ISSUE 01 /16
T HE INNOVATION MAGAZ INE
F ROM DE N TS PLY SIRONA
FEATURES FOR HYGIENE
WHAT’S ON THE
INSIDE MATTERS, TOO Page 16
ALARA PRINCIPLE
RELIABLE DIAGNOSIS
DESPITE LOW DOSAGE
A91100-M4-B977-01-7600
PAGE 28
Clean conscience
HOW HYGIENE
IMPROVES OUR LIVES
OPTIMIZED PRACTICE
STRUCTURE
THE HIGHEST PRIORITY
IS THE RIGHT BALANCE PAGE 36
CONTENTS
FOCUSED
THE DENTAL SOLUTIONS COMPANY
Quality joins together with quality
04
AT A GLANCE
Clean means healthy08
A QUESTION OF HYGIENE
Clean processes – clear conscience10
KNOWING ABOUT HYGIENE
Different times, different customs
15
FEATURES FOR HYGIENE
What‘s on the inside matters, too16
Starry-eyed idealists – Hygiene is a
surprisingly easy way to combat any risks
to our health and well-being, as the Briton
Joseph Lister discovered.
p A question of hygiene 10
INFORMED
INSTRUMENT PREPARATION
There is no way around hygiene
20
INFECTION PROTECTION
Breaking the chain of infection
24
ALARA PRINCIPLE
Reliable diagnosis despite low dosage
28
INNOVATIVE SPIRIT
Old-timer finds new love
30
IN PRACTICE
CHAIRSIDE FULL CONTOUR ZIRCONIA
High-temperature furnace for more speed32
PRODUCT INNOVATIONS
Software updates ensure greater flexibility
Trendsetter – Panama has set new
guidelines for reprocessing and
makes automatic cleaning and disinfection compulsory for dental clinics.
p Instrument reprocessing 20
35
OPTIMIZED PRACTICE STRUCTURE
The highest priority is the right balance
36
AMBITIOUS IMPLANTOLOGY
A safe solution for challenging cases
38
DIGITAL ALIGNER THERAPY
Using CEREC for faster transparent aligners40
GOOD TO KNOW
INDUSTRY
‘Doc’ on the playing field and in the office42
MISCELLANEOUS
App, legal notice
43
Accelerator – A new sinter furnace and
new manufacturing process allow for
full-zirconia restorations in one visit.
p Hot tip for more speed 32
EDITORIAL page 03
Promoting oral health is the major
focus of Dentsply Sirona’s vision
DEAR READER,
July 2016
The philosopher Jean-Jacques Rousseau said that hygiene is a virtue, and we all know he was
absolutely correct. Hygiene is important and desirable because it protects us and others against
­infections and promotes health. Hygiene affects all aspects of our lives and requires our constant
attention – everywhere in the world. Our cover story investigates the complex nature of the practice
of hygiene.
By having a more complete understanding of hygiene as a holistic concept we can manage the
­increasing number of hygiene-related challenges in a globalized world. Dentsply Sirona meets
the growing requirements for hygiene by equipping dental practices and clinics with the leading
­systems for instrument processing, high quality products for preventive hygiene and by con­
tinuously developing an entire comprehensive product range. We have persistently worked towards
improving hygiene practices in dentistry. Over the years, we have been the strongest proponent of
lowering radiation doses through the use of digital imaging, promoting the use of hypoallergenic
masks for infection prevention and incorporating the disinfection of water lines in our treatment
centers.
As The Dental Solutions Company, Dentsply Sirona can further advance the management of hygiene
by combining the resources and experiences of two market leaders. We will invest as much of our
innovative power in hygiene as we do in the seamless integration of equipment, treatment, and
materials in all areas of dentistry – from preventative health promotion and diagnosis to treatment
planning and dental care. As a full-service provider with leading platforms for consumables, dental
equipment, technologies and specialty products, Dentsply Sirona will advance dentistry through
unparalleled investment in R&D and innovation. Our mission is to support dentists and dental technicians with integrated digital solutions that provide better, safer, and faster dental treatments – for
improved clinical results and better patient experiences.
As we look ahead to an even brighter future together as Dentsply Sirona, we will still honor our past
and thank our customers for supporting both the Sirona and Dentsply brands for over a hundred
years. With this issue of Vision magazine, we invite you to join us on our journey connecting our
past and future, using the familiar Sirona format and the new Dentsply Sirona brand. Stay tuned for
our upcoming issues where we will provide you with new insights and stories from the dental industry. You can rest assured: we will continue our heritage of high quality, informative and insightful
publications at Dentsply Sirona.
Yours
JEFFREY T. SLOVIN, CEO of Dentsply Sirona
VISION — ISSUE 01/16
PAGE 04
Looking forward into the future:
Bret W. Wise, Executive
Chairman of Dentsply Sirona (left)
and Jeffrey T. Slovin,
CEO of Dentsply Sirona (right).
QUALITY JOINS TOGETHER
WITH QUALITY
FOCUSED — The Dental Solutions Company
PAGE 05
On February 29th, Dentsply and Sirona merged to create the world’s largest manufacturer of
professional dental products. Dentsply Sirona, as the new company is called, is the market
­leader in consumables, equipment, digital technologies and integrated solutions for dental
practices, clinics and labs. In this VISION interview, CEO Jeffrey T. Slovin talks about the WHY:
the rationale behind the merger and why he is so excited about Dentsply Sirona shaping the
future of dentistry.
Several months have passed since the merger closed.
What are your first impressions? Has anything surprised you?
— First, it is early days; We’ve just gotten through our first 1201
days, but I have to tell you that I'm thrilled with what the team has
been able to do together and how talented we are across the globe
in sales, marketing, R&D, and certainly our functional areas, like
HR and finance. We’re so lucky to be in such a great industry.
­Dentistry is full of talented caregivers and we can all relate to it
because we’re all patients. So when we talk about helping improve
patient care, it really does impact each and every one of us.
It’s a big deal when two of the largest companies in an industry
come together. You need to make sure that you have the right cultural fit, but when we came out with our mission to empower dental
professionals to deliver better, safer, faster dental care the team
really rallied behind it. And those aren’t empty words. We expect
to have a big impact on dentistry for the better. We have high expectations of what we can accomplish as an organization and we
know our customers – who always come first – are not going to
tolerate excuses. And we are not going to disappoint them.
When we agreed on this merger we knew that it was the best
­decision for both companies and would be beneficial to our in­
dustry. Today, I feel even more confident that our future is brighter
as D
­ entsply Sirona. As we partner with dental professionals around
the globe we will do extraordinary things together.
Both Dentsply and Sirona were innovative and successful
as separate companies. What drove your decision to merge?
— I appreciate you saying that. I think one of the things we have to
remember is that both Dentsply and Sirona have over hundred
years experience in dental. Both were very successful in their business segment. We need to keep in mind the values and cultures
that made both companies successful. We need to respect our past
– even as we look to the future. Before we came together, we recognized that there are a number of mega trends in dental. Dentistry
is going digital and demand for single visit dentistry continues to
rise. Dental professionals and labs are demanding fully integrated
solutions and more efficient end-to-end workflows. Technology is
enabling faster and safer procedures. We believe that integrating
equipment, technology and consumables is the only way to truly
address these growing needs. By creating more efficient end-toend workflows we can make adoption of technology easier and
therefore accelerate the digitization of dentistry. This is a signifi-
Q
Dentsply Sirona has locations in more than 40 countries worldwide
and sales presence in more than 120 countries.
cant undertaking, and we recognized that there were only two
companies in the market equipped to drive these trends. Rather
than expending resources on competing with each other, we believed that collaborating will enable us to put more combined resources towards finding the best solutions for our customers.
Combining the consumables from DENTSPLY and technology and
equipment from Sirona will not only enable the new company to
offer a broad product portfolio but also develop new, integrated
end-to-end solutions. These will create safer and more efficient
workflows from diagnosis to treatment. We will optimize the tools
and materials required for both standard treatments as well as
specialty procedures such as implantology, endodontics and orthodontics. In this way, the competencies of both companies complement and enrich each other for better, faster and safer dentistry.
How does the merger benefit the dentists,
dental technicians and patients?
— Coming together was all about being able to better serve the
market and improve clinical outcomes. Our friends, our loved ones
– and of course, ourselves – are all patients. As Dentsply Sirona,
we have more resources than anyone else in the industry. This will
enable us to accelerate the development of ground breaking innovations that truly advance patient care in dental. p
1
As of July 2016
VISION —ISSUE 01/16
pAGE 06
THE MERGER IN FIGURES: DENTSPLY AND SIRONA ARE ‘THE DENTAL SOLUTION COMPANY’
DENTSPLY
YEAR OF FOUNDATION
1899
IN NEW YORK CITY
EMPLOYEES SINCE 2015
11.600
LTM 31.12.15
2,7
BN US-$
SALES WORLDWIDE
120
COUNTRIES
p As a result of the merger, our customers now have access to the
most comprehensive product range from one single manufacturing
source supported by the largest sales and service infrastructure
in the dental industry. Dentsply Sirona offers a range of the most
well-established and effective brands known for quality and innovation and a commitment to investing in developing new technologies to improve on these leading products. Our broader spectrum
of integrated solutions allows dentists to offer completely new
treatment concepts such as guided implantology – with shorter
treatment times – that make a practice more efficient. In addition,
Dentsply Sirona solutions ensure high-quality esthetics and increase patient acceptance as well as experience. We will support our
solutions and customers through the most comprehensive clinical
education platform in the industry to assist practitioners in adopting new technologies and advancing patient care.
Dentsply and Sirona are known as quality manufacturers.
Will that also be the case as a large company?
— Both companies have earned the reputation with their customers of being quality providers and for good reason: The fact that
we consistently deliver on our promise of quality ensures the trust
of our customers. With all the change that we drive forward with
our products and technologies, we are committed to this reputa­tion
and to our heritage of the highest quality standards. Dentsply
­Sirona meets and exceeds the worldwide guidelines for medical
SIRONA
YEAR OF FOUNDATION
1877
IN ERLANGEN
EMPLOYEES SINCE 2015
3.500
LTM 31.12.15
1,2
BN US-$
SALES WORLDWIDE
120
COUNTRIES
devices and continues its traditional commitment to users and
patients with a comprehensive quality management program. This
commitment also extends to our suppliers and service providers.
This merger creates the opportunity for us to set a standard for
quality in our entire industry, which will benefit dental professionals and patients alike.
Dental professionals are concerned that Dentsply Sirona
will gain a monopoly position in the dental market. What is your
response to that?
— The merger has resulted in the largest and most innovative company in the dental industry. It has also brought together the largest
teams of researchers, scientists and engineers in the industry.
This more robust platform is better positioned to innovate and help
our customers and patients. We’ve also combined to create the
largest and broadest clinical education platform in the industry.
We intend to use our size and scope to better train and educate our
customers in every way we can. Although together we make up
less than 20% of the market, so we still have a lot of room for growth.
This is significant to us because we understand that our growth is
predicated on innovation, which is good for the dental industry as
a whole. We also understand that competition brings out the best
in us and invite others to challenge themselves to improve the
practice of dentistry. Improving clinical care is good for every ­single
one of us, because at the end of the day, we’re all patients!
FOCUSED — The Dental Solutions Company
People say that large companies are rather slow. How do you
make sure that Dentsply Sirona stays in tune with the times and
reacts quickly and flexibly to the requirements of the market?
— Being larger does not necessarily translate into being slower. In
fact, we’re expecting our larger infrastructure to help us innovate
faster. Through the merger, the two biggest innovators of the dental
industry found each other. Each has over 100 years of experience,
industry-wide leading R&D platforms and more than 600 scientists
and engineers. Our developers and engineers are energized by the
opportunity in front of us and are in direct communication with users
and scientists. As a larger company, we understand that we must
innovate faster and make an even larger impact on dentistry. We
always welcome the feedback of our customers as part our inno­
vation processes, and we know they have high expectations for us.
We hold ourselves to a high standard, and I strongly believe that we
will be leading the development in the industry 100 years from now.
Integrating two large companies can be challenging.
Can you update us where you stand regarding this process?
—You’re absolutely right. Integrating these companies is complex,
but I am confident that as we come together, we’re going to end up
a much stronger company. As far as the integration goes, we’re on
track with our plans. In fact, we already have much to be proud of.
We've rebranded our company, announced our leadership team,
and created an operating model to help optimize our growth. We
have organized ourselves into two segments: Dental and Healthcare Consumables, and Technologies.
More importantly, we’re already beginning to deliver on our promise of becoming The Dental Solutions Company. In our first 120 days
together, we’ve already developed an innovative new software to
make root canal treatments safer and faster. This was a result of
a collaboration between the market leading engineers, scientists
and software developers from our endodontics and digital radiography divisions. Our new 3D Endo is the first CBCT-based software
that enables endodontic treatments to be preplanned and optimized in combination with the imaging data from the ORTHOPHOS
units. Based on the 3D data and their specific visualization, the
practitioner can case-specifically recognize the demands on the
treatment of the root canal, analyze the natural shape of the root
canal and select the appropriate files using the integrated file database. Thus the endodontic treatment is more efficient and improves strongly the patient communication.
PAGE 07
the new CEREC SpeedGlaze spray as well as the Calibra Universal
Cement – a perfect setup to start working with CEREC Zirconia.
What I’m most satisfied about is that these collaborations are yielding benefits for our customers. We are delivering on our promises
to use our enhanced R&D capabilities to deliver more innovations
to the market.
How will the merger impact dentistry?
How do you envision dentistry in the year 2030?
— The last 30 years have brought enormous changes to the practice
of dentistry. If you think of implantology, laser dentistry, CAD/CAM
and digital imaging processes. Not only has the depth of innovation
been impressive but also the pace of innovation. And there are many
exciting new ideas and products that are still being developed. We
started our discussion talking about integrated solutions and I believe that this will continue to play a critical role. We will see the integration of digital technologies create more efficient workflows,
and dentists will be offering their patients end-to-end solutions from
diagnosis to treatment with consumables. This trend will by no means be limited to Europe or North America, but extended worldwide.
And Dentsply Sirona will be at the forefront of this journey, to guide
and support our customers. We’re building a company to not only
help change the industry for the next few years, but we plan on being
around to make dentistry better for the next hundred years.
Is there anything else you would like to tell your customers that
they should know about Dentsply Sirona?
— First, we always want our customers to know how important
they are to us and how much we value them. We are building a company that can better serve them and their patients. We want to be
their partner – through training and education, service and support
and of course, through innovating to create better, safer and faster
dental solutions for them. We will partner with our customers any
way we can to make our vision of ‘delivering innovative dental solutions to improve oral health worldwide’ a reality.
P
PROFILE
One thing that has made this integration easier is the fact that
Dentsply and Sirona have been working together for years. In Endodontics, we began collaborating back in 2014, when WAVEONE®
by Maillefer and RECIPROC® by VDW, both leading reciprocal file
systems, were first integrated into the TENEO treatment center.
More recently, we have also integrated these systems into our
SINIUS treatment center as well, which considerably improved the
workflow of the Endo function.
We already have many other successes to be proud of as well. Our
CEREC team and the Celtra DUO sales team from former DENTSPLY
are working closely to introduce CEREC Zirconia around the globe.
In March, when we introduced the product to the US market, our
team collaborated to design a starter kit that includes all necessary
components for an optimal workflow: including Celtra DUO blocks,
Jeffrey T. Slovin s the CEO of Dentsply Sirona. Prior to this, he served as
President and CEO of Sirona Dental Systems for three years. Mr. Slovin
has held leading management positions in the dental industry since
2004. He is member of the Board of Fellows of the Harvard School of
Dental Medicine.
VISION — ISSUE 01/16
PAGE 08
CLEAN MEANS HEALTHY
They are mostly invisible to the eye: pathogens like viruses and other things that make us sick.
The facts below show how much we are affected on a daily basis. A greater awareness of ­hygiene
and the consistent application of all necessary steps – from physical hygiene through work hygiene to IT hygiene – help us to live healthy.
10.000.000
BACTERIA BUSTLE AROUND ON AVERAGE ON JUST ONE SQUARE CENTIMETER OF A USED SPONGE.1
20 SEc.
SHOULD BE THE TIME IT TAKES TO WASH YOUR
HANDS. IT'S ENOUGH TO SING ‘HAPPY BIRTHDAY’
TWICE.
1.000.000
MORTALITIES COULD BE REDUCED EVERY YEAR BY
REGULAR HAND WASHING.2
WORLD MARKET VOLUMES FOR HOUSEHOLD CLEANERS FROM 2013 TO 2022 (IN BIL. US-DOLLARS).3
34,5
–
2013
36,6
–
2016
38,6
–
2019
40,4
–
2022
FOCUSED — At A Glance
PAGE 09
A STOMACH BACTERIUM SPLITS EVERY
30 Min.
IN ONLY ONE DAY, OVER 281 TRILLION CELLS
ARE CREATED.4
THE FIRST BACTERIA WERE DISCOVERED IN
1676
BY ANTONI VAN LEEUWENHOEK
USING A MICROSCOPE HE BUILT HIMSELF.
The bibliography can be found on page 43.
1890
2 Mio.
THE SCOTT PAPER COMPANY PRODUCES THE FIRST
TOILET PAPER ROLLS.
PCs AROUND THE WORLD WERE AFFECTED BY THE
MOST DANGEROUS COMPUTER VIRUS MYDOOM.5
GREAT BRITAIN AND AUSTRALIA HAVE THE BEST
HOUSEHOLD HYGIENE, WHILE CHINA,
THE MIDDLE EAST AND MALAYSIA ARE AT THE OTHER
END OF THE COMPARISON LIST.6
APPROX. 13% OF WORKPLACE INJURIES CAN BE TRACED
BACK TO INADEQUATE SLEEP HYGIENE
(SLEEP DISORDERS, SLEEP APNEA).7
VISION — issue 01/16
CLEAN PROCESSES,
CLEAR CONSCIENCE
page 10
FOCUSED— A QUESTION OF HYGIENE
page 11
It’s a given to anyone reaching for mineral water in the supermarket that both bottle and content provide perfect food hygiene. If the legal maximum for bacteria is exceeded, a food scandal
occurs. In other areas, too, our daily life involves us in subjects related to hygiene: especially in
medicine but also in the office, at home or in unexpected areas such as IT...
“What do you think of first when you hear the word hygiene? Sterile
instruments? Fresh water? Clean restrooms? Such associations
immediately pop into mind. However, you are only looking through
a key hole at the enormous vocabulary of concepts involved in
hygiene. For some time now, the desire for ‘clean’ processes in all
areas of life has led to a nearly inflationary use of the term hygiene.
Today, along with practice or hospital hygiene, there is corporate
hygiene, psycho hygiene, school hygiene, environment, sleep and
food hygiene, and even cyber hygiene. And in this enumeration,
we're still far from being at the end of the world of hygiene. What’s
positive: If a hygienic state is defined as worthwhile, it is the best
precondition for testing and optimizing processes, leading to general well-being, and a clear conscience.
This responsibility extends to taking proper care of natural resources
in order, for example, to make clean drinking water accessible for
­ev­ery­one. According to estimates by UNICEF and the WHO, 663 million people do not have access to clean drinking water despite this
having been recognized as a human right since 2010. Environmental
health affects humans around the world, as shown by the water crisis
in Flint, a city in the US state of Michigan. Because of a poor budget
situation, the city disconnected itself from the drinking water system
of the automobile metropolis, Detroit, and supplied citizens with river
water. The residents were soon complaining of nausea, eczema and
hair loss. The reason: The river water released heavy metals from the
water lines and in this way poisoned residents. So, water plays a ­quite
specific role in health.
HYGIENE IS EVERYONE'S RESPONSIBILITY
MEDICINE WAS ONCE A ‘DIRTY BUSINESS’
Whether it’s through media reports, special safety conditions, environmental scandals or general care instructions, we are increasingly focusing on hygiene. Every individual is jointly responsible
for the state of our physical surroundings and also our natural en­
vironment, and whether we spread biological pathogens, a negative
mood or virtual viruses.
This holds not only for the water that we humans drink, but also for
the water we use for our hygiene. We wash our hands with water and
in doing so, protect ourselves from communicable diseases. This
insight was only accepted in medicine in the middle of the 19th century. Until then, clinical work was a rather ‘dirty business’: operating
aprons were only rarely cleaned and medical instruments and p
Q
Clean drinking water from the tap at home
is often a dream even in developed countries.
VISION — ISSUE 01/16
PAGE 12
great success: The percentage of women who died of child bed fever
decreased from 18.2 percent in April 1847 to 2.3 percent within
two months. In this way, Semmelweis had produced proof for the
effectiveness of hand disinfection. In 1865, his British colleague,
Sir Joseph Lister (1827 – 1912), carried out an operation using
phenol antiseptic for the first time. The lasting effect: The mortality rate of post-­operative infections fell quickly due to the introduction of antiseptic and hygienic measures such as hand washing,
rubber gloves and disinfection of instruments. For this reason Lister is considered to be the forerunner of systematic hospital hygiene. He also gave his name to the disinfectant Listerine (today
mouth wash) and the bacterial strain, listeria.
HEALTHY CONTACT WITH OTHERS
Q Up to 400 times more bacteria are found on a computer keyboard than on
a toilet seat. Ultraviolet light shows how intensively they are implanted in a
thin biofilm.
p sponges were often used to clean the wounds of several patients.
From today’s perspective, catastrophic hygienic conditions once
prevailed.
This changed in the 1840s, when a Hungarian assistant doctor
determined at Vienna’s general hospital that disinfection can hinder transmission of diseases. Ignaz Philipp Semmelweis (1818 –
1865) directed medical students to disinfect their hands with a
chlorinated lime solution before entering the maternity ward – with
Indeed, not only the body suffers from insufficient hygiene that can
lead to worst case scenario illnesses; thoughtful behavior is also
indispensable for our mental health. Even if concepts such as psycho hygiene or social hygiene do not belong in our everyday speech,
we all benefit from the measures that are concealed behind them.
Ultimately, among other things, it is a question of protecting yourself from emotional loads that are too heavy, effectively eliminating
stress and organizing enjoyable cooperation. Included is showing
yourself to be tolerant of others and seeking appreciative and
­understanding communication. This is not only important in our
private lives, but also at work. For example, in the sense of good
corporate hygiene.
Briefly, corporate hygiene involves measures that help a company
stay healthy. This especially includes transparent corporate governance, coherent processes and a pleasant work atmosphere.
­Responsible corporate hygiene — also corporate governance —
promotes cooperation at all business levels, and deals with subjects
such as ethics, credibility and image as well as correct behavior
towards the environment, suppliers, customers or shareholders.
Compliance also falls under the areas of corporate hygiene – a concept that is currently spreading like a virus throughout the world.
Here it's mostly about breaches of rules such as bribery, corruption
or system manipulation. Corporate hygiene is not to be confused
BIGGER WITH SOAP AND WATER
In a study in 2013, British researchers reported that clean
­drinking water, sanitary facilities and good physical hygiene
not only promote health, but also allow children to grow up
­normally. With better hygiene, the occurrence of decreased
growth was reduced by up to 15 percent.
Source: London School of Hygiene & Tropical Medicine.
FOCUSED— A QUESTION OF HYGIENE
Q A monument to hygiene: Lister Monument in Kelvingrove Park
in Glasgow, Scotland (U.K.).
page 13
The similarities between damaging computer programs and biological pathogens cannot be ignored: In both cases, we are talking
about viruses and worms that attack and cripple networks and
organisms, and cause devastating damage. We can only protect
ourselves from these attacks digitally. For security in the data
environment, in particular, antivirus programs, firewalls and security patches along with careful handling of emails and file attachments provide this protection. It should be pointed out here that
the more people compute in the network or ‘the cloud’ and the
greater the quantity of processed data, the more sophisticated
and thorough measures for cyber hygiene must be.
HYGIENE FOR EVERY PURPOSE, SPOT AND STAIN
with work hygiene. Unacceptable work hygiene includes putting
workers at risk due to dust, humidity, rays, noise or infectious substances. Physicians and lab assistants, but also service providers
and tradespeople can tell us a lot about this subject.
VIRTUAL HYGIENE PROTECTS AGAINST REAL DANGERS
Infections exist not only in living beings; there's even a great risk
of contagion in the virtual world. Unfortunately no disinfectant in
the world can help against computer viruses.
Let's leave the virtual hygiene world and come back to day-to-day
life. Even here, hygiene is a much discussed subject. Most of us know
about all possible pathogens and we also have knowledge of the
things that do us good, and those things that are detrimental to our
environment. Many of us therefore also want to provide for our physical, mental and social well-being ourselves. The market for consultants, health apps, over-the-counter medicine and super foods
as well as yoga and gyms has never been more varied and extensive.
For every ache and pain, there is a remedy, for every piece of dirt, a
special cleaner, and for every problem, a clean solution. p
P Anyone who wants
to become a master
practices early on.
We learn best during
childhood that
hygiene comes with
the territory of
acting responsibly
with your body
and environment.
VISION — ISSUE 01/16
Page 14
WE CELEBRATE HYGIENE!
08. 01. 03. 02.
22. 03. 07. 04. 28. 04.
p Bubble Bath Day
p National Men's Grooming Day
p World Water Day
p World Health Day
p World Day for Safety
and Health at Work
05. 05.
26. 08.
25. 09.
10. 10.
15. 10.
15. 11.
16. 11.
19. 11.
p World Hand Hygiene Day
p National Toilet Paper Day
p Dental Health Day
p World Mental Health Day
p Global Handwashing Day
p Clean Out Your Refrigerator Day
p International Day for Tolerance
p World Toilet Day
“EVEN THE MIND
HAS ITS HYGIENE,
IT NEEDS
GYMNASTICS
JUST LIKE THE BODY.”
clinical environment can be doubted in every
p Influenced by advertising and in part excessive media coverage, there is one area in which
case.
hygiene efforts have already overshot the mark:
our households. Out of fear of infections, we reIt needs to be noted: hygiene requirements are
ach for the most varied products to clear out
as different as the areas they concern. Together
germs from every last corner. Here, the dishes
Honoré de Balzac
it is everyone's duty to comply. 400 years beare cleaned with antibacterial substances, chlofore Christ, the Greek philosopher Democritus
rinated cleaners poured down the drain and counter tops wiped with determined: “Men implore the gods for health and do not know that
disinfectant all-purpose wipes. And of course, the cleaning product they have power over it themselves.” It's up to us whether we contindustry offers us the perfect cleaner for every purpose, spot and aminate ourselves and our environment directly or virtually. We
stain.Even though it hasn't yet been definitively proven that there must live up to the responsibility, or follow the words of Jean-Jacis a connection between excessive household hygiene and the emer- ques Rousseau: “Hygiene is less a science than a virtue.” In this
gence of allergies, for healthy indivduals the need for an almost sense: Stay healthy!
P
UNCLEAN FINDINGS
In the refrigerator of a normal household, about 11.4 million
bacteria can be found per square centimeter according to a
study of the University of Arizona. Even unopened food
packages spread germs. Therefore, refrigerators should be
cleaned every four to six weeks and defrosted twice a year.
FOCUSED— KNOWING ABOUT HYGIENE
page 15
DIFFERENT TIMES, DIFFERENT CUSTOMS
Nowadays, we humans place great value on hygiene. But our understanding of what exactly
hygiene is has changed considerably over time: Water was frowned upon, and the use of
hygiene products was long unknown. Thanks to scientific research, we now know what is
good for the human body, and what is bad.
Q
Hygiene practice throughout the ages: The Roman baths in Bath in the West of England
have enjoyed a highly fluctuating level of popularity over the centuries.
“Hold your hand in front of your mouth when you sneeze!” At first,
the warning that is so frequently given by parents looks to be a good
idea, as bacteria are ejected for meters when sneezing and are therefore spread. But this hard-learned behavior is of no help: The hand
then becomes a carrier during greetings, when turning on a light
switch or when holding on while riding public transportation. With
this knowledge and driven by the fear of pandemics such as bird flu,
we have learned that it is best to sneeze into the crook of the arm.
Our knowledge about infections and general societal enlightenment
have therefore had a great influence on our hygiene ­behavior.
And this has been very different throughout the ages and in various
cultures. Between the ancient bathing culture in which daily visits
to thermal baths were a part of social life, and the pleasure that we
gain from visits to the spa in modern times, there have been times
that, from a hygienic point of view, were in a dark age. While the
Arabic and Islamic world preserved the ancient tradition in the Hamam, the plague caused a sudden end to the hustle and bustle in
European bath houses. In the following centuries, it was absolutely
taboo for someone to wash themselves. The “Change in Body Consciousness and Hygiene” (Körperbewusstsein und Hygiene im Wandel) study by the Kelkheim Future Institute (Zukunftsinstitut)
reports of supposedly scientific investigations and medical findings that declared water to be a carrier and a cause of illnesses
and epidemics. Therefore people tried to avoid contact with water.
In the modern era, aristocrats used white towels that had been
soaked in perfume which contained alcohol to clean the visible
parts of the body. The covered body parts should be kept clean by
the frequent change of clothes.
Only in the middle of the 18th century was the water that had been
presumed to be damaging gradually rehabilitated. The so-called
miasma theory, which declared that vapors were responsible for
illnesses, was only refuted by bacteriology in the 19th century when
the role of pathogens and the existence of microorganisms were
discovered. Scientific studies and the experiences from the field
hospitals of the American Civil War demonstrated the purifying effect
of water and this in turn profoundly transformed hygiene behavior
in society. Cleanliness, regular personal hygiene and the use of tissues and toilet paper are now very much considered by society to
be desired hygienic behavior. Though there are some major arguments about the correct amount; Scientists suggest that excessive
use of disinfectants and cleaning agents can support the development of skin irritations, allergies and environmental pressures. P
VISION — ISSUE 01/16
Page 16
1983 p M1
WHAT’S ON THE INSIDE
MATTERS, TOO
The water unit is securely attached to the
patient chair. A built-in amalgam separator
ensures that wastewater is not contaminated with mercurial amalgam compounds,
and thereby helps to protect the environment. The integrated disinfection system
reduces and prevents the proliferation of
bacteria in process water, and suction hoses
are now directly adapted to the water unit.
FOCUSED — FEATURES FOR HYGIENE
gonomics, but also with regard to design and hygiene features.
A modern treatment center makes life easier for the practice
team through intelligent, automated rinse and sanitization programs for water lines and suction
hoses, saving a great deal of time and work.
Dentsply Sirona is one of the worldwide
pioneers and standard setters when it
comes to hygiene.
since 1994 p C-Series
Clean water is equally important for both external and internal use – thus, a treatment center has much in common with
human beings. Hygiene is therefore particularly
important in this area. With these significant
points in mind, Dentsply Sirona has made
great improvements to its treatment centers over the past few decades – not
only in terms of functionality and er-
page 17
The disinfection system for all water lines is relocated from the
chair base to the water unit and normally features a ‘free outflow’.
Thus, the water-conducting systems is separated from the public
water supply.
All of the C units include a sanitization hood as well as automatic
programs (purge & auto purge) for rinsing and achieving reduction
of bacteria. The non-return stop integrated into the water lines of
the instruments prevents contamination of the instrument hoses
caused by secretions flowing backwards from the mouth of the patient. Another anti-reflux in the supply block of the dentist element
prevents backflow in the operation of foreign instruments.
Since the introduction of the C-Line in the year
1994, the water unit has no longer been on the
chair but firmly anchored in the floor, which
ensures additional stability for the support
arms. Since 1998, the drinking water bottle
of the C8 unit has made it possible for treatments to be carried out regardless of the quality of the available drinking water. A vacuum
producer built into the water unit based on the
Venturi principle also makes the C8 independent
of central extraction systems.
page 18
2011 p sinius
2008 p TENEO
VISION — issue 01/16
With the new generation of treatment centers (TENEO, SINIUS, INTEGO), the new integrated sanitization adapters render the sanitization hood for the cuspidor superfluous.
For regular flushing of the waterways and for
the monthly rehabilitation instrument and
suction hoses can be easily attached. Special suction cleaner can support the operation on request. Automatic sanitization- and
rinse programs allow effortless operation for
the dental team. The suction hoses can also
be connected to the sanitization adapters
and rinsed with water at the touch of a button, even during treatment. There is also the
option of inoculating this water directly with
a hose cleaning agent in the water unit. This
allows the practice team to do away with the
daily mixing and manual suctioning of the
cleaning agent.
PAGE 19
2014 p INTEGO
FOCUSED — FEATURES FOR HYGIENE
With the start of the rinse program, all water lines are automatically flushed at the
same time. This leaves the assistant with
more time for other tasks in the treatment
room while the rinsing process runs reliably
for the entire time required, ensuring safe,
completely hygienic work conditions.
VISION — ISSUE 01/16
Page 20
There is no way
Around hygiene
There are rules and regulations that need to be taken into account if you want to reach your
destination. Likewise, the dimensions of cruise and cargo ships are determined worldwide
by the lock size in the Panama Canal. In order to enable super-carriers with up to 14,000 containers to pass through the shortcut between the Atlantic and Pacific, the locks of the waterway had to be enlarged in 2016. Standardization was also the goal of Panama's health authorities when introducing strict hygiene regulations for practices and dental clinics this year.
INFORMED — INSTRUMENT PREPARATION
Pro Mundi Beneficio – For the well-being of the
world: Panama’s motto, immortalized in its coat
of arms, now gains new significance for ­advocates
of faultless infection control for instruments. The
government of this Central American country has induced
DAC ­Universal infrastructure in all dental clinics. In doing so, authorities want to ensure implementation of current guidelines for
the reprocessing of dental instruments. With these measures, Panama is in fact providing a worldwide model for carrying out hygiene standards. The National Biosafety Committee in Oral Health in
Panama previously provided a manual for hygiene standards in dental practices that outlined stricter guidelines for reprocessing instruments. To minimize the risk of cross-contamination, committee
experts considered technical support for reprocessing essential,
and defined new infection control requirements for instruments.
PAGE 21
high level of acceptance of the ‘Made in Germany’
technology raised interest of neighboring Central
American states that are now searching for a similar
route to raise hygiene standards.
STRICT GUIDELINESS IN EUROPE AS WELL
Instrument reprocessing is also subject to strict standards and
guide­lines in Europe. Such parameters regulate hygiene processes,
validation of processes, and the documentation of cleaning, disinfecting and sterilizing up to detailed technical parameters. However,
auto­mated reprocessing is not required for all instruments. In Germany, an automated reprocessing with validated method is prescribed
for 'critical B' classified medical devices. Instruments with cavities,
joints, or hard-to-access parts that come in contact with mucous
membrane, blood, inner tissue, or wounds fall into this category.
WANTED: AUTOCLAVES FOR 180 CLINICS
MANUAL REPROCESSING IS RISKY
To support clinics in meeting these requirements, the committee
looked for particularly high-performance technology. An autoclave
solution was the answer and guaranteed efficient cleaning, disinfection, lubrication and sterilization in a single process. In the DAC
Universal, hygiene commissioners finally found a device that
met all requirements. To date, 180 clinics have been equipped with
the combination autoclaves. The success of this measure and the
It is perhaps due to this limitation that even in a country like Germany
there is still potential for improvement for automated reprocessing of
­instruments, which are suitable for it. However, It should be borne in
mind that manual reprocessing has its pitfalls. First, it is not known whether all germs are safely killed. Then there is the risk of failing to comply
with documentation and validation regulations. This means that the p
Q
As in this polyclinic in Panama City, around 180 clinics in the Central American state
are now using DAC Universal for automated reprocessing.
VISION — ISSUE 01/16
PAGE 22
p proof of the reproducibility and effectiveness is difficult. Secondly, the parameters of the treatment processes are not recorded
­automatically.
The regulations require every processing step to be trace­able. That's
no problem for state of the art autoclaves, which ­guarantee comprehensive documentation of all hygiene steps. On the other hand,
practices and clinics that process instruments manually which are
classified as ‘critical B’ will have problems providing the required
evidence, and could encounter problems in one of the increasingly
stricter tests of the health authorities. The upshot: ­Anyone who uses
automatic cleaning and sterilizing does not have to worry about
­either infections or inspections by the health authorities – neither
in Europe nor Panama. P
01
Disposal of single use
instruments and appropriate
preparation
02
TESTING
FOR INTEGRITY
08
USE
03
DAC UNIVERSAL
07
DOCUMENTED APPROVAL
AND STORAGE
06
Hygiene cycle
for automated
instrument
reprocessing
06
STERILIZATION
03
CLEANING, LUBRICATION,
DISINFECTION
OR STERILIZATION
04
CULLET CHUCK
CARE
DAC PREMIUM
05
PACKAGING
05
SIROSEAL PREMIUM
Hygiene is everywhere in the dental practice. It starts with proper
hand hygiene and thorough disinfection of all surfaces in proximity
to patients. One focus is the proper reprocessing of medical devices,
an ever ongoing process. It affects all instruments that are brought
into the reprocessing room after treatment, where comprehensive
reprocessing consisting of cleaning, disinfection and if applicable
packaging and sterilization is carried out. As the Panama authorities
have recognized, the DAC UNIVERSAL is particularly suited to automated reprocessing. The combination autoclav cleans, lubricates
and sterilizes up to six straight and contra-angle handpieces and
turbines at the push of a button.
For ultrasonic tips and handpieces as well as nozzles for multifunctional syringes and solid instruments, it provides the highest level
of safety. The performance of the DAC UNIVERSAL is guaranteed by
a validation procedure that many authorities accept.
Medical devices that are used in sterile conditions are packaged and
sealed with SIRoSeal PREMIUM. Instrument sterility is achieved in
the DAC PREMIUM in the final sterilization process. The packaging
protects against recontamination in storage. All important parameters and the success of reprocessing can be documented after the
cycle finishes by archiving on the practice computer.
ALL-NEW JAGUAR F-PACE
ABOVE ALL,
IT’S A JAGUAR.
Welcome to Jaguar as you’ve never seen it before. Now you
can enjoy the dramatic drive and beauty Jaguar is renowned for,
with added practicality.
Inspired by F-TYPE, its powerful, muscular looks give the
all-new F-PACE a head-turning road presence. And it delivers
the connected steering feel and sharp, responsive handling
of a sports car too, thanks to its aluminium double-wishbone
front and Integral Link rear suspension.
A master of sporting performance and everyday practicality,
F-PACE raises the game.
jaguar.com
Official fuel consumption figures in l/100 km: urban 12.2–5.7; extra urban 7.1–4.5; combined 8.9–4.9.
CO2 emissions g/km: 209–129. Drive responsibly on- and off-road.
VISION — ISSUE 01/16
Breaking
the chain
Page 24
of infection
The outbreak of the Ebola Virus in West A­ frica
was unprecedented in severity and impact, and when it spread it brought the ­topic of
health regulations and hygiene/infection
prevention sharply into focus on a global level.
It triggered new and renewed discussions
among health regulatory experts, health
care personnel and patients. Other recent
examples of infection prevention concerns
have included the H1N1 epidemic, Middle
East Respiratory Syndrome (MERS),
and drug-resistant tuberculosis and Staphylococcus aureus infections. There are
many lessons to be learned. Disease transmission
knows no borders or countries.
INFORMED — INFECTION PROTECTION
PAGE 25
When it comes to healthcare environments, the risk of infection is
elevated with no room for hygiene compromise. To assure safety in
the dental office, strict processes, clearly defined steps and routines
are absolutely necessary – before patients enter, during treatment,
after patients leave, and at the end of the day. Each breach in the
protocol and each step not properly executed pose a hazard.
Although fortunately rare, transmission of microorganisms and disease is known to occur in dental offices. This includes, but is not
limited to, the transmission of HIV, Hepatitis B, Staphylococcus aureus and Legionnaire’s disease. For transmission to occur, the chain
of infection must be present. Protocols for hygiene/infection prevention are implemented to break that chain and prevent the transmission of microorganisms and disease; this means fighting many
small battles in the war on disease on a repeated daily basis.
There are different regulatory organizations and authorities all over
the world that provide recommendations, guidelines, policies and
protocols designed to minimize the risk of cross-contamination
and infection, as well as a regulatory process for the approval or
clearance of devices, biocidal agents and drugs. Which ones p
Chain of infection
01
infectious
agent
02
reservoir
03
Mode
of transmission
04
Portal
of entry
05
susceptible
host
Infectious agents include but are not limited to bacteria and viruses. Active agents live and multiply in reservoirs, such as humans, animals or food. The
infection can use many different modes of transmission: through direct physical contact, air, water, a needle stick injury, contaminated objects and much
more. At some point, for the infection to spread, it will find another body. A portal of entry will be needed, which can include the eyes, oral mucosa, nasal
mucosa, broken skin and sharps injuries. For the chain of infection to be complete, a susceptible host is the last step, such as someone who has not received
vaccination against a disease or who is immune-compromised
Mask use for infection prevention
During the bubonic plague in Europe, an early version of a mask was used, designed as a ‘beak mask’.
As knowledge was obtained concerning microorganisms and their control, more useful methods of
protecting against different diseases were developed. Modern surgical face masks are designed to
protect patients and the user. The rationale for wearing masks includes protection against spatter
particles, splashes, and aerosols. A high concentration of contamination is found within two feet of
the patient, including on the surgical face masks of dental care providers. Exposure to aerosolized
particles during dental procedures can be extensive and aerosols remain airborne longer and travel
farther than particles in spatter. In addition, as larger droplets evaporate, residual droplet nuclei,
smaller than 10 microns (μm) in diameter, form and can remain airborne in treatment areas for
extended periods. Ninety-five percent of dental treatment generated aerosols are 5 μm or less in
diameter and contain multiple types of microorganisms. Masks are absolutely essential in the dental
office. Dental professionals wear masks for a significant amount of time during their work day. It is
therefore not only important for them to offer protection, they should also be comfortable to wear.
Dentsply Sirona’s Preventive’s Com-Fit Plush™ Masks contain an innovative inner material that feels
soft on the skin along with gentle ear loops and a patented curved noseband for correct fit. Clinicians
found them to be more comfortable than other face masks and are hypoallergenic. Independent
tests have shown that they have better breathability than leading competitors and exceeded each
performance level of the ASTM F2100 standard.
VISION — ISSUE 01/16
Page 26
p are applicable depends on which country you are in, however the
guidelines and regulations in general have the same/similar basic
components, and all have the same goal – to keep patients and
healthcare workers safe.
Recommendations and regulations provide guidelines on hand hygiene, personal protective equipment, the treatment of environmental surfaces, instrument processing/decontamination, and the
treatment and maintenance of dental unit waterlines (water hygiene) as core elements. Of all components, hand hygiene is the single
most important element and a cornerstone of any infection prevention/hygiene program. Hand hygiene protocols should be routinely
followed before and after treating patients (before putting on and
after removing gloves), when changing out gloves, after contacting
potentially contaminated objects or surfaces, after ungloved contact
with skin, when hands are visibly soiled and before leaving the operatory (or laboratory). Since noncompliance is an issue partly due
to skin irritation and dryness, using products containing emollients
and protocols that reduce dryness improves skin health, comfort
and the functioning of skin as a natural barrier. The proper protocol
and product selection for the type of ­procedure you are performing
must be followed for all steps in infection prevention/hygiene, according to the relevant recommendations and regulations.
P
Different organizations for different countries
Globally, there is the World Health Organization, while in the US there
is the Occupational Safety and Health Administration (OSHA), the
Centers for Disease Control and Prevention (CDC) and for product
regulation the FDA and EPA. Similarly, in Europe there is the Robert
Koch-Institute (RKI) and the European Medicines Agency (EMA),
among others. Other examples include Health Canada, and the TGA
in Australia. Depending on what authority you fall under, the legal
situation and rules for your practice, and the industry regulations
on products can differ. But as we know, infection does not stop at
borders and neither is it stopped by less rigid compliance or regulations.
Everyone is accountable
Hygiene is complicated and takes time. But even if it has to be
fast, Fiona Collins, an internationally renowned hygiene expert
from Colorado (U.S.), advises prudence and care.
time or resources, lack of knowledge, the perception that the risk
is low, or inadequate knowledge and follow-up. Another source of
noncompliance would be a negative factor that discourages someone from complying – for instance, if you experience skin dryness
Fiona, in your opinion, what is the essence of creating a safe
and irritation associated with repeated handwashing, then that’s
and healthy environment?
a reason for being less likely to perform hand hygiene as often or
as thoroughly as recommended. In fact, hand hygiene has
— ‘First, Do No Harm’ is an old saying from early medical journals. It’s repeatedly been found in surveys to have lower compliance than
as relevant today as it was then, and it’s critical in the context of in- other aspects of infection prevention, and yet it's been estimated
fection control/hygiene in the dental practice and other healthcare that dental professionals typically wash their hands at least 20 to
settings. Beyond that, it’s important to have a culture of safety with 30 times a day, if they are compliant. In this situation, changing
a commitment to safety by everyone in the dental practice. This me- habits and products can help. Using soaps and handrubs that conans that everyone receives proper training, is held accountable, and tain emollients helps to improve and maintain skin health, as does
kept involved in making sure safety guidedrying hands properly after washing and
lines and policies are followed. It is further
the regular use of lotions.
“It’s important to have
important that everyone is a part of making
a culture of safety
suggestions and decisions that would improAlcohol-based handrubs have also been
ve safety. There need to be resources to enshown to help preserve epidermal water
in the dental practice”
sure and promote safety – for instance, a
content in the skin more than soap and waFiona M. Collins
designated person responsible for infection
ter, result in less skin irritation, and can be
prevention/hygiene policies, implementation
used as an alternative to hand washing as
and monitoring. Another example would be
long as hands are not visibly soiled. All of
funding for safety devices. Of course, to err is human, so it’s also im- these options demonstrate ways to increase compliance – finding
portant to have a system in place to find out what happened and to methods to improve the user’s experience.
take corrective action when things go wrong or there are ‘near misses.’
How important is the proper use of personal protective
Where do you see the biggest obstacles in terms of compliance
equipment?
when it comes to following the infection prevention cycle and
how do you think they can be overcome?
— The importance of proper use of personal protective equipment
shouldn’t be underestimated. Without it, patients and personnel
— There is a number of reasons why lack of compliance with as- are at risk. Without the use of clinical gowns (or jackets and troupects of infection prevention occurs. It can be caused by lack of sers), skin and normal clothing would be exposed to blood and other
PAGE 27
INFORMED —INFECTION PROTECTION
Instrument cleaning with Dentsply Sirona
Dentsply Sirona offers several options to clinicians
when it comes to cleaning instruments. The DAC
UNIVERSAL (left) for instance cleans, lubricates
and disinfects / sterilizes up to six straight and
contra-angle handpieces, turbines, ultrasonic
tips and handpieces as well as attachments for
multifunctional syringes at the push of a button
with maximum hygienic safety and without use
of chemical cleaners. Both the cleaning and the
sterilization processes have been proven effective
and reproducible. For instruments like hand pieces, probes, etc. that may not be cleaned with DAC
­Universal but can be cleaned in ultrasonic baths,
there is also the option to obtain the ReSurgeTM
instrument cleaner in order to clean instruments.
ReSurgeTM (right) has been tested to remove soil
and protein better than other cleaners while protecting instruments: ReSurgeTM 98% soil removal.
Everyone is accountable
potentially infectious materials. There is also the need for protective eyewear with side shields which protect against transmission
of an infectious agent and small pieces of debris.
Examination and sterile surgical gloves protect both dental personnel and patients from contact with microorganisms Utility
gloves keep personnel safe from chemicals and reduce the risk of
sharp injuries, and face masks are key to protecting against transmission via nasal mucosa and breathing. For masks, using one
that’s ASTM-rated means that you know the mask has been properly tested for efficacy and is therefore up to its task of protecting
you – beyond that, choosing between an ASTM 1, 2 or 3 mask is
based on the level of protection needed for a procedure (e.g., an
examination wouldn’t require as high a level of protection as ultrasonic scaling or restorative treatments). Of course, personal protective equipment should also fit well and be comfortable.
i­ndirect audits help to reinforce learning, spot any areas that require attention, and provide opportunities for feedback and additional training. Mixing teaching methods (written, live, observational and hands-on learning) increases its effectiveness. Finally,
leadership is required along with a culture of safety necessary to
improve compliance with existing guidelines and reduce crosscontamination and disease transmission. P
profile
How can we ensure that all existing
regulations are followed?
— The goal should always be that all existing regulations and recommendations are followed 100% of the time, even although we
know that noncompliance is an issue and 100% compliance is difficult to achieve. A multi-step approach helps to increase compliance. It’s been shown that education and training are important
components in this effort, however alone they may only result in
temporary improvements.
Making it easier and/or more attractive to follow guidelines plays
a role – for instance, by using more pleasant products, non-irritating products or products that are faster and equally effective, or
by simplifying procedures. Checklists, and observational and
Fiona M. Collins, BDS, MBA, MA is a published author, national and
international speaker on infection control, oral disease and prevention,
biofilm and tobacco cessation. She is a member of the ADA, AADR, OSAP,
ADA Standards groups and is the ADA representative to AAMI. During
her career, she has worked in clinical practice, education and industry.
Contact: [email protected].
VISION — ISSUE 01/16
Page 28
RELIABLE DIAGNOSIS
DESPITE LOW DOSAGE
Detailed X-ray images are an essential component to reliable diagnosis. However, striving to
improve image quality reaches its limits when an excessive dose of radiation leads to un­
necessary health burden. Modern dose-optimizing X-ray technologies facilitate the risk-benefit
assessment and provide for radiation hygiene.
Mr. Ahonen, as low as possible, as high as necessary — that's
the basic principle in radiation protection of patients around the
world. It almost sounds banal. Where is the problem?
— In striving for the lowest possible radiation stress, we have to
consider two aspects: first, the number of individual doses, and
second, how to minimize the radiation dose used at any given
time. Radiation hygiene involves the responsibility of the entire
practice team: doctors and dentists must always make sure
that there is a legitimate indication, and employees must ensure
that they are not producing unnecessary X-ray levels due to
operating error. Above all, training safeguards proper use and
application. What is more problematic is minimizing the dosage
applied because this is related to X-ray image quality and must
in turn be optimal to make a reliable diagnosis.
What should dentists pay attention to in practice routine in
order to keep radiation dosage as low as possible?
— Only part of the body is ever exposed to radiation in diagnostic radiology. The more we can restrict the radiated area,
the more we reduce the radiation risk. Therefore, in selecting
our radiology system, an essential requirement was that the
exposure to radiation be reduced to the area relevant to
diagnosis. The ORTHOPHOS SL 3D gives the practitioner the
possibility of limiting the 3D field of view to 5 x 5.5 cm,
for example. Furthermore, the ORTHOPHOS SL is the only unit
available that lets you shield the upper and retral area
of the skull in a lateral CEPH image for children, by that considerably reducing the radiation dose.
How do patients handle the subject of radiation protection?
Does this mean that the dentist has to decide between
diagnosis quality and radiation protection?
— Not at all. Reliable diagnosis and radiation protection can be
compatible without disregarding the requirements of the ALARA
principle. In other words, we can use the lowest possible dosage.
This compatibility results from major technical progress in the
field. In selecting our X-ray system, we looked closely into the
question of image quality and made some exciting discoveries.
Finally, the ORTHOPHOS SL imaging technology convinced us. Its
2D sensor directly converts X-ray quanta into electrical signals.
In this way, the system brings out the best in image information
from X-rays. As a result, a relatively low radiation dosage is
enough to produce very high image quality. Also crucial for good
contrast is an algorithm that should, for example, be in place to
reduce metal artifacts in 3D images.
This varies greatly. Many patients are confident that we as
physicians will do nothing to endanger their health, and we are
aware of our responsibility here. But of course, there are also
queries and curiosity among patients. This is where we provide
information and explain the ALARA principle. P
PROFILE
Marko Ahonen works as a dentist in different clinics in Helsinki
and other cities in Finland. He specializes in restorative dentistry,
occlusal rehabilitation, and esthetic dentistry. He has a comprehensive website and blogs on this subject: http://www.cerecfinland.fi/.
INFORMED — ALARA PRINCIPLE
PAGE 29
X-RAYS YESTERDAY AND TODAY: ENORMOUS PROGRESS
IN IMAGE QUALITY AND RADIATION HYGIENE
Compared to analog X-rays like those possible in 1962
with the Siemens oP3 (left), digital X-rays offer many
advantages: The X-ray images that are produced
nowadays with the oRTHoPHoS SL (below) are
available much more quickly in the treatment center
because they no longer require development.
Resolution is significantly higher. In this way the
tiniest anatomical structures can be seen clearly and
deviations from healthy tooth substance can be
located more easily. Over time, digital X-rays are less
expensive because chemicals do not have to be
purchased. The dentist running the practice saves
space as a result of digital archiving. Data does not
require much space. And the practice team does not
have to put in much time either because access to
digital data is simpler and faster. Thanks to better
positioning of the patient and the reworking of the
images, fewer repeat images have to be
taken. Limiting the field of view and
innovative sensor technology
allow for a reduction in radiation
exposure for the patient.
INNOVATIVE X-RAY TECHNOLOGY
FROM DENTSPLY SIRONA
p VARIABLE VOLUMES
Allows the optimal field of view for varying
indications to be selected. The FoV offered by
GALILEOS has a sphere diameter of 15.4 cm.
The ORTHOPHOS family offers a FoV of 5x5.5,
8x5.5, 8x8, 11x8 and 11x10.
p MARS SOFTWARE ALGORITHM
Reduces metal artifacts and allows a clearer
image for reliable diagnoses.
p SELECTABLE HD MODE
Increases resolution on demand and can be
switched off in favor of reduced radiation.
p DIRECT CONVERSION SENSOR (DCS)
Converts X-rays directly into electrical signals
without the intermediary step of converting
them into light. Unique on the market.
p SHARP LAYER (SL) TECHNOLOGY
Generates several thousand images during
a cycle, from which the best-focused
fragments are assembled into a sharply
defined X-ray image.
AL ARA
onably
As Low As Reas
e
means use of th
­Achievable. This
le
hi
w
se
radiation do
lowest possible
ng
ei
te
e guaran
at the same tim
is sufficient for
at
th
image quality
ms.
scientific proble
VISION — ISSUE 01/16
Page 30
Enthusiasm
knows no age
Dr. Reynolds Fischbach is 85 years old. But his practice is not at all old fashioned – quite the
contrary: Just recently, this enthusiastic CEREC user fell in love with a new treatment center
– and purchased it immediately.
Informed — INNOVATIVE SPIRITPAGE 31
“I'VE NEVER SEEN ANYTHING
SO MODERN AND SO BEAUTIFUL.”
Reynolds J. Fischbach
TENEO is the natural choice for everyone who
places the highest demands on quality, design
and workflow today and in the future. Integrated tabletop instrument functions, intuitive handling and innovative control elements
with many additional options make treatment
fast, convenient and efficient.
p
Too late, too old, too risky — for Dr. Fischbach these words
have yet to count for anything. While his colleagues, who are
25 years younger, are thinking about finding a successor for their
practice, he is investing in the latest dental systems to allow his dental practice in Minnesota, USA to satisfy the most modern demands
in technology and treatment comfort.
This ‘old-timer’ finds it difficult to pass up on the latest technology:
His appetite for innovation that facilitates his work and wows his
patients is too great. He’s also not worried that the investment won’t
pay off at his age. After all, a new purchase also increases the value
of his practice. This pleasure in innovation has run throughout his
entire professional life of more than 60 years: In 1958, he was the
first dentist in his region to work with turbines; he used computers
before they were considered standard in industrial companies, not
to mention dental practices. Fischbach has relied on CAD/CAM technology with CEREC for many years. The 85 year old was at the 30th
anniversary of the still innovative CAD/CAM system in Las Vegas in
September 2015 and used the opportunity to re-equip his practice.
It was there that he discovered the treatment center of his dreams
and purchased it immediately.
“I fell in love with TENEO right away.” Both its form and function impressed the techno freak. “I've never seen anything as modern and
beautiful.” He is also delighted that his patients can sit back and relax
on the anatomically shaped padding. The Orthomotion function
makes it possible to tilt the backrest and the seating surfaces backwards at a fixed angle, bringing patients into the desired treatment
position. “I like this system because I suffer from back problems
myself and know that many of my older patients have similar medical
issues,” Dr. Fischbach explains. When a comfortable position is found
for a specific patient, the dentist can easily save the setting. The next
time the patient visits,
the dentist easily calls up this
personalized setting using the intuitive interface. Both the chair and the dentist element move
automatically into the right position along the motorized tracking
rail. “I call that modern treatment comfort,” enthuses the experienced
dentist. In addition, TENEO offers him integrated tabletop-device
functions for implants. Together with the CEREC system and the
­GALILEOS 3D X-ray system, the practice is now optimally equipped
for such treatment and is a dream come true for any successor looking to eventually take over the practice. P
See Dr. Fischbach in his interview on youtube
http://www.siro.na/fischbach
PROFILE
Reynolds J. Fischbach, D.D.S., PA, has his own
dental practice in Saint Paul, Minnesota, USA.
He was formerly an associate professor at the
School of Dentistry of the University of Minnesota as well as president of various dental
organizations and of the Minnesota Academy
of Gnathological Research.
VISION — ISSUE 01/16
PAGE 32
For high masticatory forces, zirconium oxide is
the material of choice. The new CEREC ­SpeedFire
sintering furnace accelerates processing time.
In this way Dr. Michael Skramstad from Minnesota,
USA, can provide his patients in a single visit.
HIGH-TEMPERATURE FURNACE
FOR MORE SPEED
IN PRACTICE— CHAIRSIDE FULL CONTOUR ZIRCONIA
PAGE 33
Zirconium oxide is almost as hard as dental alloys. The biocompatible ceramic has been successfully used in dentistry for over 15
years – first only as a veneering framework material and for the
last six years also for full anatomical crowns. This gives me the
assurance to now use the material chairside when placing a crown
that still has to sit perfectly years from now.
90 minutes. Patients do not mind having to wait such a short time
for their crown and use the time to read or watch a film. There is no
need for them to make a second appointment and they do not require a temporary. An immediate restoration makes a lot of sense
from a clinical perspective because it allows for better preservation of the remaining tooth substance.
Besides its high stability and durability, zirconium oxide has two
more important advantages: The flexural strength of the material
allows me to fabricate restorations with very thin wall thicknesses.
This enables me to prepare the tooth in a substance friendly way.
In addition, restorations can be placed more easily: Traditional cement rather than adhesive bonding is used.
I personally devote only around 30 minutes of my work time to this
process. In the meantime, I do the preparation, take an impression
of it with CEREC Omnicam, design the restoration and then fit it into
place. I then delegate the remaining work steps to my assistant.
While the crown is milled on the CEREC MC XL Premium Package, I
tend to other patients. My assistant also operates the CEREC SpeedFire. The user interface is self-explanatory. The restoration just
needs to be placed on the occlusion surface and the start button
pressed – that is all. Dental assistants can also do repolishing, individualization and glazing. I only come back in the treatment room
once the crown has been glazed and is ready for placement.
MAKING GOOD USE OF WAITING TIMES
Fabricating and placing full zirconia restorations in one appointment is possible due to the fact that I can sinter dry-milled zirconium oxide very quickly with the new CEREC SpeedFire furnace.
For one crown, the device usually requires between 12 and 15
minutes. The entire production process therefore takes less than
As a long-time CEREC user, I know and appreciate the advantages of
being able to produce crowns, inlays, onlays and bridges in just p
CROWN RESTORATION MADE BY CEREC ZIRCONIA
After a cusp fracture in a tooth
restored with amalgam, I proposed a
CEREC crown made of full zirconia.
I drew in the preparation margins on
the virtual model with the help of the
automatic margin finder.
p
The CEREC software reconstructs the
crown automatically with the Biojaw
algorithm.
p
p
“CHAIRSIDE RESTORATION
MADE FROM CEREC ZIRCONIA
IS A GREAT BENEFIT FOR MY
PRACTICE.”
In the preview, I checked the position
of the crown in the ceramic block.
Adjustments could be made at this
point if needed.
Finally, I placed the finished polished
crown made from pre-colored zir­
conium oxide in the patient’s mouth.
p
Dr. Michael Skramstad
VISION — ISSUE 01/16
Page 34
p one session. The chairside process is a comfort that my patients
have known and expected from us for 12 years already. By now,
all four dentists in my practice use CEREC. Chairside restorations
have become indispensable for our practice and contribute significantly to its economic success. For some time now, I have been
hoping to be able to produce full anatomical zirconia restorations
in my practice and provide them in one visit. When Dentsply Sirona
CAD/CAM made this possible with CEREC, I immediately included
the fabrication of full zirconia crowns as part of my services.
profile
PRODUCING ZIRCONIUM OXIDE EASILY IN THE PRACTICE
My experiences with CEREC Zirconia have been very positive. Fabricating dental prostheses from full zirconia using CAD/CAM technology is easy; we familiarized ourselves with the process very quickly. This is not surprising since the process is hardly any different
from producing other milled restorations. By means of full anatomical zirconium oxide chairside fabrication with CEREC becomes even
more versatile and economical. A great benefit for my practice! P
Dr. Michael Skramstad is a dentist in Orono, Minnesota, USA. He specializes in restorative and cosmetic dentistry as well as implantology.
He is a certified trainer for Patterson Dental and lectures internationally
on digital dentistry.
FABRICATION OF ZIRCONIUM OXIDE RESTORATIONS IN JUST UNDER TWO HOURS
Digital impressions p The scan with Omnicam is
done in the same way as with conventional CEREC
restorations (2 minutes.)
HOUR MIN.
SEC.
Designing on CEREC AC p Excellent initial proposals are generated with the Biojaw algorithm.
(8 min)
HOUR MIN.
SEC.
Milling p Zirconium oxide is milled in enlarged
form. This allows for more detailed finishing of
the structures. (10 min)
HOUR MIN.
SEC.
00:02,00
00:10,00
00:20,00
Sintering p The assistant places the restoration in
the CEREC SpeedFire furnace and starts the sintering process with a touchpad. (16 min)
Polishing and glazing p The restoration can be
individualized between both steps. (12 min)
Fitting and finishing p The restoration is cemented
in the usual way. The remaining cement residue is
then removed and the margins smoothed. (8 min)
HOUR MIN.
SEC.
00:36,00
HOUR MIN.
SEC.
00:48,00
HOUR MIN.
SEC.
00:56,00
IN PRACTICE — PRODUCT INNOVATIONS
Page 35
SOFTWARE UPDATES
ENSURE GREATER FLEXIBILITY
SIDEXIS 4 and SICAT Suite
in a single software package
Thanks to the seamless integration of the optional SICAT Suite application
package, the imaging software SIDEXIS 4 has added numerous performance
and workflow improvements to its offering. Now objects for treatment planning can also be shown in the SIDEXIS 4 timeline.
The SICAT Function software is an ideal tool for analysis of the patient’s individual condyle-fossa relationship during jaw movement: this is particularly important for diagnosis and treatment of patients with TMJ. OPTIMOTION therapeutic appliances, which are created via a fully digital workflow, can be
ordered directly out of the application. The SICAT Air software allows for the
digital analysis of respiratory passages for patients with obstructive sleep
apnea. The therapeutic appliance OPTISLEEP, also produced via a fully digital
workflow, offers optimal fitting comfort and high stability.
Q The SICAT Suite software package includes SICAT Air
for the analysis and treatment planning of obstructive
sleep apnea.
The latest SIDEXIS 4 (V 4.1.3) and imaging system ORTHOPHOS SL (V1.0.4)
software versions offer many advantages such as compatibility with Windows 10 and various workflow improvements. The current versions now allow
for images to be subsequently assigned to the desired patient and for the
import date to be changed.
FOR THE DENTAL
PRACTICE LABORATORY
The enhanced CEREC Premium CAD/CAM software allows dentists with a
practice lab within their practice to handle cases that are beyond the scope
of chairside treatment. The software offers a greater range of machining
tools and supports, apart from CEREC intraoral scanners, also the extraoral
scanners inEos X5 and inEos Blue for a broader indication spectrum. From
crowns to copings and bridge frameworks to bridges anatomical connectors,
bars and telescopes, all work steps are carried out only with one software
together with the versatile CEREC grinding and milling units.
Many new or enhanced tools improve the machining process. This includes
the Biojaw reconstruction algorithm as well as access to dental databases for
top-quality initial proposals. This is how CEREC Premium software makes
shorter, easier and patient-oriented workflows possible. Restorations can be
prepared for a broad indication spectrum in one session or on the same day.
The digital impression and design data can be sent and received via the
­Sirona Connect portal, making it an ideal connection between dental clinics
and laboratories.
Q Crown construction
in the CEREC Premium software.
VISION — ISSUE 01/16
PAGE 36
THE HIGHEST PRIORITY
IS THE RIGHT BALANCE
In early 2014, Lutz and Hanna Ritter took over two older practices and founded the Ritter
& Ritter Specialist Practice for Orthodontic, Oral, Jaw and Facial Surgery and Implantology.
Since they wanted to offer their patients the most modern treatment methods possible, they
had to make some fundamental changes. Lutz Ritter describes how he and his wife successfully implemented their ideas.
IN PRACTICE— OPTIMIZED PRACTICE STRUCTURE
PAGE 37
Taking over a dental practice that has been established for over
30 years is like traveling through time. This is how my wife and I
felt in January 2014, when we moved into the offices of an orthodontics practice in Hennef, close to Bonn, whose owners intended
to retire. The rooms were furnished with needled felt and lino flooring, and the lobby radiated the kind of charm typically associated
with the 1980s. One thing was clear: We had a lot of work to do – and
not much time. We had planned to take no more than the two weeks for which the practice would be closed for vacation to complete
the move and the renovation. We did not want to make our referring
colleagues and patients wait any longer.
Q Clear structures help processes run smoothly and make working in a team
easier. The members of the practice team wear different colored
uniforms to help the patient recognize which function of the practice they
belong to.
SOLID BASIS FOR NEW STRUCTURES
One process that has also changed enormously is our patient communication process. To date, we have been providing patients with
advice and consulting for well over 30 years. Today, I could not
imagine my implantology practice without first conducting a thorough consulting interview using the monitor. I am constantly
amazing my patients with the virtual positioning of an implant in
a 3-dimensional X-ray image. “The things you can do these days!”
– I hear that all the time.
Our idea was to expand the range of services we offered by introducing digital technologies. So we began with a complete renovation of the practice rooms, to create a basis that would be capable
of supporting these services: The walls and ceilings were painted,
floors replaced, sanitary areas renovated, and the entrance area
was completely remodeled. We inherited all of the equipment left
by our predecessors, including orthopantomogram and lateral
cephalometric x-ray equipment. It was not possible for us to replace all of this equipment completely at that time; we would not have
been able to stay within our tight time constraints. The only machine we bought new immediately was a 3D x-ray machine. CBCT
is a must have for my demanding surgical work and for confident,
successful implantology treatments. I specialize in bone reconstruction, so 3D x-ray images are indispensable.
When the renovation and conversion work was completed, we opened our new practice – initially with an unchanged practice staff.
Over the course of the next year, we expanded the team, and today
– counting my wife and myself – there are 14 of us. A general practice manager is responsible for ensuring that the two areas of operation run efficiently and according to practice structures. This is
neccessary because my wife is in charge of orthodontics while I am
responsible for surgery and implantology. The two functions can be
distinguished because the staff wear correspondingly color-coded
practice clothing. A little more than a year after taking over the practice, we were ready to replace the practice equipment. To do this, in
February 2015 we closed the practice again for two weeks.
DIGITAL PROCESSES, MODERN PATIENT COMMUNICATION
Today, the Ritter & Ritter Specialist Practice has little in common
with its earlier incarnation. This is due in part to the modern furnishing and facilities, of course, and also to the new technologies.
But the processes have changed as well. The digital workflow is a
natural and unchanging part of our daily routine. I have long been
using GALILEOS Implant to plan implant supplies, and my wife has
used CEREC Ortho since the beginning: She uses CEREC to make
digital impressions and for Aligner treatments.
Now, the practice conversion has been completed. Sometimes I ask
myself whether we should have carried out the renovation and equipment replacement at the same time. But then I see how smoothly
all the processes are running, and how well our team works to perform its various functions. Our employees had to understand the
processes first, and then develop the willingness to support us on
this new path. This was simply a question of time, and we have been
very glad of the support we received from our team. And now my wife
and I both know: We would do it again in the same way.
P
PROFILE
Dr. Dr. Lutz Ritter is a specialist dentist for oral
surgery, and a specialist doctor in oral, jaw and
facial surgery. Together with his wife Hanna
­Ritter, a specialist in orthodontic dentistry,
he has led the Ritter & Ritter Specialist Dental
Center in Hennef near Bonn. Ritter is a member
of the German Society for Dental, Oral and Jaw
Physicians (DGZMK), and has been a board
member of the German Society for Computer-assisted Dentistry (DGCZ e.V.) since 2010.
VISION — ISSUE 01/16
PAGE 38
A SAFE SOLUTION
FOR CHALLENGING CASES
Nowadays, it is barely conceivable to attempt to complete an implant without 3D imaging.
Thanks to high-quality imaging, even the most difficult of situations can be assessed precisely.
Dr. Sapan Mistry from Bern, Switzerland, reports on his experiences.
IN PRACTICE— AMBITIOUS IMPLANTOLOGYPAGE 39
Dr. Mistry, by purchasing ORTHOPHOS SL you bought a hybrid
x-ray system at the end of last year. Why?
— Dr. Mistry: Besides the ‘standard and routine’ dental indi­
cations, I also carry out many implants in my practice, so 3D images are very important. The unit I used before, from another manufacturer, was still working, but it was no longer equal to my
requirements: I need the best possible imaging results, which I
can also combine with implant planning and CEREC.
Where do you see the biggest differences?
— Dr. Mistry: I can explain this best with an example. I ran into a
particularly difficult challenge with a 73-year-old patient: The OPG
already revealed an extensive bone defect in regio 24. I processed
the image further in the SIDEXIS 4 x-ray software with a sharpness
filter – the image quality revealed the situation in precise detail.
This enabled me to make a clinical assessment of the situation with
much more confidence. The patient wanted an implant, but emphatically declined the augmentation that such an operation really required. In truth, this was really a case for a specialist. But thanks to
the exceptionally good image quality of the oRTHoPHoS SL, in 3D
mode as well, I was able to plan and carry out the implant insertion
myself. I compensated for the deep position of the i­mplant with a
corresponding abutment and a longer restoration.
What role does x-ray software play
in treatments of this kind?
— Dr. Mistry: First, SIDEXIS 4 makes x-ray image creation easy.
Then, it offers a wide range of image processing options and extra
tools such as the Timeline or Comparison functions, which are
easy to use and deliver precise results very quickly. X-ray images
can be very simply opened from SIDEXIS 4 in the GALILEoS Implant
software. There, I make good use of the three-dimensional nature
of the images, because it makes it easier for me to position the
implant precisely by virtual means. In order to optimally im­
plement my plan for my patient, I created a surgical guide in my
own practice based on the prosthetic suggestion by CEREC. I do
not think I can be any more confident when inserting the implant.
How satisfied are you with the result?
— Dr. Mistry: With the aid of the surgical guide, I was able to insert
the implant in the patient without having to make a flap opening.
The periapical x-ray image taken immediately after the operation
confirmed the precise positioning of the implant according to the
pre-operative plan in the two-dimensional plane. The image shows
the very high degree of precision that was achieved, also with
­accurate diagnosis and treatment planning. Two follow-up checks
one day after the implant and again a week later, revealed no anomalies, and the patient reported no pain symptoms. In other
words: I am very satisfied.
P
PROFILE
Dr. med. dent. Sapan Mistry has owned ‘Dentsidecenters’ in his native city of Bern since
2011. He passed the state examination in 2008
at the University of Bern, took over the practice
in Thun formerly owned by Dr. Bühlmann, and
finally returned to Bern in 2015.
| Q ~
The high quality of the images, simple transfer of image data to the implant planning software
and the creation of a surgical guide create confidence even for difficult implants.
VISION — ISSUE 01/16
PAGE 40
USING CEREC FOR FASTER
TRANSPARENT ALIGNERS
Dentsply Sirona has made important steps in the past year to enable the use of the CEREC method in orthodontics. With the new CEREC Ortho software and CEREC Omnicam, transparent aligners can be ordered from most partners on the market such as Invisalign® and MTM® Clear
Aligner. Dr. Lawrence Yong from Singapore reports on his experience.
To start aligner treatment, I begin by scanning the dental arches
with the CEREC Omnicam, using the guided scanning process that
comes with the new CEREC Ortho software. The main advantage of
using digital impressions is that my cases can now be submitted
online immediately after I see the patient. I also have the opportunity to review the quality of the virtual models to ensure a precise fit of the manufactured aligners.
My patients are fascinated with the details captured in the virtual
models, which are literally generated in front of their eyes in real
time. Compared to physical impressions, I can now provide my
patients with the final treatment proposal and outcome simulation
by at least 7 days earlier. My patients are happy that they can start
treatment earlier and I am increasingly more confident of the fit of
the aligners.
Thanks to CEREC Ortho, I can use my CEREC Omnicam even more
effectively, and investment in this unit pays off very quickly. My
assistant is the happiest person in the team with the new digital
workflow. She no longer has to deal with the stress of helping me
mix impression materials, clean up, prepare the lab forms, pack
and ship physical impressions.
P
Q
Dr. Yong taking digital impression with CEREC Omnicam.
P
Parkway Dental Practice is located near Orchard Road, in the heart
of Singapore. It is a state of the art practice that offers a complete
range of dental solutions. We have been using clear aligners for
orthodontics since 2011. The CEREC ­Omnicam was added to our
practice in 2014. We were delighted a year later when Dentsply
­Sirona and Align Technology made the announcement of their decision to work together towards an integrated digital orthodontic
workflow.
There is an increasing demand for aligner treatment, especially
with today’s highly-informed internet-savvy patients. A few weeks
ago, a young lady came to our practice requesting ‘invisible braces’.
She had just finished her studies and wanted a better smile because she felt that it was going to be important for her career. Six years
before, she had consulted another practice but was not satisfied
with the idea of using conventional braces. She found our practice
when she was doing research on the internet for new, lifestyle-friendly ways to straighten teeth.
Almost invisible:
transparent aligners.
PROFILE
Dr. Lawrence Yong is an orthodontic specialist
located in Singapore. He is the founder and managing director of the Parkway Dental Practice that is home to seven dentists, four dental
specialists and a team of 20 support staff. He
is a member of the Royal College of Surgeons
of Edinburgh and a fellow of the Academy of
Medicine of Singapore.
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VISION — ISSUE 01/16
PAGE 42
How is it that you are located
in Dallas as an orthodontist?
‘DOC’ ON THE PLAYING
FIELD AND IN THE OFFICE
Although he was famous for his success in sports, today it's primarily his family, and his work in the surroundings he organized
personally that count for orthodontist Dr. Dipak Chudasama.
Five questions for the former batter of the Kenyan cricket team.
Why did you decide to study dentistry
even during your successful period as a
cricket player?
— Although it was a wonderful time and
I am proud of having represented my
homeland, Kenya – both as a table
tennis player and a cricketer – in international competition, I wanted to build a
third mainstay in my life and that was
dentistry.
Everyone called you the ‘Doc’.
Did you like that?
— Oh yes, the cricketers at that time all
knew me only as ‘Doc’. Word had gotten
around that I was not only a good athlete,
but also took my studies seriously.
How did it all happen?
— God was kind to me... (he laughs)
At 17, I began to play table tennis and
cricket at the same time at the international level. I then earned my BA at Mangalore
University in Karnataka, India, a Master
of Science in Orthodontics at the Eastman
Dental Institute in London.
— I'd already begun to work as a dentist
in Nairobi. When I finished with cricket at
39, I decided to return to school and
receive training in orthodontics. I then
taught at the School of Orthodontics at
Jacksonville University as Director of
Research. I seem to have done a good job;
I was twice elected Academic Professor of
the Year and in 2009 even obtained the
Orthodontists' Excellence Award in
Teaching. I then ended up in Dallas ... life
is exciting and always offers something
new ... (he laughs).
In your opinion, what makes a good
doctor?
— Dedication and humility. Moral values
count for me.
PROFILE
Dr. Dipak Nanalal Chudasama, born in Mombasa on May 20,
1963, was known internationally as the ‘Doc’ in the 1990s
when he was active as a Kenyan world-class cricketer and
played in the world championship with his team in 1996. He
also was a successful table tennis player and competed in
the Commonwealth Table Tennis Championships in Bombay
in 1982. Today, he is married with three adult children and
practices orthodontics in his own practice in Dallas, Texas,
www.orthodonticavenue.com
GOOD TO KNOW — MISCELLANEOUS
PAGE 43
DIGITAL COMPANION FOR
DAILY PRACTICE ROUTINES
Applications for smartphones – apps for short – provide quick
access to Internet-based information. The dental segment
­offers many applications for smartphones and tablets – for patients and dentists. They range from funny games and useful
software to comprehensive technical and knowledge offerings.
ORTHOPHOS SL – experiencing virtually
LEGAL NOTICE
Publisher
Sirona Dental GmbH
Sirona Straße 1
A–5071 Wals/Salzburg (Austria)
E-Mail: [email protected]
Telephone: +43(0)662.2450-0
Fax: +43(0)662.2450-510
www.sirona.com
How would the X-ray system ORTHOPHOS SL of Dentsply ­Sirona
Imaging fit into one‘s own practice room? For those who cannot imagine and want to see in advance, the ORTHOPHOS app is
just the right thing. With the camera of a mobile phone or t­ ablet,
the user records the future location of the device. The Augmented Reality app places an interactive 3D model of the X-ray
system ­ORTHOPHOS SL virtually in the practice room. The threedimensio­nal model can be viewed from all sides and shows how
the ­ORTHOPHOS SL looks when it is integrated into the practice
rooms. There is also the possibility to zoom in to see more ­details.
­Furthermore the app offers comprehensive information about
features and functions of the device (e.g. the unique direct conversion sensor, operating panel Easypad or software ­SIDEXIS 4).
This way one can easily expe­rience the ORTHOPHOS SL. The application is available for Apple and Android devices in German and
English and requires at least iOS 8.0 or Android 4.4.
Responsible under German press law
Marion Par-Weixlberger, Vincent Kummer
Sirona Dental GmbH in Wals/Salzburg (Austria)
Editorial and design
Edelman.ergo GmbH
Venloer Str. 241 – 245
50823 Cologne (Germany)
www.edelmanergo.com
Editorial office
Christoph Nösser (responsible), Daya Bronner, Marion
Güntzel, Liane Rapp, Julia Rommelfanger, Britt Salewski,
Vivian Schmidt, Eva Thoma
Q
Apple QR-Code
Q
Android QR-Code
Layout
Daniel Sanjuan
We extend a special thank you to everyone
who contributed to the preparation of this issue
The Dentsply Sirona Sales and Marketing-Team,
Marko Ahonen, Dr. Dipak Nanalal Chudasama,
Reynolds J. Fischbach, Tanja Lauinger, Dr. Sapan
Mistry, Dr. Dr. Lutz Ritter, Sonja Schmid,
Dr. Michael Skramstad, Jörg Vogel, Dr. Lawrence Yong
Printing
schmitz druck & medien GmbH & Co. KG
Weihersfeld 41
D–41379 Brüggen
Publishing interval
semiannually
All reproduction of contents, even excerpts thereof, must be accompanied by a
source attribution. Not all products are available in all markets. The provisions
of the individual countries apply. Subject to technical changes and errors.
Sources for facts and figures quoted are listed on pages 4 – 5:
1 Huffingtonpost.de, 2 National Center for Biotechnology Information, 3 Trefis.com,
­Statista 2016, 4 wikipedia.com, 5 Praxistipps.chip.de, 6 Hygiene Council V­ erhaltens­studie,
7 Sleepmedicine Reviews
Image credits
Title p Shutterstock, Table of contents p Getty Images, Shutterstock, Dentsply Sirona
P. 03 p Dentsply Sirona, P. 04 – 07 p Dentsply Sirona, iStockphoto, P. 10 – 14 p Masterfile, iStockpho- to, Getty Images, Shutterstock, P. 15 p Shutterstock, P. 16 – 19 p
iStockphoto, Dentsply Sirona, P. 20 – 22 p Shutterstock, Dentsply Sirona, iStockphoto,
P. 24 – 27 p Shutterstock, iStock- photo, Dentsply Sirona, Fiona Collins, P. 28 – 29 p
Marko Ahonen, Dentsply Sirona, P. 30 – 31 p iStockphoto, Dentsply Sirona, Reynolds
J. ­Fischbach, P. 32 – 34 p Dentsply Sirona, Dr. Michael Skramstad, P. 35 p Dentsply
Sirona, P. 36 – 37 p iStockphoto, Sebastian Dörken, Dentsply Sirona, P. 38 – 39 p
­iStockphoto, Dr. Sapan Mistry, Dentsply Sirona, P. 40 p Dr. Lawrence Yong, P. 42 p
Dr. Dipak ­Nanalal Chudasama P. 43 p Dentsply Sirona
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