Dental Asia May/June 2024

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MAY / JUNE 2024
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CONTENTS
TRENDS
13 A race to Paris: Oral care from the
world’s fastest dental nurse
UNDER THE SPOTLIGHT
15 The blue ocean of dental sleep
medicine
17 The key to leading opinions
20 The work behind the research
DENTAL PROFILE
24 Turning spares into strikes
26 Building in systems and languages of
trust
29 The AI revolution for consumer oral
health
CLINICAL FEATURE
31 Face-driven orthodontics: Myth or
reality? (Part A)
35 Tooth whitening vs tooth bleaching —
Is there a difference?
USER REPORT
40 Overcoming challenges in
processing zirconia and advanced
ceramic materials
42 Expert tips to craft predictable
smiles with Smile Creator
BEHIND THE SCENES
44 Achieving a natural aesthetic
appearance with porcelain veneers:
Case reports (Part 2)
IN DEPTH WITH
50 Milling or 3D printing: Which dental
technology best suits you?
SHOW PREVIEW
58 Bigger and better: MIDS is back for
2024!
59 Explore digital transformation in
oral-facial rehabilitation at the IAOFR
Conference
60 SIDEX 2024 out to captivate the global
dental community in Seoul
SHOW REVIEW
61 IDEM 2024 wraps up its 13th edition
with record breaking success
REGULARS
4 Editor’s Note
6 Dental Updates
54 Product Highlights
63 Events Calendar
64 Advertisers’ Index
24
15
20
40
2 DENTAL ASIA MAY / JUNE 2024

EDITOR’S NOTE
Consider the tooth
PABLO SINGAPORE
PUBLISHER
William Pang • williampang@pabloasia.com
ASSISTANT EDITOR
James Yau • james@pabloasia.com
BUSINESS DEVELOPMENT MANAGER
Pang YanJun • yanjun@pabloasia.com
As the hardest substance in the human body,
tooth enamel is a non-renewable tissue that
can last a lifetime and beyond, making enamel
preservation crucial for the dental professional.
This unique property plays a pivotal role in fields
likes forensic odontology and anthropology
where through the studying of one’s teeth, it
provides society with the means to date human
remains and produce evidence in a court of law.
In this issue, one common theme emerged
across some of the interviews which led to
the thought of the remarkable property of the
everyday tooth: What legacy do I want to leave
behind?
As the winner of the 2024 IADR Distinguished
Scientist Young Investigator Award, Assoc Prof
Gustavo Nascimento was recently recognised
for his remarkable contributions to dental
research and hopes that his future with his
current and future research, the dentist will be
placed beyond a technical role and as part of a
multidisciplinary team of health professionals
to treat patients (p.20). For key opinion leader
(KOL) Dr Kenneth Lew, the legacy he wishes to
leave is about sharing the knowledge he has
ADVISORY BOARD
gathered from his 30-year-long career as a
specialist orthodontist (p.17).
With its new Competence & Service Center
Asia up and running, Christoph Stark, CEO,
and Christian Mueller, COO and managing
director of imes-icore, sees the Asian market
growing beyond a region where they simply
“ship machines” as it forms an important
pillar of the company’s growth strategy
(p.26). In what Dr Kelvin Chye, CEO and
founder of Asia Pacific Dental Holdings, sees
as an “blue ocean”, the benefits of dental
sleep medicine drove him to dwell deep in
the field in 2017, as he currently embarks
on a mission to educate other dental
professionals of its potential (p.15).
As you enjoy this issue of Dental Asia, I invite
you to reflect upon the legacy you want
to leave. Much like the enduring tooth, its
enamel is only preserved when we make
effort to care for it daily.
James Yau
James Yau Assistant Editor
GRAPHIC DESIGNER
Cayla Ong • cayla@pabloasia.com
CIRCULATION MANAGER
Shu Ai Ling • ailing@pabloasia.com
MEDIA REPRESENTATIVE
Jamie Tan • jamietan@pabloasia.com
PABLO BEIJING
GENERAL MANAGER
Ellen Gao • pablobeijing@163.com
PABLO SHANGHAI
SENIOR EDITOR
Daisy Wang • pabloshanghai@163.net
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Dr Clarence Tam Prof Nigel M. King Dr Anand Narvekar Dr Kevin Ng Dr William O’Reilly Dr Wong Li Beng
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4 DENTAL ASIA MAY / JUNE 2024

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DENTAL UPDATES
Envista appoints Paul Keel as CEO
Envista Holdings Corporation has
announced the appointment of Paul Keel as
CEO and a member of the board of directors
effective 1 May 2024. He succeeds Amir
Aghdaei who will continue to support the
transition as a senior advisor.
"It is a great honour to lead Envista at this
exciting time in our deep and rich history.
I know and admire the company and
industry. I am thrilled to build on Envista's
strong foundation, doing ever more to serve
all our stakeholders — our customers, their
patients, our colleagues, our communities,
and our shareholders,” said Keel.
Keel is joining Envista from Smiths Group
plc, a global technology company and FTSE
100 constituent. He previously spent 16
years with 3M in various leadership roles,
including group president of the Consumer
Business Group, president of 3M Medical,
and president of 3M's Specialty Dental
business. Preceding 3M, he held positions
of increasing responsibility at GE, McKinsey
& Company, and General Mills. Paul holds
a BA from Carleton College and MBA from
Harvard Business School.
"Paul's strong track record as CEO of
a public, diversified, global innovation
company makes him the right leader for
Envista at this stage in our growth journey,”
said Scott Huennekens, chairman of Envista.
"His pertinent combination of accelerating
growth and operational excellence with
his experience in the medical and oral
care markets make him uniquely qualified
to lead Envista in our mission to digitise,
personalise, and democratise dental care.”
Paul Keel (Image: Envista)
Envista is a global family of more than 30
dental brands, including Nobel Biocare,
Ormco, DEXIS, and Kerr, united by a shared
purpose: To partner with professionals to
improve lives. Envista helps its customers
deliver patient care through dental
consumables, solutions, technology, and
services. DA
Henry Schein names new
members to executive
management committee
From left: Bianka
Wilson, Steve
Boggan, and Tom
Popeck (Image:
Business Wire)
Henry Schein has announced the
appointment of three new members to
the company’s executive management
committee — Steve Boggan and Bianka
Wilson, who were recently named co-
CEOs of the company’s Global Oral
Reconstruction Group (GORG), and Tom
Popeck, CEO of the company’s Healthcare
Specialties Group (HSG).
GORG includes Henry Schein’s portfolio
of premium value and value implant lines
and a full range of biomaterial products.
HSG includes a range of company-owned
manufacturing brands in the high-growth
endodontic, orthodontic, and orthopaedic
markets.
“We are delighted to welcome three strong
and proven leaders to the Henry Schein
executive management committee,” said
Stanley Bergman, chairman and CEO of
Henry Schein. “Steve, Bianka, and Tom
have each demonstrated vision and
commitment in inspiring and leading our
teams to excellence in a quickly changing
global healthcare marketplace. Our senior
leadership team will benefit greatly from
the added perspectives of these seasoned
professionals.”
According to Henry Schein, the GORG and
HSG businesses are central to advancing
its ‘BOLD+1 strategic plan’, in the building
of higher-growth and higher-margin
specialty products and services offerings
that complement its distribution, software,
and value-added businesses. Together, the
company aims to leverage these businesses
to broaden and deepen relationships with
customers.
Boggan joined Henry Schein in 2013 with
the company’s acquisition of BioHorizons,
which he joined as a start-up in 1995
and has led as president and CEO since
1999. As co-CEO of GORG, Boggan will
lead commercial operations in North and
South America and the Middle East as
well as global marketing.
Wilson joined Henry Schein in 2018 after
a successful 25-year career in finance
and consulting. Wilson had been serving
as CFO of GORG and, as co-CEO, she
will lead strategy, finance, and human
resources as well as the group’s business
in Europe and APAC.
Popeck joined Henry Schein in 2019 with
more than 20 years of sales leadership
and general management experience,
including extensive experience in the
medical device sector. In 2023, he was
promoted to president of Henry Schein’s
HSG. DA
6 DENTAL ASIA MAY / JUNE 2024

DENTAL UPDATES
Dentist Graham Stokes to
chair Medical Protection
Society council
Medical Protection Society (MPS) has announced the
appointment of Graham Stokes as its next chair of council.
Dental Protection is an important part of MPS and Stokes will
be the first dentist ever to hold this role leading the work of
the wider organisation.
Stokes is a general dental practitioner with a special interest
in implants and prosthetics. He also lectures widely on a
range of dental topics and has led numerous teams of dental
volunteers to Tanzania providing dental emergency care.
Stokes has been a member of MPS Council since 2017. His
tenure as chair will start following MPS’s annual general
meeting in June 2024. He takes over from Ian Eardley who
is stepping down after five years as chair. Eardley steered
the organisation through the Covid-19 pandemic, ensuring
that MPS met the evolving needs of members during this
challenging time. He leaves the post with MPS having its
largest ever membership, record member satisfaction levels as
well as strong funding.
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Confirmation of Stokes’ appointment of chair follows the
recent appointment of Karen Miller as chief executive of MPS,
with the retirement of Simon Kayll.
“Having been a member of Dental Protection all my clinical
working life, I know just how important it is to have the
confidence and
security that
there are experts
ready to support
me — especially
when I need
them the most,”
said Stokes. “I
am honoured
and humbled
to be the next
chair of Council
for the Medical
Protection
Society and
to be able to
give something
back to the
organisation that
has cared for me
(Image: Medical Protection Society)
for so long.” DA
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DENTAL ASIA MAY / JUNE 2024
7

DENTAL UPDATES
NDCS inks MOU with Nanyang Polytechnic to develop
digital dentistry talents
The National Dental Centre Singapore
(NDCS), Singapore’s flagship specialty
centre for oral healthcare, has announced
the signing of a Memorandum Of
Understanding (MOU), with Nanyang
Polytechnic (NYP) in a move to promote
digital dentistry in Singapore. The MOU
aims to nurture biomedical engineering
students to prepare them for the
expanding role that digital technologies
will play in the field of dentistry.
Comprising internships as well as
learning journeys, the key objective of the
MOU is to allow biomedical engineering
students to gain insights into the world
of CAD/CAM and dentofacial imaging in
dentistry, and to help the students have
better awareness when making career
choices.
Programme participants can expect to
gain insights into best practices in the
use of digital technologies at NDCS. The
first learning journey is planned on 31
May 2024 for between 20-30 biomedical
engineering students to visit NDCS where
its clinical engineers will share on their
work experience in the ‘Digital Dentistry
Unit', and highlight the relevance of
biomedical engineering to digital dentistry.
An internship placement at NDCS is
planned between end 2024 and early 2025.
Programme participants will be exposed
to engineering principles and techniques
in the field of oral healthcare technology
and can consider roles in clinical
engineering as career paths. Clinical
engineers typically collaborate with
other healthcare stakeholders such as
dentists, doctors, biomedical engineers,
healthcare administrators and equipment
manufacturers to support patient care.
Their primary role is to ensure the safe,
effective and efficient use of medical
equipment and technology in clinical
settings.
From left: Dr Poh Kok Kiong, Course Manager,
Diploma in Biomedical Engineering, Nanyang
Polytechnic; Dr Choo Keng Wah, Deputy Director,
School of Engineering, Nanyang Polytechnic;
Clinical Associate Professor Goh Bee Tin, CEO,
National Dental Centre Singapore; and Clinical
Associate Professor Chew Ming Tak, Data & Digital
Strategy Officer, National Dental Centre Singapore
(Image: National Dental Centre Singapore)
“Digital dentistry is a rapidly growing field
that has gained significant traction in
recent years. Advancements in technology
have greatly expanded its applications and
capabilities, leading to its emergence as
a distinct field within dentistry. Through
this MOU, we hope to train and empower
a pipeline of talent that will redefine and
elevate the landscape of dental care in
Singapore,” said Clinical Associate Professor
Goh Bee Tin, CEO of NDCS. DA
3M completes spin-off of Solventum
3M has completed the planned spin-off of
its health care business, which formally
launched Solventum Corporation as an
independent company as of 1 Apr 2024.
Solventum is listed on the New York Stock
Exchange as SOLV.
every four shares of 3M common stock
held at the close of business on 18 Mar
2024, the record date for the distribution.
For US federal income tax purposes, the
distribution is generally intended to be taxfree
to 3M shareholders.
“This is an important day for 3M and
Solventum, and I extend my sincere
congratulations to members of both teams
who have made this possible,” said Mike
Roman, 3M chairman and CEO. “Both
companies are positioned to pursue their
respective growth and tailored capital
allocation plans, and I am excited to see
both companies succeed as they innovate
new solutions and create value for their
respective stakeholders.”
Holders of 3M common stock received
one share of Solventum common stock for
3M retained 19.9% of the outstanding
shares of Solventum common stock,
which will be monetised within five years
following the spin-off.
3M first announced its intent to spin off
its Health Care business in July 2022 to
position the two public companies to
pursue their respective growth plans.
Bryan C Hanson was announced as the CEO
of the independent health care company
in August 2023 when it is spun off from 3M
before Solventum was revealed as the name
of the new company in November 2023.
(Image: New York Stock Exchange)
The 3M Board of Directors approved the
planned spin-off of its Health Care business
of Solventum in March 2024 before the
spin-off was completed.
Solventum describes its mission as
“enabling better, smarter, safer healthcare
to improve lives”, and is organised into four
operating business segments aligned to the
markets served including medical surgical,
dental solutions, health information
systems, and purification & filtration. DA
8 DENTAL ASIA MAY / JUNE 2024

DENTAL UPDATES
MPS Foundation extends
partnership with FDI
World Dental Federation
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The MPS Foundation has announced a continuation of its
partnership with the FDI World Dental Federation (FDI) on
a project aimed to raise awareness of the importance of
managing mental health and develop further resources for oral
health professionals.
“Our research has shown that increasingly more dental
professionals deal with stress, worry and anxiety, which can
result in serious mental health issues. These situations can also
affect the quality of care provided and negatively impact on
patients’ wellbeing," said Dr Graham Stokes, dentist and MPS
Foundation chair.
Named ‘The FDI project’, the partnership is in its second phase
which will run until December 2025. The project activities will
revolve around the World Mental Health Day in October to
raise awareness of and destigmatise mental health issues in
dentistry. It will focus on dental professionals and students,
promoting and extending the resources and tools created in the
first phase of the project.
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evo
In this second phase, the project aims to achieve four goals.
First, it aims to raise awareness of the importance of addressing
mental health issues and wellbeing for dental practitioners
and dental students, including the impact of patient dental
phobia on practitioner mental health. Second, the project plans
to challenge stigma by normalising the discussion of mental
health issues around dentistry. Third, the project will develop
resources and training materials for dental team members and
dental students to address specific challenges. Last, it will also
develop resources for patients, to prevent and manage dental
anxiety and fear of visits to the dentist.
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“The support from the MPS Foundation is critical to FDI
advancing its vital work in preserving the mental health and
wellbeing of our current and future dental professionals, to
ensure the highest standard of self-care and patient care,” said
Dr Greg Chadwick, FDI president. DA
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17:53:16

DENTAL UPDATES
Edentulism commonplace as dental
awareness lacking in Sri Lanka
Sri Lankan news outlet The Morning
reported that the lack of dental health
awareness among adults has been a major
cause of the edentulism which is commonly
seen among adults in the country,
according to information provided by the
Sri Lanka Dental Association (SLDA).
Speaking at a World Oral Health Day event,
it was reported that health minister Dr
Ramesh Pathirana said that 12% of Sri
Lanka’s adult population has lost all of their
teeth, prompting for oral health education
to be started in schools. Dr Pathirana also
emphasised the significance of maintaining
good oral and dental health throughout
one’s lifetime, adding that oral cancer
affects a large number of people in the
nation at present.
SLDA president Prof Hemantha
Amarasinghe verified the data disclosed
by Dr Pathirana to the news outlet
highlighting that around 12% of the
adult population aged between 65 and 75
are toothless. Prof Amarasinghe noted
that edentulism has become a common
oral health issue among the country’s
adult population as revealed in a SLDA
survey. Moreover, Prof Amarasinghe
added that around 20% of Sri Lanka’s
adult population has never visited a
dental clinic during their entire life,
underscoring a lack of awareness of the
importance of oral health.
“According to the data that we have, 20%
of the adult population has never visited
a dental clinic during their lifetime.
Most people, not only adults, think that
they should visit a clinic only if they
have buccal pain. We recommend that
everyone visit a dentist frequently. On the
other hand, this shows their unawareness
and lack of care regarding oral health.
When we spoke to them, we realised that
(Image: University of Sri Jayewardenepura)
they were not concerned about the tooth
loss,” said Prof Amarasinghe.
The Morning reported that when asked
about the accessibility of the oral health
clinics or dental hospitals in Sri Lanka, Prof
Amarasinghe noted that 65% of Sri Lankans
have access to a dentist within 5km and
that therefore, accessibility has not been
a major issue for the majority of the
people. He added that most of government
hospitals have a dental clinic where
people can get free services. He also noted
that the SLDA is conducting awareness
programmes to promote oral health among
the community and urged the public to
visit dental clinics frequently to maintain
oral wellbeing. DA
Japan funds dental hygiene training programme in Laos
The Japanese government has provided
grant assistance worth US$300,000 to set
up a dental hygiene training programme
in Vientiane province in Laos, through
its Grant Assistance for Japanese NGO
Projects. The dental hygiene course will
be taught at the Public Health School,
with the aim of improving dental and oral
health care in Laos.
Japanese ambassador to Laos Kenichi
Kobayashi and president of the Organisation
of International Support for Dental
Education Prof Dr Takashi Miyata, signed a
grant agreement on the programme at the
Japanese Embassy on 22 Mar.
“With the strong support of the Japanese
government, we have worked to establish
a dental hygienist system. This project
supports the set-up of a dental hygienist
Ambassador Kenichi Kobayashi (seated left) and
Prof Dr Takashi Miyata displaying a signed grant
agreement, watched by senior ministry officials
(Image: Vientiane Times)
training course in Vientiane province by
providing the facilities and equipment
necessary for dental education and
technical support,” said Prof Dr Miyata.
“The training will improve dental and oral
care in remote areas and prevent tooth
and gum decay and disease. We will do our
utmost to improve the health situation
for the people of Laos, in collaboration
with Vientiane province and the Faculty
of Dentistry at the University of Health
Sciences,” Prof Dr Miyata added.
Japan’s Grant Assistance for Japanese NGO
Projects is provided by the Ministry of
Foreign Affairs of Japan for economic and
social development projects voluntarily
planned and implemented by Japanese
international cooperation NGOs in
developing countries and regions.
To support Lao socio-economic
development goals in infrastructure,
education, health, UXO, tourism, and more,
the Government of Japan has provided
more than $13m through Japanese NGOs
over the past five years. DA
10 DENTAL ASIA MAY / JUNE 2024

DENTAL UPDATES
Dental jobs boosted for Saudi nationals
with 35% Saudization plan
Saudi Arabia’s Ministry of Human
Resources and Social Development (HRSD),
in cooperation with the Ministry of Health,
has recently announced a 35% Saudization
plan for the dental profession.
Saudization is officially referred to as the
Saudi Nationalisation Scheme or Nitaqat,
a policy implemented by the Ministry of
Labour whereby Saudi companies are
required to hire Saudi Nationals on a quota
basis. The localisation plan starts from 10
Mar 2024 and will be applied to private
sector establishments with three or more
workers.
According to the authorities, this comes
in line with the two ministry initiatives
to boost more fruitful job opportunities
for Saudi citizens. A Ministry of Health
representative said that the ministry will
oversee and ensure the implementation
of this decision in accordance with labour
market requirements.
The ministry added that private sector
establishments will receive support and
incentives from HRSD to promote Saudi
employment. These include support for
attracting and hiring suitable employees,
support for recruitment and job continuity,
and help with the necessary training
and qualification processes, in addition
to the priority of benefitting from all
Saudization support programs available in
the system, and support and employment
programmes through the Human
Resources Development Fund (HADAF).
(Image: Riyadh Elm University)
The Saudi Press Agency reported in
December 2023 that the participation rate
of Saudis in the private sector increased
from 1.7 million in 2019 to 2.3 million in
2023, including more than 360,000 who had
entered the labour market for the first time.
HRSD has issued a procedural guide
outlining the Saudization requirements
and percentages on its website, stressing
that establishments must comply with the
decision to avoid penalties. DA
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DENTAL ASIA MAY / JUNE 2024
11

DENTAL UPDATES
Researchers urges update to NICE
dental antibiotic guidelines
disease repairs — were recommended
to have antibiotic prophylaxis (AP)
cover before undergoing invasive dental
treatment.
In an announcement from the University
of Sheffield, it has urged the National
Institute for Health and Care Excellence
(NICE) to review dental antibiotic
prophylaxis guidelines to protect those
at high-risk of developing a serious heart
infection, following research led by the
university which found that dental patients
at high-risk of infective endocarditis, a
life-threatening infection of the heart
valves that causes heart failure and
strokes, should be given antibiotics before
undergoing invasive treatment such as
extractions or oral surgery.
This latest study is said to provide further
evidence that current UK guidelines
could be putting high-risk patients at
unnecessary extra risk when undergoing
invasive dental procedures.
Infective endocarditis (IE) is a serious heart
infection which can be fatal. According
(Image: macrovector/ Freepik)
to the university, 30% of people will die
within one year of diagnosis. In around
30-40% of cases, it is caused by bacteria
that come from the mouth either from
poor oral hygiene or during invasive dental
procedures.
To prevent this, patients at increased risk
of IE — those who have undergone cardiac
interventions such as prosthetic heart
valves, valve repairs and congenital heart
However, the university said that in
2008 NICE recommended against
the use of antibiotic prophylaxis (AP)
because of a lack of evidence for efficacy
and concerns about the possibility of
adverse reactions to the antibiotics
used.
Although guideline committees around
the world had similar concerns, they
continued to recommend AP for those
patients at highest risk of developing IE
because they felt the risks of developing
IE far outweighed any risks of giving AP
to this group of patients.
Despite considerable new evidence that
AP is safe, effective and would result
in significant cost savings and health
benefits, NICE has not reviewed their
recommendation against the use of AP
since 2015, said the university in the
announcement. DA
RCSI appoints Prof Albert Leung as
foundation head of School of Dentistry
RCSI University of Medicine and Health
Sciences has announced the appointment
of Prof Albert Leung as professor of
Dentistry and foundation head of its new
School of Dentistry.
Prof Leung will lead the School of Dentistry
in advancing plans to launch a Bachelor
of Dental Surgery. Subject to regulatory
approval and conclusion of agreements
with government, the programme will
welcome its first cohort of students in 2025
and become the first community-based
undergraduate dentistry degree in Ireland.
The programme will be delivered under
the leadership of Prof Leung who is
now progressing with preparations and
recruiting key faculty roles. Its curriculum
has been developed in partnership with the
award-winning Peninsula Dental School at
the University of Plymouth and has been
designed to equip graduates to deliver
excellence in dental care for patients in a
primary care setting, improving their oral
and general health near where they live.
“We look forward to working with the
Department of Health and the HSE to
contribute to improved oral health in the
population. I wish Professor Leung and his
colleagues every success as they prepare to
launch the new Bachelor of Dental Surgery
and look forward to seeing the first cohort
of graduates emerge in 2030, ready to
practice in the community,” said Prof Cathal
Kelly, vice-chancellor, RCSI, welcoming
Prof Leung’s appointment.
Prof Leung served as dean of the Faculty
of Dentistry RCSI from 2020-2023. He has
achieved international distinction including
Prof Albert
Leung (Image:
RCSI University
of Medicine and
Health Sciences)
receipt of the Association for Dental
Education in Europe (ADEE) Excellence in
Dental Education Mature Career Award,
one of the highest international accolades
in dental education.
The new school will build on a heritage of
undergraduate dental education at RCSI
and will complement the very successful
Faculty of Dentistry at RCSI, which
provides postgraduate and specialist
training and assessments to over 1,500
dentists annually, awarding membership
and fellowship qualifications. DA
12 DENTAL ASIA MAY / JUNE 2024

A race to Paris:
Oral care from the
world’s fastest
dental nurse
By Nina Garlo
Balancing a day job as a dental nurse with a
high-level sporting career is no easy feat; but
with careful planning, support from her work
team, and a winning belief, Finnish sprint star
Aino Pulkkinen proves that it is possible to
break records both in the dental clinic, and on
the track.
Pulkkinen comes from Äänekoski, a small
town in Central Finland, and has been
representing the Finnish sports team
Jyväskylän Kenttäurheilijat since 2017.
Winning numerous national-level medals
and representing Finland in international
competitions, Pulkkinen currently holds the
Finnish record in the 150m run. She also set
records in each distance of 100m, 200m,
and 400m.
“Last summer, I represented Finland in the
European Championships, and this summer, I
got to participate in the World Championships
in Budapest. The World Championships were
always a dream for me. The fact that I got
to participate was a pleasant surprise. The
competitions were fantastic and added more
motivation to my training,” said the 26-year-old.
Her journey to the podium has progressed
steadily, and with the qualification for her
first-ever Summer Olympics Games currently
underway, Pulkkinen is running faster than ever
to be on road to Paris where she will proudly
represent her nation and oral health.
February 2023. Pulkkinen
finds that working in
the oral health service
profession provides
a suitable balance
to the life of a
competitive
athlete —
intense
training sessions and the rigours of
competitions. However, without her
employer's flexibility, support, and
encouragement, managing a day job
and a tight training schedule would be
impossible.
“Work hours are always adjusted according
to my training schedule, depending on
whether the competition season is underway.
Usually, I work at least a couple of shifts per
week but if training allows, I am happy to take
on more work shifts,” said Pulkkinen.
Pulkkinen has been involved in athletics
since the age of four. Until the age of 17,
she combined sprinting with long jump. For
the past eight years, she has focused on
running with the upcoming Paris Olympics
as her current goal. Despite the challenging
qualification standards for the Olympics,
Pulkkinen is motivated to do everything
possible to secure her spot in an individual
event or a relay race, engaging in 6-10 training
sessions each week.
SPORTS FROM AN EARLY AGE
Pulkkinen graduated as a dental nurse in
2022 and has been working at the Oral
Hammaslääkärit clinic in Jyväskylä since
“Last year, my coach and I found a training
solution that works for me. It has already
produced significant results. Currently, I have
training sessions every day except Sunday. On

TRENDS
workdays, if I have training, it is either after or
before work,” Pulkkinen added.
SETTING AN EXAMPLE FOR OTHERS
Studies in dental nursing have brought
oral health issues to Pulkkinen's attention
in a new way. She is eager to share this
newfound knowledge, especially concerning
the benefits of the antibacterial Lumoral
treatment.
Pulkkinen finds the treatment, which
administers a photodynamic reaction in a
handheld device to prevent plaque formation,
suitable for her hectic schedule between
work and trainings. The treatment has
become part of her routine with since late
autumn and has already noticed that the
antibacterial oral care method brings a new
level of cleanliness to her mouth.
“I have noticed that tartar accumulates
quickly on my teeth. I hope that Lumoral will
also help with that aspect. On the other hand,
when you drink coffee, it causes stains. I also
believe that the device will help with that,”
Pulkkinen said.
She added: “If there has ever been a bit
of laziness in brushing teeth and cleaning
between them, now I do it diligently. I
remember to do it and understand its real
significance. It is easy to use especially
when I consume unhealthier foods or sports
drinks.”
Pulkkinen has also started raising awareness
of the importance of oral health to overall
health and athletic performance, especially
within sporting circles. This is supported by
research, as high-performance sports are one
of the significant risk factors for the onset of
oral diseases.
According to one study, cavities are found in
up to 70% of elite athletes, dental erosion in
almost 40%, and severe gum disease in up
to 15% of individuals engaged in competitive
sports.
Several possible reasons exist for the
increase in inflammatory oral diseases among
elite athletes. Physical stress is one of the
most significant factors. Intensive training
increases the body's stress levels, directly
affecting oral health and susceptibility to
various gum diseases.
Physical stress alters saliva composition
during training and reduces its secretion.
Frequent mouth breathing during training
and dehydration further increases dryness
in the mouth. According to Pulkkinen, all
these factors expose teeth to cavities and
dental erosion and contribute to the onset of
inflammatory oral diseases.
Pulkkinen emphasises the significant impact
of diet on athletes' oral health. Rigorous
training programmes require regular eating,
often supplemented with sports nutrition such
as carbohydrate gels and bars consumed
during training. These further stresses oral
health by increasing the daily number of
acid attacks in the mouth. Many athletes
consume sports drinks, especially
during intensive training and
competitions.
“At this point, being aware of the constant
snacking and the impact of energy drinks
on the mouth, it is a bit unpleasant to
consume foods and beverages that
are harmful to oral health. However, as
an athlete, I need sufficient energy and
hydration to run fast and achieve my
personal best,” said Pulkkinen.
Endurance athletes can protect their oral
health by maintaining a balanced diet rich
in vitamins and minerals, avoiding snacking
on sugary foods, and using fluoride
mouthwash to strengthen tooth enamel.
During endurance training, it is good to take
a sip of plain water after consuming energy
drinks.
The acidity and sugar content of sports
drinks and gels vary significantly between
different brands; choosing products with
a neutral pH level can help minimise tooth
erosion. Citric acid is often added to energy
gels as an additional ingredient to enhance
flavour. However, it should be avoided as it
increases the risk of erosion.
Pulkkinen concluded: “Thanks to my
studies, I have reduced my use of sports
drinks a lot, but during the summer
especially in the competition season, I
increase their consumption to avoid muscle
cramps or other harm to the body. At the
same time, it is good to enhance the use of
Lumoral and overall oral hygiene even more.
I just visited the dental hygienist to remove
minor tartar and stains from my teeth, so
I can now monitor how it helps maintain
cleaner teeth!” DA
As a dental
nurse, Pulkkinen
is a vocal
advocate of
oral health in
sporting circles
14 DENTAL ASIA MAY / JUNE 2024

The blue ocean of dental
sleep medicine By James Yau
Dental sleep medicine is defined by the
American Academy of Dental Sleep Medicine
as an extension of general dentistry that
focuses on the management of sleep disorder
breathing in adults, including disorders such
as snoring, obstructive sleep apnoea, and
sleep related bruxism.
For Dr Kelvin Chye, CEO and founder of Asia
Pacific Dental Holdings, dental sleep medicine
provides the benefits of non-invasive, nonsurgical
and reversible forms of treatment,
which first drove him to dwell deep in the
field in 2017, by training with the American
Academy of Dental Sleep Medicine.
“I had set my mind to find out more about
it at the time. As a general dentist then, I
encountered patients who grind and break
their teeth, fillings, crown, and issues with
implant loosening; the patients will think that
it is the fault of the dentist or quality of the
materials,” said Dr Chye.
“Traditionally, we as dentists are trained
to make a mouth guard to help protect the
patient's teeth. But a lot of patients in fact do
suffer from a more serious underlying medical
Seeking to address the underlying conditions
encountered by patients, Dr Chye decided to
embark on the journey of dental sleep medicine
condition like sleep apnoea. I decided to dwell
further to the root cause problem and learn
about dental sleep medicine.”
The branch of dental sleep medicine
represents one of four broader treatment
strategies. Other strategies include lifestyle
modification such as dieting and weight loss
management, continuous positive airway
pressure (CPAP) devices which pushes
air through the obstruction that may be in
the mouth, and surgeries such as skeletal
surgery, soft tissue surgery, septoplasty, and
hypoglossal nerve stimulation.
The principle of oral appliances in dental sleep
medicine operates by stabilising the jaw in a
slightly forward position. Because the tongue
is attached to the jaw by the higher bone, the
appliance helps to prevent the lateral collapse
of the pharyngeal wall. This ensures that an
airway is created and maintained for a patient
to breathe without obstruction in their airways.
Using oral appliance therapy to treat patients
with sleep disorders, dental sleep medicine
serves three important functions according
to Dr Chye. First, it helps to reduce a patient’s
snoring. Second, it helps to improve the
patient’s sleep apnoea condition. Third, it
protects the patient's dentition from the
effects of teeth grinding during sleep.
INTERDISCIPLINARY MANAGEMENT
Within the past five years, Dr Chye has noted
several developments which has raised the
popularity of dental sleep medicine as a
treatment method.
The advancement of digital dentistry
has enabled shifts in workflows from
physical impressions providing precise and
customisable oral moulds in the creation
of oral sleep appliances. Coupled with the
improvements in printing materials, endproducts
have greater qualities for durability
and comfort. Dr Chye further noted that most
reputable manufacturers are increasingly
providing warranty periods for structural
defects of an appliance.
Simultaneously, Dr Chye has witnessed
a growing awareness and interest in the
field. Through his personal practice and
interactions, he seen different specialists
such as orthodontics, prosthodontics, and
oral maxillofacial surgeons, reporting a good
experience when collaborating with Dr Chye to
treat patients with sleep apnoea.
However, Dr Chye believes that education
needs to focus on the multidisciplinary
and interdisciplinary nature of dental sleep
medicine to make the treatment practice
more widespread. With a background in public
health, Dr Chye is trying to marry the practice
of public health and dental sleep medicine.
“In public health, there is a part that focuses
on the management of non-communicable
disease. Using this principle, we look at
all the management strategies and risk
factors related to sleep apnoea, and it is a
multidisciplinary condition involving dentists,
respiratory physicians, ENT surgeons,
neurologists, and psychiatrists to help manage
the patient,” said Dr Chye.
He added that dental sleep medicine also
needs to be interdisciplinary as each patient
is unique and the right solution may involve a
combination therapy of CPAP, oral appliances,
or surgery. Moreover, whatever measures are
taken, lifestyle modification is still required to
sustain the treatment outcome which involves
changes to one’s lifestyle, diet, and activity
levels.
DENTAL ASIA MAY / JUNE 2024
15

UNDER THE SPOTLIGHT
Specifically, Dr Chye noted that there is
potential for medical sleep professionals to
collaborate with dentists to screen cases,
referring to a policy statment adopted by
FDI World Dental Federation in 2018 which
highlighted the important role of dentists in
prevention, early screening and treatment of
young or adult patients with Sleep-related
Breathing Disorders by establishing effective
inter-professional collaboration with medical
sleep doctors.
Moreover, Dr Chye believes that dentists are
in a unique position to screen for symptoms
of sleep apnoea because of the nature of their
interactions. “Dentists see patients daily and
from looking into the patient’s mouth, straight
away there are many telltale signs whether
a patient has sleep apnoea. For example,
dentists can assess a patient’s melon party
score by examining elongated uvulas and
enlarged tonsil, the presence of tori, signs of
bruxism due to sleep apnoea.”
Following the American Board of Dental Sleep
Medicine standards and guidelines in his
practice, Dr Chye follows up with a patient
at the first, third, and sixth month intervals.
Along the process, Dr Chye coordinates with
other specialists to monitor patients through
reports like sleep studies to assure them of
their progress.
“For the past five years, I have been trying
to build an ecosystem, identifying all the
different stakeholders in this ecosystem and
how to establish links with everyone so that
we can have a more successful and effective
management strategy for sleep apnoea
patients,” Dr Chye said.
BLUE OCEANS
An important milestone in a positive direction
for the field was the launch of the first
Fellow of Dental Sleep Medicine (FDSM)
programme in 2022 by the Australasia
Sleep Association (ASA). The fellowship
certifies the achievement of minimum clinical
competencies in the practice of dental sleep
medicine where Dr Chye was among one of
the first dentist outside of Australia to be
awarded the fellowship.
Certification for the fellowship required
the submission of three detailed case
The spectrum of oral appliances made from
traditional impressions to digital scans. Evolution
of dentistry has seen the increased use of
digital technology in the practice of dental sleep
medicine, and enabled improvements in the
design and performance of oral sleep appliances
reports demonstrating clinical competence,
submission of a logbook with a minimum
of 15 dental sleep medicine cases, two
references from sleep physicians in a
specified format, a three-hour multiplechoice
examination, and a sleep laboratory
placement. “I think that with sleep medicine
fellowships being launched in the market,
the field is slowly getting more traction and
recognition,” said Dr Chye.
Dr Chye sees dental sleep medicine as a
scarcely known yet exciting blue ocean in
managing sleep disorders. To realise its
potential, Dr Chye started Asia Pacific Dental
Sleep Academy to provide training and
education courses, and promote the benefits
of the field among both consumers and
practitioners.
Dr Chye has made a concerted effort to bring
his message across Asia collaborating with
various local and regional sleep medicine
associations and events. Dr Chye shared
that for World Sleep Day in March, he visited
different events and conferences organised
in Malaysia, Singapore, and Taipei. He also
has upcoming travel plans to the US for the
American Academy of Dental Sleep Medicine
annual meeting, and to Australia for the Sleep
DownUnder conference by the Australasian
Sleep Association.
Moreover, Dr Chye noted that beyond
dental professionals, a wider network of
manufacturers and partners is needed to
help the field the truly flourish. As most
oral appliance device providers have its
manufacturing based in North America, a
manufacturing presence in Asian markets
would likely lower the cost and spur demand.
Financing for oral appliances treatments, he
added, was also not as comprehensive by
local insurance providers as compared to
North American markets where oral appliance
therapy are reimbursable by insurance such as
Medicare.
“We are still in a very primitive stage, and I
think a lot more can be done. We can learn
from what has been happening in Western
countries,” said Dr Chye.
Regardless, Dr Chye holds a bright outlook
for dental sleep medicine which he remains
invested in through the ecosystem he is
building and the education he is providing.
He foresees that with improvement of its
manufacturing technology, oral appliance
therapy devices will become more comfortable
and durable, encouraging higher compliance
rates. He also shared a recent interaction
with an appliance manufacturer which has
integrated technology into the devices to track
compliance level and usage rates.
Dr Chye concluded: “I have been trying to
educate and share with a lot of other dental
professionals that dental sleep medicine is a
blue ocean. It is not a congested space where
much more can be done and many players that
can come into this field.” DA
In addition to treating patients at his clinic, Dr Chye
is active as a advocate of dental sleep medicine
and connects with various associations in Asia to
share its benefits
16 DENTAL ASIA MAY / JUNE 2024

UNDER THE SPOTLIGHT
The key to leading opinions
By James Yau
OPEN-MINDED AND UP-TO-DATE
For Dr Anand Narvekar, being a key opinion
leader (KOL) is no easy task involving
responsibilities both inside and outside the
clinic.
“Working closely with industry partners
requires trust and collaboration as companies
provide a platform for you to share your
expertise and network with a wider dental
community. Companies trust you not only for
your clinical skills, but also for your ability to
share your knowledge to inspire others while
respecting the company’s interests,” said Dr
Narvekar.
After graduating from Bharati Vidyapeeth
Deemed University in 1996, Dr Narvekar
immersed himself in the field, establishing
a practice in Mumbai, India, where he has
dedicated his efforts to advancing dentistry,
particularly in aesthetic dentistry.
As a fellow, trainer, speaker and advocate for
Minimally Invasive Cosmetic Dentistry (MiCD)
and its global partner Shofu,
Dr Narvekar has honed his skills to treat
complex full-mouth rehabilitation and smile
design cases, emphasising minimally invasive
dentistry techniques where management
of occlusal disorders and restoration of a
balanced occlusion are key components in his
restorative treatment protocol.
“MiCD focuses entirely on minimal invasive
cosmetic dentistry, so in my own clinical setup,
I prioritise applying MiCD principles wherever
possible. This enables me to effectively
advocate these principles to students and
colleagues with confidence, using various
clinical cases as examples,” Dr Narvekar said.
Given the reputation and influence of these
organisations, Dr Narvekar views his role
as a KOL as a significant responsibility. To
shoulder this weight, Dr Narvekar highlighted
the importance in building a foundation of
understanding products and their usability,
with a focus on how it can be incorporated
into practice.
The challenges for Dr Narvekar came
in adapting and implementing different
innovations into his practice, then modifying
and simplifying them to ensure better and
easier understanding for participants when
sharing his knowledge through workshops
and lectures. Factors such as ease-of-use,
handling, mechanical properties, and results
produced, are essential considerations rather
than just relying on the brand name alone.
“As a KOL for many companies, it is
essential to spend the time to thoroughly
understand the material and its clinical
capabilities and study all materials, including
their composition, pros, and cons. This
in-depth knowledge permits me to handle
these products effectively in my daily work
optimising clinical performance while
ensuring predictability,” said Dr Narvekar.
Dr Narvekar further elaborated that being
recognised as a KOL comes with the added
responsibility of working closely with industry
partners and consistently delivering highquality
work with a passion for sharing
knowledge with the wider dental community.
Therefore, it is important for Dr Narvekar to
be open-minded and always stay updated to
perform his role.
“Being open to experience new materials and
techniques while maintaining a high standard
in clinical practice not only enhances your
credibility as a dentist, but it also provides
a morale boost, knowing that your clinical
expertise is being recognised and valued
by providing an opportunity to contribute
positively towards dentistry,” he said.
Dr Narvekar approaches this by updating
his presentation slides with the latest
information and maintaining thorough
case documentation with proper records
and diligent follow-ups. He remarked that
clinicians today have access to information at
the click of a button with a trove of resources
online for published research, latest trends,
new materials, and clinical tips.
“By continuously updating your knowledge
and skills, you gain access to a significant
platform to showcase your work, meet
new people, and interact with the dental
professionals from various places. Most
importantly, the more you share knowledge,
the more you gain,” he added.
Beyond his associations as a KOL, he
also publishes articles on patient cases
DENTAL ASIA MAY / JUNE 2024
17

UNDER THE SPOTLIGHT
Dr Narvekar places an emphasis on keeping
abreast of the latest skills and knowledge as a KOL
highlighting restorative techniques and
regularly shares his work on various social
media groups, where he welcomes and values
constructive comments. “I have always
been open to embracing new materials and
techniques from day one to enhance my skills
and provide the best treatment options for my
patients,” he said.
Dr Narvekar concluded: “The primary goal
for any dentist is to be honest and dedicated
to their work; skills are developed over time
through continuous learning. Once you are
focused on delivering quality work, whether it
is a simple class I restoration or routine oral
prophylaxis, it reflects automatically on your
clinical practice and the respect you gain as an
educator.”
AN ON-SCREEN PRESENCE
Hailing from Argentina, Dr Adriana Locher’s
journey in dentistry began at the University of
Buenos Aires (UBA) in 2010. Since earning her
DDS degree, she felt a strong urge early in her
career to pass on her knowledge, leading her
to become a faculty member at UBA at the age
of 19.
After graduation, Dr Locher specialised
in oral implantology and high-complexity
rehabilitation. This field — encompassing
implantology, bone regeneration, and
prosthesis rehabilitation — has since
become her passion and expertise. Notably,
her master's degree presentation on periimplantitis
won the first prize for oral
presentation among all universities in Spain.
This recognition fueled her desire to address
such critical concerns in implantology.
As a KOL for W&H, Dr Locher is able to marry
her wish to impart knowledge with her dental
expertise. “My role revolves around sharing
insights to enhance the practices of medical
professionals, bridging the gap between
medical advancements and those who can
benefit from them,” she said.
Dr Locher approaches her role by leveraging
social media platforms with an on-screen
presence to share her insights, with a primary
focus on creating informative videos and posts
primarily on Instagram to her audience of over
12,000 followers. “Through these mediums, I
not only introduce new products and surgical
techniques but also create a contextual
understanding of their applications, enhancing
the practice of medical professionals," she
said.
Beyond social media, Dr Locher’s
communication approach extends into
different platforms such as live courses
and conferences. Her intention is to present
products in a relaxed and approachable
manner, while ensuring that the depth of
knowledge and expertise behind them is
maintained.
“I have had the privilege of speaking at
numerous conferences, conducting handson
courses, writing books and scientific
articles, and contributing to the educational
development and training of various
international dental companies. For me,
dentistry is not just a profession — it is a daily
opportunity to engage in what I love,” she
added.
It is in engaging in this passion that Dr
Locher’s remains committed to excellence
for herself and her audiences. Beyond her
It is not uncommon to find Dr Locher in front
of the camera unpacking topics of interests or
interviewing profiles from W&H
personal preferences, the most important
factor for Dr Locher when collaborating with
brands or organisations is the quality of its
products.
“My community trusts my recommendations.
I want to work with products that I believe in,
products that I can stand by and confidently
look my colleagues and patients in the eye
while doing so. For me, it is important to feel
that the brand represents what I need for my
daily practice. What I appreciate about W&H
is their holistic approach to dentistry. They do
not just produce surgical devices — they offer
comprehensive solutions,” said Dr Locher.
Moreover, Dr Locher views her role as a KOL
not as an end, but a progression reflective
of her own growth that allows her to reach
and educate a wider audience of medical
professionals. “I am perpetually engaged
in learning because it is inherent to the
responsibility of teaching and holding this
position. Continuous study, daily reading,
and connecting with other KOLs are integral
to providing the community with the highest
quality education they deserve,” she said.
Dr Locher concluded: “Just as W&H
continuously improves its products, I attach
great importance to further developing my
qualifications. It is an integral part of working
in the medical field, where patient care is our
utmost responsibility. As professionals, we
must continuously improve our skills to ensure
we provide the highest standard of care.
Being a KOL does not mean abandoning my
professional identity.”
KNOWLEDGE IS ONLY OF VALUE
WHEN SHARED
In Dr Kenneth Lew’s 30-year-long career as a
specialist orthodontist, with his first decade in
academia as a full-time staff at the National
University of Singapore and subsequently as
a clinician where he also provides training
and education courses in orthodontics, the
filter of these experiences has shaped his
perspective as a KOL and led him to assuming
the role which he never intended on, but rather
“serendipitously stumbled into”.
“As a KOL, my twin responsibilities are to be
brand agnostic, then have a good experience
myself with the product and extrapolate this
18 DENTAL ASIA MAY / JUNE 2024

UNDER THE SPOTLIGHT
to an audience of highly intelligent dentists,
for the product to receive a more considered
engagement,” said Dr Lew.
As a clinician based in Singapore, Dr Lew
believes many mild occlusions cases in Asia
are unique as there are certain features that
are very prevalent in the local population which
is not seen in Caucasians. With a focus on
Asia as his target audience, Dr Lew sees his
KOL role as about bringing brand awareness
to potentially innovative technologies that
otherwise might not have exposure and
penetration in the Asian market.
As keynote speaker in Asia for clear aligner
brands and fixed braces, Dr Lew shares his
clinical experiences at training courses and
conferences where he seeks to raise a genuine
interest in products and techniques, for
clinicians to further explore in their practice
rather than dogmatically promoting its
benefits. “An effective KOL is impartial, critical
and evaluative, and draws curiosity and brand
awareness to the new product,” he said.
Dr Lew believes that academic awareness
created by a KOL should work in concert with
different business units such as research
and development, testing, manufacturing,
licensing, regulations, and marketing, to truly
drive consumer adoption of a product.
He underlined a collective responsibility of
these business units that should be upheld
for its customers. Differentiating orthodontic
products due to their invasive nature, Dr
Lew highlights the duty of care the product
regulatory team discharges relating to
emerging technologies, regulatory approvals
and registrations.
Realising how the landscape of dentistry as a
profession and industry has been transformed
in the last decade by factors such as social
media and digital dentistry, Dr Lew believes
that increased modes of communication to
one’s audience brings an added responsibility
for a KOL.
Dr Lew highlighted targeted symposiums
as a useful platform for KOLs as it attracts
large audiences and sets a conducive
environment where dental professionals are
receptive to new ideas. “I have noticed that
Dr Lew giving a lecture on accelerated orthodontics
during the IDEM 2024 scientific conference
dental meetings are very good — we speak
to a community of people who are centred
on emerging technologies that have the
potential to enhance treatment outcomes
and the patient experience free from everyday
distractions,” he said.
Dr Lew shared that in 2024, he will focusing
on sharing new innovations he has found in
the fields of acceleration in orthodontics, clear
aligners and lingual orthodontics. With an
eye on emerging technologies, Dr Lew raised
a balancing act that KOLs must manage in
encouraging their audiences to explore such
innovations. He explained that innovative
solutions are likely to contain a calculated level
of experimentation in their approaches. “We
cannot have an exhaustive set of data because
by the time you wait for it, companies will no
longer be in the forefront,” he said.
“There is a sense of responsibility for me
as a KOL knowing that audiences will be
evaluating what I say. Everything I say cannot
be supported by literature and literature is not
fully extensive to be able to support everything.
Some of my reflections are empirical because
I have tried something and it works in my
hands,” Dr Lew added.
This poses a challenge for KOLs where Dr Lew
relies upon the “muscle memory” developed
through his extensive experience. He explained
the process of how ideas are adopted into
clinical practice where clinical observations
are interlinked while working principles are
developed over the same timeframe. When
a clinician sees a patient, they evaluate new
techniques and try to apply it clinically. “We can
either evaluate and accept new techniques,
adopting it with minimum of fuss, or identify
techniques which do not work in our hands and
move onto new research,” said Dr Lew.
Moreover, it is along this process where Dr
Lew places an invaluable weight on both
the fundamentals of dental education and
continuing education which enables dental
professionals to develop an acute instinct to
evaluate new methods. This is what drives
him to be an active speaker for education and
training, summed up in his personal motto:
Knowledge is only of value when shared.
“After graduation, the most perceptive dentist
is the one who realises that he really needs to
proactively seek education because the dental
school is only limited to 4-5 years, and really is
not meant to go beyond basic dentistry,”
Dr Lew said.
With most dentists globally engaged as
private professionals, Dr Lew believes that
continuing education has made scalable
orthodontics accessible, where dentists of
differing capabilities are able to learn the skills
needed for orthodontics treatment. Moreover,
continuing education allows dentists to
improve their skills while still seeing patients
to earn an income. Dr Lew cited how in the
1980s, braces were perceived as affordable by
the higher stratum of society but have become
almost “bread-and-butter” in dentistry today.
Dr Lew characterised the impact of sharing
professional knowledge as a geometric
progression compared to an arithmetic
progression if he were to confine his skills
within his own practice. “If I have any
possibility of leaving a living legacy, is that I
have tried to share what I know. There is no
use keeping my know-how to myself; to me it
is meaningless because I can only touch a very
small sector of the population,” he said.
Dr Lew concluded: “What I find meaningful
is when I teach dentists who have a passion
in orthodontics. They share their amazing
work with me and in turn encourage their
junior colleagues to improve their skills
because they want everybody to share this
knowledge. I feel that it is my calling to share
my knowledge with the younger members of
the community.” DA
DENTAL ASIA MAY / JUNE 2024
19

The work
behind the
research
By James Yau
As the winner of the 2024 International
Association for Dental, Oral, and Craniofacial
Research (IADR) Distinguished Scientist
Young Investigator Award, Assoc Prof Gustavo
Nascimento was recognised for his dedication
and remarkable contributions to dental research
on 13 Mar 2024 in New Orleans, US, at the 102nd
General Session of the IADR.
This includes publishing over 160 peer-reviewed
articles, serving as a reviewer for 65 international
journals, and obtaining more than S$1.5m in
grants in his 16-year-long career since graduating
with a DDS from the Federal University of Rio
Grande do Sul of his home country of Brazil.
With a PhD in oral epidemiology, Assoc Prof
Nascimento investigates the relationship
between oral and systemic diseases as the core
focus of his research. Based in Singapore, he
holds appointments as an Assoc Prof of the
Duke-National University of Singapore Medical
School and principal investigator of the National
Dental Research Institute Singapore (NDRIS) and
National Dental Centre Singapore (NDCS).
Assoc Prof Nascimento is currently engaged in
research such as the establishment of the NDCS
oral disease registry (ODR), an ongoing project to
leverage big data in investigating the relationship
between oral health and systemic health through
the entire SingHealth cluster, comprising four
hospitals, three community hospitals, five
national specialists centres and eight polyclinics.
While the prestige of these awards and projects
represents proud moments for Assoc Prof
Nascimento, he is equally reminded of the hard
work involved behind the scenes. He hopes
that this milestone in his career inspires others.
“I hope that this award can also inspire other
researchers to aspire to greater achievements.
For a public health guy from Brazil to be in the
spotlight, I hope that they will see their goals

UNDER THE SPOTLIGHT
as reachable regardless of their geographic
or cultural background,” said Assoc Prof
Nascimento.
“I must say that while a research path
sometimes can be very lonely, this award is
definitely a result of teamwork. I have had the
privilege of working with excellent researchers
as my mentors, colleagues, and students.
While this prize was awarded to me, I must
acknowledge that I could not have done it by
myself if I did not have the wonderful partners
I had along the way.”
CHARTING A PATH FROM BRAZIL
Supported by P&G Professional Oral Health,
Crest Oral-B, the IADR Distinguished Scientist
Young Investigator Award is designed to
stimulate basic research in all dental research
disciplines and is awarded to nominees within
10 years of completing their last terminal
degree.
Assoc Prof Nascimento shared that his
choice to venture into dental research was not
a result of planning but rather of curiosity. “It
was a very natural path while I was doing my
dental school, as I was involved in research
since the first year, which I grew curious
about,” he said.
After graduating with his DDS and an
“intense” experience during clinical training
residency, Assoc Prof Nascimento felt
disconnected from academia, which led
him to pursue a PhD in oral epidemiology
where he discovered his research interest. “I
realised that it should not be a coincidence
that the unprivileged have the heaviest
burden of disease. This is the same with
oral disease, so I wanted to understand why
some people get sick and why some do not,”
he explained.
He added: “During the time I started doing
my PhD 12 years ago, we would still focus
on dental disease as infectious disease,
where you treat the bacteria as a solution
for dental disease. But when I started one of
the studies within my PhD, we showed that
irrespective of the bacteria, if you accumulate
health detrimental behaviours, you will
increase the risk of periodontitis regardless
of the frequency of toothbrushing.”
The paradigm shift of dental diseases
from an infectious disease to a noncommunicable
disease and the
understanding of it as a similar disease to
diabetes or cardiovascular disease is one
of the proudest contributions of Assoc Prof
Nascimento’s research to date.
Since winning the distinguished award, Assoc
Prof Nascimento has noticed an uptick in
attention to his work, which he hopes will
open more opportunities and visibility in his
field of research. He added that while the field
today is more open to accepting oral disease
as a chronic disease, the treatment for oral
diseases is still largely based on scaling and
removing plaque.
“I do hope that with my current and
future research, we can place the dentist
beyond a technical role and as part of a
multidisciplinary team of health professionals
to treat patients. Dental treatment can be
isolated in the sense that we have a difficult
time reaching out to other professionals, so
I do hope that we can expand our horizons,”
said Assoc Prof Nascimento.
As the 2024 IADR Distinguished Scientist
Young Investigator, Assoc Prof Nascimento
has also been named to the IADR board
of directors as the Young Investigator
Representative on a two-year term lasting
till March 2026. With this seat, Assoc Prof
Nascimento has been allocated to the
strategic planning committee and will assume
responsibilities such as judging recipients for
the next edition of the awards.
Having spent time in South America,
North America, Europe, Australia, and Asia
across his career, Assoc Prof Nascimento
incorporates his exposure into his outlook as
a researcher and professional.
Assoc Prof Nascimento welcoming guest during opening ceremony of the Joint 37th Annual
Scientific Meeting IDAR-SEA Division & 2nd International Oral Health Symposium hosted by National
Dental Centre Singapore (NDCS) in November 2023. As the new Young Investigator Representative on
the IADR board of directors, Assoc Prof Nascimento will advocate for a more inclusive organisation
“I will try to advocate for a very inclusive
organisation, meaning to push focus on
regions that somehow have been neglected.
It is easy for an organisation to be focused
on the regional interests where its members
originate, but I believe the organisation
should represent everyone. I will try to
advocate for more representation and think
that IADR is ready to embrace the diversity of
everyone,” he said.
DENTAL ASIA MAY / JUNE 2024
21

UNDER THE SPOTLIGHT
In Asia, one particular issue he
highlighted was the impact of ageing
on oral health.
“I think that, on the one hand, it is a
challenge because it is probably going
to be one of the first regions in the
world to have a super-aged society. On
the other hand, it offers possibilities
to research this unexplored topic,
and I hope that the region can take
advantage of that and actually lead our
research in that direction. I think that
the world is actually looking to Asia for
directions regarding how it handles the
challenges that might arise,” he said.
It is undeniable that Asia will become
the most powerful region in the world,
and that will not be an exception in
terms of research.”
Assoc Prof Nascimento stresses that
research that might not be immediately
applicable or commercialised such as
basic laboratory research, is pivotal
to establishing a foundation for future
research and discoveries. In fact, most
basic research does not translate
into products but helps explain the
world around us. However, even the
discovery of some molecules may take
several years to reach the market.
1 (GLP-1), which the medicine is based
on, was discovered over 40 years ago.
Sharing his advice for other
professionals pursuing research,
Assoc Prof Nascimento highlights
the wisdom in being open. “I am very
glad that I have always been able to
find trustworthy partners that made
my journey more pleasant. These are
mentors, colleagues, and students who
inspire me to be a better professional
and researcher. I think it is important
to be open to learning from our own
mistakes and the mistakes the others
have made,” he said.
Moreover, Assoc Prof Nascimento
looks towards the Asian landscape as
a potential place to pioneer innovative
solutions. “I think that Asia is ahead
of the world in applying innovation in
research. In Asia, I was challenged
to go one step further beyond just
publishing papers and evaluating the
impact of research on the population.
He cited the example of Ozempic, a
popular anti-diabetic and anti-obesity
medicine commercialised in 2016.
Its economic impact contributed to
the growth of its manufacturer, Novo
Nordisk, to become the most valuable
company in Europe at the time of
writing. The company’s synthetic
version of the glucagon-like peptide
He added: “Of course, one must deal
with frustrations. To restart, change
direction, or throw away many months
or even years of research because
the hypothesis does not hold or
things go wrong is not an easy task.
However, research can also be very
rewarding, mentoring students and
seeing the results of research where
policies, protocols or clinical practice
are changed to improve people's oral
health. You have to be open to dealing
with all of it.”
For professionals who do not
see themselves in the academic
environment, Assoc Prof Nascimento
believes that to be the best clinician,
one must be able to incorporate
research into what they are doing. “We
know that the one-size-fits-all approach
does not hold anymore. We must
provide individual care to every single
patient sitting in our chair. To be able
to do that, you have to be updated.”
Assoc Prof Nascimento with colleagues from National Dental Research Institute
Singapore (NDRIS) at the IADR General Session in March 2024
Assoc Prof Nascimento concluded:
“Research is very tough, but resilience
is a key word. Look for opportunities
and partners. The world is ‘small’ and
globalised, and there is always a place
for everyone. If you do not find partners
in your city, go beyond borders. Try to
reach out to people who are thinking
closely about what you are doing. I
have partners with whom I have been
collaborating for many years, and I only
met this year at IADR.” DA
22 DENTAL ASIA MAY / JUNE 2024

Turning spares into strikes
By James Yau
Located in Ningbo, a coastal city in the
east of Zhejiang province in Eastern China,
Woson Medical Instrument (Woson) began
as manufacturer of quality spare parts for
stomatology equipment in 1985.
After accumulating more than 20 years of
experience in machining and producing
instruments and parts, the Woson brand was
introduced with a wide offering of dental
solutions sold under the name. Today, the
Woson Group houses its sub-brands like
‘Purple Dental’ for dental equipment and
devices, ‘WoQute’ for dental consumables,
and ‘Parson’ for dental accessories and
spare parts.
“Starting out by making parts for big dental
brands was like our training ground. We got
good at making top-notch stuff because
those brands have very high standards.
When we decided to make our own dental
gear, all that experience paid off big time,”
said Puneet Saini, regional director, MEA,
India & South East Asia, for Woson.
Woson holds a presence in more than
100 countries, with a network of 200
agents spread over 136 countries. It further
established six subsidiaries in Poland, India,
Russia, Mexico, Brazil, the Netherlands, and
the US; two service centres in Italy and the
Netherlands; a research and development
base and acquired Galbiati, an Italian brand of
dental products founded in 1935.
Saini shared that with Woson’s unique
background and siting in key national
infrastructure projects, the company is ready
to venture towards a new strategic direction.
“Woson Group has been continuously
innovating and expanding its product
offerings, these innovations can be
experienced with our current range of
products. We are also working on some
exciting developments and updates that
customers in Asia can look forward to. An
updated digital range of products and new
version of dental units are expected soon,”
said Saini.
THE BIG PICTURE
In 2013, the Chinese government proposed
to create a regional economic belt, with a
view to national development: The Ningbo
Meishan Health Industry. The Woson
Medical Meishan Health Industry project
was approved in 2018 for an area of
500,000m 2 and an investment of CN¥200m.
After construction was finished in 2022 and
global trade reopened after the Covid-19
pandemic restrictions, Woson consolidated
its operations in the Port of Meishan to
expand its portfolio with products aimed at
digital imaging diagnosis.
The establishment of trade cooperations
like Ningbo Meishan International Logistics
Industrial Group further integrated China’s
main global brands such as Woson, with
a consolidated industry, commerce, and
service delivery network dedicated service to
the health segment. This created conditions
for the definitive change to the new facilities
at Ningbo Meishan Health Industry.
“Getting in on projects like the Woson
Medical Meishan Health Industry and
Ningbo Meishan International Logistics is
like leveling up for us. It has changed how
we do things and where we are headed,”
said Saini.
24 DENTAL ASIA MAY / JUNE 2024

DENTAL PROFILE
Saini highlighted that being part of these
projects made Woson think bigger. “We are
not just about dental stuff anymore; we are
thinking about how we fit into the whole health
and logistics scene. This big-picture view has
helped us tweak our game plan,” he said.
Moreover, the country’s investment has turned
the global spotlight on the region and created
a trove of opportunities. “Being involved
in these projects means we are right there
when new infrastructures and industries
are popping up. That means more potential
customers and partnerships right on our
doorstep. Jumping into these big projects has
given us a whole new outlook and set us up
for some serious growth,” Saini added.
on our feet and are able to compete with new
technologies and solutions. If there is a new
trend or a sudden surge in demand, we can
tweak our production or whip up something
new in a jiffy. Long story short, our roots in
making parts for the big players helped us
become a real contender in the dental gear
game,” he said.
Saini concluded: “I would urge all our
customers, readers, and dental enthusiasts
to keep an eye on the horizon for the next
breakthroughs that will shape the future of
dentistry. In conclusion, the Woson Group’s
story is not just about dental equipment;
it is about the betterment of healthcare
worldwide.” DA
In addition to Woson’s new physical structure,
which features a 46,000m 2 manufacturing
factory, Woson Medical Meishan Health
Industry project developed a new management
intelligence capability. With a strong emphasis
on R&D, manufacture, sale, and distribution
of products for the wider health segment, the
integration of technology, human resources,
and foreign equipment into its production and
operating systems created a digitalised and
globalised network for the medical-industrial
complex.
The development of key infrastructure has pushed Woson towards a new strategic direction
Saini likened the heterogeneity of consumers’
demands and needs to that of a salad. While
catering to this diversity, Saini placed an
emphasis on providing a comprehensive
solution with an excellent price performance
ratio as Woson’s goal in a competitive Asian
market.
“Asia’s dental market is very dynamic. Many
new products and technologies come into the
picture daily, and these are the challenges.
The needs of consumers in the Asian market
are evolving, with a focus on value for money,
quality, and digital experiences. Success is a
journey not a destination and there is a long
way to go on this journey.
Woson’s 20-year background of producing
parts for other manufacturers is paying
dividends as Saini is confident that it
enabled the company to develop a keen
understanding of quality control processes
as well as the needs of dentists. “Now,
because of that background, we are quick
Woson at a trade show in Brazil. With its wide network and unique background, the company is gearing
up to offer customers with innovative solutions
DENTAL ASIA MAY / JUNE 2024 25

Building in systems and
languages of trust
From left: Christian
Mueller, Christoph
Stark, David Figge,
Joerg Brenn, Dominik
Kreuzer, and Nik Koh
As a first-time exhibitor at the recent IDEM 2024 in Singapore, imes-icore’s
physical presence of both staff and equipment represents the realisation of a
picture over 20 years in the making since its founding in 2002. Dental Asia speaks
with Christoph Stark, CEO, and Christian Mueller, COO and managing director,
of imes-icore on how it plans to complete this frame. By James Yau
On 31 Aug 2023, imes-icore opened its new
Competence & Service Center in Singapore
as part of its global expansion strategy in
Asia. Responding to a strong demand for
CAD/CAM systems in the region, the centre
was established to support its regional
customers in covering all aspects of its CAD/
CAM systems, from installation, service and
maintenance support, and training for end
users.
Helmed by Joerg Brenn, general manager of
imes-icore Asia, who holds over 30 years of
experience for building offices from scratch in
Asia Pacific, Brenn was joined by the visiting
management team from imes-icore some
eight months later at IDEM to mark not only
its presence, but ambitions in Asia.
“We have been serving Asia since many years,
but it was just a region where we ship our
machines and that is it. Now we have a strong
footprint here and we have a commitment
linked to this footprint. We came to stay here,”
said Mueller.
Mueller noted that the opening of its
Competence & Service Center Asia has been
received well among its distributors and
end users. “What we hear is a lot of positive
responses, and what we see in general is that
our customers appreciate our approach to be
closer to them,” he added.
imes-icore's distributors are positioned as the
first level of support for end users. The office
in Asia now forms the second level of support
for customers, by working closely with
distributors on competence and qualifications
through initiatives like its CORiTEC training
academy, extended warranty contracts, and
preventive maintenance services.
“I think it is still important that the first level
support is still up to the distributor. He must
be responsible because he sells the machine.
But we are now here to do the second level of
support with close access in the same time
zone. We can make sure the dealer has the
right qualifications and is capable to provide
the best possible support," said Mueller.
Moreover, Stark highlighted that with imesicore’s
systems being positioned as a premium
offering, the level of support provided should
be of an equally premium service that inspires
trust in its users.
“The name is important to understand,
'Competence & Service Center', because this is
exactly what we mean — service and support
training. The dental technology in Germany is
the highest worldwide. We want to bring not
only the service for the machines, but also
26 DENTAL ASIA MAY / JUNE 2024

DENTAL PROFILE
the applications and indications needed for
the user to produce. We want to train our
customers and this is only possible with our
own staff,” said Stark.
A-ONE-STOP-SHOP
Inspiring confidence in its investment and
goals in Asia, the pair pointed that among the
mass, middle, and premium offerings, they
see enough potential in the Asian market
for its premium class systems. Moreover,
they believe that customers seek value
above anything. For imes-icore, this means
a seamless and integrated workflow for a
hassle-free experience.
“It is our philosophy to offer open systems
and workflows, but we think there is a great
benefit to have all the bits and pieces fit
together. A customer does not want to care if
a CAM works with a machine, tool, or milling
strategy because they can trust our system
where everything is validated and integrated,”
said Mueller.
Moreover, beyond the ease-of-use which
integrated systems provides, integration is
how the pair sees technology developing
within the next 5-10 years, where
advancements will push systems towards
digitalisation and automation.
Recognising this shift, imes-icore rolled out
its Dental Smart Market (DSM) in 2023, as
an integrated and automated platform for
its customers and marketplace partners
to facilitate services such as procurement,
maintenance planning, inventory management,
and real-time status updates.
“With this digital network, we can send a
message directly to the machine even before
the user knows the next step. We can offer
users the right time for maintenance or to
change a part. We can offer users better
solutions for dental applications, such
as denture production, by sending direct
information to optimise their workflow. These
are all digital because with these solutions,
we are able to support our global customers
globally despite tight time, labour, or
geographical constraints," said Stark.
The DSM in combination with the Smart-
Control User-Interface also provides
diagnostics opportunities through smart
control systems and notifies users of
potential errors. “If you analyse the root
cause of a complaint with the machine, you
figure out that 80% of the cases go down to
approximately 10 root causes. The machine
can tell you in 80% of the cases what the
issue is and how to fix it, either as a user or a
service partner, and these are the things which
we will expand," said Mueller.
Stark envisions that through DSM, the
intelligence of its systems would be as easy
to use as a “coffee machine”. He added: “I
always say that a milling machine alone is
no solution — the milling machine is only one
component for a whole production solution.
We are not only a milling machine builder.
Metal Processing
For Every Lab Size
CORiTEC
Effortlessly print detailed dental restorations in
CoCr & Ti with our laser melting technology,
expanding your metal printing options.
CORiTEC 150i PRO Best in Class
Metal processing of CoCr blanks.
iCAMHD for free with perfect fitting templates.
CORiTEC 350i Loader
PRO
Expand the diversity of dental restorations in
your lab through the combination of traditional
and hybrid machining techniques.
More information abailable at: www.imes-icore.com
DENTAL ASIA MAY / JUNE 2024 27

DENTAL PROFILE
While other companies only offer machines,
customers need much more such as the
right CAM, materials, interfaces, and tools. A
machine is only a machine while customers
are looking for production systems.”
Beyond building its DSM ecosystem, Stark
highlighted that the foundations for imesicore’s
expansion strategy in Asia was laid
prior with strategic acquisitions to build
a comprehensive portfolio of premium
offerings.
Since 2018, imes-icore developed into a
group of companies with the goal of offering
dental production systems, consumables, and
services to the market. Pritidenta, a German
manufacturer of premium zirconia blocks,
was acquired along with i-ProDens, a German
technology and milling centre.
“The idea was to offer premium products at
an affordable price. Due to the integration of
Pritidenta into the imes-icore Group it was
possible to increase the sales, and we were
able to reduce the entry price for regular
dentists and labs to access Pritidenta’s
premium blanks for our CAD/CAM systems,”
said Stark.
Mueller added: “I think the acquisition of
Pritidenta was also an important step to
expand our offering because before we
have only been a pure machine builder. Now
with Pritidenta we can offer materials and a
complete solution for the customer.”
imes-icore’s Competence & Service Center
USA was also established through the
integration of PM Technologies, a service
company with many years of experience in
servicing dental machines, which served
as a footprint to launch the company’s first
regional Competency & Service Center in
2019. This approach has also been replicated
to guide the office in Singapore.
Moreover, having secured the materials,
machines, and service centres, Mueller added
that it “completed the picture” by housing the
right experience all under one roof.
“Pritidenta’s CEO, David Figge is an important
part of our dealer meetings because he is
an expert in dental material technology who
can answer questions in detail; he has the
benefit of being part of our team for new
opportunities. Stark and I are coming from the
machine building business, and this is where
we have a great synergy,” Mueller said.
Indonesia, and the Philippines, with far
larger populations than Germany’s 80
million residents. In a 5-10 year horizon,
there is so much potential and this provides
a lot of opportunities for us. imes-icore
will not be focused so much on Germany
or Europe anymore, it will be on Asia as
an important pillar of our growth strategy,”
said Mueller.
Furthermore, Stark highlighted that
consumers are also increasingly expecting
higher quality of restorations, as technology
and materials improve. “It is also clear that
everyone globally wants to have better teeth.
Everybody wants to have a better fitting,
longer lifetime, better materials, and quality,
which is very normal. Nobody goes back.
Everybody wants to have better solutions,”
he said.
Stark further shared that a premium offering
also means a range of machines with
different capabilities for customers. He
highlighted the CORiTEC AM100 printer with
its capability in titanium and cobalt-chrome
production, the CORiTEC 350i X Pro series
for its speed and quality, and the CORiTEC
150i series as a smaller-sized system
without compromising on capabilities.
With its Competence &
Service Center Asia up and
running, Mueller shared that
this marks a pillar of strategic
growth for the company
due to the large population
of customers and growing
demand for restorations.
“I always like to
count the number
of inhabitants
of countries
like Malaysia,
An important learning point for the pair in the
past few months, is the statement, "Quality
expectations in South East Asia are a bit
lower than in the Western countries", no
longer holding. “People want to have their
standards like Germany or Western Europe
or the US,” Mueller said.
It is in these nuances that Stark and Mueller
are assured that imes-icore meets the needs
of customers. Despite the emphasis placed
on itself as a premium brand, the pair is
confident that its production systems offer a
competitive price-performance ratio.
Ahead of its first
IDEM showcase
on 19 Apr, the
new imes-icore
Competence &
Service Center Asia
hosted an open
house on 18 Apr for
guests and partners
Stark concluded: “That is the key, not just
to build the cheapest machine. Given
the customer's demand for good dental
restorations, we think that is important to be
improve in terms of precision and quality.
We need to always bring a level of machines
which can produce a range of premium
products. A lesser-class system is not our
vision.” DA

DENTAL PROFILE
The introduction of AI-based technology in dental care platforms and services has
refined the means and scales to which this care is provided. Believing this to only
be the start of what the technology has to offer, Dr Jie Feng, CEO and co-founder
of KELLS, believes that these AI capabilities are but the start of a wider revolution.
Dental Asia speaks with Dr Feng to find out how far and wide AI can reach.
By James Yau
The AI revolution for
consumer oral health
Offering convenience, lower cost, and better
experience, telehealth has become a norm in
modern care delivery systems.
When it comes to dentistry, the way
teledentistry operates now is largely based on
a network of online dentists providing video
consultation. It is an important component
in making care accessible especially
for scenarios like emergency cases and
geographically inaccessible regions.
Despite this existing value, Dr Jie Feng, CEO
and co-founder of KELLS, believes that the
service-led model is missing out on the
technological transformation that is happening
in every other sector especially when it comes
to AI.
“At KELLS, we are building the oral health
platform for the future that uses AI-powered
products as digital front door and puts
consumers at the centre of the experience. The
KELLS platform is designed as an all-in-one
digital hub for consumers to access a rich set
of dental benefits that meets their daily needs
outside the physical clinics,” said Dr Feng.
Named after Charles Edmund Kells, a popular
American dentist credited for introducing
some of the earliest x-rays of teeth from
live patients, KELLS is an AI-powered virtual
dental care platform enabling accessible and
personalised oral health and benefits.
Offering capabilities like real-time consultation
via voice or text chat, at-home dental scan
with smartphone photos, virtual second
opinion on x-rays for treatment verification
and personalised benefit reminder, these
components are interconnected as different
engagement points to understand a more
holistic patient profile driven by data and offer
values when they need it the most.
“AI is without a doubt rapidly changing the
landscape of every industry. Healthcare is one
of the hotspots where AI is poised to play a
DENTAL ASIA MAY / JUNE 2024 29

DENTAL PROFILE
foundational role across all verticals
within. Dentistry is no exception. We
are already seeing AI adoption in the
dental practices to support dentists
for diagnosis and treatment planning,”
said Dr Feng.
Since its preliminary launch in April
2024, Dr Feng shared that KELLS has
received strong traction and support
from its partners including payors,
providers and digital health companies.
However, Dr Feng sees the roll out of
such AI-powered technologies as only
the “dawn of an AI revolution”.
With a PhD in computer science
and background working with AI
startups before founding KELLS, Dr
Feng foresees that in the next 5-10
years, data flows will become more
seamlessly not only for a single
practice but across the system under
unified exchange protocols. “Inoffice
workflow will be much more
automated where AI can schedule
appointments by phone or text, verify
insurance, analyse patient records to
optimise capacity, simple procedures
will be done by robots, claims are
automatically reviewed and reimbursed
in almost real-time,” said Dr Feng.
Moreover, AI will also act as a personal
dental assistant for individuals to
identify early sign of diseases, create
Despite the benefits of teledentistry,
Dr Feng, CEO and co-founder of KELLS
believes that there is more room to
incorporate AI-powered tools
Dr Feng believes that dental professionals
should verse themselves in the basic of AI
to take advantage of its benefits
and monitor daily care routine, educate
families on health and financial risks,
help form good oral hygiene habits
and eventually improve preventative
actions. Dr Feng noted that while
many of these are not new ideas, AI
will enable these solutions to become
scalable as the technology matures.
Dr Feng added that generative AI and
multimodal AI have great potential
to open doors to new applications in
dental. In particular, multimodal AI
will allow users to combine different
types of records to gain a deeper
understanding of a person’s risk profile
and needs like never before.
While the role of AI is to augment
and not replace dental professionals,
it enables users to become more
efficient decision makers and doers
on a higher level without being
handicapped by tedious work. With
the future more integrated with AI
applications, Dr Feng believes that it is
a skill not to be overlooked by dentists.
“Dental professionals would do
themselves a great service by
learning the basics of AI, how it
works, and staying on top of the latest
applications where AI are being utilised
in dentistry so they can position
themselves to take advantage of the
values AI generates,” he said.
Similarly, Dr Feng highlighted that
consumers will be more intelligent with
the help of AI to process information
from their dentists and ask smart
questions when it comes to key
decisions. This will make meaningful
collaborations between patients and
providers more common with AI being
the equaliser.
With this “technological revolution”
underway, Dr Feng is reminded that
history teaches the best thing to do
is to embrace it and use it to improve
what one does.
Based in New York City, Dr Feng is
now looking beyond the US to spread
the platform, sharing that KELLS is
looking to partner with organisations
that have deeper expertise in a given
market where larger impact and values
can be generated via collaboration.
This is made possible by its design as
a scalable and flexible solution to be
leveraged in different contexts to meet
diverse needs, which can be accessed
anywhere in the world with internet
for its AI-powered care and dental
benefits.
“By leveraging our proprietary AI and
dental experts, we can democratise
access to high-quality and delightful
experience in dental care and wellness
for the masses. We recognise every
market has its own challenges when
it comes to oral health including care
delivery, integration and regulation.
However, consumers would always
look for dental solutions that are
convenient, cost effective and provide
excellent experience,” said Dr Feng.
He concluded: "We believe better
oral health can only be achieved
when individuals are engaged and
empowered to make informed
decisions and take preventative
actions, and KELLS is built to
remove frictions for people to do
so and serves as the extension and
augmentation of traditional dental
workflow in the brick-and-mortar
offices." DA
30 DENTAL ASIA MAY / JUNE 2024

CLINICAL FEATURE
Face-driven orthodontics:
Myth or reality? (Part A)
By Dr Ruan Kok, Adjunct Prof Dato’ Dr How Kim Chuan, Dr Kevin Ng, and Dr Liew Denlee
INTRODUCTION
Aesthetics is the discernment of art, design
and beauty and stems from the Greek word
“aisthetikos”, that can be defined as the
perception of sense. Davis et al. reported that
patients seek aesthetic dental enhancement
to improve self-esteem and social acceptance
due to the social impact of an aesthetically
pleasing smile. 1 There has been a paradigm
shift in patient focus toward aesthetic dental
treatment from mere restoration of broken
teeth and pain relief. 2
For 100 years, orthodontic theory and practice
has been based on the Angle’s paradigm. 3
According to this paradigm, all adults should
have perfectly aligned dental arches with 16
teeth each that ideally articulate with the teeth
in the opposing jaw.
Over the past 20 years, there have been
subtle yet continuous changes in the way that
orthodontic diagnosis is approached. Hard
tissue-based evaluations have given way
to a wider appreciation of facial and smile
appearance by patients and the orthodontic
specialty. 4
Arnett and Bergman presented the ‘Facial
Keys to Orthodontic Diagnosis and Treatment
Planning’ as a three-dimensional clinical
blueprint for soft tissue analysis and
treatment planning. 5
Some of the first academic work to propose
objective indicators for smile aesthetics,
was done by authors that studied complete
dentures and the ways to make it look more
natural. 6 Frush suggested that the “smile line”
be seen as that following the incisal edges of
the central incisors up to the distal ends of the
canines. 6
Hulsey, was one of the first in orthodontics to
study smile aesthetics, aiming to formulate
objective guidelines for an aesthetically
pleasing smile by comparing the smiles of
patients that had undergone orthodontic
treatment with smiles of normally occluding,
untreated individuals. 7 The conclusions drawn
from this study are still often referenced in
literature as guidelines for smile aesthetics.
Macro-aesthetic considerations encompass
broader facial features such as the facial
profile, vertical proportions, lip fullness,
chin and nasal projection, and overall facial
widths. These factors play a significant role
in achieving harmonious facial aesthetics in
orthodontic treatment planning.
Mini-aesthetic factors focus on finer details
such as the smile arc, symmetry of the smile,
transverse smile dimensions, and incisor
display. Micro-aesthetic elements delve into
subtler aspects including gingival shape and
contour, emergence profile, tooth shade and
shape, and precise positioning of individual
teeth in terms of rotations, tilt, and torque
control. Fine-tuning the midline alignment is
also crucial at this level.
The arc of the maxillary incisors, in harmony
with the smiling lower lip is crucial for an
aesthetic smile. 8 Proffit claimed that a slight
amount of gingival display when smiling is
considered aesthetic, whereas no gingival
display is less appealing. Too much gingival
display, more than 2mm, is also considered
unaesthetic. 9
According to Hulsey, the presence or
absence of the buccal corridor space does
not contribute greatly to smile aesthetics, 10
although Proffit et al., insisted that a wider
maxillary arch with less corridor space is
more aesthetic. 11 Ideally, in an aesthetic
smile, the central incisors should both have
the same clinical crown lengths and vertical
positions of gingival heights.
According to Proffit et al., the length of the
cuspids should appear to be equal to that of
the central incisors and its gingival margins
should be at the same vertical position. 11
The position of the maxillary lateral incisors
should more incisally. 11
The gingival margins should follow the
cemento enamel junctions of all teeth and be
displayed 0.5-1mm. 12 Proffit et al. suggested
that the level of the gingival margin for the
lateral incisors be less apical to the central
incisors and considered that where there
exists a difference of more than 2mm
between that and the central incisor, it is
unaesthetic. 11
The central incisors and canines are regarded
most aesthetic where the gingival zeniths are
positioned distal to its long axis and when
they take on an elliptical shape. For the lateral
incisors, it should ideally have an oval or halfcircle
appearance. 8
CLASS II TREATMENTS
Class II malocclusions are treatable with a
variety of techniques. Some propose that
palatal expansion is not appropriate when
treating Class II malocclusions, whereas
others believe that the associated dental
expansion will cause spontaneous correction
or improvement of the problem.
The removal of occlusal interferences by
widening the maxillary dental arch allows
the mandible to move forward into a more
comfortable position, rather than increased
mandibular growth, which would have caused
this improvement. 13 When the mandible is free
to move forward, it creates a condition for the
mandible to grow to its full extent. 14
Some believe that maxillary expansion is
detrimental to a Class II malocclusion, since
the maxilla might be displaced downward
DENTAL ASIA MAY / JUNE 2024
31

CLINICAL FEATURE
and forward, while simultaneously leading
to a downward and backward rotation of the
mandible, thereby increasing the likelihood of
developing an open bite tendency. 15,16
- Nasio-labial Angle: Average NLA angle
- Chin point is coincident with facial midline
(Figs. 1-4)
Interincisal angle 122°
Wits appraisal
+1mm
Gianelly suggests that after the “shoe” is
broadened, the mandibular arch functions
as a “narrow foot” that advances. It was
hypothesised that the constricted maxilla is
holding the mandible back in its distal position
at the centric relation (CR) initial contact
Lower incisor to APo line
+2mm
position. 17
Fig. 1
Fig. 2
The “induced change”, as described by
Timmons, was observed clinically after
the upper teeth had been banded with the
edgewise mechanism and an attempt made
to establish ideal arch form with the use of an
018 stainless steel round arch wire bent to an
ideal. 18
Fig. 3
Fig. 4
Fig. 5
The following case report attempts to
illustrates that with the use of a 019x025
CuNiti broad arch wire (Damon), the abovementioned
phenomenon of “induced change”
might be achieved.
BACKGROUND
The following patient is a 15-year-old female
patient that presented with a main complaint
of her front teeth sticking out too far forward.
This patient has a beautiful upper lip-to-nose
relationship with a strong chin button. The
lower lip is slightly everted due to the position
of the anterior dentition. Treatment planning
challenge are present in these cases when
using conventional mechanics.
Functional disorders
- Swallowing pattern: Normal swallowing
pattern
- Lips: Incompetent
- Lip wedge present
Pre-treatment radiographic survey
- Developing wisdom teeth (48,38)
- Alveolar bone presents no abnormalities
- Dental age > 12 years
- All teeth present
- No fillings
- No other abnormalities detected
Variable
T0
Fig. 6
Micro aesthetic evaluation
- Patient’s “smile-line” did not follow curvature
of lower lip
- Increased Buccal corridor
- Labially/proclined incisors
- Midline diastema
- Gingival zenith, canine gingival level below
that central incisors
Treatment options for this patient were
to distalise the molars, extract upper first
premolars or dento-alvoelar decompensation
and orthognathic surgery as soon as growth
ceases. The first two treatment options could
have had a significant impact on the profile
with loss of upper lip support.
Macro aesthetic evaluation
- Facial form: Dolico - Mesio facial form
- Horizontal symmetry: Symmetrical
- Vertical symmetry: Symmetrical
- Facial proportions: Harmonious
- Lower facial proportions: Increased
lower 1/3
- Convexity: Convex profile
- Lower lip - E Line: Lower lip on E-Line
SNA 80°
SNB 77°
ANB +3°
MMPA 34°
Face height ratio 59%
SN to maxillary plane 9°
Upper incisor to maxillary plane 114°
Lower incisor to mandibular
plane
90°
Fig. 7
Fig. 8
32 DENTAL ASIA MAY / JUNE 2024

CLINICAL FEATURE
Occlusion evaluation
- Incisors (overjet): 8.5mm
- Left molar: Class II 1/2 unit
- Right molar: Class II 1/2 unit
- Left canine: Class II
- Right canine: Class II
- Overbite: 5mm
- Curve of spee: 3.5mm
- Mandibular midline: Coincident with
maxillary midline
Fig. 14
Fig. 17
Fig. 9
Maxillary arch
- Total space demand: +1.94mm
- Anterior arch width: 31.90mm
- Posterior arch width: 43.41mm
- Spacing present
- V shaped, Narrow arch
- Rotated second premolars and first molars
Fig. 18
Fig. 10
Bolton ratio
Anterior ratio: Total of mandibular 6 / Total of
maxillary 6 X 100
= 35.81mm/ 46.37mm X 100
= 77.23% (Within normal range)
Fig. 11
Fig. 15
Overall ratio: Total of mandibular 12 / Total of
maxillary 12 X 100
= 84.81mm / 93.24mm X 100
= 90.9% (Within normal range)
Fig. 12
Fig. 13
Fig. 16
Mandibular arch
- Total space demand: -0.11mm
- Anterior arch width: 32.71mm
- Posterior arch width: 45.84mm
Diagnosis
Orthognathic maxilla and slight retrognathic
mandible, class II skeletal base confirmed by
(WITS and individualised ANB) accompanied
by a neutral-vertical growth pattern
- Spacing in the maxillary arch, -2.11 space
deficiency in the mandibular arch
- Proclined and protruded maxillary incisors.
- Over-erupted maxillary and mandibular
incisors
- Large overjet (8.5mm), over bite (5mm), and
curve of spee (3.5mm)
- Left molar: Class II 1/2 unit
- Right molar: Class II 1/2 unit
- Left canine: Class II
- Right canine: Class II
- Lower lips relative to E-Line = 0mm
DENTAL ASIA MAY / JUNE 2024 33

CLINICAL FEATURE
- Slight sub-labial fold
- Average Nasio labial angle
- Lip wedge
TREATMENT GOALS
The treatment complexity lies in correcting
the Class II molar and cuspid relationship,
eliminate spacing, addressing the curve of
Spee, all while avoiding further protrusion of
the lower incisors.
1. Facial considerations guided the treatment
planning options.
2. Extraction of upper first bicuspids was ruled
out due to potential negative effects on
facial aesthetics.
3. Establishing an arch form to provide lateral
facial support.
4. Torque control on labial and palatal aspect
of upper and lower anterior segments.
5. Maintain an attractive nose-to-lip
relationship.
6. Minimising eversion of the lower lip.
- Initial alignment with 014 NiTi in both the
maxillary and mandibular arches, excluding the
premolars.
- After initial alignment, placement of a 016 SS
arch wire with anchor bends and class II elastics
(2 OZ) for correction.
- Subsequent placement of a 020 SS arch wire
with bite sweeps after correcting overbite and
overjet, with premolars bracketed.
- Transition to a 019x025 CuNiti (Damon arch
wire) to widen the maxillary arch.
- Final detailing and seating, including freeing
the buccal segments from main arch wire and
utilising vertical seating elastics at night.
- Retention: Fixed retainer from 12-22/33-43 and
removable retainers for night time wear. DA
This two-part article will conclude in Part B
of the series in the Dental Asia Jul/Aug 2024
issue, which will present the patient’s treatment
progress and possibility of the “induced
change” phenomenon.
REFERENCES
1. Davis, L. G., Ashworth, P. D., & Spriggs, L. S. (1998).
Psychological effects of aesthetic dental treatment.
Journal of Dentistry, 26(7), 547–554. https://doi.
org/10.1016/S0300-5712(97)00031-6
2. Kokich, V. O., Asuman Kiyak, H., & Shapiro, P. A.
(1999). Comparing the Perception of Dentists and
Lay People to Altered Dental Esthetics. Journal of
Esthetic and Restorative Dentistry, 11(6), 311–324.
https://doi.org/10.1111/j.1708-8240.1999.tb00414.x
3. Ackerman, J. L. (1974). Orthodontics: Art,
Science, or Trans-science? The Angle Orthodontist,
44(3), 243–250. https://doi.org/10.1043/0003-
3219(1974)0442.0.CO;2
4. Sarver, D. M. (2015). Interactions of hard tissues,
soft tissues, and growth over time, and their impact
on orthodontic diagnosis and treatment planning.
American Journal of Orthodontics and Dentofacial
Orthopedics : Official Publication of the American
Association of Orthodontists, Its Constituent
Societies, and the American Board of Orthodontics,
148(3), 380–386. https://doi.org/10.1016/j.
ajodo.2015.04.030
5. Arnett, G. W., & Bergman, R. T. (1993). Facial keys to
orthodontic diagnosis and treatment planning. Part
I. American Journal of Orthodontics and Dentofacial
Orthopedics : Official Publication of the American
Association of Orthodontists, Its Constituent
Societies, and the American Board of Orthodontics,
103(4), 299–312. https://doi.org/10.1016/0889-
5406(93)70010-L
6. Frush, J. P., & Fisher, R. D. (1958). The dynesthetic
interpretation of the dentogenic concept. The
Journal of Prosthetic Dentistry, 8(4), 558–581.
https://doi.org/10.1016/0022-3913(58)90043-X
7.Hulsey, C. M. (1970). An esthetic evaluation of lipteeth
relationships present in the smile. American
Journal of Orthodontics, 57(2), 132–144. https://doi.
org/10.1016/0002-9416(70)90260-5
8. Proffit WR FH. (2013). Contemporary Orthodontics.
Mosby.
9. Kokich, V. G. (1996). Esthetics: the orthodonticperiodontic
restorative connection. Seminars in
Orthodontics, 2(1), 21–30. https://doi.org/10.1016/
s1073-8746(96)80036-3
10. Hulsey, C. M. (1970). An esthetic evaluation of
lip-teeth relationships present in the smile. American
Journal of Orthodontics, 57(2), 132–144. https://doi.
org/10.1016/0002-9416(70)90260-5
11. Proffit, W. R., Turvey, T. A., & Phillips, C. (2007).
The hierarchy of stability and predictability in
orthognathic surgery with rigid fixation: an update
and extension. Head & face medicine, 3, 21. https://
doi.org/10.1186/1746-160X-3-21
12. Kokich, V. (n.d.). Esthetics and anterior tooth
position: an orthodontic perspective. Part II: Vertical
position. Journal of Esthetic Dentistry, 5(4), 174–178.
https://doi.org/10.1111/j.1708-8240.1993.tb00774.x
13. Lima Filho, R. M. A., Lima, A. C., & de Oliveira
Ruellas, A. C. (2003). Spontaneous correction of
Class II malocclusion after rapid palatal expansion.
The Angle Orthodontist, 73(6), 745–752. https://doi.
org/10.1043/0003-3219(2003)073
2.0.CO;2
14. Haas, A. J. (2000). Headgear therapy: The
most efficient way to distalize molars. Seminars in
Orthodontics, 6(2), 79–90. https://doi.org/10.1053/
od.2000.5900
15. Haas, A. J. (1970). Palatal expansion: just the
beginning of dentofacial orthopedics. American
Journal of Orthodontics, 57(3), 219–255. https://doi.
org/10.1016/0002-9416(70)90241-1
16. Sarver, D. M., & Johnston, M. W. (1989). Skeletal
changes in vertical and anterior displacement of
the maxilla with bonded rapid palatal expansion
appliances. American Journal of Orthodontics
and Dentofacial Orthopedics : Official Publication
of the American Association of Orthodontists, Its
Constituent Societies, and the American Board
of Orthodontics, 95(6), 462–466. https://doi.
org/10.1016/0889-5406(89)90409-5
17. Gianelly, A. A., & Boston University School of
Dental Medicine, M. 02118-2392, USA. gianelly@bu.
edu. (2003). Rapid palatal expansion in the absence
of crossbites: added value? American Journal
of Orthodontics and Dentofacial Orthopedics :
Official Publication of the American Association of
Orthodontists, Its Constituent Societies, and the
American Board of Orthodontics, 124(4), 362–365.
https://doi.org/10.1016/s0889-5406(03)00568-7
18. Timmons, L. S. (1972). Induced change in the
anteroposterior relationship of the jaws. The
Angle Orthodontist, 42(3), 245–251. https://doi.
org/10.1043/0003-3219(1972)0422.
0.CO;2
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.
He is also a visiting associate
professor at both the Air Force University and
Hong Kong University.
Dr Liew Denlee was born
and raised in Ipoh, Malaysia.
He pursued his Bachelor
of Dental Surgery at AIMST
University. Outside of
dentistry, Dr Denlee finds joy
in cooking and maintaining
a healthy lifestyle through regular workouts.
Currently, he works at the Imperial Dental
Specialist Centre, bringing his passion for oral
health to his patients every day.
Dr Ruan Kok was born and
raised in Johannesburg,
South Africa. He finished
his undergraduate dental
training at the University of
Witwatersrand in Johannesburg, and obtained
his Master’s degree in Orthodontics from
the Danube Private University in Austria. He
currently runs a private practice dedicated to
orthodontics.
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 2017-2019.
34 DENTAL ASIA MAY / JUNE 2024

CLINICAL FEATURE
Tooth whitening vs tooth
bleaching — Is there a difference?
By Dr Alan Kwong Hing, DDS, MSc, Dr Michael R Hamblin, PhD, Dr Jacqueline Crossman, PhD, MSc, and Brenda Kwong Hing,
CEO of PBM Wellness
The public and dental profession have become
confused. They both use the terms tooth
whitening and tooth bleaching interchangeably.
Teeth whitening involves removing surface
staining and bringing teeth back to their natural
shade. Teeth bleaching is changing the shade
of teeth beyond their natural shade, which
makes the teeth look whiter.
Fig. 1: An example of teeth bleaching results where the tooth shade is lighter than the natural shade of
the teeth. Before bleaching (left) and after bleaching (right)
According to the American Academy of
Cosmetic Dentistry, 99.7% of Americans
believe a smile is an important social
asset. Ninety-six percent of adults believe
an attractive smile makes a person more
appealing to members of the opposite
sex. Seventy-four percent of adults feel an
unattractive smile can hurt a person’s chances
for career success.
In a survey conducted by the American
Academy of Cosmetic Dentistry, the top two
responses to the question “What is the first
thing you notice in a person’s smile?” were
straightness, and whiteness and colour
of teeth. The most popular response to
the question “What types of things do you
consider make a smile unattractive?” was
discoloured, yellow, or stained Teeth. The most
common response to “What would you most
like to improve about your smile?” was whiter
and brighter teeth. 1
WHAT IS THE DIFFERENCE BETWEEN
WHITENING AND BLEACHING?
The confusion about diferrence whitening
bleaching is common within the dentistry
profession, where even the American Dental
Association does not distinguish between
the two terms. 2 The two terms are also used
interchangeably in dental practice and product
marketing. Although many people use these
terms to mean the same thing, the truth is
they are quite different. The FDA has a specific
definition of each term.
Teeth whitening means whitening teeth, so
they revert to their natural white hue. Teeth
bleaching is the whitening of the teeth beyond
its natural white hue. The bleaching process
makes the teeth appear much whiter than they
would otherwise appear naturally.
Teeth whitening can be done with either
bleaching or non-bleaching products. The
whitening process for teeth involves restoring
the natural colour of teeth by removing stains
and discolouration from the tooth surface.
Store-bought or over-the-counter whitening
products clean off the surface stains caused
by consumption of coffee, red wine, tobacco,
and other habits that can make teeth dull and
discoloured.
Whiteners are cleaning agents that can be
found in some toothpastes, mouth rinses,
whitening strips, whitening rinses, and
whitening gels. Most whitening products
can be bought over-the-counter, but some
whitening processes can also involve
chemicals or laser treatments done at
the dentist’s office. These products are
considered inexpensive and safe. Their
effectiveness, however, will depend on the
type and severity of the stains. 3
Teeth bleaching involves using chemicals
producing reactive oxygen species, such as
hydrogen peroxide or carbamide peroxide. It
removes both deep and surface stains and
can make teeth even whiter than their natural
shade (Fig. 1).
The chemical degradation of the chromogens
within or on the tooth surface is termed
bleaching. 4 Bleaching treatments are usually
administered at the dentist’s office over a
series of visits. In some cases, a dentist will
prescribe at-home treatments that patients
can do themselves. Because these methods
use a higher concentration of hydrogen
peroxide, they often have better results
than whitening procedures, which contain a
lower percentage of carbamide or hydrogen
peroxide. 3
The cause of a patient’s tooth stains will
sometimes determine whether a whitening
product is sufficient, or whether bleaching
might do a better job at cleaning the teeth.
Tooth stains can come from both extrinsic
and intrinsic sources.
Intrinsic stains are caused by things outside
a person’s control, like heredity, ageing, or
certain medical conditions where the teeth
are greyish or yellow. Extrinsic stains are the
easiest to remove. Whitening toothpaste may
be all that is needed to see results. A good
dental cleaning can make a big difference.
Most importantly, there are none of the side
effects from tooth bleaching such as sensitive
teeth and gums when whitening procedures
are done.
DENTAL ASIA MAY / JUNE 2024 35

CLINICAL FEATURE
Intrinsic stains are located deep within the
teeth and are harder to treat, so a professional
bleaching product might be needed to see a
change in tooth colour. Dentists use hydrogen
peroxide or carbamide peroxide at a much
higher concentration of up to 40% compared
to what is available commercially for sale to
the public, which is up to 10% for take-home
whitening products. Patients may also use
ultraviolet light or lasers with advanced blue
light emitting diode (LED) light-accelerated
whitening, which delivers results in minimal
time. 4 This amplifies the bleaching activity for
more dramatic results, but this treatment is
typically delivered in the dental office (Fig. 2). 5
Some stains may not be completely removed
no matter what method or product is used.
Medications such as tetracycline will
permanently discolour the teeth. 5 It should
also be noted that whitening or bleaching can
change the shade of natural teeth, but they
will not have any effect on tooth-coloured
dental work like dental fillings or crowns.
The chemicals used for tooth bleaching are
generally safe. However, there could be a
risk of enamel damage when carried out
incorrectly. It is important that every tooth
bleaching procedure is carried out by a dental
professional, as they have been trained in this
field. 6
Before starting to whiten or bleach their teeth,
a patient should be aware of some possible
side effects and health concerns. In-office
tooth bleaching involves the use of bleaching
chemicals, usually 30-40% hydrogen peroxide,
and a light source. The high concentration of
peroxide can result in a high level of postbleaching
sensitivity in the teeth and gums.
Some people experience tooth sensitivity
or gum irritation after tooth whitening and
may never be able to sufficiently whiten or
bleach their teeth no matter what system
they use. Sensitivity could be a result of
chemical solutions that are too strong for their
tissues or teeth, or treatment sessions that
are too frequent. It could also mean that the
patient may simply have a low tolerance for a
particular product due to the structure of their
teeth and gums.
Discomfort and sensitivity, although annoying,
is usually short-lived and in some cases can
be treated with anti-inflammatory medication.
As a cosmetic dental treatment, teeth
whitening comes with its own share of risks.
Fortunately, the side effects of whitening are
mild compared to bleaching.
Safety and sensitivity considerations for
both teeth whitening and teeth bleaching
procedures include:
• Allergy to peroxide or whitening materials
• Pre-existing sensitive teeth
• Cracks or exposed dentine
• Defects in enamel development
• Acid erosion
• Receding gums (gingival recession) and
yellow roots
• Naturally sensitive gums and teeth
Despite its widespread usage, the effect
of whitening and bleaching on the tooth
shade is often temporary and lacks stability
and predictability if the person returns
to the habits that may have created the
discolouration in the first place. 5 However, the
side effects of sensitivity from teeth bleaching
can be so severe that it will often preclude
a person from undergoing another in-office
bleaching session. Although they may be
reluctant to try to bleach their teeth again, they
still may be a candidate for teeth whitening to
achieve lighter teeth.
Safety issues and adverse effects of
tooth bleaching systems have been well
documented due to the known toxicity of
hydrogen peroxide. Post‐treatment tooth
hypersensitivity, gingival/oral mucosa
irritation, alterations of the tooth enamel
surface, and changes in restorative materials
are commonly reported. The severity of these
adverse effects depends on the hydrogen
peroxide concentration, duration, and the
method of application of the bleaching
procedure. 7,8
Although the adverse effects of tooth
sensitivity and gingival irritation can be
decreased by adding desensitising agents into
bleaching products, 9 the incidence of gingival
irritations ranges up to 62% depending on the
application methods like strips, gel in a tray,
paint‐on gel, or films. 8
PBM WHITE
PBM White is a product created to combat
the issues with tooth sensitivity. Its unique,
patent-pending formulation allows for the
whitening of teeth. It is not to be confused
with teeth bleaching and has shown only
minimal side effects after thousands of cases
have been completed.
Experience has shown that educating the
patient and managing expectations are
important to help them understand the actual
result they will obtain. PBM White is a gentle
and gradual whitening procedure that is
completed over a period of 30 days.
Opalesence, one of the leaders in teeth
whitening, recommends a 30-day period
before judging the results of its products
as shown by before and after images on
its website. It is claimed that a change of
4-5 shades can be obtained by using a 10%
hydrogen peroxide gel after 30 days. However,
one of the two studies they quote used a 7.5%
hydrogen peroxide concentration and was
done on extracted teeth, so the sensitivity
levels could not be determined from the
resultant shade change. 10
Fig. 2: A typical
and popular dental
in-office bleaching
system that is
clinically proven to
whiten up to eight
shades in one visit.
(Image: Phillip Zoom)
Using a non-toxic gel, PBM White can
slowly remove tooth discolouration without
damaging the teeth. The gel is supplied in a
pen with an applicator tip that allows the gel
to be applied to the tooth surface. The PBM
White gel contains 0.1% carbamide peroxide,
phthalimidoperoxycaproic acid (PAP), glycerol,
36 DENTAL ASIA MAY / JUNE 2024

CLINICAL FEATURE
propylene glycol, deionised water, carbomer,
carboxymethyl, poly- vinylpyrrolidone, sodium
hydroxide, and menthol. It is convenient to use
at home and allows patients to do touch-ups
easily at any time.
PBM White utilises the power of LED light to
activate the proprietary gel in a process called
photodynamic action to whiten teeth gently
and effectively over a period of four weeks.
The process may be slower than in-office or
other take-home dental whitening systems
that use conventional hydrogen peroxide gels,
but there have been few reports of tooth or
gingival sensitivity (Figs. 3 and 4).
Prior to making a financial commitment to a
whitening product or procedure, it is important
for a patient to understand what they are
paying for and what their expectations are. To
add to the confusion of the teeth whitening
and bleaching market, any product that
combats stains by whitening teeth cannot use
the phrase “bleaching” in its marketing, but a
product that bleaches teeth can use the term
“whitening.”
The patient also needs to be aware that
only bleaching the teeth will produce a
strong white colour that exceeds the natural
whiteness of the teeth. They must understand
that when the teeth are bleached there is a
high potential for tooth sensitivity to cold
temperatures, cold air, and overall sensitivity
of the teeth and gums.
Some studies show that the effectiveness
of teeth whitening is not necessarily a good
indicator of patient satisfaction. 11,12 While
teeth whitening products may produce visible
changes in tooth colour, patient satisfaction
with the treatment can be affected by factors
beyond the whitening effect alone.
Sociodemographic characteristics and lifestyle
habits can play significant roles in determining
how satisfied patients will be with the overall
outcome of the teeth whitening procedure. 13
In another study, a more positive satisfaction
with the whitening treatment was observed
in female patients compared to males. On
the other hand, a negative association with
age was observed for overall satisfaction and
colour satisfaction. Additionally, there was no
correlation found between the change in tooth
colour and satisfaction with the treatment. 11
Therefore, it is difficult to predict how any
patient will react to teeth whitening or
bleaching procedures, as the actual degree
of shade change that occurs does not
necessarily mean the patient will be satisfied
with the result. Their expectations may not
always align with reality, and they often
express dissatisfaction or satisfaction with
the final treatment results in ways that the
therapist may not expect. 14
Some patients may even have unrealistic
expectations when it comes to teeth
whitening. It is important to note that teeth
can only be whitened so much before they
reach a physical limit. That limit is defined by
the structure of the teeth, their composition,
and genetic factors. Multiple dental fillings
prevent teeth from being whitened to an
optimal level.
Blemishes or structural defects on teeth may
also not be removed by whitening agents.
For a “chiclet hollywood white” smile, the use
of dental veneers or crowns may be the only
realistic option, where teeth can be made
as white as desired. Unfortunately, no teeth
whitening or bleaching process will result in
permanently white teeth beyond the natural
colour of the individual’s teeth.
An interesting psychological condition has
been termed “bleachorexia” and is defined as
an unhealthy obsession with whitening one’s
teeth. People who misuse or abuse teeth
bleaching products may have “bleachorexia”,
somewhat similar to body dysmorphic
disorder, or may be a “whitening junky”. 15,16
This new term, a blend of “bleach” and
“-orexia” (meaning appetite), was first coined
by Dr Jennifer Jablow in 2005. The condition
was also described by the American Dental
Association. 16
Because of the presented reasons, dental
professionals and manufacturers of whitening
or bleaching products must help the patient
to set more realistic expectations about
tooth whitening and bleaching products and
educate them about the potential risks and
the potential outcomes.
It is important to inform the patient that
their teeth will reach a maximum whiteness
even with bleaching, after which no further
treatment of any type will increase the
whiteness. When patients stop bleaching,
there is a slight relapse of about a half-shade
and its effect may only be stable for a few
months and may not last for years.
Dentists should also emphasise that the
discolouration of teeth occurs with the normal
physiological ageing process. Patients should
be advised to avoid as much as possible the
factors that cause stains and discolouration
of teeth, such as consuming coffee, tea, and
red wine.
CONCLUSION
At the end of the day, most patients are
looking to improve their smile and have the
colour of their teeth improved and brightened
no matter how this is achieved. Prior to
Fig. 3: A PBM White gel pen and LED
mouthpiece
Fig. 4: Teeth whitening where the teeth are returned to their lightest natural state using the PBM White
device and gel. Before treatment (left) and after treatment (right)
DENTAL ASIA MAY / JUNE 2024 37

CLINICAL FEATURE
choosing tooth whitening or bleaching
alternatives, it is helpful if the patient
comes into the dental office to undergo a
comprehensive oral examination that consists
of a full medical, dental, and social history.
This will allow the clinician to see if there is
any preliminary treatment that needs to be
done such as restorations to remove cavities,
and to assess whether the patient will be
a good candidate to have the whitening
or bleaching procedure. As there are
fundamental differences in the processes
and the results of tooth whitening and tooth
bleaching, the most important thing is to
manage the patient’s expectations.
Both dental professionals and manufacturers
of whitening and bleaching products must
educate the patients, so they understand the
differences between whitening and bleaching.
Both are good treatments if carried out with
appropriate diagnosis and monitoring, and
so the choice of teeth whitening, or teeth
bleaching must serve the patient’s needs.
Then they will have an excellent result, a more
positive experience, and a better outcome.
Thus, we will have more happy, white-toothed
smiling patients. DA
REFERENCES
1. American Academy of Cosmetic Dentistry. (2012).
Whitening Survey. https://aacd.com/proxy/files/
Publications%20and%20Resources/Whitening%20
Survey_Aug12(1).pdf
2. American Dental Association. Tooth whitening:
What you should know. The Journal of the Americak
Dental Association 2009;140:384.
3. Dental Health Society. (2019). Teeth Whitening
vs. Bleaching – Are They the Same? https://
dentalhealthsociety.com/general/teeth-whiteningvs-bleaching-are-they-the-same/
4. Philips Zoom! (2024). Philips Zoom lightaccelerated
in-office whitening. https://www.
philips.ca/c-m-pe/dental-professionals/products/
whitening/in-office-whitening
5. Carey C. Tooth Whitening: What we now know. J
Evid Based Dent Pract 2014;14 Suppl:70–76.
6. The Teeth Blog. (2024). Teeth Whiten vs. Bleaching:
What is The Difference. https://theteethblog.com/
teeth-whitening-vs-bleaching/
7. Goldberg M, Grootveld M, Lynch E. Undesirable
and adverse effects of tooth-whitening products: a
review. Clin. Oral. Investig 2010;14:1–10.
8. Bruzell E, Pallesen U, Thoresen N, Wallman C, Dahl
J. Side effects of external tooth bleaching: a multicentre
practice-based prospective study. Br Dent J
2013;215:E17.
9. Bernardon, J. K., Vieira Martins M., Branco Rauber
G., Monteiro Junior S., and Baratieri L. N. 2016. Clinical
evaluation of different desensitizing agents in homebleaching
gels. J. Prosthet. Dent. 115:692–696.
DECLARATIONS
Dr Alan Kwong Hing is the founder and
chairman of The PBM Group of Companies,
which makes medical devices focused on use
of photobiomodulation to enhance healing and
decrease pain in humans and animals. He is also
the founder and chairman of A&H Academy.
Dr Jacqueline Crossman, PHD, MSc, is the
director of research at PBM Healing. She has
published several original research articles,
review papers, and book chapters, and has
received many awards during her recent
graduate studies.
Dr Michael R Hamblin, PhD, is a scientific advisor
to PBM Healing. He has published over 800
peer-reviewed articles, over 150 conference
proceedings, book chapters and international
abstracts and holds 10 patents. He is editor-inchief
of Photobiomodulation, Photomedicine
and Laser Surgery, associate editor for 10
journals, and on the editorial board of a further
60 journals.
Brenda Kwong Hing is CEO of PBM Wellness and
PBM Pet, which includes products for overall
body wellness including tooth whitening with
PBM White and products for helping animal
friends.
10. Forville H, Favoreto M, Wendlinger M, Dias R,
Ferreira Borges C, Reis A, Loguercio A. Evaluation
of at-home bleaching protocol with application
on different surfaces: bleaching efficacy and
hydrogen peroxide permeability. Restor Dent Endod
2023;48(4):e33.
11. Tadin A, Galic S, Gavic L. Assessment of
Color Change, Esthetic Perception, Treatment
Satisfaction, and Side Effects Following the Use
of Over-the-Counter Whitening Products. Acta
Stomatol Croat 2023;57(4):300-315.
12. Heinisch C, Larsson K, Mattsson J, Karlsson
S, Alstad T, Bruzell E. Patient Satisfaction and
Complications of Over-the-Counter Bleaching
Products. J Oral Hyg Health 2015;3:176.
13. Naidu A. Factors affecting patient satisfaction
and healthcare quality. Int J Health Care Qual Assur
2009;22(4):366–381.
14. Kovacevic Pavicic D, Kolceg M, Lajnert V, Pavlic
A, Spalj S. Changes in quality of life induced by
tooth whitening are not influenced by global
self-esteem: a randomized double-blind placebocontrolled
trial. Odontology 2020;108(1):143–151.
15. Demarco F, Meireles S, Masotti A. Over-thecounter
whitening agents: a concise review. Braz
Oral Res 2009;23(Suppl. 1):64–70.
16. WomensHealth. (2011). Bleachorexia: When
Teeth Are Never White Enough. abcNEWS. http://
abcnews.go.com/Health/WomensHealth/
bleachorexia-quest-pearly-whites-destroy-teeth/
story?id=13733092
ABOUT THE AUTHORS
Dr Alan Kwong Hing, DDS,
MSc graduated with his
Doctor of Dental Surgery
degree with distinction from
the University of Western
Ontario. He received the University Gold
Medal and completed a concurrent Master’s
Degree in Pathology with a focus on Bone
Biology. He has earned multiple degrees and
received numerous awards including the IADR
predoctoral Hatton award.
Dr Jacqueline Crossman,
PhD, MSc, is the director of
research at PBM Healing.
She graduated with her
Doctor of Philosophy in
Medical Sciences, Oral
Biology in 2022 from the
University of Alberta after completing a Master
of Science in Medical Sciences, Oral Biology in
2015 from the same institution.
Dr Michael R Hamblin, PhD,
was a principal investigator
at the Wellman Center
for Photomedicine at
Massachusetts General
Hospital, an associate
professor of Dermatology
at Harvard Medical School for 25 years and is
now a distinguished visiting professor at the
University of Johannesburg, South Africa and
affiliated faculty at Radiation Biology Research
Center, Iran University of Medical Sciences,
Tehran, Iran.
Brenda Kwong Hing is a
professionally trained chef.
She ran a culinary school and
catering company, and she
was a corporate chef. During
the COVID-19 pandemic, she
made a career change to
focus on PBM Wellness and PBM Pet products
to help humans and animals achieve higher
levels of physical and mental health. She brings
her considerable experience running teams and
managing the introduction of new ideas and
techniques to grow the positive impact of PBM
technology around the world.
38 DENTAL ASIA MAY / JUNE 2024

USER REPORT
Overcoming challenges in
processing zirconia and
advanced ceramic materials
Ceramic materials such as zirconia are being used more and more frequently
in modern restorative dentistry. However, removing zirconia restorations
with conventional contra-angle handpieces is a challenging and lengthy
procedure. Added to this is the high wear on the burs, especially with
monolithic material. In some cases, the bur has to be changed at one-minute
intervals. To address this problem, W&H has developed a new product line
specifically tailored for these
applications.
By Dr Romana Krapf, MSC
The removal of zirconia restorations with
standard contra-angle handpieces is a
demanding and time-consuming procedure.
Conventional contra-angles are struggling to
keep up cutting performance. Applying even
more load to improve removal rate wears out
the bur much faster, 1,2 and may risk thermal
damage to vital teeth. 3
What must be considered is therefore on the
one hand the effect of speed and torque on
the cutting performance and, on the other
hand, the generated heat during cutting.
Cutting efficiency is maximised due to
the optimum ratio of torque and speed
transmitted to the bur from the electric motor.
The clinical indication determines whether
higher torque or speed is more efficient.
Heavy-duty applications require additional
torque, and not the maximum, but the
recommended bur speed.
Since most manufacturers recommend
a rotating speed of 160,000rpm for their
high-performance rotary instruments, a
contra-angle handpiece with a transmission
rate of 1:4 is an especially convenient
solution. It allows working at the optimal
bur speed without having to change the
standard setting of 40,000rpm on the
electric motor.
Studies show that a higher force for cutting
of zirconia increases the damage to the
diamond burs, resulting in a decrease of the
total cutting depth. 4
POWER AND RELIABILITY MAKES THE
DIFFERENCE
W&H has developed a new Synea series,
specifically for processing high-strength
ceramic materials such as zirconia. The
new Synea Power Edition impresses with a
robust design and more power.
Problems that may occur during the removal
of zirconia restorations, such as overheating
of the contra-angle handpiece, high wear
on burs, and generally the high load on the
transmission instrument, can be reduced
with the new contra-angles.
40 DENTAL ASIA MAY / JUNE 2024

The power and durability of the new Synea Power Edition makes it a lasting tool for applications on high-strength materials
Thanks to the modified transmission ratio, the
Synea Power Edition contra-angle handpieces
ensure optimum bur speed and provide the
extra torque required for processing hard
materials efficiently. The capacity to remove
tooth structure more successfully at the same
surface pressure reduces both severe wear
of the bur and the risk of thermal damage to
the teeth.
The Synea Power Edition also comes with
a triple water spray feature, enhancing bur
cleaning efficiency. Despite using the same
amount of water as the traditional W&H 5x
spray, this development increases the flow
rate per nozzle, ensuring thorough cleaning of
the bur during treatment while also enhancing
cutting performance.
Another factor that contributes to the
durability of the handpieces is the extra-stable
chucking system from W&H. With a 20%
increase in clamping force, the system is
made for applications involving high-strength
materials. Although the clamping force has
been increased, exchanging burs remains
easy and smooth. For this purpose, W&H has
designed a new push-button, where the loads
are distributed more evenly. Additionally,
the new push-button is black, providing a
visual indicator of handpieces optimised for
demanding applications.
The service life of the new Synea series has
also been extended by at least 20% compared
to standard transmission instruments, as they
are less susceptible to mechanical failures.
The high-speed contra-angle handpieces
are great for crown cutting and lengthy
preparations, minimising the need for frequent
bur changes and reducing bur consumption.
However, it is crucial to match the burs to the
material because one thing does not replace
the other. Overall, the new high-speed contraangle
handpieces from W&H are robust and
durable, protecting other existing contra-angle
handpieces used in dental practice.
THE BIG WAVE OF ZIRCONIA
SEPARATIONS IS YET TO COME
As zirconia grows in popularity as a material
for its high-strength properties, it is likely that
the demand for the removal of zirconia will
also increase. The new Synea Power Edition
is therefore recommended for all those
who want to remove zirconia restorations
safely and comfortably and at the same time
ABOUT THE AUTHOR
Dr Romana Krapf,
MSC is an experienced
dentist with a focus on
prophylaxis, implantology,
periodontology, and dental preservation.
From 2006-2007, she served as a dental
hygienist at Dr med dent Hans-Dieter John’s
dental practice in Düsseldorf, Germany
where she managed the prophylaxis
protect their existing high-speed transmission
instruments.
W&H contra-angle handpieces are generally
recognised for their high quality. They are
less likely to require repairs and ensure userfriendliness.
With the Synea Power Edition,
W&H has launched new high-speed contraangle
handpieces to the market, which will
also be of great importance in the future. DA
REFERENCES
1. Cutting efficiency of diamond burs operated
with electric high-speed dental handpiece on
zirconia - Nakamura - 2015 - European Journal of
Oral Sciences - Wiley Online Library
2. Diamond Bur Cutting Efficiency of Dental
Zirconia (wvu.edu)
3. High-speed cavity preparation techniques
with different water flows - Journal of Prosthetic
Dentistry (thejpd.org)
4. Cutting efficiency of diamond burs operated
with electric high-speed dental handpiece on
zirconia - Nakamura - 2015 - European Journal of
Oral Sciences - Wiley Online Library
department before pursuing her dental
studies and completing her PhD at the
Ernst-Moritz-Arndt-University in Greifswald,
Germany from 2007-2012.
Since 2018, Dr Romana Krapf has been
operating as an independent dentist in her
own practice, and recently completed a
Master of Science degree in Implantology
and Periodontology at DTMD in Luxembourg
in 2021.
DENTAL ASIA MAY / JUNE 2024
41

USER REPORT
Expert tips to craft
predictable smiles with
Smile Creator
With exocad’s Smile Creator, the desired aesthetics
of the finished construction can be demonstrated
before treatment begins. Dr Paul Schnitzspan,
director of Software Quality Assurance and Medical
Software Development at exocad, guides users
through the latest features of the Smile Creator
module and shares his tips and tricks to get the
most out of the tool.
feature is one of the highlights
of DentalCAD 3.2 Elefsina. The
software automatically recognises
the position of the teeth in the 3D
scan and can transfer this directly to
Smile Creator.
Smile Creator from exocad is an in-CAD
smile design solution that makes aesthetic
smile makeovers more predictable. With
DentalCAD 3.2 Elefsina, Smile Creator has
acquired some new features.
Among the new features, my personal
favourite is the ability to switch freely back
and forth between DentalCAD and the Smile
Creator module. This means that users can
return from any workflow step in DentalCAD
to any position in Smile Creator. The
integration of DentalCAD and Smile Creator
is robust and gives users freedom and
flexibility in designing their workflows with
greater ease.
AUTOMATIC TOOTH SEGMENTATION
The ‘automatic tooth segmentation’
This allows users to start designing
the new smile immediately, based
on the current smile. Automatic tooth
segmentation is particularly interesting for
cases where only minor modifications to
individual teeth are required (Fig. 1).
MORE NATURAL VISUALISATION
Another advantage of automatic tooth
segmentation is visible in the visualisation
area. As the gums are now also segmented,
they can be better visualised. This is
particularly advantageous when viewing
patients with a high smile line, or “gummy
smile”. In addition, all teeth in a jaw are now
recognised by the software — regardless of
whether they are to be worked on.
The rear tooth areas can be shaded so
that the simulation of the aesthetic smile
makeover has a more vivid image depth and
42 DENTAL ASIA MAY / JUNE 2024

USER REPORT
Fig. 1: With version 3.2 Elefsina, the option of automatic tooth
segmentation has been added. Teeth and gums are recognised
and segmented on the scan, for more design and visualisation
possibilities
Fig. 2: Thanks to tooth segmentation, the gingiva and adjacent
teeth can also be visualised to obtain a uniform image of the
new setup in the patient’s mouth. In the posterior region, the
natural shadow in the oral cavity is simulated
Fig. 3: The three-dimensional scan is aligned with the twodimensional
photo of the patient. The scan is visible only as an
outline, which facilitates perfect superimposition. Furthermore,
the depth of field of the photo can be applied to the digital scan
using a slider control
Fig. 4: Dr Schnitzspan’s final practical tip for users is the ‘adjust
light’ tool to adjust light and shadows to simulate a natural look
looks much more natural. Patients
can more easily imagine how they
will look later with their new teeth. I
am convinced that a more realistic
preview helps dentists to better
communicate with their patients and
increases patient acceptance of the
treatment (Fig. 2).
IMPROVED ALIGNMENT FROM 2D
TO 3D
Smile Creator works with 2D/3D
technology, which enables reliable
assessment of the prosthetic
feasibility of the planned aesthetic
restoration as early as the planning
phase. At the start of planning, 2D
images and 3D scans of the patient
are aligned in the software.
At this point, a new tool ensures a
more natural visualisation of the
initial situation; the camera angle, or
field of view, can now be set when
assigning the 2D image to the 3D
scan. The closer the technician is
to the patient during photography,
the higher the field of view must be
set. This allows the 2D image in the
software to be better aligned with
the 3D scan (Fig. 3).
LIGHT ADJUSTMENT IN SMILE
CREATOR
This tool can be used to change
the light source in the preview of
the planned new teeth. Light and
shadow can be adjusted in the
mouth area so that the simulation
looks much more natural.
Using the ‘adjust light’ tool, the
light source follows the mouse
pointer, now displayed as a small
light bulb. The incidence of light
on the construction can be aligned
identically to that of the photo,
ensuring a more realistic spatiality of
the planned restoration (Fig. 4). DA
ABOUT THE
AUTHOR
Dr Paul Schnitzspan, director of
Software Quality Assurance and
Medical Software Development at
exocad. Paul’s smile was created using
exocad’s Smile Creator software.
DENTAL ASIA MAY / JUNE 2024 43

BEHIND THE SCENES
Achieving a natural
aesthetic appearance
with porcelain veneers:
Case reports (Part 2)
The master ceramist combines technical skill and an aesthetic
sensibility setting the work of a dedicated artist apart from that
of the tradesman. Part 1 of this series explored the creation of
bespoke ceramic veneers using traditional methods over modern
CAD/CAM restorations, and Part 2 presents the artistry involved
for a challenging restoration.
By Somano Luang Phaxay, director of Oral Design Phuket
INTRODUCTION
The evolution of dental aesthetic
technology began in 1982, marked by
a significant milestone initiated by Mr
Willi Geller, the founder of Oral Design
in Zurich, Switzerland. Over the course
of four decades, he diligently observed
and collaborated with practicing dental
aesthetic professionals, harnessing
their insights and experience.
This extensive period of engagement
enabled him to curate a diverse range
of skills and materials, culminating in
the development of groundbreaking
technology capable of faithfully
replicating the nuances of natural
teeth. He also recognised that close
communication and co-operation
between technicians and dentists is
imperative to patients’ oral health and
self-image.
The process begins in his lab with an
initial consultation provided to the
patient. This complimentary service
creates confidence and support for
both the patient and dentist. However,
it is the subsequent three-way
collaboration that proves to be the
essential ingredient in realising the
patient’s dream smile.
The patient consultation
The face, with its unique contours and
expressions, conveys the individual
personality that shapes lasting
impressions. A smile stands out as a
focal point, where the alignment and
appearance of one’s teeth within the
frame of the mouth affects the entire
shape of the face. This is the essence
of that crucial first impression and it is
paramount that the integration of teeth
with the shape of the mouth and face
precedes decisions regarding colour
and enhancements.
Assessing patient cases goes beyond
examination of techniques and
materials. These elements are simply
stages on the path to ensuring patient
satisfaction. When consulting with a
patient, it is important to discuss the
patient’s personality, needs, hopes
and expectations by actively listening
to them, and engaging in dialogue. This
is where we connect with our patients,
addressing their oral concerns and
limitations.
CASE REPORT: LITHIUM DISILICATE
The patient had visited several dental
clinics prior to visiting our lab; asking
the clinicians if they can provide
her requirements to make her smile
makeover with lots of characteristic
like natural teeth, i.e. translucencies,
opalescence, and cracks like the natural
youthful tooth.
They could not give her the results that
she desired as most of the dental labs
in the area only do monolithic work.
After a two-hour consultation, listening
to her desires and wishes about her
veneers, we were confident we would
give her what she desired. I referred her
to our closest dentist partner in Phuket,
Dr Ketkarn Sakultap of Dental Design
Phuket clinic.
A precondition for successful
treatment in this challenging case
44 DENTAL ASIA MAY / JUNE 2024

BEHIND THE SCENES
was our involvement in the preoperative
planning phase as dental
technicians. By leveraging on our
experiences with different restorative
materials during case planning,
we were confident in providing
the best possible service for the
patient. Intensive communication
between patient, dentist and master
ceramist followed, in which a variety
of pre-restorative treatments were
discussed (Figs. 1-3).
After receiving the impressions, a
diagnostic wax up was made for
the new smile that we selected
the shape and colours with the
cooperation of the patient visiting
the lab (Figs. 4 and 5).
Fig. 1
Fig. 3
Fig. 2
Fig. 4
This first stage of diagnostic
approach consists of defining a
preliminary restorative goal, which
is mostly obtained by the addition
of wax onto preliminary model
(Figs. 6-9). This procedure requires
a precise knowledge of the tooth
anatomy but also needs creativity,
sensibility and a good perception of
the patient’s individual personality. It
often calls for open communication
between the patient and the master
ceramist.
Fig. 5
Fig. 7
Fig. 6
Fig. 8
Thereafter, the process of mock-up
was done at the clinic (Figs. 10 and
11). At this stage the patient can
approve her new smile or decide
to alter a small detail. From here
everything must be clear between
the patient’s approval and the dentist
before passing the information to
the lab to process the next stage.
It is the most important stage for a
successful result.
The layering technique
Each patient case is unique and no
standard colours recipes exists for
all. However, this colours reading
and mapping was from the natural
tooth as reference from the patient’s
internal effects such as opacity, low
value or high value, translucency and
opalescence (Figs. 12-29).
Fig. 9
Fig. 1: Initial state of old composite veneers
Fig. 2: Intraoral of old composite veneers
Fig. 3: After removing the old composite
Fig. 4: Upper study cast model upper
Fig. 5: Wax up aesthetic for mock up, teeth 16-26
Fig. 6: After the Geller model and dies preparations,
the final framework was waxed-up according to the
space between the silicone index and in proportions
of the final veneering materials
Fig. 7: Ingot Creation LS press MT A1 Invest. Pressing
is very standard to any pressable technique ensuring
no residue is present prior. Cleaning was performed
without using acid index liquid
Fig. 10
Fig. 11
Fig. 8: Treatment grinding and fitting individually
on the die. A thin wash layer was done for a good
connection with an opaque dentin OD37 and a
fluorescence powder HT51
Fig. 9: After sandblasting with alumina oxide at
1.5bar glass beads
Fig. 10: Mock-up in situ test drive, a great
simulation of the new smile which encourages
acceptance from the patient
Fig. 11: Patient with provisional in situ, feeling
more relaxed and natural
46 DENTAL ASIA MAY / JUNE 2024

BEHIND THE SCENES
Fig. 12
Fig. 13
Fig. 14
Fig. 15 Fig. 16
Fig. 17
Fig. 18
Fig. 19
Fig. 20
Fig. 21
Fig. 22
Fig. 23
Fig. 24 Fig. 25 Fig. 26
Fig. 12: Dentin layers and mamelons A1 OD43 A1/
PSO Make-in 61/A1/HT52
Fig. 13: Translucency and Opalescence Geller
mix+ OT+ SO10/OT HT52, all alternative layering
Fig. 14: Special mix OT+ Geller mix+ TI02 HT51
TI03 used to make a deeper depth
Fig. 15: Palette tray in ceramics for layering and
the Creation LS materials
Fig. 16: Selection of Shapes and Colours with
the patient, a set of study models for the wax up
and colours wheel from Creation Willi Geller, and
also some natural anteriors set of Dr Jan Hatjo
for the references form. Colours mapping and
references, colours chosen by the patient A1 and
1M1 base and the natural effects
Fig. 17: Ready for the 1st firing for the internal
effect
Fig. 18: After the first and the most intense
layering of the internal effects. First baking at
780°C
Fig. 19: Trimming and grinding to make space for the
enamels layers. The mamelons were quite intense
but would soften down with the enamels layers
Fig. 20: The final contour with the enamels
powders, E59/58 CLO PSO OT SI02 HT 52 HT51
alternative layering
Fig. 21: Shaping and contouring the final anatomy
to create grooves, textures, and perikymata. A
very useful technique very useful from MDT Gérald
Ubassy
Fig. 22: A smooth pre-polishing with a white
rubber and positioned back on the simulation with
another model of a pink gingiva to check their
emergence profiles as in the mouth
Fig. 23: After normal glazing at lower
temperature 780°C to provide a natural
effect. A hand polishing is done to all
restorations, with very high polishing for
the cervical area to avoid the depot of food
residue which can inflame the gingival
junction between the veneer and the
margins
Fig. 24: The opacity and translucency of the
veneers
Fig. 25: Minimal preparation of the mesial
and distal are reduced to allow space for
the translucencies
Fig. 26: Final with Creation LS lithium
disilicate
DENTAL ASIA MAY / JUNE 2024 47

BEHIND THE SCENES
Fig. 27 Fig. 28 Fig. 29
Fig. 30 Fig. 31
Fig. 32
Fig. 27: Before trying on the completed veneers,
after removal of the old composite
Fig. 28: Before trying on the completed veneers,
the patient with a high smile line
Fig. 29: After trying on the completed veneers,
the patient with a relaxed smile
Fig. 30: After trying on the completed veneers, a
dominant central incisors 11 and 21 with natural
Fig. 31: Before (left) and after (right) intraoral with
a healthy gum
LUXURY IS IN EACH AND EVERY DETAIL
Our aim, in collaboration with our dentist
partners, is to leverage our expertise,
technical skills and experience to restore
patients’ self-confidence and self-esteem
by recreating a beautiful smile that closely
resembles natural teeth.
Not all dental labs are equal or deliver the
same level and quality of service. While a
satisfactory result can be achieved through a
tradesman or mass production, in the hands
of a master ceramist every detail is exquisite,
and the final product, resulting in a true
masterpiece.
In this regard dental restorations created in a lab
are comparable to other forms of art. The results
distinguish mere functional improvement from
life changing aesthetics provided by a one of a
kind restoration created for a specific patient.
As one of only a handful ceramists worldwide
who have trained with many masters and
acknowledged as a member of the world
renowned Oral Design International Foundation
by Master Willi Geller, I prioritise not only the
functional efficiency of every veneer, crown,
bridge and implant-supported restoration, but
also how they harmonise with the aesthetics of
one’s face. DA
ACKNOWLEDGEMENTS
The author would like to thank Dr
Ketkarn Sakultap Phuket for his
excellent clinical and photography
skills. The author also wishes to
thank his mentor Mr Gèrald Ubassy,
members of the Oral Design
International Foundation and its
founder Willi Geller, for sharing their
expertise and guidance in shaping
him to become the ceramist he is
today.
ABOUT THE AUTHOR
Somano Luang Phaxay
qualified as a dental
technician in 1998 from
‘CEPAL — CENTRE
ENSEIGNEMENT PROMOTION DES
METIERS (Dental Technology)’ in Nancy,
France, and spent a 3 month internship at
the Ivoclar Vivadent International Training
Center in Schaan Liechtenstein for Dentists
and Technicians. Since then, Somano has
undergone many courses in ceramics and
collaborated with other technicians to learn
new techniques.
Somano worked three master class per year
from 2006-2017 with MDT Gérald Ubassy at
his International Training Center in Avignon,
France. In 2015 Somano also worked with
Dr Cyril Gaillard to translate from French into
English the 1st DSD Course by Dr Christian
Coachman in Paris, France. Somano became
a member of the Oral Design International
Foundation in 2022 by maestro Willi Geller.
Since 2018, Somano moved to Phuket,
Thailand, and opened ‘Oral Design Aesthetic
& Function Dental Studio Phuket’, a member
of the Oral Design International Foundation,
where he focuses on aesthetic veneer and
full mouth rehabilitations cases, and training
master classes on ceramics for dental
technicians and dentists in the region.
48 DENTAL ASIA MAY / JUNE 2024

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1. Boyd RL (2009) Periodontal and restorative considerations with clear aligner treatment to establish a more favorable restorative environment.
Compend Contin Educ Dent 30, 280- 282, 284, 286-288 passim.
2. Data on File at Align Technology as of Sept 20, 2017. Based on survey data of current Dental Practitioners in the USA, doctors (n=251) were asked
“What percent of the patient cases for prosthodontic procedures (ie veneers, implants, bridges, partials) would have benefited from a better initial
position of the teeth?” (n=251). An average of 45% was developed from the doctor’s responses.
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Milling or 3D printing: Which
dental technology best suits you?
Speed, aesthetics, flexibility, material compatibility, cost, and maintenance
needs. There are a host of factors at play when considering the right choice
of manufacturing technology for one’s practice. In this article, the Ackuretta
editorial team compares and contrasts milling and dental 3D printing to
help dental professionals decide which technology aligns best with their
practice’s needs.
INTRODUCTION: WHAT IS MILLING AND
DENTAL 3D PRINTING?
Dentistry has witnessed remarkable
technological advancements in recent years,
revolutionising practice productivity and
how dental professionals provide care to
their patients. Two prominent technologies
that have gained significant attention are
milling and dental 3D printing. Both of these
methods of fabrication have advantages
and limitations, making it crucial for dental
practitioners to make an informed choice
based on their specific needs and objectives.
Dental milling is a subtractive manufacturing
technique, which uses high-precision
machines to produce dental restorations, such
as crowns, bridges, inlays, onlays, and dental
implant components.
The dental milling process begins with
the acquisition of digital impressions of a
patient’s teeth or the area that requires a
restoration, using an intraoral scanner. Once
the digital data is obtained, it is transferred
to CAD/CAM software where the precise
specifications of the restoration can be
designed and sent to the milling machine.
Milling machines come in various sizes and
configurations, from tabletop models suitable
for small clinics to larger and more advanced
models for dental labs. The machine uses
high-speed rotary instruments to carve the
restoration from a solid block or disc of
biocompatible material, such as zirconia or
porcelain.
On the other end, dental 3D printing is an
additive manufacturing technology that
uses 3D printing to create various dental
applications, including crowns, bridges,
dentures, aligners, surgical guides, and
models of teeth and jaws. This technology
has revolutionised dentistry by providing more
accurate, efficient, and customisable solutions
for both dental professionals and patients.
There are three types of dental 3D printers
which differ based on the technology they
use — stereolithography (SLA), Digital Light
50 DENTAL ASIA MAY / JUNE 2024

IN DEPTH WITH
Processing (DLP), and liquid-crystal display
(LCD). These technologies generally are
differentiated based on the speed, precision,
accuracy, and XY resolution that each enables.
LCD printers such as the Ackuretta SOL Plus
are calibrated for high precision and accuracy,
and are made with quality components that
ensure the longevity of the device.
The dental 3D printing process begins with
digital scanning of the patient’s oral cavity
which is converted into a 3D model using CAD
software. After the application is designed
and customised to ensure a precise fit and
aesthetic match for the patient, CAM software
like Ackuretta’s ALPHA AI is used to orient,
support, and prepare the file for the printing
process.
The development of
CAD/CAM software
allows dentists to design
and customise a variety
of applications for
patients with dental 3D
printing
Once the print file has been prepared it is
sent to a 3D printer. Dental 3D printers use a
variety of materials, including biocompatible
resin or ceramic-filled resin, to build the
desired application layer-by-layer. The printed
applications require post-processing steps,
such as washing, post-curing, polishing, and
surface finishing, to ensure biocompatibility
and necessary quality.
KEY FACTORS TO CONSIDER WHEN
DECIDING BETWEEN 3D PRINTING AND
MILLING
While these technologies digitalise traditional
dental workflows further, there are significant
differences between them that play a role
in determining whether they are the right
fit for a dental practice. Key considerations
to understand when deciding between
milling and 3D printing include precision and
accuracy, speed, aesthetics, flexibility, material
compatibility, cost, maintenance needs, and
training requirements.
Precision and accuracy
Precision and accuracy are critical factors
in the production of dental appliances. The
success of digital dentistry technologies in
enabling reliable, consistent, and high-quality
applications which are generally highly precise
and accurate is a key factor for the growing
adoption of digital workflows.
Milling machines create precise restorations
like crowns, bridges, and implants. While
milling can achieve fine detail, a major
limitation to these fine details is the bur sizes.
Bur sizes have improved over the years, but do
not match the intricate detail that 3D printing
with a high-resolution printer can achieve.
Modern dental 3D printers are constantly
improving their capabilities and can produce
highly detailed dental applications, and
far exceed milling technology in its ability
to achieve fine detail and smooth surface
finishes. This fine detail is extremely
important for the millimetre margins of dental
restorations.
Restorations produced through both milling
and dental 3D printing are highly accurate
ensuring that each application is close to the
original design sent via an .STL file. Milling
is exceptionally accurate in the reproduction
of original designs and can repeat the same
results over time. 3D printing accuracy can
be impacted by external factors such as
environment, resin temperature, and UV light
exposure. However, speed and precision, as
well as improved hardware and software, have
ensured an impressive success rate for 3D
printing.
Speed
Speed is a matter of looking at the end-result.
3D printing is a lot more efficient than milling
when producing more than one application at
a time. Milling is limited to a single application
each time, though the milling process is
incredibly quick.
Milling machines can create a restoration in
a matter of minutes to hours, depending on
the complexity. 3D printing’s layer-by-layer
process takes longer to complete, though it
still allows the practitioner to practice sameday
dentistry. The speed of 3D printing is more
variable-dependent, as it depends on factors
such as layer thickness, the size of the build
platform used, the size of the printed object,
and the complexity of the final application.
However, advances in 3D printing technology
continue to innovate towards faster print
speeds and larger build platforms, making
it an increasingly efficient option for many
dental applications.
While dental 3D printing can precisely produce
applications in accordance with its digital
designs, external factors during the printing and
post-printing process can impact the final results
DENTAL ASIA MAY / JUNE 2024
51

IN DEPTH WITH
3D printers like Ackuretta’s SOL Plus can
produce multiple applications simultaneously
in a time-efficient single printing process,
making this technology more effective for
mass production and high-volume businesses
such as dental labs.
Aesthetics
Restorations can be customised to match the
natural characteristics of a patient’s teeth,
for more aesthetically pleasing outcomes.
Both milling and dental 3D printing enable
the production of highly individualised
restorations that increase patient satisfaction.
Milling materials allow for multi-layered
translucency and produce better aesthetic
outcomes than 3D printing. However, with
the surge of focus on 3D-printed restorative
materials, users have achieved notable
improvements in aesthetics. The range
of possibilities in 3D printing far exceeds
the material availability of milling, though
3D printed resins do not yet truly rival
milling materials on the market in terms of
aesthetics.
Flexibility
Dental 3D printing offers greater design
flexibility compared to milling. 3D printers
can create intricate and complex shapes
with ease, allowing for more individualised
dental solutions. This is especially valuable
for producing removable partial dentures,
orthodontic appliances, and other complex
dental prosthetics.
Milling, while highly precise, has limitations
in the complexity and versatility of design
available due to the specialisation of materials
used with this technique.
The fit and quality of 3D-printed dentures
exceed milled dentures when looking
at undercuts. Milling does not allow for
undercuts, which are essential to a good fit of
dentures for the patient. Similarly, there are
no truly flexible materials available for milling.
Splints, surgical guides, and in-bonding
bracket trays require flexible materials that are
exclusively available for 3D printing.
Material compatibility
Dental milling machines work primarily
with harder materials like zirconia, titanium,
and various ceramic materials while dental
3D printing primarily relies on resin-based
materials.
While these materials have improved
significantly in terms of strength and
aesthetics, their mechanical properties such
as strength and durability do not yet match
the consistently proven performance of the
materials available for milling. However, the
materials available for dental 3D printing, as
well as the properties of resin used, continue
to evolve, and the gap between the two
technologies is narrowing.
Cost
Cost is a significant factor for dental practices
when deciding to adopt any new process or
technology.
When it comes to comparing dental milling
and 3D printing, it is important to note
that milling machines are generally more
expensive to purchase, set up, operate, and
maintain. Milling also requires ongoing
expenses for tooling, maintenance, and
material costs. These costs are generally
passed on to patients in the form of higher
fees for dental procedures.
Dental 3D printers are more affordable
upfront, and their operating costs are lower.
Over time, dental 3D printing is very costeffective
for dental practices, as it reduces
labour and material costs as well as the need
for costly outsourcing while improving control
over the process.
Decision-makers need to factor in material
and maintenance costs for both technologies,
as these can add up. Users can purchase
many types of consumables such as resins,
build platforms, or device accessories. The
cost of milling materials is also generally
higher, though it can still be cost-effective for
some specialised practices.
Milling machines require regular maintenance
that can sometimes be costly to ensure
their accuracy and performance. While
3D printers sometimes require changes in
consumables such as the vat, vat film, and
LCD screens, these replacements are needed
less frequently and are not as expensive as
maintenance needs for milling machines.
While the high initial costs of both of these
technologies can be an impediment for some
smaller practices in adopting these digital
dentistry workflows, costs continue to reduce
yearly, promising increased availability of
digital technologies in the future for costconscious
practitioners.
Operator training and skills development
Effective use of milling technology requires
dentists and dental technicians to participate
in time-consuming training. Many dental 3D
printing ecosystems, such as Ackuretta’s 3D
Printing Solution, operate intuitively and allow
users to learn quickly and even start their
digital workflows within 30mins of unboxing.
Systems such as Ackuretta offer great
customer support which provides real-time
troubleshooting, online FAQs, and other tips,
tricks, and tools, and can be extended with a
special concierge service.
Additional Considerations
Milling machines
are compatible with
materials such as
zirconia for different
aesthetic outcomes
Biocompatibility, meaning the ability of a
dental application or material to be safe for
exposure to the body after fabrication, is
an essential consideration for dentists as
they adopt digital dental workflows. Both
52 DENTAL ASIA MAY / JUNE 2024

IN DEPTH WITH
milling and dental 3D printing are validated
for biocompatibility, though post-processing
steps such as UV curing must be undertaken
to guarantee biocompatibility.
While milling and 3D printing are both not as
wasteful as traditional restoration workflows,
milling is disproportionately more wasteful due
to its subtractive nature which often does not
use many parts of the block when fabricating
an application. As an additive manufacturing
method, 3D printing only uses the material
required to build the dental device.
The size of a machine’s footprint is an oftenunderestimated
factor to consider. Many
dental practices are space-constrained and
unable to integrate large devices into an
already crammed environment.
THE FUTURE OF DIGITAL DENTISTRY
TECHNOLOGY
In summary, milling technology offers
advantages predominantly in precision and
speed. 3D printing is a more cost-effective
option that is more flexible, versatile, and
accurate. The future of milling and 3D printing
in dentistry is an exciting and rapidly evolving
landscape. Both technologies have their
advantages and limitations, and they are often
used in complementary ways.
Milling has been a staple in the dental industry
for over a decade and will continue to be used
to reliably fabricate precise crowns, bridges,
and other restorative dental devices. Materials
used for milling, such as zirconia, are also
well-established and known for their strength,
biocompatibility, and durability. As technology
advances, milling machines are becoming
more compact, efficient, and capable of
handling a wider range of materials.
The design freedom and flexibility that dental
3D printing enables are likely to continue,
particularly in the production of dental
models, surgical guides, and removable partial
dentures. The range of 3D printing materials
suitable for dental applications will continue
to expand, including biocompatible and highly
durable resins.
Therefore, the future of milling and 3D printing
in dentistry may involve a combination of
both technologies. Advances in software
and hardware will continue to improve the
precision, speed, and cost-effectiveness of
both milling and 3D printing technologies.
Hybrid approaches, where a combination of
milling and 3D printing is used, may become
more common to leverage the strengths of
each method for specific dental applications.
In addition, emerging technologies, such
as 3D bioprinting, hold the potential to
revolutionise the field of dental implants and
tissue regeneration in the long term.
Ultimately, the future of milling and 3D printing
in dentistry will be driven by factors like
cost-effectiveness, speed, material science,
and the evolving requirements of each case.
Dentists and dental technicians will continue
to adopt and adapt these technologies
and other technologies to provide the best
possible care to patients.
CONCLUSION
Factors like waste products and space constraints are important
considerations in designing an optimal workflow
The decision to adopt milling or dental
3D printing ultimately comes down to the
specific needs and resources of a dental
practice. Milling offers exceptional precision
that makes it ideal for producing standard
restorations quickly. Dental 3D printing, on
the other hand, provides design flexibility and
is currently the more cost-effective option.
3D printing is often preferred for complex,
multi-unit restorations and devices, while
milling may be a better choice for single-unit
restorations that require exceptional precision
and strength.
Dental professionals should carefully
evaluate factors such as precision, material
compatibility, speed, cost, aesthetic results,
maintenance and training requirements, and
design flexibility when deciding between
milling and 3D printing.
Many dental practices may find that a
combination of both technologies can optimise
their workflows, allowing them to offer a
broader range of services to their patients.
Ultimately, the choice should align with the
practice’s unique requirements such as patient
base, specialisation, and business model.
Ackuretta’s Plus line, which includes SOL Plus
with the CURIE Plus curing oven and CLEANI
with Tank Plus washer, is an example of a
validated, biocompatible 3D printing workflow
that enables practitioners to print and postprocess
a variety of applications. The Plus
line’s ease-of-use, built-in integration, and
calibrated workflows furthers the capabilities
of dental 3D printing, improving practice
productivity and patient satisfaction. DA
Dentists and dental labs
will choose the methods
that best suits the
specific requirements of
their practice
DENTAL ASIA MAY / JUNE 2024 53

PRODUCT HIGHLIGHTS
Pac-Dent unveils iMatrix Clear
Sectional Matrix System
Pac-Dent has announced the launch of the
iMatrix Clear Sectional Matrix System at
the Chicago Mid Winter Dental Meeting.
Featuring clear Mylar matrices, rings,
and wedges, the addition of this Sectional
Matrix System expands Pac-Dent’s existing
iMatrix Sectional Matrix System according
to the company.
The iMatrix Clear system features clear
Nickel Titanium (NiTi) matrix rings with
a unique undercut design that allows for
better handling and greater visibility,
while being strong enough to avoid
slipping and to provide consistent, ideal
tooth separation. Two clear NiTi rings are
provided in the system that provide optimal
tooth separation with an undercut design
for greater visibility and improved handling.
Moreover, the clear Mylar matrices and
clear interproximal wedges aims to allow
ample light to pass through for complete
uniform restoration curing. The matrices
are colour-coded and clear with convenient
pinholes which leave the composite with a
more polished and contoured finish than
traditional stainless-steel matrices. It is also
designed to provide a more pronounced
marginal ridge for correct anatomical form.
(Image: Pac-Dent)
The starter kit includes matrix ring
placement forceps, pin tweezers, a clear
molar and a clear premolar NiTi matrix
ring, assorted clear Mylar matrix bands,
and assorted clear interproximal wedges.
The wedges are designed to be easy
to place and remain in position while
providing a good gingival seal. The kit also
includes an assorted composite polishing
kit for high aesthetic finishing of composite
restorations. DA
SprintRay introduces Midas, first
3D printer with DPS technology
SprintRay has recently unveiled the Midas
Digital Press 3D Printer to over 250 dental
professionals at 3DNext, their summit in
Miami, US.
With Midas, SprintRay revealed what is
said to be the first and only Digital Press
Stereolithography (DPS) technology and
patent-pending Resin Capsule System,
enabling the use of previously unworkable
and highly viscous resins with 3D printing.
The combined product and technology
process is said to set an entirely new
standard for what has been previously
possible in 3D printing.
“Materials, more than anything, have
dictated what is possible in the dental
restoration field,” said Amir Mansouri,
PhD, co-founder and CEO of SprintRay.
“The introduction of Midas revolutionises
both the manner in which material is
transformed and reveals an entirely new
paradigm of what can actually be printed.
Until now, materials like ceramics were
too thick for traditional 3D printers to
handle. Midas changes everything. Not
only does this innovation handle today’s
ceramic-based materials but sets the stage
for future advances in composites and
ceramics. We are on the brink of a new
era in biomaterial innovation, and we are
thrilled to be leading the charge.”
According to SprintRay, Midas is the first
3D printer ever to use DPS technology,
thus eliminating the need for large resin
vats and other reusable parts. Utilising a
vacuum-sealed Midas Resin Capsule that
can print up to three units in less than
eight minutes, Midas delivers a clean
and simple workflow without viscosity
limitations. The patented process removes
the boundaries chemists have previously
faced to change the mechanical properties
and aesthetics of resin.
The Midas Resin Capsule contains
a pressurised resin chamber which
houses viscous material that is pressed
and dispensed into the build area using
hydrodynamic principles. When finished,
the build platform is extracted along with
the printed restoration.
Complementing the printer, SprintRay
has also introduceed AI Studio, a cloudbased
design software that automates the
Hossein Bassir, chief product officer at SprintRay
unveils Midas, reportedly the world’s first Digital
Press 3D Printer, to more than 250 dental
professionals at the 3DNext summit in Miami
(Image: SprintRay)
creation of dental restorations. AI Studio
is integrated with 3Shape, Dexis, and
Medit scanners to give doctors the ability
to edit and change the design including
margin editing, positioning and adaptation
adjustments, and edits to anatomy — all
without requiring any CAD experience.
A single click sends designs to Midas,
including any .STL design file from any
dental design software or lab for maximum
convenience.
According to the company, Midas and AI
Studio, combined with NanoCure, signify
an advancement in dental restoration
manufacturing, characterised by speed,
simplicity, and groundbreaking innovation
in restorative materials. The waitlist for
Midas is now open, with deliveries set to
begin in Q4 2024. DA
54 DENTAL ASIA MAY / JUNE 2024

PRODUCT HIGHLIGHTS
Sagemax launches NexxZr + Multi 2.0 zirconia disc
Sagemax has announced
the launch of its
NexxZr + Multi 2.0
high translucent
dental zirconia disc.
As the successor to
the highly aesthetic
NexxZr + Multi, the
(Image: Sagemax) improved formulation
in the NexxZr + Multi
2.0 aims to provide users with more options
in terms of aesthetics, colour, and thickness
choices.
Founded in 2006, Sagemax is provider
of aesthetic zirconia products for dental
CAD/CAM systems. Based in Federal Way,
Washington, US, the Sagemax development
team has over 15 years of experience in
preparing and processing zirconia powders
to provide unique manufacturing and
colouring processes.
The disc is crafted from a dental multilayer
zirconium oxide, 5Y-TZP incisal and 4Y-TZP
cervical. It offers a natural colour gradient
for the efficient fabrication of natural
looking restorations with translucencies
of 49% in the incisal region and 45% in the
cervical region. The disc also features high
flexural strength of 650MPa in the incisal
region and 850MPa in the cervical region
for single-unit restorations of up to threeunit
bridges.
Together, these two properties of the disc
are said to enable the fabrication of highly
aesthetic, monolithic single-tooth and bridge
restorations in the anterior and posterior
region. The specially adjusted translucency
gradient ensures good coverage in the
cervical area and increased translucency
in the incisal area. The integrated colour
gradient also ensures the efficient fabrication
of natural-looking restorations.
The NexxZr + Multi 2.0 disc comes in
14mm, 16mm and 20mm thickness varieties,
and is available in 16 A-D shades and four
bleach colours. Its processing techniques
include the infiltration technique, staining
technique, and cut-back technique. DA
Spectrum Solutions presents
SimplyPERIO saliva test powered
by SimplyTest
Spectrum Solutions, a saliva diagnostic
biotech company, has announced the
official release of a new saliva diagnostic
testing innovation, SimplyPERIO. As
advances in science continue to focus on
the mouth-body connection and its direct
link to systemic disease, SimplyPERIO
aims to fill a testing void by delivering
more intelligent health measures with real
clinical relevance using 16 oral targets from
a single patient sample.
According to the company, periodontal
disease is one of the most undiagnosed
and untreated diseases but has some of the
highest negative impacts on many bodily
systems and functions. In addition, gum
disease decreases a person’s ability to fight
infection and inflammation.
SimplyPERIO uses a proprietary molecular
technology to test for and measure
periodontal bacteria, caries, fungal and
viral targets all for one affordable cost.
Understanding treatment success is often
influenced by host immunity and host
response, this unique, highly sensitive and
highly specific saliva test offers providers
the real opportunity to elevate patient care
with the most complete oral health picture.
“We are using science to make saliva
diagnostics simple for both patients and
providers. SimplyPERIO testing is not only
pain-free it takes less than 30secs for a
patient to collect their own sample,” said Dr
David Vigerust, PhD, chief science officer at
Spectrum Solutions. “In addition, our CAP
accredited laboratory delivers providers the
independent, 3rd party results necessary
for intelligent, data-supported patient
conversations about stopping and even
reversing their disease and systemic risks.”
In the US, numbers illustrate that 80% of
individuals aged 35 and over have a form
of gum disease. Gingivitis, periodontitis
and peri-implantitis are all forms of gum
disease. These numbers demonstrate
that for the vast majority, there may be
dangerous and damaging periodontal
disease pathogens hiding that can be
(Image:
SimplyTest)
identified with a perio-probe or visual exam
during regular semi-annual cleanings. Gone
unchecked, these harmful oral bacteria and
toxins are allowed to sit and accumulate
inside the mouth. From inside the mouth
these microorganisms move freely to and
through the bloodstream with far reaching
and catastrophic effects on the heart,
arteries, central nervous system and more.
The SimplyPERIO is designed with a
patented blue buffer solution, located inside
the collection device’s cap, which stabilises
saliva samples at room temperature
eliminating any special post-collection
storage or shipping requirements. Easily
deposit one at a time, supporting athome
patient testing for follow-up and
treatment monitoring, or gather an entire
day’s worth of in-office collections into the
USPS postage-paid return box for mailing
samples back to the lab for processing. DA
DENTAL ASIA MAY / JUNE 2024 55

PRODUCT HIGHLIGHTS
Medit launches i900 intraoral scanner
Medit has introduced the Medit i900
intraoral scanner which aims to set new
standard for speed, accuracy, and comfort
by streamlining workflows and optimising
patient care.
“The brilliance of the Medit i900 lies in its
sleek, unibody design. There is complex
innovation within its simplicity. The i900
is light and easy to handle, but offers the
most cutting-edge technology to date,” said
Michael Lee, CTO of Medit.
The Medit i900 is said to improve the
scanning process with its intuitive Touch
Band and Touch Pad functionality. The
button-free operation offers control from
any angle and allows for a comfortable
experience for all hand sizes.
The 360° Touch Band enables users to
experience real-time haptic and light
feedback, navigate effortlessly with, and
customise commands via the interactive
Touch Pad and Touch Menu.
The i900 also boasts a featherlight
design, weighing 165g, three tip sizes,
and improved ergonomics allowing for
absolute control scanning from any
position.
The 3rd-Generation Optical Engine with
a 10-bit camera delivers a wider and
deeper field of view, improved accuracy,
and sharper detail yet smoother scan
data. It also ensures flawless capture of
challenging conditions including highly
reflective metal or bleeding soft tissue.
The Medit i900 is powered by Medit Link,
the company’s open software platform,
providing access to a suite of free dental
apps that encourage productivity and
enhance patient care. The system provides
adaptive software updates to improve
smart features, patient consultations, and
lab communications. DA
(Image: Medit)
Invisalign Palatal Expander System
now available in AU and NZ
Align Technology has announced that its
Invisalign Palatal Expander System has
been included in the Australian Register
of Therapeutic Goods (ARTG) and the
New Zealand Web Assisted Notification
of Devices Database (WAND), and is
commercially available in both Australia
and New Zealand.
The ARTG and WAND entries for Invisalign
Palatal Expender System cover broad
patient applicability, including growing
children, teens and adults, with surgery or
other techniques.
The Invisalign Palatal Expander System
is a direct 3D printed device based on
proprietary and patented technology,
intended for use in rapid expansion and
subsequent holding of skeletal and/or
dental narrow maxilla with primary, mixed,
or permanent dentition during treatment
of patients.
Align Technology also shared that the
Invisalign Palatal Expander System is
expected to be available in other APAC
(Image: Invisalign)
markets pending regulatory approvals
starting in 2024.
“The Invisalign Palatal Expander is an
example of our continuous commitment
to innovation by advancing digital
orthodontics and delivering products with
greater efficiency for doctors and provide
better treatment experiences for patients
and their parents,” said Raj Pudipeddi,
Align Technology chief marketing officer,
executive vice-president and managing
director, Asia Pacific. “We are delighted to
introduce the Invisalign Palatal Expander
system, Align’s first directly fabricated
orthodontic appliance, to the Asia Pacific
region.”
The Invisalign Palatal Expander System
consists of a series of removable devices
staged in small increments of movement
to expand a patient’s narrow maxilla to
a position determined by their treating
doctor. Each direct 3D printed device is
customised to the patient’s unique anatomy
based on an iTero intraoral digital scan. A
palatal expansion treatment plan and device
design are then developed using Align’s
proprietary AI-driven orthodontic software.
Combined with Invisalign First aligners,
Invisalign Palatal Expanders provide doctors
with a full early intervention treatment
solution for Phase 1 treatment, an early
interceptive orthodontic treatment for
young patients.
Phase 1 treatment is traditionally done
through arch expanders or partial metal
braces, before all permanent teeth have
erupted — typically at ages 6 through 10.
Invisalign First clear aligners are designed
specifically to address a broad range of
younger patients’ malocclusions, including
shorter clinical crowns, management of
erupting dentition, and predictable dental
arch expansion*. DA
*Data on File at Align Technology, as of June 2021.
56 DENTAL ASIA MAY / JUNE 2024

PRODUCT HIGHLIGHTS
New packaging designs
for VITA CAD/CAM and
DISC products
PERFECTION IN
BONE SURGERY
→ YOUR SURGICAL
APPROACH WILL CHANGE -
THE PIEZOSURGERY® touch
In order to provide even better protection for its products
and use sustainable packaging materials, VITA has
announced that its packaging for VITA CAD/CAM blocks and
DISC products have been optimised.
→ best cutting efficiency
→ optimal intraoperative control
→ perfect ergonomics
→ made in Italy
Starting from April 2024, the VITA CAD/CAM blocks will
be gradually supplied in standardised folding boxes. This
optimisation will reduce the number of packaging variants
from 12 to six. The products will now be differentiated by
their unique labelling. The exceptions will be the VITA YZ
products over 55mm, as well as VITA CAD-Waxx and VITA
CAD-Temp over 65mm in height, which will continue to be
available in special packaging.
The new block packaging will no longer use foam inserts
and will rely instead on a cardboard cavity that offers the
products optimised protection. Instructions for use can be
accessed digitally via QR codes on the packaging, which will
reduce paper consumption.
Improvements have also been made to the DISC packaging.
Plastic foils and foam inserts have been replaced by
environmentally friendly cardboard and cellulose half-shells,
which will result in a significant reduction in waste. In
addition, QR codes on the outer packaging will promote the
digital availability of instructions for use, which will further
reduce paper consumption.
The design of the new slipcases, which are now constructed
as closed boxes with a fold-out base, has also been updated
and adapted to match the design of the block packaging.
The products will also be differentiated via labels, which will
reduce the amount of packaging to a minimum. DA
→ www.mectron.com
DENTAL ASIA MAY / JUNE 2024 57

Bigger and
better:
MIDS is
back for
2024!
The Malaysia International Dental Show (MIDS
2024) is set to unfold with a promise from its
organisers to be bigger and better than before.
The show will take place from 15-17 May at
Sunway Pyramid Convention Centre (SPCC) in
Sunway City, Kuala Lumpur, a top-notch venue
that provides the perfect setting for this highly
anticipated dental event.
MIDS 2024 will be providing attendees with
ample opportunities to network, connect,
and learn from some of the brightest minds
in the dental industry. Additionally, there will
be an oral presentation competition, allowing
delegates to showcase their research and
share their findings with their peers.
A cornerstone of MIDS 2024 is its scientific
lectures. These lectures will feature
internationally renowned speakers from
MIDS 2024 offers cash vouchers for visitors to
sample the latest developments and solutions
showcased
more than 10 countries. Be prepared to be
amazed by the latest developments and
first-hand innovations in the field of dentistry,
where these lectures provide attendees
with insights into the latest trends, dental
techniques, and best practices.
Furthermore, MIDS 2024 will be offering
attractive incentives to match the learning
opportunities provided for visitors.
Delegates who attend the scientific lectures
at MIDS 2024 can collect MAX A1 20 CPD
points, approved A1 CPD by the Malaysian
Dental Council. MIDS 2024 is also offering
a total of US$105,000 (RM500,000) worth
of cash vouchers for visitors which can be
used for purchases during the three-day
exhibition.
With the programme lined up, MIDS 2024 is
set to be the perfect opportunity for dental
professionals to stay at the forefront of
global industry advancements and expects
to attract thousands of visitors from around
the world. Take advantage of MIDS 2024 to
connect, learn, and grow one’s professional
network. DA
Speakers from a variety of fields and nations will share their expert insights and methods with at the scientific lectures
58 DENTAL ASIA MAY / JUNE 2024

SHOW PREVIEW
Explore digital transformation
in oral-facial rehabilitation at
the IAOFR Conference
The field of oral-facial rehabilitation
has experienced a profound revolution
through digitisation, particularly
in the treatment of congenital,
developmental, and acquired
deformities. As the healthcare industry
embraces the digital age in the 21st
century, remarkable technological
advancements have emerged,
leading to disruptive innovations that
completely transform the approach to
patient care.
Addressing these advancements, the
International Academy for Oral and
Facial Rehabilitation (IAOFR) will be
hosting a conference on from 29-30
Jun at the Hong Kong Academy of
Medicine HKAM Jockey Club Building.
Titled ‘Digital Transformation in Oral-
Facial Rehabilitation: Harnessing the
power of AI, additive manufacturing,
navigation, robotics, and augmented
reality for enhanced patient’, the twoday
symposium serves as a dynamic
platform convening distinguished
speakers from local, regional, and
international backgrounds.
Across eight sessions, speakers
will share the latest developments
in digitisation and the evolution of
digital workflows and offer optimised
treatment solutions for a wide range
of challenges. The symposium
will specifically focus on exploring
the practical aspects, economic
significance, challenges, and promises
of integrating pivotal technologies
such as AI, additive manufacturing,
navigation, robotics, and augmented
reality, into patient care.
By delving into these cutting-edge
technologies, participants will gain
valuable insights into how they can
elevate treatment outcomes and
enhance the overall patient experience.
IAOFR is a study club, composed of
internationally recognised specialists
that are involved in the rehabilitation
of patients who have lost their teeth
and/or parts of the jaws or other
parts of the face. Established in
1983, the academy evolved over the
years from a club of surgeons and
prosthodontists who were interested in
preprosthetic surgery into the current
multidisciplinary group, involving
surgeons, prosthodontists, and dentists
with competence in implant dentistry,
including specialists in basic sciences.
The mission of the International
Academy for Oral and Facial
Rehabilitation is to progress the
quality of oral and facial rehabilitation
through the advancement of patient
care, education and research, with
a particular interest in optimising
treatment outcomes of surgicalprosthetic
interventions.
Organised by IAOFR and the Hong
Kong Association for Oral and Facial
Rehabilitation, along with its coorganisers
Hong Kong Prosthetic
Dentistry Society, Hong Kong
Association of Oral and Maxillofacial
Surgeons, and Young Oral and
Maxillofacial Surgeon Group of Hong
Kong, the conference stands as a
testament to the exciting possibilities
that arise from digital transformation in
oral-facial rehabilitation.
The speakers at the IAOFR conference will highlighting the transformative impact of AI,
3D printing, navigation, robotics, and augmented reality on oral-facial rehabilitation
By harnessing the power of AI,
3D printing, navigation, robotics,
and augmented reality, healthcare
professionals can unlock new
frontiers in delivering advanced and
personalised care, ultimately improving
the lives of patients facing oral-facial
challenges. DA
DENTAL ASIA MAY / JUNE 2024 59

SHOW PREVIEW
SIDEX 2024 out to captivate
the global dental community
in Seoul
Scheduled to take place at COEX Convention
& Exhibition Center (COEX) from 7-9 Jun,
the Seoul International Dental Exhibition
& Scientific Congress (SIDEX) Organising
Committee is paying special attention to
SIDEX 2024, considering it as a rehearsal for
SIDEX 2025, which will celebrate the 100th
anniversary of dental exhibition in Seoul,
South Korea.
The finishing pieces of SIDEX 2024 are in
place, with both the academic programme
and exhibition booths finalised, and preregistrations
for the 2024 International
commencing from mid-April.
“Everything is being prepared smoothly, with
more than 1,000 exhibition booths completed
and 20,000 couples expected to participate,”
said the SIDEX Organising Committee. "We
will do our best to make SIDEX a place where
all dentists who visit the site, including SIDEX
participants and exhibitors, have a nourishing
experience.”
Under the theme ‘Remaster Knowledge,
Reload Experience!’, SIDEX 2024 aims
to provide participants with an enriching
experience featuring
a total of 57 speakers
delivering 42 lectures
during the two days
of its scientific
congress on 8 and
9 Jun. Placing an
emphasis on diversity
in lecture topics
and programme, a
variety of formats
have been planned,
including general lectures, joint presentations,
one-day master series, hands-on sessions,
core subjects, overseas lectures, and general
education lectures.
A rich academic programme awaits
participants, covering a wide range of topics
including orthodontics, oral and maxillofacial
surgery, conservative dentistry, prosthodontics,
periodontics, anatomy, and three core subjects
for mandatory continuing education credits.
As in previous years, participants will have
the opportunity to earn continuing education
credits from the American Dental Association
Continuing Education Recognition Program
(ADA CERP). SIDEX is recognised as an
academic conference in the Asian region
where ADA CERP credits can be obtained,
and simultaneous interpretation in English,
including lectures by international speakers,
will be available in Room 401 of COEX.
The dental exhibition of SIDEX 2024 is also
in full swing with booth reservations closing
early and final preparations underway. It is
anticipated that a total of 260 companies will
participate, occupying 1,100 booths, including
180 companies with 930 booths in COEX Hall
C & Hall D, as well as 80 companies with 170
booths in the lobby area.
Various auxiliary events will be conducted
to enhance the exhibition experience, such
as stamp tours to activate the exhibition, a
SIDEX e-SHOP where attendees can purchase
items at discounted prices and collect them at
exhibition booths for payment, and technical
seminars to support marketing activities of
participating companies.
SIDEX 2024 is gearing
up to be a captivating
rehearsal for its 100th
anniversary in 2025
Furthermore, in response to the support from
participating companies, additional events
and services have been provided, including
a Seoul night networking event, technical
seminars, and showcase for new products. DA
60 DENTAL ASIA MAY / JUNE 2024

IDEM 2024
wraps up its
13th edition with
record breaking
success
Back for its highly anticipated 13th edition, the
International Dental Exhibition and Meeting
(IDEM 2024) successfully concluded on
21 Apr 2024 at the Marina Bay Sands Expo
& Convention Centre with record breaking
success. IDEM 2024 officially marked
a significant increase in attendees and
countries compared to the previous edition
reaffirming its position as the leading dental
exhibition and conference in Asia Pacific.
From 19-21 Apr, IDEM 2024 welcomed 8,917
attendees from 74 countries and regions,
exceeding the record number of participants
and countries. The event offered a showcase
of cutting-edge dental innovations and
expertise, spanning over 17,000m 2 of
exhibition space, with the conference theme
of ‘Exceptional Dentistry: Techniques,
Technologies, and Trends’, providing a
platform for dentistry professionals to learn
from experts and improve their practice.
“The success of IDEM 2024 was based on
the reputation and the credibility we have
developed here in Singapore for over 20 years.
The feedback from the exhibitors and the
delegates has been excellent. We will build
on what we have achieved this year here at
IDEM and continue to emphasise quality,
high-level scientific programme and bring the
latest technologies and innovations to future
editions of IDEM,” said Mathias Kuepper,
managing director and vice-president of Asia-
Pacific, Koelnmesse.
The exhibition floor hosted 500 exhibitors
showcasing 629 exhibiting brands from 35
countries and regions as they presented
their latest solutions and products, covering
prosthodontics, orthodontics, endodontics,
paediatric dentistry, and more. This year,
among the participation of 12 national
pavilions — Australia, China, France, Germany,
Italy, Japan, Singapore, South Korea, Spain,
Switzerland, Taiwan, and the US — the event
also welcomed the first-time participation
of the Spain pavilion, adding to the diverse
representation of global dental industry
players.
Formlabs, an exhibiting brand under Eye-2-
Eye Communications, seized the opportunity
to showcase its newly launched Form 4
and Form 4B 3D printers at IDEM. IDEM
2024 saw exhibitors presenting their newly
launched products and unveiling the latest
technologies, further highlighting IDEM's role
as a go-to launchpad for dental brands in the
Asia Pacific region.
IDEM 2024 visitors
were treated to an
array of the latest
and innovative
dental solutions
from 500 exhibitors
showcasing 629
exhibiting brands
“It was the biggest exhibition we had for the
overall region, and being here in Singapore,
it was an important place for exhibiting our
products and most importantly to educate
our customers about the importance of our
health. For us, IDEM 2024 was the perfect
platform to showcase our brand. I am very
happy with the organisation and the scope of
the events we have here,” said Maik Walther,
president of GC Asia Dental, one of the
exhibiting brands and a platinum sponsor.
In addition to the exhibition, IDEM 2024
featured a comprehensive scientific
conference programme and hands-on
workshops, comprising a total of 44 speakers
and 42 scientific conference sessions split
DENTAL ASIA MAY / JUNE 2024
61

SHOW REVIEW
among ‘Scientific Conference’, ‘Interactive
Workshops’, ‘Dental Hygienist & Therapist
Forum’, and the inaugural ‘Asian Speaker
Series’. The conference sessions covered a
wide range of topics across three tracks of
conference running concurrently, with the
most popular ‘SDA Masterclass: The Black,
White and Gray of Crack Management’
conference session hosting 904 delegates,
making it the most attended session of the
conference programme.
Dr Brina Ho, a dentist at Sunshine Dental,
spoke of her experience as a delegate at
IDEM 2024. “I wanted to see the latest
developments in equipment, technology, and
information, and I think IDEM was the best
place to be. There are a lot of advancements
in a short while in the whole industry, and
IDEM has brought all of that together.”
Dr Davey Alleman, DMD, a
general dentist who currently
practices biomimetic dentistry
in Utah, US, presenting his ‘SDA
Masterclass: The Six Lessons
Approach to Biomimetic
Dentistry’ lecture
The activities at the Innovation Arena were
also a standout feature, offering networking
and educational opportunities for dentistry
professionals and aspiring dentists. The
Innovation Arena hosted informative talks
by exhibitors, including ‘A New Trend in Root
Canal Treatment - ROOT ZX3’ by MORITA
and 'Oral Health Matters to the Heart' by
Xepa-Soul Pattison. Additionally, the Student
Programme, themed 'Crafting Bright Smiles,
Shaping Future Dentists’, provided a platform
for dental students to connect with industry
leaders and build valuable connections with
mentors.
“I attended the IDEM 2024 because I
wanted to represent the Asia Pacific
Dental Students Association (APDSA)
organisation. However, I felt like this
event gave me more than that. I gained
valuable experiences and met different
companies and professors. I also joined the
conference, so it was a great opportunity,
especially for a third-year dental student
like me,” said Punyisa Pintola, a third-year
dental student and APDSA representative
from Thailand.
Additionally, IDEM360+ usage statistics
revealed a significant increase in
downloads and usage levels of the digital
platform, further enhancing the attendees'
experience and engagement throughout
the event. With IDEM 2024 core offerings
streamlined into the app and the addition of
the Trade Visitors’ e-badges, the IDEM360+
platform recorded 2,681 connections
made and 106 meetings arranged, and
saw a significantly reduced number of
printed materials, marking a significant
step towards reducing the overall carbon
footprint.
A comprehensive conference programme of 44
speakers and 42 scientific conference sessions was
planned for conference participants
After setting new heights for this year's
event, IDEM looks forward to welcoming
attendees to the next edition, which will
take place on 17-19 Apr 2026 at Marina
Bay Sands Singapore, promising even more
innovation, education, and collaboration. DA
62 DENTAL ASIA MAY / JUNE 2024

MAY
2 – 5
47th Asia Pacific Dental Congress
(APDC) 2024
Taipei, Taiwan
3 – 6
AAO Annual Session 2024 - American
Association of Orthodontists
New Orleans, US
8 - 11
IDEX 2024 - International Istanbul Dental
Equipment and Materials Exhibition
Istanbul, Turkey
9 - 11
International Team for Implantology (ITI)
World Symposium 2024
Singapore
15 - 17
MIDS 2024
Kuala Lumpur, Malaysia
16 - 18
Expodental Meeting 2024
Rimini, Italy
31 May – 2 June
Famdent
Mumbai, India
JUNE
7 – 9
SIDEX 2024
Seoul, South Korea
9 – 12
Sino Dental China
Beijing, China
13 – 15
Implant Solutions World Summit
Miami, US
17 – 18
DentalForum UK
Alicante, Spain
28 – 29
Digital Dentistry Show (DDS) Berlin
Berlin, Germany
EVENTS
CALENDAR
2 24
29 – 30 June
International Academy for Oral and Facial
Rehabilitation (IAOFR) Conference
Hong Kong, Hong Kong (China)
AUGUST
1 – 3
Vietnam Dental Expo 2024 – Ho Chi Minh
Ho Chi Minh, Vietnam
21 – 23
Vietnam International Dental Exhibition &
Congress (VIDEC) 2024
Hanoi, Vietnam
23 – 25
Hong Kong International Dental Expo and
Symposium (HKIDEAS) 2024
Hong Kong, Hong Kong (China)
23 – 25
Malaysia International Dental Exhibition and
Conference (MIDEC) 2024
Kuala Lumpur, Malaysia
SEPTEMBER
8– 10
DentalForum USA Fall
Florida, US
12 – 15
FDI World Dental Congress (WDC)
Istanbul, Türkiye
23 – 26
Dental-Expo 2024
Moscow, Russia
26 – 28
International Congress of Oral Implantologists
(ICOI) World Congress 2024
Orlando, US
OCTOBER
8 – 10
Central Asia Dental Expo (CADEX)
Almaty, Kazakhstan
10 – 12
Dental World 2024
Budapest, Hungary
24 – 26
31th EAO Annual Congress
Milan, Italy
24 – 26
Makkah Dental 2024
Mecca, Saudi Arabia
24 – 27
DenTech China 2024
Shanghai, China
NOVEMBER
7 – 9
Central European Dental Exhibition (CEDE) 2024
Łódź, Poland
13 – 15
Swedental 2024
Gothenburg, Sweden
14 – 16
Oral Reconstruction Internation
Symposium 2024
Bangkok, Thailand
29 Nov – 4 December
Greater New York Dental Meeting 2024
(GNYDM)
New York City, US
DECEMBER
5 – 7
Vietnam Dental Expo 2024 - Hanoi
Hanoi, Vietnam
13 – 14
International Congress of Adhesive & Aesthetic
Dentistry (CIDAE 2024)
Brussels, Belgium
14 – 15
8th Korea International Dental Exhibition
(KDX 2024)
Seoul, South Korea
DENTAL ASIA MAY / JUNE 2024 63

ADVERTISERS’ INDEX
COMPANY PAGE COMPANY PAGE
Align Technology - Invisalign 49
Ningbo Woson Medical Instrument Co., Ltd
IBC
Coltene
IFC
Renfert 9
Dental Asia 39
Shofu Dental Asia-Pacific
OBC
exocad
FC
SIDEX 45
Fotona 1
Sino-Dental 2024 3
imes-icore 27
TeKne Dental 64
Mectron 7, 57
VITA Zahnfabrik 11
MIDS 2024 23
W&H 5
HIGH-PERFORMANCE
DYNAMIC INSTRUMENTS
SIMPLIFYING DENTAL MOTION
TeKne Dental srl – Italy
info@teknedental.com www.teknedental.com
64 DENTAL ASIA MAY / JUNE 2024