft enhanced complete 

root coverage probability compared 

coronally-advanced flaps alone (Cairo et al., 

2008). Restoration of the cervical abrasion 

of tooth 13 was not done due to the lack of 

Fig. 7a 

Figs. 7a-b: (a) Pre-operative photo (b) post-operative photo after 18 months 

deep wedge-shaped NCCL, although studies 

regarding root coverage procedures with 

Class V restorations have shown promising 

results (Zuchelli et al., 2011). Tetracycline 

hydrochloride application to the exposed 

root surface was done for it reported 

actions such as demineralisation of root 

surface, removal of smear layer, fibrin 

clot stabilisation, and increased fibroblast 

adhesion and growth (Dantas et al., 2008). 

The 18-month post operative periodontal 

probing values on the labial (distal to 

mesial) were 2, 2, 2 and gingival margin 

values were +2, +2, +1. Computed clinical 

attachment gain at distal site is 0mm, 

3mm gain at midroot and 0mm gain at the 

mesial site. Gingivoplasty was suggested 

to the patient for more aesthetic gingival 

form (Figs. 7a-b). DA 

REFERENCES 

• Chan HL, Chun YH, MacEachern M, Oates TW. 

Does gingival recession require surgical treatment? 

Dent Clin North Am. 2015;59:981–996. 

• Douglas de Oliveira DW, Oliveira-Ferreira 

F, Flecha OD, Gonçalves PF. Is surgical root 

coverage effective for the treatment of cervical 

dentin hypersensitivity? A systematic review. J 

Periodontol. 2013;84:295–306. 

• Jati, A. S., Furquim, L. Z., & Consolaro, A. (2016). 

Gingival recession: its causes and types, and the 

importance of orthodontic treatment. Dental Press 

Journal of Orthodontics, 21(3), 18–29. https://doi. 

org/10.1590/2177-6709.21.3.018-029.oin 

• Zucchelli, G., Mele, M., Stefanini, M., Mazzotti, 

C.,Mounssif, I., Marzadori, M. & Montebugnoli, 

L.(2010) Predetermination of root coverage. 

Journal of Periodontology 81, 1019–1026. 

• Miller, P. D. (1985) A classification of marginal 

tissue recession. International Journal of 

Periodonticsand Restorative Dentistry 5, 8–13. 

• Cairo, F., Nieri, M., Cincinelli, S., Mervelt, J., & 

Pagliaro, U. (2011). The interproximal clinical 

Fig. 7b 

attachment level to classify gingival recessions 

and predict root coverage outcomes: an 

explorative and reliability study. Journal of Clinical 

Periodontology, 38(7), 661–666. https://doi. 

org/10.1111/j.1600-051x.2011.01732.x 

• Pini-Prato, G. (2010). The Miller classification of 

gingival recession: limits and drawbacks. Journal 

of Clinical Periodontology, 38(3), 243–245. https:// 

doi.org/10.1111/j.1600-051x.2010.01655.x 

• Cairo, F., Pagliaro, U., & Nieri, M. (2008). 

Treatment of gingival recession with coronally 

advanced flap procedures: a systematic review. 

Journal of Clinical Periodontology, 35, 136–162. 

https://doi.org/10.1111/j.1600-051x.2008.01267.x 

• Zucchelli G, Gori G, Mele M, Stefanini M, Mazzotti 

C, Marzadori M, Montebugnoli L, De Sanctis M. 

Non-carious cervical lesions associated with 

gingival recessions: a decision-making process. J 

Periodontol 2011: 82: 1713–1724. 

• Dantas, A. A. R., de Paula Ishi, E., Batista, L. H. 

C., Onofre, M. A., & Sampaio, J. E. C. (2008). Smear 

Layer Removal and Collagen Fiber Exposure Using 

Tetracycline Hydrochloride Conditioning. The 

Journal of Contemporary Dental Practice, 9(5), 

25–33. https://doi.org/10.5005/jcdp-9-5-25 

ABOUT THE AUTHOR 

Dr Francesca Daye C. 

See-Santos 

graduated with a 

degree of Doctor of 

Dental Medicine in 

2014 and Masters of 

Science in Clinical Dentistry major in 

Periodontics in 2020 from the University 

of the East, College and Graduate School 

of Dentistry (Philippines), respectively. 

She is a visiting periodontics consultant 

at St Paul Augustine Dental Clinic in San 

Pablo City, Laguna, and a periodontist 

at Dayanghirang Dental Clinic, Manila 

branch. 



Endodontic perforation: 

The hole that pricks 

Dr Denzil Albuquerque and Dr Jojo Kottoor discuss the management and 

prevention of endodontic perforations to increase the success rate and 

predictability of treatment. 

passive ultrasonic activation (PUI) followed by 

heated obturation to obtain a hermetic seal up 

to working length. 

Tooth perforation is an artificial 

communication between the root canal 

system and the supporting tissues of teeth 

or to the oral cavity. They can either occur 

accidentally or due to pathologic causes 

like resorptions or caries. Accidental root 

perforations do occur in approximately 

2–12% of endodontically treated teeth that 

might have serious implications. 

Perforations occurring during root canal 

therapy may account for as many as 10% of 

all failed endodontic cases. In multi-rooted 

teeth, furcation perforations may occur 

whilst searching for the canal orifices, as 

dentin is removed from the pulpal floor. 

Misidentification of orifices or canals and 

routine endodontic causes (47%) along with 

over-zealous post space preparation (53%) 

are other common causes. 

The biologic response of a perforated tooth 

is inflammatory and can cause a breakdown 

of the osseous and peri-radicular tissues. 

This perforation acts as an open channel 

encouraging bacterial entry either from root 

canal or periodontal tissues or both eliciting 

inflammatory response that results in fistula 

including bone resorptive processes may 

follow. When perforation occurs laterally 

or in furcation area, there might be over 

growth of gingival epithelium towards the 

perforation site. There are only two options 

in managing perforations, repair via a coronal 

approach or surgically, or else extraction. If a 

tooth is restorable, then visibility and access 

to the perforation site determine treatment 

success. 

CASE REPORT 

A 40-year-old patient was referred by a 

dentist who encountered a bleeding point 

in a previously root canal treated tooth. The 

patient complained of mild, intermittent 

pain with her right mandibular first molar. 

Clinically, the tooth had a temporary occlusal 

filling and was tender to percussion and 

palpation. The gingiva had mild recession 

with furcal probing on the buccal. A preoperative 

x-ray and clinical exploration 

showed a bur-hole size furcal perforation 

along with thinning of the dentin on the 

pulpal floor. The radiograph confirmed 

an inadequate previously done root canal 

treatment and persistent apical periodontitis 

with both roots apices. 

Root canal retreatment was completed in 

a single visit. Key emphasis was placed on 

irrigation with 5% sodium hypochlorite and 

The furcal perforation was cleaned of any 

inflamed or granulation tissue, the dentin 

defect was smoothened out using slow 

speed burs and then filled with white 

mineral trioxide aggregate (MTA), (ProRoot 

MTA, DentsplySirona). The MTA was then 

immediately covered with a layer of resinmodified 

glass ionomer cement (Fuji, GC) 

followed by composite resin (Empress, 

Ivoclar). The patient was then referred back 

to the referring dentist for a bonded coronal 

restoration and was advised regular follow-up. 

DISCUSSION 

The best treatment for any complication 

is prevention. For instance, hasty and 

impatient work or inappropriate patient 

scheduling is avoidable. Sound knowledge and 

understanding of the internal and external 

tooth anatomy along with multiple angulated 

pre-operative radiographs add clarity and 

allow for improved planning before the 

procedure. 

Possessing the right tools and equipment and 

using them appropriately; like accurate bur 

orientation, slower speed, safe ended burs, 

measured depth of penetration are important 

factors in uneventful endodontics. Recognising 

change in handpiece angulation and thus 

access orientation due to restricted mouth 

opening or by the bow of rubber dam clamps 

is crucial. 

Use of magnification, adequate illumination, 

ultrasonics and long shank burs provide 



enhanced visualisation and thus better 

control. Negotiating calcified pulp chambers 

should be done with caution especially 

for completely attached pulp stones. 

Visualising the pulpal floor aided with 

magnification will prevent misidentification 

of orifices or canals. Using non-diamond 

rotary drills at slow speed and respecting 

canal and root dimensions will prevent 

perforations during post space preparation. 

The first sign of a perforation is sudden, 

profuse uncontrolled bleeding possibly 

accompanied with pain. Bleeding can be 

controlled by pressure or hypochloritesoaked 

cotton pellets on the pulpal floor, 

or paper points or calcium hydroxide 

within canals. 

If a perforation is suspected or perceived, 

it can be confirmed in the following ways. 

Direct visualisation using a dental operating 

microscope. Using radiographs with hand 

files extending through the perforation will 

demonstrate the files extruding laterally 

from the tooth outlines or a cone shift may 

be necessary. An apex locator is another 

useful gadget to accurately and quickly point 

out an undesired communication with periradicular 

tissues. CBCT scans are additional 

means of confirming the location and extent 

of the perforation defect. 

Once a perforation has been diagnosed, the 

most critical factor determining prognosis 

in the long term is time to treatment. 

Immediate or early sealing of the perforation 

provides the tooth the best prognosis in the 

long term. If a referral is needed, immediate 

temporary filling to seal the access cavity 

and an early appointment should be sought 

for an endodontist. 

The aim of perforation management is 

regeneration of healthy periodontal tissues 

against the perforation without persistent 

inflammation or loss of periodontal 

attachment. If there is a case of periodontal 

breakdown, then the aim here is to reestablish 

tissue attachment. The major 

factors determining the prognosis include 

size of the defect and its location; time and 

the duration of exposure to contamination, 

the material used to repair it. The material 

used to repair the defect along with the 

clinician’s skill are the only controllable 

factors. 

Numerous materials are available and 

have been used for perforation closure or 

repair. Among the most promising with 

dependable clinical results are bioactive 

materials including MTA, BioDentine 

(Septodont) and BioCeramics. Each have 

their advantages and disadvantages, but 

in the present case MTA was preferred 

because of its ease of availability and 

familiarity with the material along with 

long-term clinical evidence of success. 

A clean dentin surface allows for a good 

chemical and physical bond to form 

between the material and tooth substrate. 

An MTA carrier (MAPS System or Dogvan 

Carrier) should be used to place MTA on 

to the defect and compact it to a minimum 

thickness of 2mm. An internal matrix, like a 

collagen sponge or membrane (CollaCote) 

can be used as an apical barrier to prevent 

excess extrusion of MTA. Compacting MTA 

with low density materials like microapplicator 

tip, cotton pledget or butt end 

of paper points or gutta percha is always 

helpful. Additional use of low level, indirect 

ultrasonics allows for a more compact 

material fill. Once placed, MTA should be 

left undisturbed for maturation for about 

24-48 hours. 

Immediate adhesive reconstruction of the 

tooth provides less possibility for coronal 

leakage and strengthens the tooth. When 

MTA is used, it is preferable to place a 

barrier of resin modified GIC over the 

MTA and restore the tooth immediately. 

Biodentine, on the other hand, allows for 

immediate restoration after its setting time 

of approximately 12mins. 

Restoration of a perforated tooth should 

be planned with adhesive techniques, 

minimally destructive of remaining tooth 

structure. Preserving peri-cervical dentin 

and minimising transfer of excessive or 

prolonged occlusal forces on the tooth 

should be prioritised. 

In cases of furcal or lateral perforations, 

additional periodontal procedures may 

be necessary along with guided bone 

regeneration. Long-term follow up of all 

perforations are essential, to allow for early 

intervention whenever necessary. 

As more complex endodontic treatment 

cases are being attempted, it is not an 

unrealistic expectation that there will be an 

increased frequency of perforations in the 

future. Management of perforations is a lot 

more predictable if done early through a 

coronal access and using magnification. DA 

REFERENCES 

• Kratchman SI. Perforation repair and one-step 

apexification procedures. DCNA 2004; 48: 291–307. 

• Tsesis I, Fuss Z. Diagnosis and treatment of 

accidental root perforations. Endodontic Topics. 

2006;13:95–107. 

• Clauder T, Shin S J. Repair of perforations with 

MTA: clinical applications and mechanisms of action. 

Endodontic Topics 2006; 15: 32–55. 

• Mohammed S, Ashley MP, Darcey J. Root 

perforations: aetiology, management strategies and 

outcomes. The hole truth. BDJ 2016; 220: 171-180. 


Dr Denzil Albuquerque, 

MDS, is a clinician, 

writer and speaker 

with a private practice 

exclusively dedicated 

to microscope assisted 

endodontics, restorative and cosmetic 

dentistry at Mumbai, India. 

Dr Jojo Kottoor, MDS, 

is an academician and 

professor at Royal 

Dental College, Kerala, 

India. He runs a private 

practice dedicated 

to microscope assisted endodontics, 

restorative and cosmetic dentistry at 

Kochi, India. 


USER REPORT 

Biomimetic oral care: Preventing 

oral diseases with hydroxyapatite 

Hydroxyapatite is the main mineral component of tooth enamel and dentin. 

Used as an active ingredient in oral care products, Dr Bernard Siew, together 

with Dr Joachim Enax and Dr Frederic Meyer, discuss its effectiveness in the 

prevention of tooth decay and gum disease. 

Oral health in Singapore remains a big 

issue. Dental caries and periodontal 

diseases do not only affect children 

but also adults and the elderly. As the 

proportion of children with dental 

caries decreased between 1970 and 1994, 

recent data suggest an increase of this 

disease in children. 

Studies indicate a prevalence of dental 

caries of up to nearly 50% of young 

children (18 months to four years of 

age) 1 . Early childhood caries is a very 

serious problem 2 . A worse oral health 

status were reported in adults and the 

elderly. In a cohort of people aged 60 

or older, the proportion of people with 

natural teeth was only 10.3% in women 

and 12.8% in men, and many of them were 

edentulous (37% of women and 24% of 

men) 3 . The high level of tooth loss can be 

attributed to dental caries and periodontal 

disease 4-6 . 

Apart from the loss of teeth from oral 

diseases, other issues can affect the 

quality of life 7 . Dentin hypersensitivity, 

usually due to excessive enamel loss by 

attrition, abrasion or acid erosion, is well 

known to have a negative impact on an 

individual’s sense of well-being. Dentin 

hypersensitivity is a result of exposed 

dentinal tubules. Patients with dentin 

hypersensitivity often experience short 

and sharp pain when consuming cold or hot 

food and beverage 8 . 

The simplest process to prevent oral diseases 

and their resultant symptoms is with correct 

regular oral care. Tooth brushing for at least 

two minutes twice a day using an effective 

toothpaste is the basic standard of care. 

As more is understood of the demineralisationremineralisation 

process of our tooth structure, 

more research and development has led to the 

concept of pH control and supersaturation the 

tooth surfaces with minerals. 

These minerals were traditionally different 

types of fluoride such as monofluorophosphate,

USER REPORT 

control, confirmed the efficacy of HAP 

containing toothpastes as anti-caries 

agent. Limeback et al. recently published 

a meta-analysis summarising these 

results 16 . The results from this analysis 

confirm the efficacy of HAP as cariespreventive 

agent. HAP has been shown 

to remineralise enamel defects 26-27 , and 

to reduce bacterial adhesion on dental 

surfaces 28-29 . Furthermore, HAP can buffer 

acidic (caries) biofilms and simultaneously 

release calcium which can prevent the 

teeth from demineralisation and increase 

remineralisation 30 . 

Gum health 

Besides anti-biofilm (anti-adherence) 

properties of HAP, clinical trials report of 

improved gum health, when HAP-products 

are used for daily oral care. A German 

multi-centre trial has confirmed these 

results 31 . 

Fig. 1: Modes of action of HAP used as active agent for the prevention of oral diseases. HAP does not 

only form a protective layer on enamel and dentin, but also occludes dentin tubuli. The figure was 

originally published elsewhere 15 . 

sodium fluoride or stannous fluoride. 

However, fluoride has certain limitations, 

as calcium and phosphate are needed for 

the remineralisation-process 9 . Additionally, 

fluoride has to be applied in only small 

amounts for children (due to its toxicity), 

but rice-sized or pea-sized amounts 

of toothpaste have a limited cleaning 

efficacy 10 . 

The concept of biomimicry and its 

efficacy in toothpaste formulation was 

studied since the 1980s 11 . There have been 

developments of a biomimetic toothpaste 

with the aim of tackling early childhood 

caries as excessive fluoride exposure have 

traditionally led to dental fluorosis and 

fluoride toxicity 12-13 . 

HYDROXYAPATITE 

One possible option is choosing a 

hydroxyapatite-based toothpaste. 

Hydroxyapatite (HAP) is not only known 

to be the hardest material in our body as 

enamel (approximately 97% HAP), but also to 

be the main part of dentin (approximately 

70% HAP), and it can be synthetically 

produced to be used as active ingredient in 

oral care products 7,14 . 

Recently published studies, including 

clinical trials and meta-analyses report 

of HAP containing oral care products to 

be effective in preventing various oral 

diseases 7,15-18 . While fluoride, an active 

ingredient to prevent tooth decay 19 , has 

many confirmed or discussed side-effects 

(e.g. fluorosis) 12-13,20-22 , HAP shows good 

biocompatibility as it is the main part 

of human teeth 15,23,24 . In the scientific 

literature including in situ studies and 

clinical trials, HAP is described as an 

effective agent used in oral care 25 . Figure 

1 shows the modes of action of HAP as 

published elsewhere 15 . 

Caries prevention 

Placebo-controlled clinical trials, and 

comparative in vivo and in situ studies 

with fluoride toothpaste used as positive 

Erosion protection 

Dental erosion is increasingly prevalent as 

the reason for accelerated loss of enamel 

and dentin. When the pH of the oral 

environment drops below 5.5, the HAP 

crystal structure of the enamel dissolves 

leading to demineralisation of the 

enamel. Among others, Fabritius-Vilpoux 

et al. used a cyclic demineralisationremineralisation 

model, with or without 

the application of HAP. The results confirm 

that HAP is able to protect the teeth from 

mineral loss 18 . 

Prevention of dentin hypersensitivity 

Several clinical trials have shown that HAP 

can relieve sensitivity effectively after 

only three to five days when used twice 

daily 11,32 . Compared to other actives used 

for dentin hypersensitivity prevention, 

such as stannous fluoride, HAP does not 

stain teeth, but has a natural whitening 

effect 33 . Stannous fluoride is known to 

reduce dentin hypersensitivity, but at the 

same time leading to a yellow or brown 

stain on teeth 34 . Clinical trials and casereports, 

and a recently published metaanalysis 

come to the conclusion that HAP 

is effective at reducing sensitivity from 

external stimuli 17 . 


USER REPORT 

CONCLUSION 

Hydroxyapatite (HAP) is an effective 

active ingredient used in oral care 

products (toothpaste, gel, mouth rinse) 

to prevent tooth decay and gum disease. 

Further benefits are well known from 

clinical trials, such as preventing dentin 

hypersensitivity. Compared to other 

actives (i.e., fluorides), HAP shows 

good biocompatibility and is safe if 

swallowed. DA 

REFERENCES 

1. 

B. Lai, W.K. Tan, Q.S. Lu, Clinical efficacy of a 

two-year oral health programme for infants and 

toddlers in Singapore, Singapore Med J 59(2) 

(2018) 87-93. 

2. 

F. Meyer, J. Enax, Early childhood caries: 

Epidemiology, aetiology, and prevention, Int. J. 

Dent. 2018 (2018) 7. 

3. 

C.-T. Chiu, R. Malhotra, S.M. Tan, J. Lim, A. Chan, 

K.H. Teoh, S.T. Gan, Y. Saito, Dental health status 

of community-dwelling older Singaporeans: 

findings from a nationally representative survey, 

Gerodontology 34(1) (2017) 57-67. 

4. 

J.E. Frencken, P. Sharma, L. Stenhouse, 

D. Green, D. Laverty, T. Dietrich, Global 

epidemiology of dental caries and severe 

periodontitis - a comprehensive review, J Clin 

Periodontol 44 Suppl 18 (2017) S94-S105. 

5. 

P.C. Passarelli, S. Pagnoni, G.B. Piccirillo, V. 

Desantis, M. Benegiamo, A. Liguori, R. Papa, P. 

Papi, G. Pompa, A. D’Addona, Reasons for tooth 

extractions and related risk factors in adult 

patients: A cohort study, Int J Environ Res Public 

Health 17(7) (2020) 2575. 

6. 

M.A. Peres, L.M.D. Macpherson, R.J. Weyant, 

B. Daly, R. Venturelli, M.R. Mathur, S. Listl, R.K. 

Celeste, C.C. Guarnizo-Herreño, C. Kearns, H. 

Benzian, P. Allison, R.G. Watt, Oral diseases: 

a global public health challenge, The Lancet 

394(10194) (2019) 249-260. 

7. 

J. Enax, H.O. Fabritius, K. Fabritius-Vilpoux, 

B.T. Amaechi, F. Meyer, Modes of action and 

clinical efficacy of particulate hydroxyapatite 

in preventive oral health care − state of the art, 

Open Dent J 13 (2019) 274-287. 

8. 

D.G. Gillam, Dentine hypersensitivity: Advances 

in diagnosis, management, and treatment, 

Springer International Publishing2015. 

9. 

M. Epple, J. Enax, F. Meyer, Prevention of 

caries and dental erosion by fluorides-a critical 

discussion based on physico-chemical data and 

principles, Dent. J. 10(1) (2022) 6. 

10. 

S. Sarembe, C. Ufer, A. Kiesow, H. Limeback, 

F. Meyer, I. Fuhrmann, J. Enax, Influence of the 

amount of toothpaste on cleaning efficacy: An in 

vitro study, European journal of dentistry (2022). 

11. 

R.W. Huettemann, H. Doenges, Untersuchungen 

zur Therapie überempfindlicher Zahnhälse mit 

Hydroxylapatit, Dtsch. Zahnärztl. Z. 42 (1987) 

486-488 

12. 

M. Ekambaram, A. Itthagarun, N.M. King, 

Ingestion of fluoride from dentifrices by young 

children and fluorosis of the teeth--a literature 

review, J Clin Pediatr Dent 36(2) (2011) 111-21. 

13. 

R. Green, B. Lanphear, R. Hornung, D. Flora, E.A. 

Martinez-Mier, R. Neufeld, P. Ayotte, G. Muckle, 

C. Till, Association between maternal fluoride 

exposure during pregnancy and IQ scores in 

offspring in Canada, JAMA Pediatr (2019) 

e191729. 

14. 

H.-O. Fabritius, J. Enax, F. Meyer, Eine Reise ins 

Innere unserer Zähne/A Journey into our Teeth, 

Titus Verlag (2021). 

15. 

F. Meyer, J. Enax, B.T. Amaechi, H. Limeback, 

H.-O. Fabritius, B. Ganss, M. Pawinska, E. 

Paszynska, Hydroxyapatite as remineralization 

agent for children’s dental care, Frontiers in 

Dental Medicine 3 (2022). 

16. 

H. Limeback, J. Enax, F. Meyer, Biomimetic 

hydroxyapatite and caries prevention: a 

systematic review and meta-analysis, Can J 

Dent Hyg 55 (2021) 148-159. 

17. 

M.L. Hu, G. Zheng, H. Lin, M. Yang, Y.D. Zhang, 

J.M. Han, Network meta-analysis on the 

effect of desensitizing toothpastes on dentine 

hypersensitivity, J Dent 88 (2019) 103170. 

18. 

K. Fabritius-Vilpoux, J. Enax, D. Mayweg, 

F. Meyer, M. Herbig, D. Raabe, H.-O. Fabritius, 

Ultrastructural changes of bovine enamel 

and dentin surfaces under chemical erosion 

in presence of biomimetic hydroxyapatite 

crystallites, Bioinspir. Biomim. Nan. 10(4) (2021) 

132-145. 

19. 

T. Walsh, H.V. Worthington, A.M. Glenny, V.C.C. 

Marinho, A. Jeroncic, Fluoride toothpastes of 

different concentrations for preventing dental 

caries, The Cochrane database of systematic 

reviews (3) (2019). 

20. 

A.L. Choi, G. Sun, Y. Zhang, P. Grandjean, 

Developmental fluoride neurotoxicity: A 

systematic review and meta-analysis, Environ. 

Health Perspect. 120(10) (2012) 1362-1368. 

21. 

P. Grandjean, P.J. Landrigan, Neurobehavioural 

effects of developmental toxicity, The Lancet 

Neurology 13(3) (2014) 330-338. 

22. 

A.J. Malin, C. Lesseur, S.A. Busgang, P. Curtin, 

R.O. Wright, A.P. Sanders, Fluoride exposure and 

kidney and liver function among adolescents in 

the United States: NHANES, 2013–2016, Environ 

Int (2019) 105012. 

23. 

C.C. Coelho, L. Grenho, P.S. Gomes, P.A. 

Quadros, M.H. Fernandes, Nano-hydroxyapatite 

in oral care cosmetics: characterization and 

cytotoxicity assessment, Sci. Rep. 9(1) (2019) 

11050. 

24. 

J. Ramis, C. Coelho, A. Córdoba, P. Quadros, 

M. Monjo, Safety assessment of nanohydroxyapatite 

as an oral care ingredient 

according to the EU cosmetics regulation., 

Cosmetics 5(3) (2018) 53. 

25. 

K. O’Hagan-Wong, J. Enax, F. Meyer, B. Ganss, 

The use of hydroxyapatite toothpaste to prevent 

dental caries, Odontology, 110, 223–230 (2022). 

26. 

B.T. Amaechi, P.A. AbdulAzees, D.O. Alshareif, 

M.A. Shehata, P.P.d.C.S. Lima, A. Abdollahi, P.S. 

Kalkhorani, V. Evans, Comparative efficacy of 

a hydroxyapatite and a fluoride toothpaste for 

prevention and remineralization of dental caries 

in children, BDJ Open 5(1) (2019) 18. 

27. 

B.T. Amaechi, P.A. AbdulAzees, L.O. Okoye, F. 

Meyer, J. Enax, Comparison of hydroxyapatite 

and fluoride oral care gels for remineralization 

of initial caries: a pH-cycling study, BDJ Open 

6(1) (2020) 9. 

28. 

A. Kensche, C. Holder, S. Basche, N. Tahan, 

C. Hannig, M. Hannig, Efficacy of a mouthrinse 

based on hydroxyapatite to reduce initial 

bacterial colonisation in situ, Arch. Oral. Biol. 80 

(2017) 18-26. 

29. 

C.M.G. Nobre, B. König, N. Pütz, M. Hannig, 

Hydroxyapatite-based solution as adjunct 

treatment for biofilm management: An in situ 

study, Nanomat. 11(9) (2021) 2452. 

30. 

F. Cieplik, C.M. Rupp, S. Hirsch, D. Muehler, J. 

Enax, F. Meyer, K.-A. Hiller, W. Buchalla, Ca2+ 

release and buffering effects of synthetic 

hydroxyapatite following bacterial acid 

challenge, BMC oral health 20(1) (2020) 85. 

31. 

I. Harks, Y. Jockel-Schneider, U. Schlagenhauf, 

T.W. May, M. Gravemeier, K. Prior, G. Petersilka, B. 

Ehmke, Impact of the daily use of a microcrystal 

hydroxyapatite dentifrice on de novo plaque 

formation and clinical/microbiological 

parameters of periodontal health. A randomized 

trial, PloS one 11 (2016) e0160142. 

32. 

G. Orsini, M. Procaccini, L. Manzoli, S. 

Sparabombe, P. Tiriduzzi, F. Bambini, A. 

Putignano, A 3-day randomized clinical trial to 

investigate the desensitizing properties of three 

dentifrices, J. Periodontol. 84 (2013) 65-73. 

33. 

S. Sarembe, J. Enax, M. Morawietz, A. 

Kiesow, F. Meyer, In vitro whitening effect of a 

hydroxyapatite-based oral care gel, Eur. J. Dent. 

(2020). 

34. 

J.E. Ellingsen, H.M. Eriksen, G. Rolla, Extrinsic 

dental stain caused by stannous fluoride., 

Scand. J. Dent. Res. 90(1) (1982) 9-13. 


Dr Bernard Siew 

is a Malaysianborn 

Australian 

from Adelaide. 

The director of 

Smilefocus Dental 

Clinic, he is qualified 

from the University 

of Adelaide and has practiced dentistry 

in Singapore for over 20 years. He is 

passionate about managing excessively 

worn teeth due to lifestyle problems, 

ranging from grinding to acid reflux. His 

focus is on preventative and minimally 

invasive therapy. 


Torq Control® 

Universal Torque 

Wrench 

Torq Control® is the Anthogyr universal 

torque wrench offering the guarantee of 

tightening precision, whatever the type 

of implant connection or the difficulties of 

access. 

Precise tightening is a key factor to secure 

implant treatment success. Torq Control® 

has been specially designed by Anthogyr 

to meet these requirements for all 

prosthetic manipulations, in all safety 

thanks to automatic declutching. 

A must-have, especially for full-arch 

restorations.

USER REPORT 

Alternative solution for 

managing implant failure 

Dr Claude Authelain presents a surgical protocol utilising 

the Anthogyr Mini Implant System to manage a case of failed 

maxillary implants. 

The 72-year-old smoking patient 

presented a case of implant failure 

with an all-on-six case treated 15 

years ago. With advanced periimplantitis, 

the patient has already 

lost two implants. The proposed 

treatment is a maxillary implantstabilised 

removable overdenture 

solution. 

Surgical protocol: 

Fig. 1: Pre-operative panoramic x-ray 

Fig. 2 

Fig. 3 

Figs. 2-3: Former all-on-six that was placed 15 years ago after two failed implants 

Fig. 4: Residual implants on the day of surgery. The anterior 

implant will be re-embedded and the other two removed 

Fig. 5: View of the bone crest after removal 

of the implants 


USER REPORT 

Fig. 6: Mini implant on the sterile implant holder 

Fig. 7: The cap served as initial implant holder 

Fig. 8: The implants were screwed in using the special 

tightening mandrel 

Fig. 9: The alignment of the 

implants was checked using 

the depth and alignment 

gauges included in the Mini 

Implant System surgical kit 

Fig. 10 Fig. 11 

Figs. 10-11: Mini implants in place 

Fig. 12: Post-surgical situation 

Fig. 13: Post-surgical x-ray 


USER REPORT 

Fig. 14 

Fig. 15 Fig. 16 

Figs. 14-16: Gingival healing three months after the placement of the Mini Implants 

Fig. 18a 

Fig. 18b 

Fig. 17: Intraoral view with mounting collars 

which protect the implant neck from any resin or 

adhesive residue 

Figs. 18a-b: (a) Mini Implant with mounting collar and white insert mounted into the matrix housing. Valoc 

recommends the use of low retention inserts (yellow or white) for the initial preparation stages and the 

first placement of the denture 

(b) These inserts will then be replaced by inserts of other colours, offering stronger retention force, if 

required 

Fig. 19: Mini implants with mounting collars and 

matrices, positioned during the preparation stage, 

before loading the prosthesis. The collars will be 

removed during the final stage, before placement 

of the denture in the patient’s mouth 

Fig. 20: Bottom view of the complete 

removable prosthesis stabilised by the mini 

implants using an Optiloc connection 

Fig. 21: Smile of the patient following the 

placement of the maxillary removable prosthesis 

CONCLUSION 

Mini implants are an alternative to 

conventional intra-axial precision 

attachments, which are usually placed 

on two implants in the mandible and 

four implants in the maxilla. Their 

small diameter does not hinder their 

primary stability, thanks to the selftapping 

design of the implant, and 

enables their use in thin crests or for 

the management of implant failures, 

as in the case presented here. This 

makes it possible to place the implants 

in areas of reduced bone where there 

is damage due to previous periimplantitis. 

The Anthogyr Mini Implant System is a 

good compromise for the practitioner 

and an alternative solution for the 

patient. The surgical protocol is very 

user-friendly and simple, and the 

prosthetic rehabilitation of Optilock 

prosthetic system is of excellent 

quality and seems to have long lasting 

durability. DA 


Dr Claude Authelain 

has an exclusive 

practice in France 

focussing on 

implantology, bone 

reconstruction 

and regeneration, 

and mucogingival 

surgery. He holds university diploma 

in implantology, bone tissue and 

biomaterials as well forensic dentistry. 



Indirect hybrid nano-ceramic 

adhesive restorations 

In a mixed analogue-digital workflow, Dr Pierre Dimitrov, Dr Assen Marinov 

and MDT Boyanka Vladimirova demonstrate how they utilised Cerasmart270 

to aesthetically restore three posterior teeth in the lower quadrant, without 

compromising on its longevity. 

Indirect composite and ceramic restorations 

are a valid solution in restoring medium 

to heavily damaged teeth in the posterior 

region, providing strength, longevity and 

aesthetics. With the advancement of CAD/ 

CAM technologies and intraoral scanners, 

we can produce and deliver these kinds 

of restorations in one visit or a few days, 

minimising the chance of sensitivity, 

maintaining tooth vitality and protecting 

the damaged tooth structures from cracks 

and fractures. 

Using contemporary adhesive systems and 

composite materials, we are able to bond 

indirect restorations with little to no 

retention in the preparation, without 

unnecessary sacrifice of tooth structures 

and still be able to guarantee a predictable 

long-term success to our patients. 

In the following case, we used mixed 

analogue-digital workflow to restore 

three posterior teeth in a quadrant 

where Cerasmart270 blocks (Fig. 1) in two 

translucencies were used – A3 HT for the 

molars and A3 LT for the endodontically 

treated, darker shaded premolar. The 

treatment was completed in two visits in 

the span of three days. 

INITIAL SITUATION 

The patient initially presented with a few 

direct restorations in the left lower jaw 

(third quadrant) (Fig. 2). Complaints of the 

patient were increased sensitivity to 

thermal stimuli in this region and food 

impaction. 

The second premolar was endodontically 

treated without radiologic or symptomatic 

signs of apical periodontitis, the buccal 

and lingual walls and the mesial marginal 

ridge were thin and undermined, and the 

shade of the tooth was visibly different. 

The first molar was vital with a big direct 

composite restoration of the mesial, 

occlusal and distal surfaces with residual 

caries on the distal. The buccal and 

lingual wall were thin and suspected to 

crack or fracture at any time. The second 

molar was vital with a faulty direct 

restoration, showing degradation of the 

bond between restorative material and 

tooth, uncovered dentin, suboptimal 

proximal contacts and thin buccal and 

lingual walls. 

The soft tissues were inflamed. The 

decided treatment plan with consent of 

the patient was to restore the second 

premolar and two molars with full 

coverage Cerasmart270 overlays in 

two visits – one for preparation and 

impressions and another one for bonding 

the restorations. 

Fig. 1 Fig. 2 

Fig. 1: CERASMART270 overlay, milled with Sirona Cerec 4 

Fig. 2: Preoperative photograph, occlusal view 

TREATMENT PROCEDURE 

After isolation with rubber dam, the old 

restorations and underlying caries were 

removed with a round diamond bur on 

high speed with plenty of water cooling, 

followed by final cleaning of the decayed 

dentin with a steel manual excavator 

and gentle sandblasting with 27micron 

aluminium oxide particles. 



Fig. 3a 

Fig. 3b 

shade A2, was applied over the dentin, 

sealing it and removing all uneven surfaces 

and undercuts of the preparation. With 

a diamond bur, the enamel margins were 

prepared once again to ensure to adhesive 

or composite has been left. Preparation 

and marginal finishing were done after the 

removal of the rubber dam (Fig. 4). 

Fig. 4 

Fig. 5 

Fig. 6 Fig. 7 

A one-step VPS impression of the lower 

jaw, an alginate impression of the upper 

jaw, a bite registration and a face bow 

were transferred from the patient to the 

laboratory. In the lab, stone models were 

fabricated from GC FujiRock. The models of 

the jaws were mounted in a semi-adjustable 

articulator using average settings using 

the bite registration and the face bow. The 

preparation model was cut into separate 

stone dies for optimal scanning and access 

to the margins. A check model of the 

prepared teeth was also poured from GC 

FujiRock (Fig. 5). 

Fig. 8 

Figs. 3a-b: Intraoperative view – restoration and 

caries removal, cusp reduction 

Fig. 4: Immediate dentin sealing and deep margin 

elevation 

Fig. 5: Stone models mounted in the articulator 

Fig. 6: Digital design of the restorations 

Fig. 7: Milled restorations straight from the milling 

machine 

Fig. 8: The finished restorations on the check model 

The models and the separate preparation 

dies were scanned using Medit Identica 

T500 laboratory scanner. The restorations 

were then designed in exocad according 

to the static occlusion and the dynamic 

relationship of the teeth in protrusion 

and lateral movements using the virtual 

articulator function (Fig. 6). 

A small portion of the mesiolingual pulp 

horn was exposed. The undermined and 

unsupported cusps and walls were reduced 

to ensure stable dentinal support of the 

tooth structures and provide restorative 

material space of 1.5-2mm. A buccal chamfer 

preparation was chosen for the second 

premolar out of aesthetic considerations 

(Figs. 3a-b). 

An immediate dentin sealing procedure 

was carried out to ensure optimal 

adhesion to the freshly prepared dentin 

and to create a hermetically sealed 

biological system, protecting the tooth 

structures from contamination. A deep 

margin elevation was performed for the 

distal margin of the second premolar. 

Enamel margins were left uncovered to 

be available as an adhesion substrate in 

the cementation step. The pulp exposure 

was only sealed using adhesive and flowable 

composite. 

The tooth structures were gently sandblasted 

for 10-15 seconds with 27micron aluminium 

oxide particles under pressure with plenty 

of water cooling. Dentin was then etched 

with 37% phosphoric acid for 15 seconds and 

generously rinsed afterwards, followed by 

gentle drying of the dentinal structure with a 

three-in-one syringe to prevent desiccation 

of the tooth structures. 

With a microbrush, a coating of G-Premio 

Bond was applied and rubbed for 20 seconds 

onto the dentin. After thinning of the 

adhesive with air it was cured for 20 seconds 

using the high-power mode of D-Light Pro. 

A layer of G-ænial Universal Injectable, 

The restorations were milled from 

Cerasmart270 with a Roland DWX-4W 

milling machine using a milling strategy 

for hybrid ceramics. The second premolar 

restoration was milled from Cerasmart270 

A2 LT and the two molars were milled 

from Cerasmart270 A2 HT (Fig. 7). 

The restorations were cut from the sprues, 

finished with a rubber point, sandblasted 

with 27micron aluminium oxide and 

cleaned with a steam cleaner. A coating 

of Ceramic Primer II was applied and set 

to dry. Characterisation was done using 

Optiglaze Colour and Optiglaze Clear. 

Each layer of the stains was polymerised 

for 20 seconds using D-Light Pro in highpower 

mode. The restorations were finally 

polished with diamond paste and a goathair 

brush (Fig. 8). 



Fig. 9 

Fig. 10 

Fig. 11a 

Fig. 11b 

Fig. 11c 

Fig. 11d 

Fig. 11e 

Fig. 11f 


Fig. 9: Inner surface treatment before adhesive cementation of the restorations 

Fig. 10: Isolated and sandblasted preparations, prepared for adhesive cementation 

Figs. 11a-f: Adhesive cementation of the restorations using G-Premio Bond & G-ænial Universal Injectable 

Figs. 12a-c: Final view of the cemented restorations after rubber dam removal, inspection for excess cement with D-Light Pro in DT Mode 

On the day of the cementation, the 

restorations’ inner surfaces were 

sandblasted with 27micron aluminium 

oxide particles and subsequently cleaned 

using phosphoric acid for 30 seconds. 

With a microbrush, a coating of Ceramic 

Primer II was applied to the clean surface 

and let to evaporate. G-ænial Universal 

Injectable A2 was used as the cementing 

composite. It was applied right before the 

cementation (Fig. 9). 

The preparations were isolated with a 

rubber dam and were sandblasted with 

27-micron aluminium oxide particles under 

pressure with plenty of water cooling in 

order to achieve a clean and rough surface, 

ensuring optimal adhesion between the 

restorations and the teeth (Fig. 10). 

The cementation of the restorations was 

carried out one by one for each tooth 

following the same protocol for treating the 

tooth surface. Enamel and composite were 

etched with 37% phosphoric acid for 30 

seconds, followed by generous rinsing with 

water. The preparation surface was air dried 

with air. G-Premio Bond was applied to the 

preparation surfaces in accordance with the 

manufacturer’s instructions. The restoration 

was put and held in place by hand. All 

composite excess was removed using a 

probe and a brush until visual control of the 

sealed preparation’s margins was achieved. 

Everything was polymerised after 

complete cleaning on each surface of the 

tooth (buccal, lingual and occlusal) for 

20 seconds on each surface with D-Light 

Pro in high-power mode (Figs. 11a-f). 

Finishing and polishing of the margins 

of the restorations were done using 

abrasive metal and polishing plastic 

strips, rubber points and a polishing 

brush with diamond paste. Using the 

detection mode of GC’s D-Light Pro, 

we were able to inspect the margins of 

the restoration and tooth structures for 

excess cement. A good overall integrity 

of the tooth-restoration complex was 

achieved (Figs. 12a-c). 




Fig. 13 Fig. 14 

Fig. 13: Bitewing radiograph after cementation of the CERASMART270 restorations 

Fig. 14: Two months recall of the cemented CERASMART270 restorations 

A bitewing radiograph of the cemented 

overlays was taken to assure proper 

restoration adaptation and visualise 

composite excess. The small excess of 

composite viewed at the distal margin 

of the second molar was removed 

subsequently and the margin was polished 

using rubber points and polishing brush 

(Fig. 13). 

A checkup of the restorations two months 

after cementation showed good aesthetic 

and functional integration. The patient 

was comfortable and satisfied with the 

treatment. No complains of sensitivity, 

food impaction or any discomfort have 

been reported. The restorations displayed a 

pleasant aesthetic integration, including the 

second premolar which had a significantly 

darker shade before the treatment (Fig. 14). 

CONCLUSION 

Cerasmart270 is a great addition to 

GC’s CAD/CAM solutions. Compared 

to its original predecessor, it offers 

increased strength, while maintaining 

flexibility, simplified laboratory steps and 

maintaining the same clinical protocols in 

preparation and cementation procedures 

Thanks to the great line and wide 

selection of GC’s restorative materials – 

flexible and simplified adhesive systems, 

different kinds of clinical and laboratory 

composite materials, highly aesthetic and 

durable ceramics and other equipment, 

we are confident to offer our patients a 

long-term solution and provide them with 

functional and aesthetic restorations with 

a minimised risk of procedural mistakes 

and complications. DA 

Dr Pierre Dimitrov 

graduated from the 

Medical University of 

Sofia (Bulgaria), Faculty 

of Dental Medicine in 

2016. He is working in the 

dental clinic DentaConsult 

in Sofia. His interests are in restorative 

dentistry of posterior teeth, endodontics, 

digital dentistry and dental technology. He has 

attended postgraduate courses in the fields 

of composite restorations, indirect ceramic 

restorations, endodontic treatment and digital 

workflow in restorative dentistry. 

Dr Assen Marinov 

graduated from the 

Medical University of 

Sofia (Bulgaria), Faculty 

of Dental Medicine. He 

is practicing in the fields 

of dental implantology, 

functional and aesthetic dentistry. Dr 

Marinov has finished the basic curriculum 

at the Vienna Interdisciplinary School of 

Dentistry (VieSID) (Austria), implementing 

the protocol of Prof Rudolf Slavicek in his 

practice. He also finished the complete 

course in functional diagnostic wax-up of 

DTG Stephan Provancher and attended the 

Master Programme in digital and aesthetic 

dentistry with Paulo Kano. Together with 

the team of DentaConsult, Dr Marinov is 

developing a growing practice in Sofia. He is 

combining digital and analogue workflow in 

treatment planning and execution. 

MDT Boyanka Vladimirova 

became a dental technician 

in 1994. She got her training 

and Dental Council’s 

registration at the Medical 

Collage in Varna (Bulgaria). 

She is a member of the 

Dental Technologists Association (DTA). She 

has been working at various laboratories and 

owns her own company since the beginning 

of 2018. She is also a ceramist at the team of 

DentaConsult. Her focus is on aesthetic crowns 

and bridges, with a strong attention to design, 

detail and quality. 



Emotional dentistry 

The practice of dentistry today is not just repairing cavities or replacing missing 

teeth with restorations – it became an active part of aesthetic comfort feeling as 

Mr Alexander Wünsche elaborates. 

Combined with plastic surgery or other 

aesthetic treatments, aesthetic dentistry 

is one of the most impactful tools to help 

human beings feel beautiful and gain 

confidence. When we are looking into 

aesthetics and wellbeing, we automatically 

associate emotions. So, it would be a more 

proper way to describe aesthetic dentistry 

as – emotional dentistry. 

WHY EMOTIONAL DENTISTRY? 

Most treatments take several weeks to 

finish before the patient finally receives the 

outcome he or she was looking for. During 

this time, emotions are a crucial aspect 

during treatment. We need these emotions 

to help us to achieve the target outcome 

and success. 

The worst nightmare is when patients freak 

out when the first temporary is placed. 

So, we already have to pay attention that 

the provisional restoration not only looks 

good, but that the placement procedure is 

also running smoothly and that we have all 

the necessary tools, guides and other aids 

to place a temporary in the correct place. 

This requires pre-treatment planning and 

planning of the final outcome from the first 

moment we plan the treatment. 

In the following case examples, I would like 

to show how proper treatment planning 

helps to arrive at a successful final outcome, 

without stressing the patient’s emotions. 

FIRST CASE 

The presented case is a 24-year-old photo 

model who went overseas to have his 

smile corrected. The treatment plan was 

to minimally prep 10 anterior teeth in the 

maxilla and veneer via the direct bonding 

technique with composite. As we can see, 

the standard at which this was done, would 

never satisfy a 24-year photo model whose 

livelihood is his smile. 

After nine months, he presented himself to 

one of my clients with whom I do aesthetic 

rehabilitations and explained that he was 

not happy with his smile and was deeply 

frustrated and depressed, since he has to 

hide his smile ever since coming back. 

The patient was invited to visit me in my 

laboratory to take initial photos in my photo 

studio, so that we could evaluate his current 

situation and start planning (Figs. 1-4). 

As we can see, the proportions and positions 

are grossly misaligned, and the tooth shade is 

not what the patient wishes for. 

Planning started with a smile design and 

evaluation of the dentition 

Presenting the proposed outcome in a digital 

manner not only allows dentist and patients 

to get an idea of the final smile, but also gives 

us technicians a guide which we can use 

throughout the whole treatment. 

After the digital smile design was approved 

by the patient, it was printed with a 3D model 

printer. We need three different models to 

move forward – the current situation, the 

digitally designed and proposed design and 

a model with both situations combined. The 

last model was crucial, as it supports the 

treating dentist in prepping the current teeth 

as a visual guide. I also prepared silicone 

matrices of the proposed digital design 

model. One I left untouched, the other I cut 

horizontally into two pieces. This helped to 

guide during prepping the teeth, so that the 

exact amount will be prepped. 

In our case, the treatment team decided for 

24 crowns. The reason for not being able to 

fabricate minimal invasive restorations, was 

the pre-treatment with non-guided preps for 

composite veneers. 

After receiving the impressions, face bow and 

bite records in the laboratory, models with 

Fig. 1 Fig. 2 Fig. 3 Fig. 4 

Figs. 1-4: Initial situation (first case) 



the Giroform System from Amann Girrbach 

were fabricated and articulated in the Artex 

CR articulator. That allowed me to imitate 

all the patient’s movements properly as they 

were in the patients’ mouth. 

The next step was to scan all the records 

(Fig. 6) with the Ceramill Map 400 scanner 

and start on the design. Throughout the 

design process, the occlusion and function 

can be fully controlled with the virtual 

articulator in the Ceramill Mind design 

Fig. 5: Scanned models 

Fig. 6: Restorative design 

software (Fig. 7). For maximum aesthetics, 

we decided to fabricate fully layered 

restorations. But to guarantee stable 

and long-lasting crowns, the restoration 

was designed with a minimal cutback for 

micro layering. Therefore, the digital smile 

design was digitally overlaid on the actual 

restorative design, so that the crowns were 

literally a copy of the smile design and just 

minimally reduced (Fig. 8). 

The case is nested in the Ceramill Match 

2 software so it can be milled in Zolid HT+ 

in the Ceramill Motion 2 DNA. I decided in 

favour of Zolid HT+, because the patient’s 

stump shade was in the darker range and 

the targeted final tooth colour is OM1. 

After milling, the restorations were sintered 

overnight. I usually utilise overnight sintering 

with an eight-hour programme, to avoid any 

chance of stress to the zirconia. 

The next day, all copings were seated on 

the master casts and GC ZrFs porcelain 

was applied with my own micro layer 

technique. Before glazing, we went through 

a bisquebake try in, so occlusion, function 

and aesthetics can be evaluated and minor 

adjustments were completed before all 

crowns went through a stain and glaze 

process. 

Finally, our patient got his well-deserved and 

wanted smile (Figs. 8-9). 

SECOND CASE 

My second case is a combination of tooth 

borne and implant borne reconstructions. 

The patient presented with an edentulous 

posterior region in the maxilla. This resulted 

in a totally collapsed occlusion (Figs. 10-12). 

Over the years, the patient had postponed 

any dental treatment because of her fear 

of dentists, so it took her years to get 

comfortable with her current dentist and 

she was able to start her treatment. Implants 

were previously placed, two on each 

posterior side in the maxilla. The collapsed 

situation over such a long period resulted in 

excessive wear of the lower anterior teeth. 

After evaluating the patient’s photos and 

speaking to the patient personally, the 

decision was made to treat the patient 

with a full mouth rehabilitation in stages. 

So, a digital smile design was fabricated. 

With this, we were able to decide for a bite 

opening of several millimetres, so enough 

space was given for veneers in the mandible 

anterior area and proper-sized crowns in 

the posterior area. For the anteriors in the 

maxilla, we decided for crowns and threeunit 

implant bridges in the posterior area. 

Fig. 8 Fig. 9 

Fig. 7: Overlay of actual restorative design and the 

previous smile design 

Figs. 8-9: Final restoration of the first case 

Fig. 10 Fig. 11 Fig. 12 

Figs. 10-12: Initial situation (second case) 



Since the periodontist had to proceed with 

crown lengthening for the anteriors in the 

mandible, we started with the maxilla. Not 

to lose track throughout the treatment is of 

absolute priority. 

Therefore, the dentist took an implant-level 

impression. After model fabrication with the 

Giroform System, the records were scanned 

with the Ceramill Map 400 scanner and the 

bite opened with the virtual articulator, 

the same way as with the overlaid digital 

smile design. At first, the three-unit screwretained 

implant bridges were designed 

following an anterior temporary shell. 

Fig. 13 Fig. 14 

Figs. 13-14: Milled temporaries and printed placement guide 

This process was necessary to carefully open 

the patient’s occlusion before fabricating 

the final restorations. The digital design was 

milled with the Ceramill Motion 2 DNA in 

Ceramill Temp Multilayer. 

Fig. 15: Guided anterior preparation 

Fig. 16: Placed temporary implant bridges 

With this process, we can evaluate the 

patient’s smile with the executed opening of 

the occlusion in conjunction with test driving 

function. To be able to place a combination 

of implants and temp shells in one arch, we 

need to fabricate placement guides. 

I designed a stent over my final temporary 

design to help the dentist to seat everything 

in the perfect location with the planned 

occlusion. 

This stent can be 3D printed or milled. In 

this presented case, it was 3D printed. After 

milling the implant bridges, I cemented the 

bridges to Variobases (Straumann) on the 

master cast to guarantee a perfect passive 

fit (Figs. 13-14). 

After delivering the case to the dentist, she 

was able to prep the anterior teeth in the 

maxilla with the help of our printed models 

of the smile design, the current situation and 

the overlaid smile design over the current 

situation. She was also able to utilise all 

fabricated matrices to guide her through the 

prep protocol (Fig. 15). 

Next, she placed the implant bridges first 

(Fig. 16), put the temp shells into the 3D 

printed stent and placed them over the 

Fig. 17: Guided anterior placement 

preparations. So, everything was perfectly 

in place and slight occlusal adjustments 

were finalised during this temporary fit 

(Figs. 17-18). 

The patient will go through the crown 

lengthening procedure next before we 

start the final restorations in the maxilla 

and mandible. 

CONCLUSION 

Both treatments were emotionally very 

involved throughout the whole process, 

not just for the patient, but for the whole 

treatment team. I want to say thank you for 

the partnership and exceptional teamwork 

in both cases to Dr Rita Dargham, Miami 

FL, US and her team as well as the team of 

Zahntechnique, Dental Laboratory, Miami, 

FL, US. DA 

Fig. 18: Guided anterior bridge placement 


Alexander Wünsche 

is the president of 

Zahntechnique Dental 

Laboratory located 

in Miami, Florida. He 

completed a four-year 

multidisciplinary programme at the Otto 

Umfried School of Dental Technology 

in Nuertingen, Germany. He attained 

accreditation as a CDT in Germany and in 

the US, specialising in ceramics. Today, 

Wünsche fabricates a wide variety of case 

types and specialises in cosmetic and 

complex implant restorations and speaks 

internationally regarding innovations in 

dental technology. 


IN DEPTH WITH 

Increasing patient 

comfort with 

advanced technology 

Helping patients relax allows practitioners 

to do their treatment efficiently, thus 

providing a more pleasant experience. 

In any healthcare environment, patient 

comfort is incredibly important. While 

hygienists are highly trained with this in 

mind, technology can make it even easier 

to ensure patients are relaxed when in 

the chair. In fact, when dental offices stay 

up to date on the latest technological 

advancements, it assures patients they are 

getting the highest level of care and comfort. 

It also leads to better outcomes for those 

patients — who are more likely to return for 

care and to have lifelong and multigenerational 

relationships with the practice. 

One excellent use for today’s dental technology 

has to do with a cause near and dear to our 

hearts: relieving patient anxiety safely. 

No matter how much clinicians try to make 

patients feel at ease, some of them will still 

have tremendous anxiety about dental care. 

Clinicians can focus on how comfortable 

the chair and neck support are, give them 

sunglasses to block out the harsh lighting, and 

even create ambience with lighting and music, 

but they are still tense and uncomfortable. 

And the tenser the patients are, the more 

likely they will jolt and jump during the 

procedure, which makes it hard to work with 

instruments, drills, and other equipment. 

This is a real concern. 

In those situations, one way to deliver 

treatment safely is to use nitrous oxide 

or oxygen sedation, which can make the 

patient’s experience much less stressful. It 

keeps them calm throughout the procedure, 

while helping them feel as if the time has 

passed faster. This happens with minimal 

side effects – just five minutes of 100% 

oxygen eliminates nitrous oxide from the 

bloodstream. 

Using nitrous oxide is also beneficial for 

the practice. More cooperative and relaxed 

patients create a less stressful environment 

for clinicians. The higher patient satisfaction 

can then lead to more referrals and better 

reviews for the practice. 

Nitrous oxide and oxygen delivery is easily 

adjustable so users can provide the right 

mix for each patient. While analogue and 

digital technology accomplish the same 

job, the Accutron Digital Ultra Flowmeter 

actually has more safety features than the 

other models. Plus, the completely flat 

surface allows for easy disinfection or barrier 

protection. 

The American Dental Association’s published 

best practices for using nitrous oxide 

dictates that the practices use a single-use 

nasal mask and tubing that is sterilised per 

the manufacturer’s recommendations. 

Nasal masks are beneficial to patients in the 

age of COVID-19 in that they require patients 

to breathe through their nose and lessen 

their exposure to respiratory droplets. 

The ClearView Nasal Mask uses a patient 

demand system for administering gas, which 

is designed to match the patient’s flow of 

breathing. And the soft inner mask creates 

a better seal against the patient’s face for 

better administration of gas. Features of the 

ClearView Nasal Mask include mask-in-mask 

design to reduce ambient N2O with clear 

outer mask that shows patient “breathing 

through nose”. It also has low profile that 

provides easier access to the patient’s mouth. 

The Axess Low Profile Nasal Mask is a 

single-use mask that works with positive 

flow systems. Its low profile offers better 

visibility and better access to a patient’s 

mouth. The nasal mask fits comfortably 

and snug, and its lightweight circuit tubing 

makes it easier for patients to move without 

displacing the mask. 

To help make patients even more comfortable 

and relaxed, both the ClearView and the Axess 

Nasal Masks come in scents and colours that 

appeal to patients. 

There is no doubt that patient comfort 

is among the top priorities among dental 

practices today. Combining best practices 

with technology is the most effective way 

to ensure patient comfort while providing a 

superior patient experience. DA 

Courtesy of 

HuFriedyGroup 


IN DEPTH WITH 

Award-winning CAD software 

for single-visit dentistry 

ChairsideCAD from exocad receives a Cellerant Best of Class Technology Award 

for the fourth consecutive year. 

exocad, an Align Technology company 

and a dental CAD/CAM software provider, 

has announced that ChairsideCAD, its 

CAD software for single-visit dentistry, 

received a 2022 Best of Class Technology 

Award from Cellerant Consulting Group. 

This is the fourth consecutive year that 

ChairsideCAD has been recognised for 

this award. 

“To receive this prestigious industry 

award from dental industry leaders for a 

fourth consecutive year makes us truly 

proud,” said Larry Bodony, president 

of exocad America. “We designed 

ChairsideCAD with clinicians in mind, 

aiming to simplify the chairside design 

process, while making it faster and more 

accurate. We’re confident the intuitive 

design workflow of ChairsideCAD, plus the 

freedom to use any open hardware, makes 

this a fantastic tool to streamline even the 

most complex cases.” 

exocad is the software of choice for 

manufacturers of dental CAD/CAM 

systems because of its flexibility, reliability 

and ease of use. Dental professionals 

use exocad software to streamline their 

workflows for a broad range of indications. 

Based on exocad’s lab software DentalCAD, 

ChairsideCAD is the first complete openarchitecture 

CAD software platform 

for single-visit dentistry. The software 

includes a step-by-step guide through the 

design process, simple integrations with a 

broad spectrum of devices and the ability 

to seamlessly share information between 

clinicians and labs. 

Since the inaugural presentation in 2009, 

the Cellerant Best of Class Technology 

Awards announcement has grown to 

occupy a unique space in dentistry by 

creating awareness in the community 

of manufacturers who are driving the 

discussion on how practices operate now 

and in the future. The 2022 Cellerant Best 

of Class Technology Award was decided 

on by a panel of technology leaders in 

dentistry. DA 


IN DEPTH WITH 

Full range of oral surgery 

applications 

With the Piezomed module, a new add-on 

for Implantmed Plus, W&H breaks new 

ground: implantology and piezo surgery 

are now combined in a single device. 

For the first time, W&H can cover the 

entire workflow for minimally invasive 

oral surgery with a modular solution, 

simplifying clinical work and opening up 

new prospects for treatment. Andreas 

Brandstätter, strategic product manager 

for Oral Surgery and Implantology, 

expounds on the product’s positioning 

and its benefits for users. 

What makes the Piezomed module 

from W&H a genuine breakthrough in 

oral surgery? 

Andreas Brandstätter: At W&H, we want 

to push boundaries and think outside 

the box with our users. We definitely 

achieved this in the development of our 

Piezomed module. It is easy and costeffective 

to fit onto the Implantmed 

Plus. The result is a 

modular system that combines 

implantology and piezo surgery in one 

device for the first time, simplifying 

workflows. It is a component that was 

missing on the market until now. 

This, coupled with the implant stability 

measurement and documentation 

features, makes us the first 

manufacturer to cover the entire 

surgical workflow. Oral surgeons can 

now discover a new world of treatment 

possibilities. For me, this marks a 

genuine breakthrough in oral surgery 

that meets our users’ requirements. 

How does W&H’s surgical portfolio differ 

from that of competitors? 

Brandstätter: We have the complete range 

of oral surgery portfolio fully tailored to the 

user’s workflow. For instance, Implantmed 

Plus ensures efficient, safe implantology 

work, while the Piezomed module gives 

oral surgeons all the benefits of W&H piezo 

technology. 

Our surgical contra-angle handpieces allow 

procedures to be performed with precision, 

while the wireless foot control ensures 

greater comfort and freedom of movement. 

The Osstell Beacon for measuring implant 

stability provides certainty in assessing 

the correct loading time for an implant. 

Comprehensive documentation guarantees 

full traceability. That means we are offering 


IN DEPTH WITH 

a modular system with dovetailed 

components, guaranteeing maximum 

efficiency and reliability in everyday 

clinical practice. 

What market strategy are you pursuing 

with the Piezomed module? 

Brandstätter: We want to embed piezo 

surgery as the new oral surgery standard 

in dental practice and establish it as a fixed 

element of surgical workflows. The aim is 

for our new modular system to become the 

synonym for oral surgery and implantology 

in the future. 

What are the strengths of W&H piezo 

technology? 

Brandstätter: First and foremost, it is easy 

and intuitive to use. Another technical 

highlight is the patented automatic 

instrument detection. This automatically 

sets the right power class when the 

instrument is inserted and reduces the 

risk of instrument overload. 

In addition, with more than 30 different 

instruments and saws, our product range 

covers a broad spectrum of tasks. The 

specially developed saw-cutting geometry 

ensures outstanding cutting performance. 

For example, bone block removals can be 

carried out with little bone loss, which is 

Andreas Brandstätter, strategic product manager for Oral Surgery and Implantology 

ideal for ensuring procedures are minimally assisting with tooth extractions, or for 

invasive. And, we use a special spray design intensive use, both versions are designed to 

to cool the treatment site perfectly. 

simplify processes in dental practice. 

What advantages does the W&H modular Another benefit is the standardised operation. 

system have in store for users? 

What’s more, only irrigation tubing and a 

Brandstätter: We are offering two versions saline solution are required, which enables 

of our Piezomed module: Piezomed Plus optimised handling. In addition, users always 

and Piezomed Classic. Whether it is for have the right device (implantology motor 

general dental scenarios, for example or piezosurgical instrument) to hand in a 

compact and space-saving form, whatever 

the application. 

What is your personal highlight of the 

product innovation? 

Brandstätter: With our modular system, we 

are pushing the boundaries of oral surgery. 

The way of working is changing and becoming 

simpler, helping modern dentistry to progress. 

In addition, we are offering our customers an 

attractive solution in terms of price. 

Even as early as the product development 

stage, we kept an eye on the manufacturing 

costs and deliberately avoided using multiple 

components. For example, only one display, 

touch screen and coolant pump are used 

for a surgical application. We are delighted 

we can pass on this manufacturing cost 

reduction to our customers – a classic winwin 

situation. DA 


IN DEPTH WITH 

Discovering perfection 

in prophylaxis 

Mectron introduces the new Combi Touch, an ultrasonic 

unit and powder blasting device in one. 

The Combi Touch combines ultrasound 

and air-polishing in one unit to provide a 

complete prophylaxis treatment from the 

removal of supragingival and subgingival 

calculus to gentle removal of stain and 

biofilm, and even implant cleaning. 

The ergonomic touch panel allows for fast 

and intuitive control of every function and 

at the same time cleans and disinfects the 

device in no time. 

The ultrasound unit, thanks to its Soft 

Mode function, allows for ultra-gentle 

scaling, which reduces the insert’s 

oscillation amplitude, rendering its motion 

compatible with even the most sensitive 

patients. On the other hand, while also 

guaranteeing optimal performance with 

prosthetics and extractions treatments, 

Combi Touch’s Pulse Mode function 

transforms the ultrasound oscillation to a 

new profile. 

Combi Touch is also provided with the 

new slim handpiece with circular LED 

light weighing only 55g, minimising the 

discomfort for the operator and allowing 

for optimal illumination of the treatment 

area at all times. It can either be hooked up 

to the office’s regular water system or used 

with a 500ml external bottle. 

The air-polishing unit allows the use of 

different types of powder (supra or 

subgingival), depending on the desired 

treatment type. The greatest advantage 

is the ability to manage the use of both 

powders on the same patient with a 

simple click. 

Furthermore, it is not necessary to change the 

air-polishing handpiece. Instead, users can 

simply insert any one of the newly available 

handpieces with different orientations (120°, 

Perio and the optional 90°). The Combi Touch 

Technology makes it possible for the operator 

to decontaminate the oral cavity effectively, 

while being able to work ergonomically, easily 

reaching all necessary sites. 

The greatest advantage for the operator, 

therefore, is that the technology provides a 

complete set of tools for effective, fast and 

minimally invasive non-surgical periodontal 

therapy. It is suitable in periodontal pockets 

deeper than 5mm, thanks to the dedicated 

subgingival perio tips attached to the perio 

handpiece. Soft, flexible, and anatomically 

adjustable to the periodontal pocket, this 

tip gently removes bacterial biofilms from 

the periodontal and peri-implant pockets. 

This combined technique allows the 

operator to obtain an excellent clinical 

result, benefitting the timing of the 

procedure much appreciated by patients. 

The device maintenance is fast and simple, 

thanks to containers that can be removed 

without having to switch off the device, 

and an exclusive anti-clogging system for 

the powder. DA 


IN DEPTH WITH 

LED headlights 

as clinical illumination 

Dr B. Jin Chang, PhD, president and chief scientist of SurgiTel, 

answers commonly raised questions about LED headlights. 

Is there an ideal 

clinical LED 

headlight? 

Dr B. Jin Chang: 

No. For dental 

procedures, 

neutral or warm 

LED lights are 

recommended. 

Neutral LED lights 

offer the best colour 

accuracy and are safe for the eyes. If you 

want to minimise the blue light hazard, you 

can use warm LED lights which are similar 

to halogen light: good colour accuracy and 

the safest for eyes. For surgical procedures, 

cool LED light may be a better choice. 

Are brighter lights better? 

Dr Chang: The definition of good illumination 

is neither too bright nor too dim. Eyes can 

adapt to the wide range of brightness by 

controlling light which is entering the eyes 

by adjusting the iris of the eyes (1-3mm 

under the bright illumination). If you can 

control the overhead illumination to meet 

the recommended target to background 

ratio by adjusting the brightness of 

background illumination, all LED lights 

available today are bright enough for most 

procedures. If you compare cool LED lights 

with warm or neutral LED lights, cool LED 

lights will make you feel brighter because 

these lights have a stronger blue light. Cool 

LED lights not only distort the colour but 

are also harmful to the eyes. 

Which LED lights do you recommend for 

dental procedures? 

Dr Chang: Neutral or warm LED lights are 

recommended. SurgiTel neutral LED lights 

have a balanced spectral distribution and 

thus offer the best colour accuracy and 

are relatively safer for eyes. If you want to 

minimise the blue light hazard, you may 

choose SurgiTel’s new warm LED lights 

which offer good colour accuracy and are 

the safest for eyes as shown in Figs. 1a-b. 

Which LED lights do you recommend for 

surgical procedures? 

Dr Chang: Cool LED lights are recommended 

for surgical applications because cool LED 

lights will enhance the image of veins and 

nerves. Because red tissues absorb most 

blue lights, surgeons will face less blue 

light hazards. 

I am a surgeon and feel that SurgiTel LED 

headlights are not bright enough for my 

surgical procedures. Do you have brighter 

LED headlights? 

Dr Chang: SurgiTel will continue to design 

new LED headlights with new features. 

If you reduce the brightness of the 

overhead illumination to meet the target 

to background ratio (3:1), you will find 

that our LED headlights become very 

bright. My personal opinion is that surgical 

overhead lights are too bright. Too bright 

background illumination will strain your 

eyes and dry tissues quickly. Surgeons 

who have been practicing with reduced 

overhead lights told me that their eyes are 

no longer strained. 

Can the colour rendering index (CRI) 

be used to evaluate the quality of LED 

headlights? 

Dr Chang: The CRI was developed to 

evaluate traditional thermal light sources 

for architectural lighting by using sunlight 

as the reference. Using CRI for evaluating 

the quality of LED lights used as clinical 

illumination is not proper because 

lights with low CRI can show anatomical 

features better. 

The use of LED lights as clinical 

illumination should be evaluated by 

illuminating specific anatomical subjects. 

Some will compare two light sources 

using a supposedly neutral target such 

as a piece of white paper. However, this 

type of test does not take into account 

the actual use of the light. Two lights 

that have the same appearance on a 

white piece of paper may look drastically 

different when cast on anatomical objects. 

For example, red tissue may appear dull 

under a white light composed of yellow 

and blue light. Under equally white light, 

but composed of a continuous spectrum, 

red tissue will appear a true red. 

Therefore, if we are evaluating the colour 

quality of light for clinical applications, we 

should test light sources on anatomical 

objects and not a neutral subject, like a 

piece of white paper. DA 

Figs. 1a-b: Comparison of neutral and 

warm LED Light 


IN DEPTH WITH 

Precise, fast and clean 

– that’s Simplex 

Orthodontic offices and laboratories that value eco-friendly 3D model 

printing free of harmful fumes will find the Simplex 3D filament 

printer system from Renfert the ideal printer for their everyday work. 

3D printing opens up a whole new world 

of possibilities in orthodontics. With 3D 

printer, users only need to press a button 

to generate a physical model (e.g. a 

planning or aligner model) from the digital 

data set in the dental office or laboratory. 

But which printer is best suited for model 

printing in orthodontics? 

There are various 3D printing methods 

(e.g. filament printing, resin printing). 

However, many resins used in 3D printing 

are not biodegradable and are a hazard to 

the environment unless properly disposed 

of. In addition, odour-intensive vapours 

are released during printing, which are 

annoying and can affect health. A more 

environmentally friendly alternative is 

filament printing (FFF/FDM). Bio filaments 

are often used. The great advantage of 

filament printing is that both office and 

laboratory remain free of unpleasant 

chemical odors. 

“The Simplex 3D filament printer stands 

out thanks to its simplicity and intuitive 

operation. And there are no chemicals 

and no post processing. This means no 

isopropanol and no light curing. This allows 

us to meet our objectives, not only regarding 

environmental and climate protection but 

also regarding health protection within 

our office team,” said Dr Oliver Raeth, 

orthodontist from Engen, Germany. 

THE HEALTHY AND MORE 

ENVIRONMENTALLY FRIENDLY WAY 

TO THE PRINTED MODEL 

The Simplex 3D filament printing system 

from Renfert is the first 3D printing system 

specifically tailored to orthodontics. 

The 3D printing system offers several 

advantages all at once. In addition to being 

easy to use and cost-effective, Simplex 

special filaments are the strong answer 

to the demand for more environmental 

protection. Unlike resin printing, the 

air remains free of irritant components, 


IN DEPTH WITH 

because filament printing does not release any harmful 

vapors during the printing process. 

The high-quality Simplex filaments are suitable for the 

special requirements of the orthodontic field. They offer 

excellent mechanical and physical properties and at 

the same time are biologically harmless. For example, 

the Simplex Study Model Filament is recyclable and 

biodegradable under the special conditions of industrial 

composting. Since no post-processing is required for 

filament printing, no chemicals are needed for cleaning. 

NEW 

3D printing with 

Ease of use, automated presets, mainly biologically-based 

filaments and a clean printing process make the Simplex 

3D filament printer system a state-of-the-art “colleague” 

in day-to-day orthodontic work. With its dental-specific 

slicer software and special filaments, the printer ensures 

consistently reproducible, reliable results. 

“The Simplex 3D filament printer stands out thanks 

to its simplicity and intuitive operation. And there 

are no chemicals and no post processing. This means 

no isopropanol and no light curing. This allows us to 

meet our objectives, not only regarding environmental 

and climate protection but also regarding health 

protection within our office team,” said Dr Oliver Raeth, 

orthodontist from Engen, Germany. DA 

The first filament 

printer system 

specifically designed 

for orthodontic 

model fabrication. 

SPECIFICATIONS 

• Simplex consisting of: Simplex 3D filament printer, 

Simplex sliceware, Simplex print, Simplex study 

model, Renfert Connect app 

• Process reliability thanks to filament monitoring 

system and automated troubleshooting 

• Intuitive touchscreen navigation 

plug 

and 

print 

Getting started is so 

easy – simply at the 

touch of a button – 

find out more: 

• Safety thanks to closed building chamber, lockable 

door, and removable cover 

• Heatable print bed: optimal adhesion and simple 

cleaning 

• Simple handling thanks to removable print platform 

• Wi-Fi (currently EU and US) for print control 

• Working with filaments that are harmless to health 

making work easy 


20220412_SIMPLEX_Anzeige_95x250_EN.indd 1 12.04.2022 09:16:33

SHOW PREVIEW 

IDEM 2022 returns 

with exciting, 

new programmes 

and initiatives 

The biennial International Dental Event and 

Meeting (IDEM) trade fair and convention 

returns with its 12th edition this year. Themed 

“Building Resilience in Dentistry”, the physical 

event will be held from 7–9 October at Sands 

Expo and Convention Centre, Marina Bay 

Sands, Singapore. 

After the in-person hiatus caused by the 

pandemic, participants will now be able to 

come together again to explore more and 

better business opportunities, and network with 

likeminded professionals face-to-face to learn 

about the latest trends and updates in dentistry. 

In addition to conferences conducted by 

renowned speakers, there will also be handson 

and interactive workshops for delegates, 

showcases and exhibits for visitors to 

experience and learn about new technologies 

and the latest innovations in the dental sector. 

Participants can look forward to a curated 

series of programmes: 

Full-day SDA Masterclass conducted by 

leading clinical researcher in periodontology, 

Dr Maurizio Tonetti, on the topic— “Implants 

in Stage III and IV Periodontitis Patients: 

Benefits and Risks”. Dr Tonetti will present 

key concepts for attendees to understand the 

importance of appropriate periodontal therapy 

before implant placements, benefits, and risks 

of biological complications in Stage III and IV 


SHOW PREVIEW 

periodontitis patients. He will also share on 

specific approaches to decrease the risk of 

peri-implantitis in these high-risk subjects. 

Trade Exhibition in a 14,000sqm allencompassing 

exhibition hall showcasing 

close to 500 international exhibiting brands 

from more than 30 countries. Participants can 

meet manufacturers and cornerstone brands 

in person, speak directly with the producer of a 

product, and learn about the finer nuances of 

a tool and how it can enhance their business 

or practice. Participants can also look to build 

international partnerships with exhibitors from 

countries such as Brazil, France, Germany, Italy, 

Japan, Korea, Switzerland, China, US and more. 

AOHTS@IDEM (Association for Oral Health 

Therapists Singapore Symposium in 

collaboration with IDEM) brings together the 

AOHTS’ flagship event with IDEM’s Dental 

Hygienist and Therapist Forum (DHTF) 

providing hygienists, therapists, and oral health 

therapists a central platform to network and 

learn about the latest developments in their 

field of practice. There will be 10 conferences 

conducted by notable speakers to cover 

topics such as dental care for the elderly 

with neurological diseases, child protection 

for dental professionals, oral health care 

responsibility for the dental profession and 

more. 

Singapore Speaker Series is a brand-new 

programme featuring local speakers who will 

cover specialised topics on comprehensive, 

conservative approaches to dentistry. 

Participants can look forward to learning 

about a multidisciplinary approach to aesthetic 

rehabilitation, contemporary techniques on 

perio-restorative outcomes, patient-centric 

orthodontics and treating ameloblastomas. 

Innovation Arena is a first-of-its-kind initiative 

curated for young companies and start-ups in 

the dental and non-dental sectors to showcase 

the latest innovations and products targeting 

the dental market. The Innovation Arena aims 

to bridge start-ups with participants in order to 

promote cross-sector collaborations between 

the dental sector and businesses at large. 

IDEM360+, a digital community platform 

supplements IDEM 2022 in providing 

participants with a holistic experience: 

• Watch conference content shared by industry 

experts after the event has ended 

• Preview the latest products and solutions 

prior to the exhibition 

• Shortlist and book meetings with exhibitors 

before heading down to the event 

• Bookmark conference sessions for easier 

navigation and schedule planning 

• Build connections and network with fellow 

participants 

• Access IDEM information 24/7 from anywhere 

with no additional cost 

Delegate registrants will be able to attend all 

on-site activities and have full access to the 

digital platform IDEM360+. DA 


PRODUCT HIGHLIGHTS 

Garrison Dental Solutions 

Five-in-one multi-function composite instrument 

The special coating process withstands 

diverse cleaning and sterilisation methods, 

including ultrasonic cleaning. 

Moreover, its lightweight large-diameter 

stainless steel handles provide improved 

ergonomics and precise control for delicate 

contouring and shaping. 

The five-in-one composite instrument includes 

two blades, two condensers and one acorn. 

Garrison Dental Solution’s five-in-one 

composite instrument has been carefully 

designed to provide the most streamlined 

and versatile instrument assortment for 

composite restorations. 

Its titanium nitride coating is 40% harder 

than stainless steel and testing has 

proven it to be the best non-stick surface 

for placement, shaping and carving of 

composites. 

Garrison Dental Solutions specialises in the 

design, development and manufacturing of 

product solutions to improve the quality 

and efficiency of dentistry. Established in 

1996, the company is the industry leader in 

sectional matrix systems and its products are 

sold globally. ■ 

SprintRay 

Excellent fit and reproducible results 

remarked Sumeet Jain, vice-president 

of Materials at SprintRay. “By reducing 

the cost and lead times associated with 

restorative procedures, we’re enhancing 

dentistry for patients and doctors.” 

SprintRay Crown is Class IIa medical 

product with outstanding marginal 

integrity. It is easy to handle and polish, 

and formulated for radiographic visibility. 

A material collaboration between 

SprintRay and Bego, SprintRay Crown 

is a ceramic-filled hybrid material for 

3D printing permanent single crowns, 

inlays, onlays, and veneers. It delivers 

an excellent fit and reproducible 

results, allowing dental professionals 

to provide budget-friendly custom 

restorations confidently. 

“With this new material introduction, 

SprintRay continues to shape the future 

of the dental industry, widening the 

reach and scope of digital technology,” 

“Dental 3D printing solutions, especially 

for durable restorations, are becoming 

increasingly important. In addition to the 

excellent material properties and good 

aesthetics, are the low material costs, the 

speed in production and the customisability 

of the dental objects that make SprintRay 

Crown future-proof,” said Thomas Kwiedor, 

head of Business Development 3D Printing 

for Bego. “The expansion of the partnership 

with SprintRay and the introduction of 

SprintRay Crown will further accelerate this 

trend.” ■ 



Parkell 

Articulation simplified 

AccuFilm has introduced its simplest and thinnest film 

to date. At only eight microns, AccuFilm FastCheck 

incorporates the accuracy dental professionals routinely 

rely on with the added convenience of a built-in frame. 

CONSISTENT STRENGTH 

SEAMLESS BEAUTY 

The built-in frame facilitates easy positioning over the 

occlusal surfaces of posterior teeth without the need 

for forceps. Its thin film consistently produces sharp, 

easy-to-interpret markings even on hard-to-test highly 

polished metal and ceramic surfaces. 

Practitioners can easily identify the smallest occlusal 

discrepancies with precise marking on the points 

of contact. Its double-sided colour coating for 

simultaneous marking of both arches and it is equally 

effective on both wet and dry metal, porcelain, and 

zirconia surfaces. 

For almost 75 years, Parkell has been designing and 

manufacturing innovative, premium quality, and 

internationally recognised dental materials and 

equipment, with predominately all activities proudly 

being performed in the United States on Long Island, 

New York. Parkell has a diverse and robust variety of 

product offerings, with advanced dental materials and 

devices. Parkell’s products are sold in over 60 countries 

through an extensive network of distributors, as well as 

our European subsidiary. ■ 

VITA YZ® ST Multicolor 

• High strength (1200 MPa) for precise processing 

and predictable results 

• Fascinating esthetics and high shade reliability 

thanks to the VITA Shade Formula 

• Speed Sintering in under 60 minutes 

For more information, 

scan the QR Code 



Bego 

Compact DLP 3D printer 

The high dental technology requirements 

regarding precision, safety, and 

reproducibility of 3D printing solutions 

differ considerably from those of other 

application fields. 

Varseo XS from Bego is a compact DLP 

3D printer specially developed for dental 

uses. This high-resolution DLP 3D printer 

comes with outstanding detail at an 

attractive price. Its building speed is 

independent of the number of elements 

to be produced. 

What’s more, Varseo XS has a handy 

building platform — it is capable of 

printing up to 20 crowns or two largespan 

bridges with up to seven units. 

The network capability via W-LAN or 

Ethernet connection allows fast and 

uncomplicated data exchange to the PC. 

Right-sized and appealing design, Varseo 

XS features a replaceable resin tank 

which allows easy material change. It is 

compatible with VarseoSmile Crownplus, 

VarseoSmile Temp, VarseoWax CAD/Cast 

and VarseoWax Model. 

BEGO is a long-established family 

company with 130 years of dental 

expertise, a pioneer of CAD/CAM 

technology with more than 20 years of 

experience in the field of 3D printing, 

and a specialist in all dental fabrication 

techniques. 

The BEGO Varseo 3D printing system 

offers users a system specially developed 

with and for dental laboratories; a 

coordinated portfolio of 3D printer, 

light-curing device, scientifically tested 

materials, software tools, and services; 

the means to achieve fast, simple and 

cost-efficient fabrication of a wide range 

of restorations made from resins and 

ceramic filled hybrids — in their own 

laboratory and with complete flexibility 

and unrivalled precision; and validated 

processes from scanning to finishing. ■ 

Directa 

Initiate extraction process simply 

The Luxator P-series from Directa are 

periotomes intended to cut off the 

periodontal ligament axially before 

final extraction is made with forceps 

or elevator. It features a grip-friendly 

pen-liked designs that provides 

maximum tactility, sight and control. 

• Luxator P3, contra angle, dark blue 

• Luxator P4, dual edge, lilac 

Directa’s products are developed, tested 

and evaluated by selected team of highlyqualified 

and renowned Swedish and 

international dental professionals. Their 

aim is to make life easier for all dental 

professionals in their daily clinical work. 

Modern techniques as implants requires 

instruments and equipment offering 

possibilities to achieve fast healing 

and placement of direct implants after 

extraction. ■ 

The upper part of the instrument is 

equipped with a knob that allows for 

increased axial force by a surgical 

mallet. Additionally, the tips are 

coated with titanium nitride for 

durability. 

The Luxator P-series includes: 

• Luxator P1, straight blade, dark green 

• Luxator P2, inverted curved, light blue 



Ultradent 

Dental bone grafting plug 

The OsteoGen Plug by Impladent is a 

dental bone grafting plug that combines 

non-ceramic OsteoGen bioactive 

resorbable calcium apatite crystals with 

a Type I bovine achilles tendon collagen 

matrix. 

The bone graft crystals are contained 

within the collagen matrix, allowing for 

simple and effective placement without 

a membrane or the need to mix and 

pack the graft. The bioactive calcium 

phosphate crystals create a structure 

that mimics the organic and inorganic 

characteristics of actual bone. 

This resorbable quality allows the 

structure to be replaced by host bone 

tissue within a few months. The collagen 

matrix also absorbs and delivers blood 

to the graft during resorption, a crucial 

factor for the successful formation of 

new bone tissue, and provides a scaffold 

for keratinised tissue to develop over the 

grafted site. 

The OsteoGen bone grafting plug is 

radiolucent when placed but will become 

radiopaque within three to five months 

(when it has been replaced with host bone 

tissue). Implant placement can then be 

achieved. 

The OsteoGen crystals are a calcium 

phosphate-based bone graft that is not a 

β-TCP and not a dense ceramic HA, nor is 

it a biphasic mixture of the two. OsteoGen 

has a unique Ca:P ratio that mimics the 

composition of human bone. It comes in 

three sizes with four-year shelf life from 

manufacturing date: 

• Slim size: 6x25mm 

• Large size: 10x20mm 

• Extra large size: 15x20mm ■ 

Busch 

Diamond-interspersed polishers for ceramics in dental laboratories 

Final corrections are frequently needed 

on ceramic restorations, even after the 

final glaze firing. To eliminate the need 

for renewed final glaze firing, Busch 

offers a two-step diamond-interspersed 

polishing system for all popular 

ceramics used in dental laboratories. 

The diamond grit size and the bond 

hardness are optimally matched to the 

properties of the ceramics. 

Their comprehensive range of products 

includes carbide burs and cutters, 

diamond burs, polishers, abrasives, 

steel instruments and ceramic cutters. 

As a manufacturer, absolute precision 

and high-quality standards are the 

benchmarks for their production. This 

is why the entire production chain, from 

the blank to the final product is done 

at their site in Engelskirchen, Germany. 

The company-owned engineering 

department designs and realises highprecision 

manufacturing facilities 

according to their internal specification 

for products. The company is certified 

according to ISO 13485. ■ 

There are five application-specific 

shapes each for pre-polishing and 

high shine polishing. The desired high 

shine can be easily achieved in just 

two steps, eliminating the need for an 

additional final glaze firing. For easier 

identification, the diamond-interspersed 

polishers come in two colours: reddishbrown/yellow 

for pre-polishing and 

light green/yellow for high shine 

polishing. 

Busch is a specialist for rotary precision 

instruments and tools since 1905. 



Premier Dental 

Unsurpassed radiopacity 

Premier Implant Cement Plus is the 

ultimate solution for implant crown 

cementation. Versatile by design, 

this implant cement provides strong, 

secure retention yet enables easy, nondestructive 

crown retrieval, if necessary, 

at a later date. 

The elastomeric cement flexes under 

force, absorbs shock and creates a tight 

marginal seal. Clinicians will appreciate 

the predictable and easy application 

with no etch, primer or bonding agent 

required. They can easily remove excess 

cement too and its gel stage is just two 

minutes. 

Premier Implant Cement Plus comes in 

two shades and delivers unsurpassed 

radiopacity — enabling clear visibility on 

radiographs to help deliver better patient 

outcomes. 

As a fourth generation, family-owned 

business founded in 1913 by the Charlestein 

family, Premier Dental is one of the most 

trusted and respected names in dentistry. 

With a history of innovation, dental 

professionals worldwide have turned 

to Premier for quality, state-of-the-art 

dental equipment to improve their daily 

practices. ■ 

Glidewell 

Enabling safe, efficient implant placement for fully edentulous patients 

Glidewell now offers tissue- and bonesupported 

surgical guides to help 

dentists optimise implant positioning 

for cases where a fixed or removable 

implant restoration is planned. Further 

strengthening the company’s position 

as a comprehensive implant solutions 

provider, the Digital Treatment 

Planning (DTP) line extension provides 

prosthetically driven implant positioning 

and a smooth, predictable surgical 

procedure for fully edentulous patients. 

Glidewell’s DTP service leverages the 

expertise of the most technologically 

advanced dental lab in the US to aid 

clinicians in determining where implants 

should be placed to maximise safety, avoid 

vital anatomical structures, save chair time, 

minimise surgical trauma for the patient, and 

ensure a predictable restorative outcome. 

“With our new service for fully edentulous 

cases, we use advanced 3D treatment 

planning software to produce surgical guides 

that position implants in the optimal location 

needed to support the desired restoration, 

be that an implant-supported overdenture 

or the BruxZir Implant Prosthesis,” said Ilan 

Sapir, manager of the Digital Treatment 

Planning department. 

The DTP service is available for all major 

guided implant systems and is a key element 

of Glidewell Implant Solutions, which 

provides dentists with everything they need 

to succeed in implant dentistry, from live 

and online continuing education, to dental 

implants, to cutting-edge restorations. This 

“implant to crown” approach is exemplified 

by the company’s comprehensive implant 

warranty that guarantees the Hahn Tapered 

Implant as well as custom abutments and 

BruxZir restorations produced by Glidewell 

for the life of the patient. 

The expanded offerings available through 

Glidewell DTP also include an addition for 

tooth-supported guides. For cases where 

immediate loading is planned, a customised 

provisional crown can be added to the case 

for delivery on the day of surgery. Designed 

in collaboration with the experienced 

laboratory technicians in Glidewell’s implant 

lab, the immediate provisional helps contour 

the gingival tissue for an optimal emergence 

profile when the case is restored. This 

service is available for the Hahn Tapered 

Implant now and will be expanded to all 

major implant systems later this year. 

“Our goal has always been to make highquality 

dental care available to as many 

patients as possible,” said Jim Glidewell, 

CDT, founder and president of Glidewell. 

“Many dentists who choose to place 

implants for their patients follow this same 

philosophy, and we support them through 

education and innovative but cost-effective 

surgical and restorative solutions. The fully 

edentulous have the most to gain from 

implant treatment, and our new full-arch 

surgical guides will help more dentists 

place implants with the confidence they 

need to provide care for this important 

patient population.” ■ 



Voco 

Nano-ceramic hybrid CAD/ 

CAM block 

Either as crown, inlay, onlay, veneer or implant-supported 

crown – Voco’s Grandio blocs successfully cover numerous 

indications in prosthetics and are solidly established in 

practices and laboratories around the world 

Thanks to its filler content of 86% w/w, Grandio blocs 

score with an outstanding material strength. Furthermore, 

the flexural strength shows values that usually are only 

reached with silicate ceramics, although Grandio blocs are 

much more antagonist-friendly. 

The material can be milled very finely and is easy to polish, 

so that the restoration fits optimally and meets high 

aesthetic requirements. In addition, the wide shade rage in 

two translucency grades supports a natural look. Grandio 

blocs are available in two sizes, 12 and 14L. 

Grandio blocs with the appropriate pin are compatible 

with the milling devices PlanMill 30S and PlanMill 40S 

from Planmeca. The devices, which are provided with 

high-speed spindles, offer a milling speed that advances 

the work efficiency in practice and laboratory. At the same 

time, the linear motors ensure maximum precision. 

→ DISCOVER 

PERFECTION 

IN PROPHYLAXIS - 

THE NEW COMBI touch 

→ ultra-gentle prophylaxis 

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→ made in Italy 

→ 40 years experience 

→ VISIT OUR BOOTH 

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In addition to the milling devices from Planmeca, Grandio 

blocs with the universal pin can be processed with other 

milling units available on the market. These include, for 

example, vhf, imes icore, Zirkonzahn or DGSHAPE. ■ 

→ www.mectron.com 



Dentsply Sirona 

Print-on-demand denture teeth 

The conversion of denture 

manufacturing to printed 

workflows is accelerating. The next 

breakthrough is Lucitone Digital IPN 

3D Premium Tooth material from 

Dentsply Sirona. The new denture 

tooth material enables labs to printon-demand 

denture teeth with wear 

resistance and aesthetics expected 

in premium-level denture teeth. The 

new material features the superior 

durability of traditional IPN. It is 

available in 16 A-D shades plus two 

bleach options. 

The Lucitone Digital IPN material is 

fully integrated with the Lucitone 

Digital Print Denture System and 

is validated for Carbon M-Series 

printers and Asiga PRO 4K and MAX 

UV. It marks the next step towards 

the migration of removable denture labs to 

digital workflows, covering full dentures, 

implant-supported dentures, and partial 

dentures. 

“The New Lucitone Digital IPN Resin 

by Dentsply Sirona is incredible. The 

aesthetics, translucency, workflow, 

OnDemand manufacturing, and 

customisation are simply ground 

breaking,” said Trà Chambers, owner 

at Express Dental Laboratory and 

Dentsply Sirona’s key opinion leader. 

“This is definitely a step in the right 

direction for digital dentistry and 

digital dentures.” 

The Lucitone Digital IPN 3D Premium 

Tooth material is supported by new 

highly characterised (HC) libraries, 

which utilise techniques of light 

reflection and refraction. Optimised 

for the Lucitone Digital Print Denture 

workflow and specifically the new 

Lucitone Digital IPN material, the 

HC libraries enable printed denture 

teeth to feature aesthetic textures and 

translucencies expected in premiumlevel 

denture teeth. ■ 

Ivoclar Vivadent 

Protective varnish to reduce caries risk 

The caries risk rises if the number 

of mutans streptococci increases 

significantly in the mouth. In these 

cases, routine oral hygiene measures, 

professional tooth cleaning and 

fluoridation do not adequately protect 

the teeth from damage. 

Ivoclar Vivadent’s Cervitec Plus 

varnish system contains the effective 

combination of the active ingredients 

chlorhexidine and thymol to selectively 

control germs. It aids in reducing 

an important caries risk factor and 

controlling gingivitis. 

Generally, Cervitec Plus is applied every 

three months. If intensive treatment 

is required, however, the varnish may 

also be applied more frequently. It can 

be applied on exposed root surfaces 

and hypersensitive cervicals to reduce 

bacterial activity and desensitise tooth 

surface. 

A colourless, transparent clear varnish, 

Cervitec Plus offers optimum aesthetics 

in the anterior region. Moreover, it 

features enhanced moisture tolerance 

for an easy application and provides 

protection for at-risk areas with 

optimum flow and wetting behaviour. 

Cervitec Plus is based on its predecessor 

Cervitec, whose effectiveness has been 

well-documented for years. It is part 

of Ivoclar Care which is a coordinated 

range of products that enables dentists 

to offer patients oral health management 

measures tailored to their specific needs. 

Cervitec Plus comes in single dose and 

economical multi dose. ■ 


SHOW PREVIEW 

exocad Insights 2022: 

Learn. Connect. Enjoy. 

exocad, an Align Technology company, will 

host its third exocad Insights on 3-4 Oct 2022. 

The global event will take place at the Palma 

Congress Center in Palma de Mallorca, Spain. 

Around 800 dental technicians and dentists 

from around the world are expected on site, 

as well as more than 40 strategic partner 

companies who will showcase the latest digital 

technologies. Novica Savic, chief commercial 

officer at exocad, shares a preview of the twoday 

event that is dedicated to digital dentistry 

for labs and practices. 

“Learn. Connect. Enjoy.” Can you explain the 

motto behind exocad Insights 2022? 

Novica Savic: “Learn,” stands for intensive 

training. “Connect,” means networking in 

person and on site with the global exocad 

community — that includes registrants from 

around 40 countries to date. “Enjoy,” reminds 

us that we also want to enjoy our two days 

together and have a good time at our evening 

event. 

Who are you targeting with the Insights 

2022 event? 

Savic: The event is aimed at 

dental technicians and 

dentists who already work 

digitally in their practices 

and laboratories or are 

planning to enter the 

digital world. The programme offers 

interesting topics for both groups. 

Guest speakers include leading digital 

experts from the laboratory and clinical 

environments, including internationally 

renowned digital smile design specialist 

Dr Christian Coachman from Brazil. 

Speaking of topics, what will be discussed 

on the main stage? 

Savic: Industry trailblazers will give 

participants tips on how to use digital 

tools to achieve better aesthetic treatment 

results for patients and how to work even 

more productively. They will demonstrate 

various ways to collaborate — explaining 

how laboratories and practices can work 

seamlessly with each other thanks to 

modern digital tools. Among the cases 

presented, participants will see complex 

cases involving orthodontic, restorative 

and aesthetic aspects. 

At Insights, lab owners and dentists will 

share how they’ve evolved workflows in their 

Novica Savic, CCO exocad 

exocad Insights will take place on 3-4 Oct 2022, on the Spanish island of 

Mallorca and will offer a comprehensive, two-day programme for dental 

technicians and dentists. 


SHOW PREVIEW 

labs or practices with digital technologies. 

They’ll also discuss how labs are bringing 

dentists with them on the digital journey. 

Participating partner companies will also 

offer sessions. What will those involve? 

Savic: We’ll have 11 different partner sessions, 

each lasting 30mins. Visitors can decide 

which sessions they’d like to attend while at 

the event. This way, participants can choose 

the topics most relevant to their practices 

or labs. Our experience from the first two 

Insights events has shown us that this “circuit 

training” is very well received because it allows 

participants to take away a variety of new 

impressions and ideas in a very short amount 

of time. 

What do the participants learn at the exocad 

software sessions? 

Savic: At this year’s Insights, there will again 

be new software releases to present. That 

means the topic for our software sessions 

on Tuesday has been decided. Based on 

typical lab and practice cases, users will 

learn about the new features of the release 

and hear helpful tips on how to get the most 

out of the software. The clinical sessions will 

be geared toward dentists, and we’ll have 

laboratory sessions for dental technicians. 

We’ll also have three software stations 

at the exhibition where our application 

specialists will be available to answer 

individual questions and give concrete tips 

to the participants. 

Why is it worth investing in an exocad 

Insights ticket? 

Savic: The ticket price includes almost 

everything: presentations, demo sessions, 

food and drinks throughout the event, 

exocad Insights attendees can look forward to hearing tips and tricks on exocad’s latest software releases, like DentalCAD 3.1 Rijeka 


SHOW PREVIEW 

and the evening event with dinner and live 

music on Monday evening. Over two days, 

participants will receive many new ideas on 

how to advance their labs or practices using 

digital technologies. They’ll discover new 

ways to make workflows more productive and 

learn how to improve treatment results 

to benefit patients. 

The future of digital 

dentures at exocad 

Insights 2022 

Dr Lori Trost, a comprehensive restorative 

dentist from the St Louis, Missouri area with 

more than 30 years of experience, will share 

a presentation on why colleagues can “Start 

Loving Dentures.” Dr Trost talks about how 

digital workflows are improving denture work 

and why Insights is a must-see event. 

What will you present at exocad Insights 2022? 

Dr Lori Trost: The Insights event is an amazing 

opportunity to share patient cases with the 

audience, show the steps and the digital 

workflow, and demonstrate the results that 

can happen when you lean on technology. I 

will talk specifically about digital dentures and 

how that process has greatly improved. In 

the past, there were many hands-on steps for 

dentures. The process was laden with issues of 

inaccuracies. Now, with digital technology, we 

can produce something that is more accurate 

and do so more efficiently. And accuracy in the 

real world translates to happier patients, fewer 

adjustments, and fewer appointments. We are 

now able to deliver results faster, easier, better, 

and patients are thrilled. 

Can you share some examples of how your 

work has improved with digital workflows? 

Dr Trost: Last week, I delivered two immediate 

dentures, and I saw both patients 24 hours 

post-op. Neither needed adjustments. To get 

those results and to have patients be that 

satisfied is amazing. I am going to share those 

types of experiences at Insights and hopefully 

build excitement because this is the forefront 

of what’s coming, and it will only get better. 

Any other advice for colleagues looking to 

evolve their practice? 

Dr Trost: I believe that it is such an exciting 

time to be a dentist now. For instance, if 

you look at the past 15 to 20 years, we had 

an onslaught of adhesive dentistry. Almost 

everyone can now do really refined bonding. We 

have mastered that. Now let’s back up and take 

a look at those patients who need dentures. 

In the same way that adhesive dentistry 

developed, technology is now merging for these 

edentulous patients. I see a lot of excitement 

with other doctors who support this population 

of patients. We can offer them substantially 

better care now and to be able to deliver a highquality 

product is very motivating. 

What do people gain from attending Insights? 

Dr Trost: Any time that you can gather 

with colleagues and further your process, 

knowledge, and understanding is worth it. 

Going to a meeting like this is important 

because it sets the stage for collaboration 

across the aisle — by that, I mean with labs, 

software platforms, and clinical dentistry. It is 

a wonderful merging of interests that no other 

meeting offers right now. I find it really exciting. 

At Insights, you have some of the best minds in 

our profession come together and have open 

conversations. I encourage everyone to take 

advantage of that and to have one-on-ones with 

your peers. 

Any final thoughts? 

Dr Trost: If you are on the fence about whether 

you should go — go! Because you’ll come away 

with a great sense of what’s coming. These 

developments are going to be a tidal wave and 

really push dentistry in a great direction. DA 

Guest speakers include leading digital experts from the laboratory and clinical worlds, including internationally renowned digital smile design specialist 

Dr Christian Coachman from Brazil 


SHOW REVIEW 

VOCO welcomes dentists 

from different countries 

to their International 

Fellowship Symposium 

Lectures at the highest standard, 

demanding discussions on current 

topics and trends about modern 

dentistry, as well as personal exchange 

between colleagues from around 

the world: This is what the VOCO 

International Fellowship Symposium 

has stood for many years. 

For the fifth event, 50 dentists from 

almost 30 countries again accepted 

the invitation of the Dentalists from 

Cuxhaven to further intensify the 

dialogue between the manufacturer 

and the dental practice. 

The three-day event with more than 

30 lectures focused on processes 

and issues relating to conventional 

restorative and innovative digital 

dentistry. Furthermore, topics like 

fabrication of endocrowns and updates 

on molar incisor hypomineralisation 

(MIH) were focal points. 

In diversified lectures, the fellows 

presented their current clinical cases 

as well as solutions and treatment 

methods. Numerous questions from 

the audience proved the high relevance 

of the topics presented, so that the 

dental experts took home ideas and 

new approaches. At the same time, 

the presentations offered the VOCO 

team important feedback on the 

products used. 

“The close and trustful exchange with 

the dental clinic is indispensable for us 

as manufacturer: This is the only way 

we know the needs of everyday clinical 

practice and can specifically consider 

them in product development,” said Dr 

Matthias Mehring, the event manager. 

TALK FROM DR JOHN RUNDELL 

PAREDES 

Dr John Rundell Paredes is a general 

dentist passionate in aesthetic 

dentistry. He has a practice in Metro 

Manila, Philippines, and conducts 

training programmes and lectures with 

the organisation PIPE about direct and 

indirect composite as well as dental 

photography. 

His talk during the symposium about 

“Augmenting Aesthetics in Direct Ormocer 

Layering” detailed the techniques to make 

composite restorations look stunning, 

real and dynamic. He also discussed the 

properties of translucencies, opacities, 

stains and shade value. DA 


EVENTS CALENDAR 

SEPTEMBER 

15 – 17 Dentsply Sirona World 2022 

Las Vegas, NV, US 

Venue: Caesars Forum 

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

16 – 18 56th Indian Orthodontic Conference 

Pune, India 

Venue: Bharati Vidyapeeth Campus 

https://www.56thiocpune.com 

26 – 29 Dental Expo 2022 – The 52nd Moscow 

International dental forum and exhibition 

Moscow, Russia 

Venue: Crocus Expo Fairgrounds 

https://en.dental-expo.com/dental-expo-en 

28 – 30 China Dental Show 2022 

OCTOBER 

Suzhou, China 

Venue: Suzhou Jinji Lake International Convention Center 

http://www.chinadentalshow.com/en 

3 – 4 exocad Insights 2022 

Palma de Mallorca, Spain 

Venue: Palma Congress Center 

https://exocad.com/insights2022 

7 – 9 IDEM 2022 – International Dental Exhibition 

and Meeting 

Singapore 

Venue: Marina Bay Sands, Singapore 

https://www.idem-singapore.com 

13 – 15 Central Asia Dental Expo 2022 – 

6th International Dental Exhibition 

Almaty, Kazakhstan 

Venue: ATAKENT Expo 11th Pavilion Timiryazev Str 

https://cadex.kz/en 

13 – 15 Dental World 2022 

Budapest, Hungary 

Venue: HUNGEXPO Budapest Fair Center 

https://dentalworld.hu/dental-world-2022-en 

27 – 29 IFED 2022 – 12th World Congress 

of Aesthetic Dentistry 

Abu Dhabi, United Arab Emirates 

Venue: Conrad Abu Dhabi Etihad Towers 

https://ifed2022.com 

28 – 30 Korean Association of Orthodontists 55th Annual 

Congress and Asian Pacific Orthodontic Society 

13th Congress 

NOVEMBER 

Seoul, South Korea 

Venue: COEX, Seoul 

https://www.kao.or.kr/abstract/2022_fall/main_en/main.html 

25 – 30 Greater New York Dental Meeting 2022 – 

98th Annual Session 

DECEMBER 

New York City, US 

Venue: Jacob K. Javits Convention Center 

https://www.gnydm.com 

1 – 3 The International Vietnam Dental Equipment and 

Materials Exhibition 

Hanoi City, Vietnam 

Venue: ICE – 91 Tran Hung Dao Str., Dist Hoan Kiem 

http://vietnamdental.com.vn 

5 – 7 The 3rd Taiwan International Orthodontic Forum 

Taipei, Taiwan 

Venue: NTUH International Convention Center 

http://www.asianpacificortho.org/events 

With the evolving COVID-19 situation, kindly check with 

organisers for updates on the related events. Please refer to the 

local airports’ websites for the latest travel advisories too. 


ADVERTISERS’ INDEX 

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3Shape A/S 

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3Shape A/S 1 

Align Technology, Inc. 

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Amann Girrbach AG 7 

Anthogyr France 47 

BUSCH & CO. GmbH & Co. KG 13 

Carestream Dental LLC 5 

COLTENE 19 

exocad GmbH 3 

IDEM Singapore 2022 67 

Mectron SpA 9 

Mectron SpA 73 

Medical Protection Society Limited 

Outside Back Cover 

Renfert GmbH 65 

Shofu Inc. 33 

SurgiTel 15 

For information, visit us at www.dentalasia.net or 

contact us at sales@pabloasia.com 

Tekne Dental 11 

VITA Zahnfabrik 69 

@dentalasia 

W&H 

Inside Back Cover 

Company Registration No: 200001473N 

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