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Group photo of participants of this years Student Clinician Program con-ducted by DENTSPLY Asia during the annual meeting of the InternationalAssociation for Denta l Research South-East Asian Divi sion in Hong Kong.(DTI/Photo cour tesy of DENTSPLY Asia, Hong Kong) ASIA NEWS, page 3

DT Asia Pacific

CANBERRA, Australia: Mil-lions of patients Down Underare breathing a sigh of relief, asa new scheme for subsidised

dental care went through theupper house in November.

The government programmewill replace the recently closedChronic Disease Dental Scheme(CDDS) and aims to providebetter access to dental ser-

vices for children, as well aslow-income adults and pen-sioners.

The Labor government de-cided to close the CDDS inAugust this year, claiming thatthe costs had skyrocketed sinceit was implemented by theHoward government in the

year 2007. Funding for those

eligible for the scheme will ex-pire by the end of this month,they said.

Under the CDDS, patientswith chronic illnesses and com-plex care needs were able toclaim benefits of AUS$4,250(US$4,440) for dental treatmentby a private dentist when re-ferred by a doctor.

Starting in January 2014, thenew scheme, called the Den-tal Benefits Amendment Bill2012, will provide AUS$1,000(US$1,045) over two years forfamilies with children underthe age of 17 who require ba-sic dental treatment. Adults

with concession cards, includ-ing pensioners, will be able toaccess the scheme later that

year.

Overall, the governmentwill stump up AUS$4 billion(US$4.18 billion) over six years

for subsidised dental healthcare. Services in underservedareas are also expected toreceive a financial injection ofAUS$225 million (US$235 mil-lion) over the same period.

Page 12

Nakanishi speaks

Japanese manufacturer

aims for global leadershipPage 9

Industry Down Under

An interview with ADIAs

Trevor MartinPage 14

Anterior restorations

How to skilfully combine

materials

Australian Senate passes dental care bill

In an effort to boost the useof measures to identify victims

of crimes and natural disasters,dental students in Japan will berequired to answer questions onforensic dentistry in upcomingnational dentistry examinations.The changes will be implement-ed by 2014 and followed by in-

vestments into training that willprovide students with enhancedknowledge about how to identifybodies with the help of dentalrecords, the countrys Ministry ofHealth announced.

Approximately 1,200 uniden-tified human bodies are foundin Japan each year. In 2011, thisnumber increased significantlyowing to devastations caused

by the Thoku earthquake andthe resulting tsunami. While10 per cent of the victims wereidentified by their teeth, ac-cording to figures of the Ja-pan Dental Association, forensicdentistry experts in Japan lackexperience and are too few withonly half a dozen experts avail-able in some of the countrysprovinces. DT

Japan toinvest intoforensics

Representatives of the Ma-laysia Dental Association havecriticised aspects of the countrysnew dental bill at a joint meetingof the Malaysian and Singaporedental communities in De-cember. President elect Dr NeohGim Bok said that his organi-sation is currently in discussions

with political stakeholders inorder to resolve the key issuesrecently put forward by the pro-posal.

Issued earlier this year, the

bill is supposed to replace the1971 Dental Act, which regulatesthe practice of dentistry inMalaysia. Among other things, ithas been under scrutiny for ex-cessive penalties and making ittoo easy for foreign practitionersto obtain temporary licences topractice. DT

Bill discussedat Malaysia

dentalmeeting

The Swiss manufacturer an-

nounced that is has taken legalaction against various dental ma-terials enterprises. The Chineseand South Korean companies al-legedly violated Sulzers trade-mark and patent rights at the re-cent Greater New York DentalMeeting by offering counterfeitmixing tips. DT

Sulzer suits copiers

in China, KoreaGlobal dental products pro-

vider Sirona has a new CEO.As from 20 February 2013, Jef-frey T. Slovin will succeed JostFischer, who has held the po-sition for 11 years. Fifty-eight-

year-old Fischer will be retir-ing, giving up his position asboth CEO and chairman of theboard. DT

Sirona Dental

appoints new CEO

DENTALTRIBUNEThe Worlds Dental Newspaper Asia Pacific Edition

PUBLISHED IN HONG KONG www.dental-tribune.asia NO. 12 VOL. 10

Primarily children are supposed to benefit from the new scheme. (DTI/Photo Zou Zou)

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DT Asia Pacific

SHANGHAI, China: Atten-dance figures for DenTech Chinaincreased by another 4.3 percent this year, UMB ShowStar,the organiser of Chinas second-largest dental show, has re-ported. In addition to the growthin professional visitors, the ex-hibition saw 16 per cent higherparticipation by industry.

According to the latest fig-ures, almost 600 manufacturersand dealers of dental materialsand equipment took part inDenTech China 2012, almost halfof which were companies fromabroad, with the US and Ger-

many having the greatest re-presentation. The company saidto have registered more than68,000 visitors during the showheld at the Shanghai World Expo

Exhibition and Convention Cen-

ter in late October.

The event also featured afour-day dental conference, anumber of forums on specialtieslike implantology, and the sixthAsian Dental Lab OutsourcingExhibition.

DenTech China, which wasfirst held in 1994, is staged an-nually in collaboration with theChinese Stomatology Association

and the School of Stomatology atShanghai Jiao Tong University,among other dental institutions.Since March 2012, all opera-tional activities have been man-aged by Shanghai UBM ShowStar

Exhibition, a recently formedjoint venture between UBM, aUK-based B2B communicationsprovider with offices in Shang-hai, Beijing and Hong Kong,

which holds 70 per cent of the

company, and the previousowner of DenTech, ShanghaiShowStar Exhibition Service. Itsnext show will be held again inOctober next year.

In terms of visitors, DenTechChina currently ranks secondafter Sino-Dental in Beijing, with70,000 visitors. Dental SouthChina in Guangzhou, the thirdmajor dental show, reportedly at-tracted 30,000 visitors in 2012. Inaddition, smaller dental shows incities like Xian and Nanjing haverecently entered the market.

According to estimates of theNational Bureau of Statistics in

Beijing, China boosts a dentalworkforce of 120,000, a numberequal to dentists living in Ger-many, France and the BeneluxStates combined. DT

DenTech Shanghai gainsmore ground in China

While the Green party, La-bors coalition partner in thecurrent minority government,applauded the new scheme as ahistoric step towards the pro-

posed universal dental healthcare system, members of theopposition have lambasted thebill for overstretching the gov-ernments budget. Dentists toohave criticised the implemen-

tation of the scheme only inearly 2014, which will leavechildren and adults previouslycovered by the CDDS withoutproper care for over 12 months.

Treatment of the chroni-cally ill, for which this scheme

was designed, is often complex,requiring an extended period,commented Dr Shane Fryer,President of the AustralianDental Association recently.A 12-week period to complete

treatment will mean that pa-tients under the CDDS will notbe able to finalise their treat-ment plans.

Liberals claim that approxi-mately one million patientshave benefited from the CDDC

so far. The new scheme willprovide more than three mil-lion children and an additionalone million adults with accessto dental care, according to thegovernment. DT

page 1DT

Group Editor/Managing Daniel Zimmermann

Editor DT Asia Pacific [email protected].: +49 341 48474-107

Clinical Editor Magda Wojtkiewicz

Online Editor Yvonne Bachmann

Editorial Assistance Claudia Duschek

Copy Editors Sabrina Raaff

Hans Motschmann

President/CEO Torsten Oemus

Marketing & Sales Matthias Diessner

Vera Baptist

Peter Witteczek

Maria Kaiser

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License Inquiries Jrg Warschat

Accounting Manuela Hunger

Product Manager Bernhard Moldenhauer

Executive Producer Gernot Meyer

Ad Production Marius Mezger

Designer Franziska Dachsel

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Published by Dental Tribune Asia Pacific Ltd. 2012, Dental Tribune International GmbH. All rights reserved.

Dental Tribune makes every effort to report clinical informationand manufacturers product news accurately, but cannot assumeresponsibility for the validity of product claims, or for typograph-ical errors. The publishers also do not assume responsibilityfor product names or claims, or statements made by advertisers.Opinions expressed by authors are their own and may not reflectthose of Dental Tribune International.

International Editorial Board

Dr Nasser Barghi, Ceramics, USADr Karl Behr, Endodontics, GermanyDr George Freedman, Esthetics, CanadaDr Howard Glazer, Cariology, USAProf. Dr I. Krejci, Conservative Dentistry, SwitzerlandDr Edward Lynch, Restorative, IrelandDr Ziv Mazor, Implantology, IsraelProf. Dr Georg Meyer, Restorative, GermanyProf. Dr Rudolph Slavicek, Function, AustriaDr Marius Steigmann, Implantology, Germany

DENTALTRIBUNEThe Worlds Dental Newspaper Asia Pacific Edition

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DT Asia Pacific

HONG KONG: What do TanMing-Yi, Min-Cheol Song andDarapan Pattanapichakorn havein common? All three dentalstudents are winners of clinicalcase and research competitionsheld by DENTSPLY Asia duringthis years annual meeting ofthe International Associationfor Dental Research South-EastAsian Division (IADR SEA) inNovember.

In addition to its annual Stu-dent Clinician Program (SCP),

which saw National Universityof Singapore student Ming-Yicome tops with her presentation

on 3-D repositioning accuracy ofsemi-adjustable articulator castmounting systems, the dentalmanufacturer held its CERAM-Xand Endodontic Case Contest.

While the latter went to Pattana-pichakorn from the Chulalong-korn University in Bangkok,Thailand, the aesthetic dentistrycontest produced four winnersfrom universities in South Korea,Malaysia, Taiwan and the Philip-pines. They were awarded cer-tificates and prize money, amongother things.

According to DENTSPLY, SCPwinner Ming-Yi will be fundedto present her research poster

along with winners of studentcompetitions from other regionsaround the world at the annualmeeting of the American DentalAssociation in New Orleans next

year. The US-based dental groupcurrently holds its SCP contestsin over 35 countries. Initiated inthe US in 1959, the programmeaims to support and promote un-dergraduate research at dentalschools and universities world-

wide.

Magnetic mounting systemshave gained popularity in re-cent years, but this has not beeninvestigated in detail, Ming-YitoldDental Tribune Asia Pacific.

We compared a conventionalscrewed-on semi-adjustble ar-ticulator cast mounting system

with five magnetic mountingsystems. Based on our study,the conventional screwed-onsystem was found to be compa-rable to several magnetic sys-tems in terms of repositioningaccuracy.

Other entries to the com-

petitions included an evalua-

tion of the effect of carbamide

peroxide on the enamel bond

strength of composite resins at

different post-bleaching times,

and the use of Buntot-tigre,

a flowering plant of the Sanse-

vieria genus from the Philip-

pines, as antimicrobial dental

floss. All participants were

winners of their national con-

tests.

More than 5,000 studentshave participated in the SCPsince its inception. DENTSPLYs

Asian division has been conduct-

ing its South-East Asia pro-grammes since 2002. This year

was the first time that the com-pany held all three contests to-gether at one event. More than15 students from 10 countries inthe Asia Pacific region took part

in the competitions, according

to Clinical Marketing ManagerStephen Ong.

He announced that his com-pany had recently formed a part-nership with the IADR SEA and

will be the exclusive host of its

SCP contests at the organisa-

tions annual meeting for thenext four years.

The next competition cov-ered by the contract will be heldduring the 2013 IADR Asia PacificRegion meeting in Bangkok. DT

(DTI/P

hotocourtesy

ofDE

NT

SPLYAsia

,HongK

ong)

NUS student Ming-Yi (right) receivingher SCP award.

DENTALTRIBUNE Asia Pacific Edition Asia News 3

DENTSPLY Asia announceswinners of student competitions

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DTI

COLOGNE, Germany: Thedevelopment of CAD/CAM andimplantology will continue tobe the determining trends atthe next International DentalShow, representatives of theorganiser Koelnmesse and theAssociation of German Den-tal Manufacturers (VDDI) toldreporters at a press confer-ence in Germany. Besides thesemega topics, the use of lasersin different fields of dentistry

will be given particular atten-tion.

Reportedly, more than 1,900dental manufacturers and dis-

tributors have registered fornext years event, which hasbeen expanded by 5,000 sqmand will fully occupy anotherhall at the Koelnmesse fair-ground in Cologne.

According to Koelnmesseschief operating officer, Katha-rina C. Hamma, the increase inexhibitors this year is due to thehigh demand from companiesabroad, which has grown by10 per cent compared with thelast IDS. While the number ofdomestic businesses will remain

the same, almost two-thirds(68 per cent) of all companiesexhibiting in 2013 will come

from outside Germany.

IDS will prove its positionas the global leading tradeshow in the dental industryonce again. Its success is anendorsement of our trade showconcept, Hamma explained.Therefore, we will be retain-ing the successful formula forthe upcoming event.

Her company, which hostsother well-known internationaltrade events like Art Cologneand gamescom, stages theglobal dentistry showcase inpartnership with the commer-cial enterprise of the VDDI and

the Society for the Promotionof the Dental Industry (Gesell-schaft zur Frderung der Den-tal-Industrie) every two years.The last edition, held in March2011, drew 1,954 exhibitorsand 118,000 professional visi-tors to Cologne, according toreports.

Hamma announced that inaddition to professional activi-ties presented by the GermanDental Association and theAssociation of German DentalTechnicians Guilds (VDZI), theFederal Association of DentalAlumni (BdZA) in Germany

will be hosting a Generations

Lounge for the first time at nextyears IDS, which is intendedto serve as a meeting point fordental students, practice new-comers and established prac-titioners.

Furthermore, visitors willbe able to learn more about the

latest products and technolo-

gies at the customary SpeakersCorner (in Hall 3.1).

The IDS app will also be up-dated in the upcoming weeks.The application, available forseveral smartphones, allows

users to search for information

on exhibitors and productsahead of the show.

The next edition is sched-uled to open its doors with theusual Dealers Day on 12 March2013. More than 120,000 dental

professionals from Germany

and abroad are expected toattend the event from 12 to16 March to update their knowl-edge on the latest develop-ments and trends in dentalequipment and materials, ac-cording to Hamma. DT

(DTI/PhotocourtesyofKoelnmesse,G

ermany)

Koelnmesse COO Katharina C. Hammaaims for a new record-breaking IDS.

DENTALTRIBUNE Asia Pacific Edition World News 5

Foreign demand drives worldslargest dental showcase

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DTI

MALATYA, Turkey: Men intheir thirties with inflamedgums caused by severe perio-dontal disease are three timesmore likely to suffer from erec-tile dysfunction, Turkish re-searchers have found. The

study results confirm previousresearch from India from 2011

that linked both conditions.

In their study, Turkish re-searchers compared 80 men

with erectile dysfunction witha control group of 82 men with-out erection problems. They

found that 53 per cent of themen with erectile dysfunction

had inflamed gums comparedwith 23 per cent in the controlgroup.

When the results were ad-justed for other factors, such asage, body mass index, house-

hold income and educationlevel, the men with severe peri-

odontal disease were 3.29 timesmore likely to suffer from erec-tion problems than the men

with healthy gums were.

The men in both groupswere aged 30 to 40, with an av-erage age of just under 36, andthere were no significant dif-ferences when it came to bodymass index, household incomeor education.

Their sexual function wasassessed according to the Inter-national Index of Erectile Func-tion and their gum health usingthe plaque index, bleeding onprobing, probing depth and

clinical attachment level.

Erectile dysfunction is amajor public health problemthat affects the quality of lifeof some 150 million men, andtheir partners, worldwide, saidlead author Dr Faith Oguz fromnn University in Malatya,Turkey.

Physical factors cause near-ly two-thirds of cases, mainlybecause of problems with theblood vessels, with psychological

issues like emotional stress anddepression accounting for theremainder.

According to Oguz, manystudies have reported thatchronic periodontitis (CP) mayinduce systemic vascular dis-eases, such as coronary heartdisease, which has been linked

with erection problems.

To our knowledge, erectiledysfunction and CP in humansare caused by similar risk fac-tors, such as ageing, smoking,diabetes mellitus and corona-ry artery disease, said Oguz.We therefore excluded men

who had systemic disease andwho were smokers from thisstudy.

We particularly selectedmen aged between 30 and 40 toassess the impact of CP on erec-tile dysfunction without theresults being influenced by theeffects of ageing. The results ofour study support the theorythat CP is present more often inpatients with erectile dysfunc-tion than those without andshould be considered a factorby clinicians treating men witherection problems. DT

Erectile dysfunction affects about150 million men worldwide.

Men with erection problems three timesmore likely to have inflamed gums

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DTI

NEW YORK, USA: As movementbetween countries has become in-creasingly unrestricted, people areable to receive medical treatmentalmost wherever they like andmedical tourism has thus become agrowing phenomenon. A new sur-vey of 18,713 adults aged between16 and 64 from 24 countries hasfound that 18 per cent of people arewilling to travel to another countryfor medical or dental care.

In addition, about 36 per cent

reported that they would probablyconsider going abroad to receivetreatment. These were predomi-nantly younger adults, either be-low the age of 35 (19 per cent) orbetween 35 and 49 (19 per cent).Approximately 46 per cent, mainly

aged between 50 and 64 (15 per

cent), said that they would nottravel to another country for med-ical reasons.

With an average of 32 per cent,medical tourism was most appeal-ing to people from India, Indonesia,

Russia, Mexico and Poland, accord-

ing to the investigators. In com-parison, survey participants fromJapan, South Korea, Spain, France,Belgium and Sweden were the leastlikely to travel for medical treat-ment. Only an average of about7 per cent of participants from these

countries said that they wouldtravel abroad for medical care.

People who were employedwere more likely to consider treat-ment abroad than unemployedindividuals were; and more men(19 per cent) than women (17 percent) would travel to another coun-

try for medical treatment, accord-ing to the survey. Many participantssaid that they would be willing totravel for medical treatment if thecosts were significantly lower thanin their home country, the investi-gators said. DT

DTI

CHICAGO, USA: The AmericanDental Association has recentlypublished an update of its 2004recommendations for prescriptionof dental radiographic examina-tions. In collaboration with variousdental and other institutions, theorganisation aimed to provide adocument to guide practitionersin using diagnostic imaging appro-priately in daily practice.

Among other topics, the docu-ment covers receptor selection,hand-held X-ray units, techniquecharts and radiation-risk commu-nication, which were not coveredin the earlier version. In addition,ADA updated its recommendationsfor shielding to be consistent withguidelines established by the Na-tional Council on Radiation Protec-tion and Measurements (NCRP).For example, it now recommendsthe use of thyroid collars for allpatients, which was recommendedonly for children and pregnantwomen before.

Rather than being a standard,

the new set of recommendationsis intended to serve as a usefulresource that dentists can refer toif their patients have questions orconcerns about the level of radia-tion exposure, said Dr SharonBrooks, professor emeritus at theUniversity of Michigan and a con-sultant to the ADA Council onScientific Affairs. We are encour-aging dentists to look at the issueof selecting radiographic exami-nations for their patients on anindividual basis, not as a one-size-fits-all, she said.

According to the NCRP, radia-tion exposure from dental diagnos-tics accounts for about 0.2 per cent

of the total exposure from naturaland man-made sources in theUS (3.6 mSv). Nevertheless, ADArecommends that dentists weighthe benefits of taking radiographsagainst the possible risk of expos-ing patients to X-rays, as the effectsmay accumulate from multiplesources over time. DT

ADA updates

imagingguidelines

DENTALTRIBUNE Asia Pacific Edition World News 7

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Sales of dental equipment inAustralia have fallen againthis year, according to a re-port by the Australian DentalIndustry Association (ADIA).

Dental Tribune Asia Pacifichad the opportunity to speakwith the organisations newlyelected national presidentand Gunz Dental managingdirector, Trevor Martin, aboutthe reasons for the declineand the prospects for the in-dustry Down Under.

DT Asia Pacific: The latest

figures released by your or-ganisation show that the den-tal market in Australia hasdeclined for the second con-secutive year. Is this still theeffect of the global financialcrisis or are there other rea-sons for this negative perfor-mance?

Trevor Martin: The overalldecline was actually quite smallbut significant in a sector thathad grown by around 6 to 8 percent annually for more than twodecades. The decline is a resultof the crisis, but not necessarilyfor the reasons that peoplethink. The Australian govern-ment introduced a number of

incentives in the early days ofthe financial crisis to sustainthe economy. This saw dentalpractices making new invest-ments in equipment, particu-larly large equipment, whichdrove growth and overall salesto record highs. The overalldecline is actually coming offthat peak.

That said, both the data andanecdotal evidence from ADIAmembers confirm that themarket has softened in the past18 months. Its certainly a com-petitive place to do business,

with conditions tougher thanthey were a few years ago.

Thats why ADIA is deliveringa range of support programmesand tools, such as the Aus-tralian Dental Industry Intel-ligence Report, that allowmember businesses to makeinformed decisions about thedirection of their business tohelp them face the future withconfidence.

According to the Bureauof Statistics in Canberra, the

Australian economy is grow-ing rapidly and is about toovertake Spain as the 12th

largest economy in the world.Do you expect any impact onthe dental industry from thisdevelopment?

Australias economic growthneeds to be put into context. Itis true that we are relatively

well positioned internationally,with GDP growth at more than3 per cent, unemployment atslightly above 5 per cent and thefederal governments budget

returning to surplus this year.However, the bureau data alsoshows that this is largely drivenby extraordinary growth in themining sector, which is sustain-ing the overall economy. Thenon-mining sector is basically

flat and for this reason ADIA ex-pects that the dental industry

will grow in the short term, butat a rate lower than the long-term average.

The Australian government

recently agreed to a AUS$4billion dental care package.Could this benefit the sales ofdental equipment?

The Australian govern-ments announcement is wel-come and addresses some veryreal impediments to dental andoral health care. That beingsaid, the expert analysis com-

missioned by ADIA shows thatthe impact of the announce-ment on sales of dental products

will be negligible, as the gov-ernments new programmesare only repackaging existingspending.

Indeed, government expen-diture on dental and oral healthcare services will actually de-crease in the current financial

year, with the new measuresnot being implemented until2013.

The dental service indus-try in your country is growingby 2.5 per cent. Are Australiandentists becoming lazy in-

vestors?Thats an unfair character-

isation. The dental professionin Australia has a strong trackrecord of pioneering new tech-nologies and investing in newproducts and services. Indeed,

when the Australian govern-

ment provided incentives toinvest in new equipment atthe onset of the crisis, the den-tal profession responded posi-tively.

Earlier this year, ADIA heldthe ADX Sydney dental exhibi-tion, Australias premier dentalevent. Attendance increasedby a whopping 24 per cent andADIA members reported strongon-site sales. Are dentists cau-tious? Sure. Are dentists look-ing for a good deal? Certainly.Are they lazy investors? That is

not how ADIA would describethem.

The dental market in de-veloped markets is changingsignificantly owing to newtechnologies like dental CAD/CAM. Have Australian den-tists followed the trend?

The dental profession inAustralia is an early adopterof new technologies and thiscontinues to drive sales in keyproduct areas. The uptake ofproducts that utilise CAD/CAMtechnology is a good example ofAustralian dentistry picking up,and some might say leading,the trend.

One of ADIAs roles is towork with regulators such asthe Therapeutic Goods Admin-istration to ensure that dentistsand the broader communityhave access to new products

and technologies within a rea-sonable time frame.

You have identified one ofthe priorities of your pres-idency as the regulation ofdental devices in Australia.What, in your opinion, are thedeficits of the current regu-lation and what do you wantto achieve in that respect?

Australia represents only2 per cent of the global marketfor dental products and morethan 95 per cent of what is usedlocally is imported. In this con-text, Australian dental productsuppliers face considerablecompliance costs associated

with local technical and regu-latory standards.

In Australia and internation-ally, ADIA has taken the leadin advocating the approvedonce, available anywhere ap-proach to dental product regu-lation. Over the next two years,

ADIA will support the effortsof the Australian and NewZealand governments to estab-lish the proposed Australia NewZealand Therapeutic ProductsAgency.

At a global level, ADIA re-cognises and supports the im-portant work of the Interna-tional Medical Device Regu-lators Forum, which is workingtowards regulatory harmoni-sation and convergence at aglobal level.

ADIA will only support re-form that ensures the dentalproduct regulatory frameworkis based on a risk-managementapproach designed to ensurepublic health and safety, whileat the same time freeing in-dustry from unnecessary regu-latory burden.

In your opinion, what arethe general prospects for thedental industry in Australiain the years to come, and whatwill ADIAs contribution bein this regard?

Setting aside the currentsluggish environment, ADIAbelieves that Australias dentalindustry has a strong future.

Our member businesses, in-dividually and collectively, arecommitted to providing dentistsand allied oral health care pro-fessionals with the latest prod-ucts from Australia and over-seas. Through the ADX Sydneydental exhibition, ADIA alsoprovides member businesses

with the platform to establishand strengthen their relation-

ship with key customer andclient groups.

However, our focus is onmore than just trade shows. Thestrategic plan endorsed by theADIA board sets a clear direc-tion for the future. As an organ-isation, we are investing in thepersonnel and infrastructure toprovide member businesses

with the tools to grow.

Whether its verifiable salesdata or programmes to upskillthe industrys workforce, weare firmly committed to engag-ing with our member busi-nesses to assist them in un-

derstanding and influencingchanges to the commercial,technical and regulatory en-

vironment to help them toachieve their objectives.

Thank you very much forthis interview. DT

Trevor Martin

DENTALTRIBUNE Asia Pacific Edition Business 9

Australian dental product suppliersface considerable compliance costsAn interview with ADIA national president Trevor Martin

AD

The dental profession in Australiahas a strong track record of

pioneering new technologies.

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DT Asia Pacific

SINGAPORE/BASEL, Switzer-

land: The Government of Sing-apore Investment Corporation

(GIC) has increased its stake ina dental company. As reportedin late November, the govern-ment-run fund recently bought10 per cent of shares fromDr Thomas Straumann, the ma-

jor shareholder of the Swiss

implant manufacturer of thesame name.

With the transaction, esti-mated to be worth more than

CHF167 million (US$179 mil-lion), GIC now holds 14 per centof the companys shares and isthe second largest shareholderafter Straumann himself. DrRudolf Maag, former Strau-mann chairperson and another

major shareholder, holds 11 percent.

GIC first bought into Strau-mann in October this year. In

July 2011, it also acquired morethan 5 per cent of shares in NobelBiocare, a major competitor ofStraumann based in Zurich.

Worldwide, the sovereign wealthfund based in Singapore is cur-rently managing assets of ap-

prox. US$100 billion, accordingto business news providerBloomberg.

Straumann, who served as

chairperson from 1990 to 2002,commented in a statement thatthe reallocation of his sharein the company was necessaryowing to the current economiccircumstances; however, heagreed not to reduce his remain-

ing stake of 17 per cent for oneyear.

Owing to decreasing de-mand for high-cost dental treat-

ments in Europe, the companyrecently announced the reduc-tion of its global workforce by6 per cent from 2013 in an effortto improve profit margins. DT

DT Asia Pacific

SHANGHAI, China: Owing tothe fast-growing dental marketin China, the restorative materi-als specialist Ivoclar Vivadenthas expanded its Shanghai of-fice into a new subsidiary. TheShanghai office, established inthe 1990s, is now the companysseventh local division in the AsiaPacific region.

The new subsidiary, intro-duced during DenTech China,

was established in order to pro-vide better product services toChinese dental professionals andto meet the challenge of long-term growth in China.

According to the company, anestimated 13 per cent growth is

expected for the dental market inAsia Pacific in 2012 and the den-tal market in the region will ac-count for 18 per cent of the globaldental market by then. Giventhis development, a subsidiary inChina emerged as an importantstrategic investment, the com-pany stated.

Founded as a manufacturerof ceramic teeth about 85 yearsago, Ivoclar Vivadent today ownssubsidiaries and sales offices

with more than 2,600 employeesin 22 countries, including Aus-tralia, India, New Zealand, Japanand now China. It is one of thelargest international dental com-

panies and ranks third in theglobal market.

Ivoclar Vivadent products,including ceramic systems, fur-naces, resin teeth, compositesand adhesives, are shipped toabout 120 countries worldwide,according to the company. DT

IvoclarVivadentestablishessubsidiary

Singapore fund buys major stake in Straumann

IN 1997WE INVENTED PIEZOELECTRICBONE SURGERY. NOW WE DID IT AGAIN.

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Business DENTALTRIBUNE Asia Pacific Edition10

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DTI

HAMBURG, Germany: TheGerman dental manufacturerDMG Dental has announced

that its successful Luxatempbrand of bis-acrylic compositeshas been on the market now for

20 years. Launched in 1992, itwas the first temporary crownand bridge material that did notrequire time-consuming handmixing.

It is currently available inthree different versions that areindicated not only for temporarycrowns and bridges, but also forinlays, onlays, veneers as well aslong-term temporaries.

Recently awarded the highest

possible rating of five stars by the

independent test lab REALITY,

the companys latest product

Luxatemp Star is said to offer

top performance with regard tobreak resistance and flexural

strength, while ensuring de-

pendable stability and durability.

Long-term shade stability has

also been optimised, according to

DMG. Moreover, Luxatemp Star

is claimed to attain its final hard-

ness in just five minutes, making

it faster than its predecessor

Luxatemp Fluorescence, which

was acclaimed as Top Provisional

Material and Best of the Best by

Dental Advisor in February 2011.

The company currently pro-

vides more information aboutLuxatemp on its website atwww.dmg-dental.com/20-years.

The Luxatemp product family isavailable in markets worldwidethrough a network of more than70 dealers. DT

DT Asia Pacific

SINGAPORE: Healthcare Solu-tions & Services (HSSC) in Sin-gapore has taken over the dis-tribution of laser technology forboth hard- and soft-tissue dentaltreatment by Syneron DentalLasers in Israel. The LiteTouchEr:YAG laser, featuring a fibre-free laser delivery system, willbe officially launched in the city-state in February next year.

Negotiations between Syneron

and HSSC regarding a distribu-tion deal already began in Octo-ber, said HSSC business managerTommy Ng, commenting on the

recent transaction. According tohim, the agree-ment with Sy-neron is partof a larger ex-pansion plan

that will al-so see thec o m p a n yentering the

market formedical de-

vices.

HSSChas been

distrib-u t i n g

tooth re-

placements and biomaterialsfrom Southern Implants andCentrix, among other dentalcompanies, since mid-2011. Be-sides the scheduled soft launchearly next year, Ng said that itwill also have the Li teTouch ondisplay at an upcoming lasersymposium in Singapore later in2013.

Singapore is a mature andsophisticated dental market, hesaid. With a high average num-ber of GDPs, dentists are capableof investing in high-technologyequipment, while the future poolof well-educated dental patientsare more receptive to treatment

using dental lasers.

Syneron Dental Lasers intro-duced its latest LiteTouch modelat this years congress of theWorld Federation for Laser Den-tistry in Barcelona, Spain. It hasbeen on dental markets since2007. DT

Singapore

corp. starts

distribution

of laser tech

DENTALTRIBUNE Asia Pacific Edition Business 11

DMG celebrates success story of Luxatemp

www.fdi2013istanbul.org

[email protected]

Bridging Continents for Global Oral Health

FDI 2013 IstanbulAnnual World Dental Congress

28 to 31 August 2013 - Istanbul, Turkey

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DT Asia Pacific

TOKYO, Japan: It is no secretthat the years since the globalfinancial crisis have not been

very kind to companies in Japan.First, the recession slowed busi-ness investments significantlydown, then the negative effectsof last years tsunami and themassive destruction it wroughtalmost brought the worlds thirdlargest economy to a halt.

For NSK, one of the countryslargest dental manufacturers,troubles in the home market are

its least concern because thecompany conducts most of itsbusiness elsewhere. Accordingto president and CEO EiichiNakanishi, with whom DentalTribune International recentlyhad the opportunity to speak atthe companys headquarters inTochigi, more than 80 per centof the companys revenues arenow generated by its operationsoutside of Japan.

In the last three years, NSKhas been performing particu-larly well in mature marketssuch as Europe and North Amer-ica, where it boosted its pres-ence with the opening of its new

headquarters near Chicago lastyear, despite unfavourable con-ditions such as high market sat-uration and the ongoing declineof the yen against the dollar.

Since 2009, Nakanishi hasalso seen his company regainingits former market shares in Asiathrough centralised distribu-tion and after-sales support of-fered by its new subsidiary inSingapore. Another significantcontributor has been NSKsEuropean office in Germany,

which accounted for almostone third of the 22.2 billion Yen

($278 million) in sales the com-pany reported in 2011.

That is why economic con-ditions in our home market have

little or no impact on our overallbusiness. We really think glob-ally, Nakanishi explains.

According to the 48-year-old,who has run the company since2000, one of the major reasons

for NSKs strong market posi-tion, even in established mar-kets, is its dedication to innova-tion and quality, combined withthe excellent after-sales service

it is able to provide to customersin almost every country exceptNorth Korea. But this hasntalways been the case.

Founded in the 1930s, thecompany had a rough start and

operations were completelyhalted during World War II. Sincethe production of dental hand-pieces resumed in 1951, how-ever, the company has grown ex-

tensively and now employs morethan 700 people in its Japaneseoffices in Tochigi and Tokyo.

NSK still produces most ofthe precision parts in-house,

which, according to Nakanishi,

is one of the reasons that dentistsnow identify the company withhigh-quality products. We em-ploy many good engineers andmarketing people who help usto constantly improve our brandand make it more attractive todentists, he says.

One of NSKs recent innova-tions, launched at last years IDSin Cologne, for example, is theTi-Max Z series, a durable pre-mium handpiece that is claimedto have the smallest heads andnecks in the industry, as wellas an exceptionally low noise

level and virtually no vibration.The Surgic Pro surgical micro-motor has also received muchinterest, particularly by dentalimplant surgeons, and is nowdistributed alongside systemsby major implant manufac-turers.

NSK asserts it pays close at-tention to the needs of its cus-tomers, a philosophy that hasresulted in products such as theS-max pico, which was devel-oped solely for the treatment ofpatients with smaller mouths,such as children.

Moving into other markets is

conceivable but unlikely to hap-pen anytime soon, Nakanishisays. Even though his companyhas begun to enter new areas inthe last decade with the launchof instruments such as ultra-sonic scalers and polishers, itscore business will remain dentalhandpieces and other small-motor equipment.

When it comes to hand-pieces, we have produced moreinnovations than our compe-titors, he remarks. Our goal isto become the No. 1 company

worldwide in this segment. DT

Eiichi Nakanishi, right, in talks with DTI Publisher and CEO Torsten R. Oemus. (DTI/Photos Lutz Hiller)

NSK still manufactures most of the precision parts in-house. The companys headquarters in Tochigi, Japan.

Handpiece manufacturer NSK

aims for global leadership

Business DENTALTRIBUNE Asia Pacific Edition12

Our goal is to becomethe No. 1 company worldwide

in this segment.

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Trends & Applications DENTALTRIBUNE Asia Pacific Edition14

Grald UbassyFrance

For the creation of a bright

smile, a precise evaluation of

aesthetic and functional as-

pects of treatment is required.

A well-planned working pro-

tocol is essential in the fabri-

cation of dental restorations.

We have developed a special

approach in our dental labo-

ratory that is presented here

with the help of a case report.

The restorative work in-volved the fabrication of sixveneers for the anterior teeth.In challenging cases, the dentallaboratory technician beginsthe restorative procedure bycarefully analysing all of theavailable data. This includesphotographs of the initial situa-tion, study models and a face-bow registration.

The facial photograph of thepatient alone provides impor-tant information. Based on thisimage, we can carefully analysethe tooth shape and the facial

parameters (morphology) andgain significant insight intohow to approach the creation ofan aesthetic smile (Fig. 1). Inour case, the intra-oral imagesshowed that the anterior andposterior teeth had been se-

verely abraded (Fig. 2). The pa-tient asked for these flaws to beremoved and for the naturalshape of his teeth to be restored.After in-depth consultation

with his dentist, it was decidedto restore the affected teeth

with all-ceramic veneers ac-cording to minimally invasiveprinciples.

As a preliminary step, ortho-

dontic treatment was per-formed to move teeth #11, #12,#13, #21, #22 and #23 towardsthe vestibular aspect and thusachieve less traumatising func-tion. Then the vestibular sur-faces of the maxillary ante-rior teeth were then prepared(Fig. 3).

We chose to produce the ve-neers with pressed ceramic,

which we then proceeded tobuild up according to the in-dividual requirements. I firstfabricated restorations (IPSEmpress, Ivoclar Vivadent) inthis way in 1992 and have beenusing this technique for many

years.1

IPS Empress 2 was my ce-ramic of choice but I now useIPS e.max Press (lithium disili-cate glass-ceramic) exclusivelyfor this purpose. In my opinion,this solution is ideal for fabri-cating restorations of this kind.

Although the conventional lay-ering technique using refrac-tory models produces highlyaesthetic results, it is very time-consuming and demanding.The restoration has to be firedseveral times without the possi-bility of monitoring its colour in

the process. With the techniqueI use, however, a framework ispressed and then the incisalthird is cut back. Thereafter,the dental technician merelyhas to apply the veneering ce-ramic. This procedure takesless time and the outcome iseasier to control.

The layering schemeIn anterior restorations in

particular, it is important tomatch the colour saturation andthe brightness carefully. Inmost cases, however, severalceramic layers are required toachieve the appropriate blend.

In the present minimally pre-pared case, very little space wasavailable for the veneer. I guessthat every dental technicianis familiar with this scenario.In order to achieve a true-to-nature result nonetheless, adetailed layering scheme is in-dispensable (Fig. 4).

In this case, I used two dif-ferent IPS e.max Ceram Dentinmaterials (Ivoclar Vivadent):A3 and A2, as well as a lighterDentin B1 mixed with 1/2 OpalEffect 4 (OE 4) to increase the

value. As we all know, the in-cisal third of natural teeth is

translucent. Therefore, in thispart of the restoration, theDentin material has to be desat-urated with a translucent neu-tral material. The Opal Effect 1(OE 1) material is indispen-sable owing to its opalescentproperties. It has a translucentblue appearance in reflected

light and an amber tint in trans-mitted light. Consequently, weplaced some OE 1 in the prox-imal corners and along theincisal edges.

Natural teeth often havesmall areas on the edges thatabsorb light. In the presentcase, these areas were imitated

with a violet material (OpalEffect violet) and 1/2 OE 1.I have given this mixture the

descriptive name of absorp-tion material. As only limitedspace was available for theenamel material, I decided touse the bright OE 4. The layer-ing technique presented aboveand my method for ensuring thecorrect shade, as well as manyother useful tricks, are de-scribed in detail in my bookTricks and Hints.2

Pressed and...The IPS e.max Press ingots

are ideal for fabricating theframeworks of layered veneers.In the present case, my associ-ate Florence Ozil pressed sucha framework using a medium-

opacity (MO) 1 ingot (frame-work thickness of 0.4/0.5 mm;Fig. 5). The colour and opa-city of these ingots is optimal.The material masks the colourof the prepared tooth satisfac-torily, but it is not excessivelyopaque.

The broad range of IPSe.max ingots provides a suit-able solution for almost anyclinical situation and owing tothe choice of various levels ofopacity, translucency, bright-ness and fluorescence, evendifficult cases can be treatedsuccessfully:

1. MO 1 ingots mask the colourof the prepared tooth, butdo not look opaque. We usethese ingots for almost 70 percent of the crowns we fabri-cate.

2. MO 0 ingots are a good alter-native for fabricating lightercrowns, particularly in casesin which the patients wantbrilliant white teeth.

3. Low-translucency (LT) pressingots are suitable for clinicalsituations in which the pre-pared tooth has a light colour.Owing to their translucentproperties, these materials

allow the preparation shadeto shine through, which im-parts a certain depth to theappearance of the restora-tions. I try not to use LT ingotsin the fabrication of indi-

vidual teeth, as their shadeafter seating is difficult toanticipate.

Fig. 1 Fig. 2 Fig. 3



Fig. 10 Fig. 11 Fig. 12

Fig. 13 Fig. 14

Fig. 15 Fig. 16 Fig. 17

Fig. 1:We carefully analysed the initial situation, the tooth shapes and the morphology on the basis of the patients facial

photograph.Fig. 2:This intra-oral image shows the severely worn anterior and posterior teeth.Fig. 3:Minimally inva-sive treatment was planned for the maxillary anterior teeth. Only the vestibular areas were prepared.Fig. 4:A detailedlayering scheme is essential in the aesthetic reconstruction of anterior teeth.Fig. 5:The pressed frameworks: the colourand opacity of the IPS e.max Press ingot used sufficiently masked the colour of the prepared tooth.Figs. 6 & 7:Afterfoundation firing, IPS e.max Ceram Essence materials were applied and the ceramic layers were placed. Only one firingcycle was needed to achieve the desired result.Fig. 810:In finalising the tooth shapes, the contours and angles of theteeth were marked with a bicoloured wax crayon.Fig. 11:The veneers had a total thickness of 0.75 mm (middle third)0.3 mm for the framework and 0.45 mm for the veneering ceramic.Fig. 12:Despite the delicacy of the restorations, theirsaturation was satisfactorily high in the cervical third. Our strategy enabled us to impart luminosity to the middle thirdof the incisors and reproduce the desired translucency.Fig. 13:When we saw the results on the model, we already knewthat the restoration would blend in seamlessly and naturally with the oral environment.Fig. 14: The seated veneersconfirmed the success of our well-planned approach.Figs. 15 & 16:After a period of several weeks, the restorations werewell integrated with regard to both periodontal and aesthetic aspects.Fig. 17:The patient is smiling again.

Analysed, pressed and layered:Excellent aesthetics owingto skilfully combined materials

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DENTALTRIBUNE Asia Pacific Edition Trends & Applications 15

4. In addition, several morefluorescent press ingots areavailable today, includingIPS e.max Press ImpulseOpal 1 and 2, as well as Im-pulse Value 1, 2 and 3. We usethese materials according tothe case.

...then layeredAfter the pressing proce-

dure, the frameworks were re-duced to 0.3 mm and coated

with a thin dentine layer(Fig. 5).Foundation firing at 750C pre-ceded the layering procedure.After firing, the IPS e.max Ce-ram Essence materials wereapplied (Fig. 6).

These working steps de-mand considerable expertisefrom the dental technician. Asthe framework (MO 1 ingot) inthe present case masked strongcolours, we had to ensure ade-quate saturation of the cervicalthird. However, the space for

the layering materials was lim-ited.

The Essence materials pro-vide a good alternative in suchcases. These materials are firedat 725C. In the case described,the subsequent layers werecompleted in one firing cycle(Fig. 7). This economical pro-cedure considerably reducesthe workload and heightens theefficiency of the laboratory. Thethickness of the veneers was0.5 mm in the middle third and0.3 mm in the cervical third.The clinician deliberately pre-pared the incisal third of theteeth to allow sufficient space

for building up the ceramic lay-ers and for creating all of thefine details required for a natu-ral-looking restoration.

Morphological designIn order to recreate the mor-

phology of the teeth faithfully,we marked the contours andangle characteristics on theveneers with a bicoloured

wax crayon (Figs. 810). Thisguided us in reproducing thetooth shapes efficiently andprecisely. The use of thismethod, which I have taught for18 years, allows one to achievehigh-quality results.

We have a collection of sev-eral thousand natural teeth atour disposal. On the basis ofthese samples, we can analysethe shape and surface texture ofteeth. The completed restora-tions were 0.75 mm thick in themiddle third (0.3 mm for theframework and 0.45 mm for the

veneering ceramic;Fig. 11).

Despite the limited spaceavailable, we managed torecreate the tooth colour asplanned. Figure 12 shows thehigh saturation of the resto-ration in the cervical third andenhanced luminosity in themiddle third. The translucent

effects (absorption areas) andreflective dentine areas in theveneers are clearly discernible.When we examined the re-storations on the model, we ob-tained a preliminary impres-sion of what they would looklike after their adhesive place-ment (Fig. 13).

We carefully polished thelifelike surface. The layeringmaterial was remarkably thin.Nevertheless, we managed toproduce highly aesthetic ante-rior restorations (Fig. 14).

Furthermore, after severalweeks in situ the restoration

showed excellent results interms of the periodontal con-siderations (Figs. 15 & 16).Undoubtedly, this successfuloutcome is also due to the closecollaboration of Dr StefenKoubi from Marseille, who was

the clinician who treated thiscase. Together we were able torestore the patients smile withtooth shapes corresponding tothe patients personality andtooth morphology (Fig. 17).

ConclusionIn cases such as the one de-

scribed, veneers represent anexcellent treatment option. We

were able to achieve outstand-ing results with restorationsinvolving pressed frameworks,

which were subsequently builtup with ceramic layers. This

method is much easier than theconventional layering tech-nique but provides optimumquality.

AcknowledgementSpecial thanks go to Dr Stefen

Koubi for his great personal and

professional qualities.

References

1. G. Ubassy, Shape and Color:The Key to Successful CeramicRestorations (Chicago: Quint-essence, 1993).

2. G. Ubassy, Tricks and Hints(Villa Carcina: Teamwork Me-dia, 2008).

DT

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Grald Ubassymaintains a den-

tal laboratory inRoche fort duGard in France.He can be contact-

ed at [email protected].

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