Day 1 :
University of Washington, USA
Keynote: Digital impressions and digital workflow for fixed prosthodontics, status of clinical research 2018
Time : 10:00-10:40
John A Sorensen is a Professor in the Department of Restorative Dentistry; Director of Biomimetics Biomaterials Biophotonics Biomechanics and Technology Laboratory; Director of Research, Graduate Prosthodontics Program at the University of Washington. He is a Diplomate of the American Board of Prosthodontics. He was awarded the 2018 Clinician-Researcher Award by the American College of Prosthodontists. He has published over 85 research articles and chapters as well as over 140 research abstracts. He has given over 150 invited lectures in 34 countries as well as over 300 lectures courses, hands-on programs and patient-treatment classes.
Statement of Problem: Few studies have objectively measured the clinical outcomes of using digital impressions and digital workflow (DFW) for fixed prosthodontics (FP). The accuracy of ceramic restorations made with a completely DWF, using no physical dies or casts, was evaluated.
Methodology: A clinical study evaluating 50 posterior CAD/CAM lithium disilicate (e.max, Ivoclar Vivadent) onlays and crowns cemented with Adhese Universal and Variolink Esthetic cement was performed digitally. That is digital impressions (intraoral scanning, IOS) (Trios, 3Shape), CAD (Dental Design, 3Shape), CAM (Wieland, Ivoclar Vivadent) and monolithic restorations with stain/glaze. Three operators performed IOS with scanning time recorded for Tooth Preparation Scan (TPS), Sextant Opposing Scan (SOS), Sextant Bite Scan (SBS), Operator 1 scanned from the most posterior tooth to sextant canine while Operators 2 and 3 scanned across the arch to contralateral canine. Mean scanning times were calculated for TPS, SOS and SBS. The amount of delivery adjustment required for proximal contacts, occlusal adjustment and marginal adaptation were recorded. An USPHS criterion was used to evaluate marginal integrity.
Results: Operators’ 2 and 3 preparation scanning technique to the contralateral canine required 39% more scanning time than Operator 1. There was no difference in the amount of occlusal or proximal adjustment necessary between the three operators. To determine the effect of operator experience, restorations were divided into three in order of their placement over time. Delivery of restorations requiring no proximal contact adjustment was: 1st/3=0, 2nd/3=33%, 3rd/3=87%. No occlusal adjustment was: 1st/3=33%, 2nd/3=44%, 3rd/3=87%. All margins were USPHS rated “Alpha”.
Conclusion: For tooth preparation scanning, capture of only the sextant was necessary to create an accurate occlusion and proximal contacts. Restorations fabricated with the completely digital CAD/CAM process required minimal to no adjustment on delivery. Other studies have yielded similar results for efficiency and minimal adjustment.
Brynhyfryd Dental, UK
Gareth Owen Crowther has completed his Bachelor of Dental Surgery at the Wales College of Medicine in 2009 and a Postgraduate Diploma in Conscious Sedation in Dentistry at Cardiff University, in 2015. He is dedicated to helping those with dental anxiety get the dental care and to that end he started Brynhyfryd Dental Practice in 2017. The practice has since achieved BDA Good Practice listing and is a Finalist in the 2018 UK & Ireland Dentistry and Private Dentistry Awards in 3 categories.
We look at how to grow the business of a dental practice and build a local reputation to generate further new patient referrals whilst developing the dental team as a whole to create a focused and motivated unit aiming for one purpose-the improvement of oral health within the patient base of the practice based on our ‘calm and caring’ philosophy. Having taken over a run-down and loss-making dental practice in Swansea, we have spent time, effort and some money to make the practice of dentistry easier and also to ease the journey of the patient in as friendly and relaxing surroundings as possible. We will explain how a multifaceted marketing campaign, spreading the cohesive message of calm and caring dentistry can bring an upsurge in new patients-we have added over 100 new private patients in the course of six months and this trend continues upwards. We will also show how we have invested in training to ensure not only that we can offer a range of treatments that people actually want but to bring career satisfaction in staff by preventing stagnation which helps keep morale and enthusiasm upto quote Richard Branson ‘if you look after your staff, they will look after your customers.’ We will also show that this all need not cost the earth by developing relationships with local media managers and other businesses and how we can reach out to our local community to improve the public image of dentistry. Additionally, we have achieved BDA Good Practice status and are 2018 finalists for Best Young Dentist and Best Team at the UK & Ireland Dentistry Awards and Best Young Dentist UK & Ireland Private Dentistry Awards.
Private Practice, Bosnia and Herzegovina
Kenan Demirovic graduate from School of Dentistry, University of Marmara in Istanbul, Turkey. He completed his master's degree in orthodontics at University of Sarajevo in the year 2010. He is an active member of European Orthodontic Society. He was a Speaker at congresses of European Orthodontic Society, Croatian Orthodontic Society, Balkan Stomatological Society and ADOH conference, Dubai. Currently, he is an Orthodontist at Private practice for dentofacial orthopedics and orthodontics, Sarajevo - Bosnia and Herzegovina. His main areas of research include temporomandibular disorders and its relation to orthodontic cases, orthodontic mechanics and segmented arch wire techniques.
Aim: The aim of this study was to evaluate the effect of stabilization splint therapy on TMD and to determine if there is a relationship between the condylar axis position as determined by the occlusion and signs and symptoms of TMD, using the condylar position indicator (CPI III).
Subjects and Method: A sample consisted of 35 untreated subjects with mild, moderate or severe symptoms of TMD. The centric relation bite registration technique developed by Roth was used. All subjects underwent stabilization splint therapy during average period of 6 months, for the stabilization of temporomandibular condyles in centric relation (CR). The comparison was based on written patient histories, clinical exams, and CPI measurements. The condylar displacements for 35 subjects were measured in vertical, sagittal and transversal components from mounted models using CPI III system. Obtained data was evaluated using Wilcoxon signed-rank test.
Results: When the pretreatment and posttreatment examination scores were compared, an 80 % reduction in symptoms was found after treatment. A high correlation (p<.001) between signs and symptoms of TMD and CPI values was documented.
Conclusions: After stabilization splint therapy, a stable centric condylar position was obtained, as a predisposition for correct orthodontic treatment planning. In patients with signs and symptoms of TMD, and significant discrepancy between the centric relation and maximum intercuspation, stabilization splint therapy is highly recommended prior to treatment with fixed orthodontic appliances.