PDF

t he INNOVATION MAGAZINE
f rom SIRONA
02/15
formula for success
tHE “WHy” GUY
page 12
SINGLE-VISIT DENTISTRY
no need to wait
page 18
TREATMENT centers
technology meets design
page 22
A91100-M4-B932-01-7600
What drives you
analyzing success
contents
focused
AT A GLANCE
Motivation – Curiosity – Discovery
04
MOTIVATING FORCES
How major innovations come about
06
BASIC DESIRES
The dentist’s motivation 11
formula for success
The “Why” Guy 12
FASCINATING TECHNOLOGY
Trying is believing
14
The Why decides – Successful people can
explain their motivations for inventions,
products or actions.
p Motivating forces, starting on page 06
informed
SINGLE-VISIT DENTISTRY
No need to wait
18
PRODUCT NEWS
CEREC innovations
21
TREATMENT centers
Technology meets design
22
center for dentistry
Convincing performance in Sydney
26
IN PRACTICE
DIGITAL WORKFLOW
A small step with a big impact
28
SUSTAINABLE HELP
When dentists take social responsibility
31
LAB TECHNOLOGY
Equipped for all tasks CASE REPORT
Guided surgery for safe and smart implantology
34
USER experience
One laser for all cases
36
32
GOOD TO KNOW
INDUSTRY
Six questions for … Dr. Alban Nazwa
38
MISCELLANEOUS
Apps, preview, legal notice
39
Complete treatment in one session –
Rockband PMMP’s lead singer Paula Vesala
(center) benefitted from such efficient and
fast treatment.
p Single-visit dentistry, starting on page 18
FOX AWARD in two
categories for
VISION
The spring edition of
VISION, published in
March 2015, won two
silver awards at this
year’s FOX AWARDS.
The magazine won
the SILVER FOX AWARD (Germany) in the
“Integrated Concept” category for external
communications in the field of healthcare/
medical technology. It was presented by a
high-ranking panel of well-known publicists,
journalists and communication scientists.
The SILVER FOX VISUALS was awarded for
the strong design concept of VISION.
EDITORIAL page 03
What drives you to do better
dear readerS,
Every day innovative products come to life but only some are successful in improving
dental practices. How can we better understand the process that results in making the
difference and becoming a standard of care?
In this edition of Vision we offer answers to the question “Why do we do what we do to be
successful?” Our approach is guided by the contention of the American author Simon O.
Sinek: “Successful people can not only explain what their innovations, products or
actions achieve and what makes them special or useful; they can also describe why they
came about in the first place.”
What we found in reflecting on our approach to innovation is worth sharing. It’s not just
about technology, it is also about attitudes and emotions. Our interview with Professor
Werner Mörmann, the inventor of CEREC, whose 30 year anniversary we have just celebrated, expands our understanding and appreciation of the creative process and the joy
of discovery.
Our success in developing solutions that are meeting the needs of dentists worldwide
is a result of competitive spirit and talented employees committed to product innovation and high quality service and training. Improving clinical outcomes, workflows and
patient satisfaction is a driving force in our daily efforts at Sirona. We are continually
investigating ways of redefining the limits of what is possible in efficient and effective
dentistry.
To put it in the words of the well-known personal and financial advisor Anthony Robbins,
“Successful people ask better questions, and as a result they get better answers.” Learn
more about his thoughts in our exclusive interview with him on page 12.
Enjoy reading how versatile the CEREC system is today and find out how it is changing
the worklife of dentists and dental technicians all over the world!
It is our hope that this edition inspires you as we are inspired by your effort to advance
dentistry.
Enjoy reading!
Yours,
JEFFREY T. SLOVIN, President and CEO
SIRONA VISION — issue 02/15
page 04
Motivation – curiosity – discovery
What is the commonality between kids posing questions, athletes pursuing regular workouts
and scientists doing persistent research? All want to find their place in life, bring body and
mind to their limits and perhaps even change the world. It’s amazing what people are able to
accomplish.
INDEPENDENCE
q
The wish to determine one’s own life
is a strong drive – America’s independence movement would not
have emerged without the enthusiasm of Samuel Adams and Thomas
Jefferson.
TRANQUILITY
q
The pursuit of security as a driving
force is crucial; it is one of the reasons for the existence of the Nobel
Peace Prize.
IDEALISM
q
Creating the conditions for justice
is a big motivation in the fight for
social change – Nelson Mandela
had to spend 27 years in jail for that
reason.
Prof. Steven Reiss has developed 16 life motives, which vary significantly
in each individual. The quintessence: everyone is driven by different reasons,
and everyone can find his or her specific way to personal luck and success.
here are some concise examples of motivators.
THRIFT
q
A penny saved is a penny earned
– the concept of stockpiling was
and is still par t of sur vival
strategy.
APPRECIATION
q
Positive reinforcement drives –
even babies repeat behavior,
which makes their parents laugh.
Relationship
q
Motivation is often based on the
relationship between people –
students are more successful
in learning if they have a good
relationship with their lecturer.
focused — at a glance
page 05
A FOUR-YEAR-OLD CHILD ASKS
437
QUESTIONS A DAY. 4
THE OLDEST MAN WHO CLIMBED MOUNT EVEREST WAS
80
YEARS AND 224 DAYS OLD.1
93%
of top executives around the world indicate
that organic growth through innovation
will drive the greater proportion of their
revenue growth. 2
THINK
T
’
DON
I
“
LIMITS.”
OLT
sprint
USAIN B
in 100 m
OLDER
H
record
world
Money is not the most important motivation
for working: In 2014, nearly
Over the last ten years, over
40
different billion-dollar startups
were founded in the U.S.
they are called the “Unicorn Club.” 3
16%
or 13 million people in Germany
had an honorary position or worked free of
charge. The volunteer rate in the U.S. was even
higher with
25%
Please find the references on page 39.
or 62.8 million people. 5
SIRONA VISION — issue 02/15
page 06
Everyone knows what motivation is, and even examples of major innovations are easy to find. But
what is the meaning of these two terms, how do they act together, and why do some ideas work
better than others? Some thoughts about what innovative and inspiring people have in common.
focused — MOTIVATING FORCESpage 07
What drives you –
and how major
innovations come
about
1964. The sportsman is bursting with adrenaline. Reporters are
hanging on his every word. You can almost reach out and touch the
aggression in this young man of simple means. “I’m the king of the
world. I am the greatest! I’m Muhammad Ali.” The boxer is the
youngest heavyweight champion of all time. He has just beaten
the favorite Sonny Liston, who is not only considerably more
experienced but also a nice guy. Ali’s motivation: anger over the
humiliation he suffered because of his colour – and no doubt also
the promise of fame, fortune and glory.
Three successful people with very different motivations. Fame,
recognition and social change – no doubt there are plenty of other
reasons that made Ali, Mandela and Sandberg what they are
admired for today. Fame, money, faith, hope, power, vision, social
norms, traditions which are passed down and learnt, rules of
conduct, passion and pain – all these things can be the motivating
forces behind progress, and every one of us is driven, spurred on
by one or more of these reasons. But not all of us become a
Mandela or Ali. Or a Sandberg. Why is this so?
p
1990. A man comes out of prison – after more than 25 years behind
bars. The reason for his conviction: inciting an armed struggle
against the government. While in prison he always refused to
distance himself from that incitement. On the day of his release he
turns to his followers and calls upon them to work in peace with all
those doing their best to improve the political situation. Nelson
Mandela becomes a global example of turning towards peace; a
symbol of reconciliation, and a Nobel Peace Prize laureate. His
motivation was a hunger for freedom. The path he took: respect
and compassion.
In 2013, the COO of Facebook released her book “Lean In” in which
the Harvard graduate and former Chief of Staff to the US Department of the Treasury encourages women to have it all – a career
and a family. We are talking about Sheryl Sandberg, mother of two
children and campaigner for equality for women in the world of
work. She propagates that companies should support their
employees in balancing family and career. Even in high school,
Sandberg was considered bossy and was annoyed that men were
patted on the back for things women were criticized for. Breaking
stereotypes, establishing a new way of thinking – Sandberg sees
this as her task. She has sold around 2.3 million copies of her
book worldwide.
Q Influential, inspiring people know how to motivate and how to create
emotions. They create a community with awareness of the fact that many
together can achieve more than one alone. Teamwork at its best.
SIRONA VISION — issue 02/15
page 08
Q Curiosity is such high motivation for innovation that NASA named its Mars rover, a mobile robot for
investigating the surface properties of our neighbouring planet, after it.
p Getting to the bottom of this “Why”
The American author and consultant Simon O. Sinek analyzed the
reasons for the extraordinary success of these people. His theory
is that successful people can not only explain what their inventions,
products or actions achieve and what makes them special or useful; they can also explain why they came about in the first place.
Take the example of Apple, the company does not say: We make
great computers. They look good and are user friendly. Want
one? Instead Apple says: “Why: We have always wanted to do
things differently because we believe that previous solutions are
not enough. How: We make things better because we make them
more attractive and user friendly. What: If you like, buy one of our
products.” *
Sinek uses a diagram to lay out the three steps
of the “what,” the “how” and the “why” in concentric circles, with the “why” at the center. He
explains that the human brain can also be
sketched out in a very similar way, with the
limbic system as one of the oldest areas in the
center, and the neocortex, which is a younger
area primarily addressed by the “what,” arguing
in the outer ring. It is this grouping, Sinek believes, that holds the hidden strength of people
who place the “why” at the center of their words
and actions. They address areas of our brain where we follow our
intuition and have a “good feeling” when we make good decisions.
This angle suddenly reveals whole new answers to the question of
how innovation comes about. It is no longer just good work and
expertise, luck, persistence, curiosity, risk-taking, courage and
drawing the right conclusions from failure: our emotions are
essential, too.
A feeling of happiness in the brain
If you ask biologists or medical experts they will probably tell you
that motivation is nothing other than a neural reward system. In
1954, the two US researchers James Olds and Peter Milner at the
California Institute of Technology discovered
that lab rats’ brains could be stimulated using
“If you always do
electricity which evidently produced a pleasant
a reward; a feeling of happiness. Before
what you’ve always feeling;
long the rats learned to press the lever themdone, you’ll always selves which set off the stimulus. Similar processes can also be found in the human brain,
get what you’ve
with different levels depending on the situation.
always got.”
When a runner reaches the finish line. When a
machine has been built and runs for the first
Mark Twain
time. When an experiment which took a long
time to prepare goes well. When another person
smiles and shows gratefulness. When food
focused — MOTIVATING FORCES page 09
Longing, yearning
and satisfaction
motivate people to act.
But where does
motivation
meet innovation?
Q The joy of discovery and the satisfaction of success are some of the oldest
motivational sources. Even children know how these emotions feel.
touches your tongue and the taste spreads. These are positive reinforcements for our behavior, and they act like the rat pressing on
the lever. Longing, yearning and satisfaction motivate people to act.
So much for the biological point of view. It explains how our brain
works. This knowledge can be used not only to analyze existing
behavior; it can also help influence one’s own behavior (and that
of others). Knowing about these connections can be of great help
in motivating yourself and others to, for example, knuckle down to
that unpleasant task, finally give up smoking, get a hand on that
tricky piano piece or run that marathon. That is exactly where
personal coaches such as Personal and Financial Advisor Tony
Robbins begin (p for more see the interview on page 12). Other
inspiring people from the field of religion or politics, or important
members of society, also frequently use the promise of a reward
to convince people to follow their aims.
But where does motivation meet innovation? After all, even when
an engineer is motivated with every fiber of his being, there is no
guarantee of pioneering innovation. And what exactly is motivation, anyway? There have been a lot of attempts to answer that
question. Some say that innovation is when combination and
recombination lead to something new: bringing together things
* Taken from Simon O. Sinek, “Start with Why,” pages 41-42
which already exist. Others object saying that a whole range of
internal and external factors stand between a good idea and an
actual innovation. Finally, many people only consider innovation to
be worth striving for as long as it does not affect their own working
methods, their outlook on life or entrenched patterns of behavior.
In brief, innovations are only exciting, sexy or spectacular if, at the
least, they do not threaten your own comfort zone. Ideally, they
should improve it – or at least act as if they are worth having.
Nothing remains as it was
However, it also applies: If everything always stayed the way it
always has been, there would be no innovation. Apple brought up
this subject in their ads for their “Think different” campaign, which
not only paints a picture of major heroes of the present and recent
past, but the accompanying audio track also explains the philosophy
behind Apple’s understanding of the power of innovation: “Here’s
to the crazy ones. The misfits. The rebels. The troublemakers. The
round pegs in the square holes. The ones who see things differently. They’re not fond of rules. And they have no respect for the status
quo. You can quote them, disagree with them, glorify or vilify them.
About the only thing you can’t do is ignore them. Because they
change things. They push the human race forward. And while some
may see them as the crazy ones, we see genius. Because the
people who are crazy enough to think they can change the world,
are the ones who do.”
p
SIRONA VISION — issue 02/15
page 10
Q
There are different kinds of inspiration for something new. Extensive, persevering research is one kind.
“every problem is a gift –
without problems we would not grow.”
Tony Robbins
p In other words, it’s about thinking off the beaten path. Ronald
S. Burt, a professor at the University of Chicago believes that innovation comes about when our usual outlook is changed. He
investigates interactions within social groups with different
makeups, all the way up to social networks. The well-known quote
by Mark Twain (“If you always do what you’ve always done, you’ll
always get what you’ve always got”) thus still applies even within
modern communication environments such as social networks.
But just “doing things differently” is not enough to produce innovation. If it were, all the world’s innovation labs and think tanks
would be obsolete. But they are not, because they gather knowledge and offer solutions to problems for specific situations, building on the ideas of others. It is often the small steps that help get
innovations accepted in the right place at the right time. The idea
of making a metal filament glow existed long before Thomas Alva
Edison. But it was the development of a power supply network that
could connect many light bulbs with high-resistance filaments that
made Edison the father of the light bulb.
The paths to innovation are varied, sometimes complicated, but
often rather simple as well. And inspiration can be found in every
individual and in every company. And that’s good news for all
those who always thought they had to count on luck or genius. P
Apple’s understanding of innovation
www.youtube.com/watch/?v=8rwsuXHA7RA
focused — BASIC DESIRES
page 11
The Dentist’s MOTIVATION
Steven Reiss Ph.D. has developed 16 basic
desires that largely shape our being and needs.
He took a look at the dental world for VISION.
Prof. Reiss, there are many reasons to become a dentist. What do
you think is special about this job?
— First of all, this profession assures you in the United States
and in many other countries a successful career. This interest is
motivated by a need for status, or respect based on social standing. Let me give you a second reason: Considering the fact that
many dentists work in their own practice, the desire for independence could be another aspect. They want to be their own boss
instead of working in a large company. Thirdly, the basic desire
for order motivates people to be careful, detail-oriented, and
clean, all important to the practice of dentistry. On the Reiss
Motivation Profile of 16 basic desires, I think that dentists as a
group might score high for these three aspects. Of course, there
are many individual exceptions to this profile.
In your book you describe 16 basic desires. Which of them do you
think is the one that drives people most to develop new products
and methods in dentistry?
— Power motivates us to perform and is certainly the main
driving force. The desire for status is also a factor. In this case it
means the desire to feel that you are right and important and
doing something useful for the world. But motivation alone does
not drive us to innovate; we also have to be curious and have
ideas. This in turn is often more a question of talent, not of
motivation.
Working in the healthcare sector: Is it a special kind of motivation?
— Dental practitioners and doctors in general help people out
of idealism. And yes, that can also be the motivation to develop
new products in this sector.
You described in your book how useful it is to be familiar with your
own kind of motivation. How exactly do these motives influence
our work?
— The basic desire for power (strength, options) leads us to
become really competent in a field and acquire qualifications.
There is also the desire for recognition and prestige. This in turn
leads us to assume responsibility in our work.
P
PROFILE
Steven Reiss Ph.D. is a professor emeritus of
psychology and psychiatry (Ohio State University in Columbus, Ohio, U.S.). He is the author of
many books, including “Who Am I?” In this book,
he postulates 16 basic desires with the “Reiss
Profile.” His latest book, “16 Strivings for God,”
has been available in the U.S. since October 2015.
SIRONA VISION — issue 02/15
page 12
the “Why” Guy
Anthony ‘Tony’ Robbins is one of the most profound personal and financial advisors in the U.S.
In our interview Robbins points out what is necessary to gain not only success, but fulfillment.
You come from a humble background. How did you manage to move
up into the circle of influential people?
— It’s true. I grew up in an environment where there was not a great
quality of life. My family was very poor financially and it was an emotionally tough environment for a kid to grow up in. It was that early
home environment that really made me want to know the answers
to life’s fundamental questions: What makes people do what they
do? Why do people behave the way they behave? Why do some
people have it all and others are struggling to get by? I’m The “Why”
Guy. As far back as I can remember, I’ve always been asking, “Why?”
As I grew up, went to school, held jobs, and began working with more
and more people, I saw that there were patterns of human behavior
that ultimately lead to success or failure. I’ve become an expert in
stepping in, identifying universal human patterns, and producing
results. That’s how I’ve come to work with some of the worlds most influential athletes, entertainers, political leaders, and businessmen.
When and how did you realize you had power to help people make
a big difference in their lives?
— First, I looked to books because I didn’t have any role models,
per se. And then, as I made changes myself, I’d share my findings
with my friends and classmates. And then I saw them make
changes and get excited. And I got kind of addicted to the
process of problems and solutions. I love to learn. When I was
in high school, everybody called me “Mr. Solution.”
Let’s talk about visions: How important is it to have one?
— There is a powerful, driving force inside every human being
that once unleashed, can make any vision, dream, or desire a
reality. Setting a goal is important because it’s the first step in
turning the invisible into the visible. But there’s something
beyond a goal; success truly requires a vision. Know what you
want and more importantly, why you want it. The power of a
vision is one of the most fundamental aspects of leadership.
What is your definition of success?
— There is a formula for success that’s called the science of
achievement. It’s the process of taking your dreams and making
them real. But living a fulfilled life is an art, not a science; it’s got
to be the art of fulfillment. What is fulfilling for one person may
be boring to another, therefore fulfillment comes in as many
textures as there are human beings. However, you must learn
focused — FORMULA for success
page 13
“setting a goal is important because
it’s the first step in turning
the invisible into the visible.
But there is something beyond a goal:
success truly requires a vision.”
Tony Robbins
P Q Robbins is seen engaging an audience during one of his galvanizing
lectures.
what makes you fulfilled because here’s the truth: Success
without fulfillment is the ultimate failure. If our goals only serve
ourselves, then achieving our goals will only make us happy for
a moment. There’s a very real difference between momentary,
fleeting happiness and true joy. When your mission is about
growing, and getting better at serving others, and adding unique
value to people, then not only will you leave a legacy of gifts,
but you will be more fulfilled in life. Learning the art of fulfillment
will allow you to create an extraordinary life full of joy and that
is the true measure of success.
After more than 30 years of experience in coaching: What do
you consider to be the greatest factor that motivates people to
achieve great things?
— People often ask me this. And I always say at the core, it’s
one thing: hunger. If you’ve got hunger, you can get everything
else. Don’t get me wrong, intelligence is invaluable, but how
many intelligent people do you know that can’t fight their way
out of a paper bag? It takes a little hunger. A little drive.
What would you say can make dentists better doctors? What is
the core essence of your advice that you can provide to all of them?
— Dentistry is a science, and it’s a practice, and it’s one that will
constantly be evolving, especially with new technologies. So
the real secret to being a better doctor or dentist, is to constantly look at, understand and appreciate the needs of your clients
and find a way to do more for them than anyone else is doing.
The secret to life is to add more value to those you love and those
you have the privilege to serve. I think it requires two things:
Firstly, continually updating yourself with the best tools and
technology, as well as your dentistry skills. Secondly, the
psychology; figuring out how to meet the needs, desires and
fears of your clients while simultaneously updating the first
element as well. If you do this well, you will not only be more
successful as a dentist and be a better healer, but also you’ll
experience the level of fulfillment you deserve.
P
Find the extended interview on our iPad App
How important is technology in achieving your goals?
— Technology is an asset that every day is compounding its
capacity to enrich your life. There are breakthroughs occurring
today and in the months and short years to come that will revolutionize the quality of your life and the lives of everyone else on
earth. We have to be ready and open to what is coming, and know
that what’s coming is exponential change. A 10-year business
plan is a joke! Disruptive technologies and/or unexpected competitors can come along and displace your business overnight.
Acknowledging technology and the impact it will have on your
industry in this hyper-competitive environment is essential in
achieving your goals and most of all, staying flexible when
everything changes.
PROFILE
Anthony ‘Tony’ Robbins, born in 1960, is a
famous American master of leadership technology, world-renowned life success and
leadership coach, and a #1 best-selling author
of “Awaken the Giant Within”. He is influenced
by NLP and developed the principle of “neuro
associative conditioning”. For the past three
decades, Robbins has served as a consultant
and advisor to international leaders, such as
Bill Clinton and Nelson Mandela.
SIRONA VISION — issue 02/15
page 14
Trying is believing
It's a question of conviction: If you are on a completely new path you follow curiosity and the
spirit of discovery. Read the stories of two dentists, who found their recipe for success by
adopting new technologies.
Q
Trying the unexpected means having confidence that you are making the right decision.
focused — FASCINATING TECHNOLOGY
It was not an easy decision for Dr. Tarun Agarwal to use CEREC.
When he decided to buy it after opening his own practice in Raleigh,
North Carolina (U.S.) in 2001, CEREC had not yet been established
as a standard. The CEREC imaging unit with the Redcam was not
yet as user friendly as the CEREC of today. The computer technology was not as advanced and application in the practice was more
difficult than Agarwal had anticipated. Further the range of materials was quite limited – but Agarwal believed in the technology.
Looking back, the 39-year-old is proud that he was so persistent.
The continued development of CEREC increased his fascination
and the range of applications grew along with the success of his
practice. Agarwal says, “The fascinating thing about the CAD/CAM
system is that its possibilities are always growing.” Initially,
treatment was focused on producing inlays. With IPS e.max CAD,
a highly aesthetic yet strong lithium disilicate ceramic, CEREC
restorations became a useful and reliable alternative for metal
ceramic crowns. “We are slowly coming to realize that CEREC has
more to offer than just restorations. Of course we use it for crowns
and other single-tooth restorations, and we work with the lab via
Sirona Connect, but the special aspect is that there is an almost
unlimited range of materials and indications, as the introduction
of 3D model printing shows. The high precision of the whole-jaw
scans makes it possible to use it for orthodontics and implantology as well as the treatment of sleep apnea,” says Agarwal. He
now uses the system for implants almost more than for restorative
dentistry. He still finds treatment with CEREC to be an exciting
challenge because it allows him to continually develop and use
new treatment methods.
CEREC also allows Agarwal, a general dentist, to practice patientbased dentistry with his colleague in their joint practice. This
includes replacing uncomfortable conventional impression taking
with digital impressions. But primarily, chairside dentistry allows
treatments to be completed in one visit – avoiding unnecessarily
page 15
“MY PATIENTS are excited
about the technology,
take pictures with their
smartphones, and share them
with friends on Facebook.”
Dr. Tarun Agarwal
long wait times for patients. “All of this ensures that patients are
comfortable,” Agarwal says. And even more, since he has been
working with the CEREC Omnicam, patients have also noticed other
things. “They notice how yellow and crooked their teeth are. ‘Do
my teeth really look like that?’ they ask.” And they are also excited
about the technology, take pictures with their smartphones, and
share them with friends on Facebook. “Without a doubt: That is a
very positive reaction – a real ‘Wow!’ moment,” says Agarwal.
Sometimes it’s difficult to provide the ideal treatment because
patients have limited budgets or insurance companies are not
willing to pay more. In case of particular hardship, Agarwal
provides free treatment ( p see the report on p. 31). But in general,
CEREC provides an option for a good compromise – not for fit or
function, but for a somewhat simpler esthetic result. He thus
recommends CEREC to colleagues in practices who do not believep
q CEREC is an example of a completely integrated system: digital impression, designing with the
software and producing with the grinding unit for precise, durable and safe restorations.
PROFILE
Dr. Tarun Agarwal DDS is a general dentist in Raleigh, North Carolina (U.S.). The
son of Indian immigrants, he graduated
from the University of Missouri in Kansas
City in 1999. He is a renowned speaker,
writer, and dental leader.
SIRONA VISION — issue 02/15
page 16
p that CEREC is worth the investment: “CEREC is particularly useful
for these practices because it allows you to work more efficiently
and precisely and to save time – for you and your patients. CEREC
is very suitable for an efficient, productive practice. There are incredibly beautiful results – also from my own practice – that show
that CEREC can also yield perfect aesthetics.”
Agarwal thinks that with CEREC, his practice is optimally prepared
for all challenges. “In a time where we still feel a commitment to
ideal dentistry, but also feel the pressure to reduce costs from
insurance companies and competition from other colleagues, the
only option remaining is to provide good quality in a reasonable
time, and CEREC makes this possible,” says Agarwal. P
immediate booM in productivity and prosperity
Dr. Anthony Ramirez has had a dental practice in Brooklyn, New York (U.S.) for more
than 30 years and specializes in cosmetic dentistry and implantology. Since he
purchased GALILEOS CBCT imaging and CEREC technologies in 2009, the standard
of care has risen in his practice – a level unmatched by the traditional analogue
dental practice.
Dr. Ramirez, you want to offer to your patients modern dentistry. What role does
CEREC play in your practice concept?
— Thanks to CEREC technology and CBCT imaging with GALILEOS, I can provide a
considerably higher level of treatment in my practice than in a conventional analog
dental practice. With the CAD/CAM system I can treat single-tooth restorations and
single-tooth implants in one sitting. I have full control over occlusion design and
the overall morphology. I believe in digital dentistry with its new options for modern computer-assisted diagnosis and personalized planning. With SICAT I have
found a partner for creating surgical guides for guided implantology with which I
meet the surgical and restorative needs of my patients and also improve their quality of life. The digital workflow is at the core of the business model of my practice.
What advantages does guided implantology have over conventional methods?
— In the integrated method, I can merge the 3D view of the patient’s anatomical
structures with the digital impression. The combined dataset is extremely precise
and has many advantages over non-guided implant surgery. Using it I can – based
on the final tooth position – precisely determine the correct drill depth and alignment of the implant and transfer this accurately to the procedure using a surgical
guide. This results in greater safety, less stress for both dentist and patient, lower
morbidity, less trauma, fewer post-operative complications, faster healing of the
patient and reduced operation time.
The integrated workflow opens up completely new options when dealing with patients.
What has your experience been?
— The core of my uniquely personalized treatment approach is the seamless integration of digital technologies into my ConceptS surgical suite combining CEREC,
GALILEOS, Sirona treatment center, the HELIODENTPlus X-ray assembly, and the
Sirona sensors Schick 33. Because of this treatment concept, my practice has
garnered a reputation of enhanced diagnostics and advanced treatments. This has
had a positive effect on treatment acceptance and patient loyalty: my relationship with my patients has never been stronger as they enjoy all of the benefits our
investments in their wellbeing have afforded them.
Working together for CAD/CAM variety
VITA congratulates Sirona on 30 years of leading innovations with CEREC.
From VITABLOCS® to VITA ENAMIC® – For 30 years,
CEREC users have relied on high-performance
materials for a wide range of indications
From the beginning, the innovation partners Sirona and VITA
individual specificity than ever before. Materials are pro-
have worked to pave the way for variety in the field of
cessed with an excellent level of precision and aesthetics.
CAD/CAM. By developing materials and CEREC systems we
VITA is happy to celebrate this joint performance and the 30th
support users with the ideal solution for all indications. Today,
anniversary of CEREC with Sirona.
it is possible for you to select the best solution with a higher
www.vita-zahnfabrik.com
facebook.com/vita.zahnfabrik
SIRONA VISION — issue 02/15
page 18
The show must go on
Q
Interrupting a tour or postponing an important date because of a toothache? No way! Neither for most people nor for the Finnish rock band PMMP.
Sometimes a dentist has to make a restoration quickly because the patient is in a hurry. In this
case there is only one solution: chairside treatment with CEREC. No other method in dentistry
makes it possible to produce finished crowns in a single visit. Thirty years and as innovative as
ever: CEREC sets new standards again with more than restorations.
informed — single-visit dentistry
page 19
A great concert. She is on stage and just about to take a drink.
Someone bumps into her. The bottle smashes into her teeth. A tooth
is broken. “Now what am I going to do?” she thinks. The idea of
breaking off their tour is even worse than the pain of the accident
and her ruined smile. But what can she do? Good thing there’s a
dentist in the audience. And he even uses CEREC. So there’s no problem. The tooth is repaired that very evening. The tour can go on.
What happened to Paula Vesala, lead singer of the Finnish
rock band PMMP, can happen to anyone – on the flight to your
vacation destination, on a business trip, right before a job interview
or your wedding. In all these situations you can’t wait for a crown to
be made by the dental technician in the long drawn-out procedure
which involves an impression tray, model cast, and wax-up followed
by a second appointment for fitting.
p
THE FASCINATION OF A GREAT IDEA
The idea of milling inlays out of biocompatible, tooth colored
ceramic blocks and cementing them in place as an alternative
to amalgam for the treatment of cavities came about at the
Center of Dental Medicine at Zurich University in 1980.
CEREC was born. Professor Werner H. Mörmann, father of the
CAD/CAM system along with engineer Dr. Marco Brandestini,
explains how it came about.
opened the way for digitization in all fields of dentistry.
Today, the entire mouth can be scanned in three dimensions,
which is very important for prosthetics, orthodontics, the
documentation of treatment progress in periodontology,
and for checking prevention methods. The combination of
3D X-ray and surface data ensures the reliability of planning
and implementation in implantology. Virtual articulation
was also implemented.
Professor, what gave you the idea for CEREC at that time?
A look to the future: Where will CEREC be in 20 years?
— In 1979 there were heated debates about the possible
health risk from amalgam. Dentists were beginning to
systematically replace amalgam fillings with composites,
even though they were not suitable for occlusal load bearing
fillings in lateral teeth. More and more patients were seeking
help for pain and secondary caries at our clinic. I was
searching for a solution to this problem. The development
of CEREC was very expensive and not without setbacks.
What motivated you to pursue your vision so persistently?
— When I was young, I experienced how a dentist kneaded
an amalgam filling and simply stuffed it into one of my
cavities with his thumb. Even I, as a member of the public,
considered this to be a primitive method. After dissertations
about amalgam and gold inlays, I first encountered adhesive
dentistry at Zurich University. The adhesive technique
promised the perfect, permanent bond between the tooth
and the restoration. That fascinated me. It was my intention
to give dentists the option of producing inlays themselves
during treatment, using a computer to permanently restore
the shape, color, and function of teeth. Ceramic was the
material of choice because it is very similar to hard tooth
substance.
After decades of development, CEREC is suitable not
only for prostheses, but for implantology and orthodontics
as well. What do you see as the most important advance?
— The CEREC method has brought many advances to dentistry that cannot be separated from one another. CEREC
— I am optimistic that by then there will be at least an
intraoral scanner, if not a complete CEREC system, in every
practice. Dentists will routinely make an optical impression
of the entire mouth for each new patient. Intraoral scanners
will make it unnecessary to stick strictly to scan paths. The
scan head adjusts to the anatomy of the teeth and jaws and
makes the necessary angle settings for complete capture
of the teeth and preparations. Regarding production, I think
that in the future, CEREC will consist of modules that will
cover all fields of dentistry. As an alternative to milling and
grinding, there will be additive manufacturing methods –
provided these methods are fast, precise and reasonable.
PROFILE
Dr. Dr. Werner H. Mörmann is professor
emeritus at the Department of Computer
Assisted Restorative Dentistry at the Center of
Dental Medicine at Zurich University (Switzerland). In 1985 he produced the first ceramic
inlay with the CEREC method he developed.
SIRONA VISION — issue 02/15
page 20
p This is when chairside treatment with CEREC comes into its own.
The patient gets his smile back in less than two hours. But even
when they are not in a hurry, patients appreciate it when they can
complete treatment in one session and so avoid a second visit and
the long wait. They need anesthesia only once and the uncomfortable conventional impression taking and temporary crown are
unnecessary which has an advantageous effect on the clinical
quality of the restorations. Patients are fascinated by the completely new view of their teeth and the amazing technology. That creates
confidence, enhances respect for the dentist, and increases their
readiness to agree to the proposed treatment.
CEREC: A system for restorations, orthodontics,
and implantology
These treatments are provided with CEREC more and more
frequently. The CAD/CAM system can now be used for so much
more than just making sinle tooth restorations, bridges, or temporaries. CEREC can also be used to make impressions for orthodontics,
for example, for treatment with “Invisalign® Clear Aligners.”
For this, Sirona has entered into cooperation with Align Technologies. The new CEREC Ortho software makes it possible to
create a digital model of the entire arch by means of a reliable
guided scan using the CEREC Omnicam. The data can then
be transmitted for use in planning orthodontic treatments and
producing the appliances required for this purpose. If a physical
model is still needed, it can be printed on a 3D printer. Consequently, treatment is more comfortable and can be started
sooner. The same applies to implants. They can be planned more
accurately and are more reliably implemented by the fusion of
3D X-ray data and the prosthetic proposal made with CEREC. A
practical illustration of how this is achieved in the practice is
provided in the article by dentist Farhad Boltchi from Arlington,
Texas (U.S.), on pages 34/35 in this issue of ­VISION.
P
View Paula Vesala’s case on the iPad App or
on our blog: blog.sirona.com/en/cerec-rocks
cerec generations: CEREC 1 to CEREC 3 and CEREC AC
— 1985 —
— 1994 —
— 2000 —
— 2009 —
— 2012 —
Development of the
dental CAD/CAM
system CEREC at
Zürich University
CEREC 2 for the
restoration of
inlays, onlays and
veneers
CEREC 3 with
separated acquisition
and milling unit, since
2003 with 3D software
CEREC AC with
CEREC Bluecam
enabling data
transfer to dental
lab via online portal
CEREC AC with
CEREC Omnicam,
powder-free
and in full color
informed — PRODUCT news
page 21
CEREC AI – INTEGRATED. ERGONOMIC.
Requested by many CEREC power users and now a reality – the CEREC Omnicam
variation can be used right at the treatment center, almost like a contraangle handpiece. With the CEREC AI model (Acquisition Integrated), Sirona now
offers this integrated option. It consists of a CEREC Omnicam with a base, which
is integrated into the TENEO treatment center by a separate support arm and
a PC with a 24" or 19" viewing screen. The CEREC Omnicam is thus easily
accessible even in the 12 o’clock position. Both the dentist and the patient can
see everything directly on the treatment center screen or on the included
tablet. An interesting solution for practices where CEREC is to be an integrated
component – conveniently situated on the TENEO treatment center.
CEREC AF – FLEXIBLE. WITH BASE.
CEREC AF (Acquisition Flexible) is a convenient solution for practices with several treatment rooms that may be located on different floors or even in different locations. This
unit consists of the CEREC Omnicam with a base and a PC with a 24" display. The camera
can be moved flexibly within the practice – and designing can be done in a separate room.
This makes it possible to design in one room while taking a new scan in the next treatment
room. Patients can watch the design process, if desired, either on the tablet included or
on a 24" display. This solution is also ideal for practices that already have one CEREC
system and wish to use an additional one: In this case, the practice can be
equipped with the AF components (camera base, PC, and display). The existing CEREC
Omnicam from the CEREC AC model can still be used and can be moved flexibly from one
room to another.
ONE VISIT
DENTISTRY!
A DEN
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VISIT: IS IN
Esthetic ceramic crowns or partial crowns in a single visit.
Ask me about CEREC.
1
NO UNPLEASANT
IMPRESSION MATERIAL
2
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NO BOTHERSOME
TEMPORARY PROSTHESIS
After the
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This year Sirona’s CEREC system celebrates its 30th anniversary.
But not all patients know about this advanced technology and
the advantages of the fully digitalized workflow. Sirona is now
offering a complete package of information and marketing
3
material that highlights the advantages of the CEREC system
for patients. This can be used to generate interest in advance
of treatment. The attractively designed material which is
tailored to patient questions focuses on the advantages offered by CEREC. The package includes posters, flyers and
appointment cards. A special marketing highlight is the option
of integrating a personalized microsite dedicated to CEREC. Sirona’s
information material for the practice can be ordered from Sirona dealers.
Digital data can be downloaded at www.sirona.com/patient-information.
A personalized microsite can be registered at
www.onlyonevisit.com/signup
Subject to technical changes and errors, Order no. A91100-M43-B826-01-7600, Printed in Germany, Dispo-no. 04605, OEW14 WS 1014.V0
CEREC: Generate interest
even in the waiting room
BY
SIRONA VISION — ISSUE 02/15
PAGE 22
Healthy teeth are a symbol of one's quality of life. For Ady Palti, esthetically maintaining and, if
necessary, restoring a smile, is a labor of love. The implant specialist from Baden-Baden
believes that three important conditions are necessary to do so: state-of-the-art technology,
practitioners with a clear task-oriented focus and a treatment environment that supports this aim.
technology
meets design
InformED— TREATMENT CENTERSPAGE 23
P Confidence-building: The first impression
conveys a pleasant atmosphere arising positive
connotations.
About two years ago and just 500 meters from where he opened
his first practice in Baden-Baden , Palti found the perfect location
that met his quality standards: A villa with stucco ceilings built in
1830, providing 400 square meters of space all on one floor. He
converted it to fit the needs of his dental center, and configured
his new work space according to Sirona's “History & Innovation”
design concept. “My services focus on esthetics,” explains Palti,
“Harmony plays an important role here. This design concept
creates exactly this feeling – for me, it bridges the gap between
tradition and modernity.” Patients are very aware of and positively
affected by this, which in turn is noticed by the entire practice
team. The acceptance of the practice has increased again with
the move to the new location, says Palti. “If I create an esthetic
atmosphere in the practice, it shapes the expectations of my
patients. It is great when we can underpin this trust with our
treatment.” For the implantology specialist, the combination of
esthetics and function is what makes for modern dentistry, which
“begins at the reception desk.” When patients come to Palti's
practice, they expect a lot. They usually have very little time, want
to experience as little pain as possible and expect the result to
satisfy the highest esthetic and functional demands. This
corresponds with exactly what Palti also offers his patients. He
calls it the “one-stop strategy.” In just one day, the patient walks
away with the desired results: beautiful and healthy teeth. Dr.
Palti believes that everyone, including the practitioner, benefits
from this: “When I treat a patient myself, from the diagnosis to the
final restoration, I have control over the entire process and can
assume responsibility for it.” This philosophy has always driven
him: “As a student, I had an immense feeling of helplessness when
extractions had to be performed. I wanted to change that. I wanted
to help provide more quality of life for these people.” For Ady Palti,
dentistry is more than repairing damaged teeth – it means
preserving them, and for longer than ever before. If that cannot
be achieved for whatever reason, implants can help in many cases.
That includes the perfect prosthetic treatment. “You can only
carry out successful treatment when you believe in what you are
doing and are completely committed,” he says. “This requires very
thorough training, such as that offered by companies which
specialize in implantology or postgraduate programs, as well as
the desire to do it correctly or not at all.”
p
P Innovative: The practice team is
working on TENEO treatment units,
which are equipped with integrated
functions for endodontics and im­plan­tology. A CEREC system belongs
to the practice facilities, too.
SIRONA VISION — ISSUE 02/15
PAGE 24
Q Generous: The rooms convey not only high aesthetic standards, but provide a lot of space, which contributes to relaxation.
p Technology that makes what you do even better
In addition to having trust in his own skills, Palti also considers stateof-the-art technology to be important. His patients expect the highest
quality treatment, which can only be achieved with expert planning
and technical support. Ady Palti uses a modern 3D X-ray system with
the corresponding imaging software (SIDEXIS 4) for this purpose.
This system can be used in a variety of ways, including for consultations with the patient right in the dental chair via the SIVISION screen.
He is a CEREC user and treats his patients on TENEO treatment centers, which are equipped with integrated endodontic as well as
implantology functions. “In my opinion, this is more effective and
hygienic than having to mount and remove various table-top units.
Particularly with extensive procedures, which we often perform in
our practice, these functions ensure a very efficient and comfortable
workflow.” One significant side effect is that the virtually invisible
technology does not intimidate the patient but rather puts him at
ease. This is very important to dentist Palti in terms of his patient's
expectations – they should feel welcome in the practice and that they
are in good hands from the minute they walk through the door.
Ady Palti sees a trend in the combination of technology and design
– today, that plays a big part in the success of a dental practice. The
keyword here is integration: “I would like all of the technology that
I use to communicate with each other. That is a real challenge. You can
only master this if you make it your business to do so.”
P
„You can only implement your ideas
successfully when you believe in THEM
and are completely committed.“
Ady Palti
PROFILE
Clinical Professor/New York University,
Ady Palti from Baden-Baden has dedicated
himself to the field of implantology for more
than 30 years. As one of its pioneers in Germany, he has made a significant contribution to
the optimization of this discipline and has obtained around 20 patents for material and medical technology. He is a board member of the
German Society for Oral Implantology (DGOI).
SIRONA VISION — issue 02/15
page 26
Convincing
PERformance
Sydney – the skyline of the Australian metropolis on the east coast with its striking landmark,
the oyster-shaped opera house – is world famous. But Sydney has even more to offer – for
example, the new “Center for Dentistry” with its sophisticated architecture.
informed — center for dentistry
page 27
“Innovative treatment methods sometimes sound
too good to be true. Nothing is more convincing than seeing
them for yourself.”
Mike Stone
Q Just like a real practice: In the middle of the showroom is a fully equipped treatment room (left).
Hands-on training can be conducted at 20 simulation workstations (right). Find more pictures in the iPad version of VISION.
The bright, open-design building in the suburb of St. Leonards is the
ideal setting for the presentation of innovative dental equipment
from Sirona. “We wanted to do more than ‘just’ equip a showroom,”
says Mike Stone, Managing Director of Sirona Australia and New
Zealand. “Our goal is to use training and educational events held
here to show customers how valuable their investment in new technologies is and how they can profit most from the products and the
potential they have. This is best accomplished in surroundings that
put Sirona products in the best possible light,” says Stone.
The 27,000 square foot building north of Sydney houses a unique
showroom, extensive training facilities, and a modern office building. Here the market leader of the dental industry presents its complete, fully functional product line of innovative dental equipment.
“Nothing is more informative and convincing than seeing high tech
in action,” Stone believes.
Keep up with progress
Technology is also developing rapidly in dentistry. Dentists need
to make sure they are able to keep up. They need to stay up to date
for advising and treating patients and should be aware of new
trends in methods and research. It is just as important for optimal
treatment that a practice has state-of-the-art technology – and of
course that the dentist knows how to use the equipment. This
makes intuitive operation very important. “Sirona devices are very
well designed and coordinated to the workflow,” states Stone. “But
innovated integrated treatment methods are still not selfexplanatory.” Training courses and live treatments are ideal for
becoming familiar with new systems and learning how to use them.
This is where the “Center for Dentistry” excels. The showroom is
not only a state-of-the-art training center, it is also a meeting point
for the dental industry on the continent.
Visitors are first welcomed at a central reception desk where they
can see the high-quality equipment designed for dentists and dental technicians in the adjacent offices, showrooms, and training
rooms. Despite the modern design, the surroundings have the look
and feel of a dental practice. The four treatment rooms of the
“Center for Dentistry” are fully equipped.
Live treatment behind glass
One highlight is the operating room with complete glass walls that
gives visitors a 360-degree view of live treatment sessions that are
performed for training and demonstration purposes. The facilities
also include a sterilization room and a digital dental lab. In addition,
hands-on training can be conducted at 20 simulation workstations.
A lecture hall designed like a conference room can seat more than
100 people for lectures and training events. Offices and other
facilities supplement the versatile uses and provide sufficient space
for consultations and events of all kinds.
P
SIRONA VISION — issue 02/15
page 28
A small step
with a big Impact
In 1992, Dirk Rosenthal and a former colleague of his took over a practice in Gernsheim (Germany). The dentist, who received his license two years before, was lucky because the practice
was equipped and very well established. He modernized the practice continuously, but it
remained analog. Around 20 years later, digitization offered him so many advantages that he
converted his entire practice from analog to digital. For VISION he reports on his experiences.
in practice — DIGITAL WORKFLOWPAGE 29
“Of course
a changeover like this
has to include
the practice team.
We discussed all changes
with our employees in
advance.”
Dirk Rosenthal
Q All necessary information at one glance: Dirk Rosenthal can call up patient data with medical history,
the current treatment status and digital x-rays from the image archive with just a few clicks.
“One small step for a man, but a giant leap for mankind.” No other
sentence describes our generation’s relationship to technology
better than Neil Armstrong’s statement after stepping onto the
moon. This came to mind when a new world opened up to me in
spring 2015: the world of the digital dental practice. Before Easter,
we were still using our old analog X-ray units, developing our film
with chemicals and interrupting treatments to do so. One week
later we started up with fully digital equipment. We had new X-ray
systems and a large practice network installed. All of the X-ray
units, the treatment chairs and practice computers in each room
and the reception area were connected to it. We were already
administering patient records and invoices digitally, but now they
were integrated into the practice network.
Gigantic difference compared to analog X-rays
We decided to change our system over because our former OPG
was growing old. It still functioned, but the quality of the X-ray
images was not good enough for today’s technology standards.
In more and more cases in my special field of surgery (in particular, implantology, periodontology and prosthetics), the old OPG
was no longer an accurate aid. I had to send my patients away for
a CBCT scan and then make my diagnosis on my laptop. I quickly
became aware that the digital world – and 3D X-rays in particular
– offer completely new opportunities for diagnosis and treatment
planning. I was curious to find out what else there was to discover
and use.
During this phase, Sirona offered me the chance to test the new
ORTHOPHOS SL in my practice. The decision was easy, but it was
not entirely without consequences. I had made up my mind: if we
changed over, it must be done properly. It would not have made
sense to work with a state-of-the-art digital hybrid X-ray system
and use film and a developing machine at the same time. This is
why I also implemented the XIOS XG Supreme sensors for my
intraoral X-rays. Their main advantage: I can open all my digital
X-rays – whether they’re intraoral, panoramic or 3D images – in
the new SIDEXIS 4 imaging software with a click of the mouse
while simultaneously making my diagnosis and tracking the
course of the illness or treatment in the patient history. The software programs for implant planning are harmonized with it and
are quick and easy to operate. This simplifies the treatment. The
new generation of treatment centers from Sirona allows us to save
patient specific treatment positions and to call them up at subsequent visits. The integration of formerly external functions in the
treatment center is becoming increasingly important. The dentist
can open the X-ray images or patient data in the practice network
and display them on the monitor. But I prefer to work with the
large, external monitor located besides the treatment center, in
combination with my iPad, which I connect to via WiFi. I can let the
patient hold the iPad while I am explaining the diagnosis and the
treatment concept. p
PROFILE
Dirk Rosenthal has been a dentist with his
own practice in Gernsheim (Germany), since
1992. In subsequent years, he specialized
in implantology, prosthetics, function analysis
and periodontology. A practice laboratory with
two staff dental technicians is integrated into
his practice.
SIRONA VISION — issue 02/15
page 30
Q Using digital sensors for intraoral X-ray is more comfortable and more
consistent than using analog devices.
P Easy to handle: The EasyPad touchscreen makes program selection fast
and simple.
Successful ORTHOPHOS family:
The digital revolution in imaging
The best image quality at the lowest
dose with a perfect workflow. That is
what distinguishes Sirona’s digital
imaging systems, whose great success is especially associated with one
name: ORTHOPHOS. Twenty years
ago, the digital era of dental imaging
began with the introduction of the
ORTHOPHOSPlus DS, the world’s first
digital panoramic X-ray unit. Initially,
it was not the imaging technology
that was revolutionary, but the act of storing the X-rays
on a sensor. Sirona, already at that time a pioneer of digital
technology in the dental industry and technology leader
in imaging systems since the invention of the X-ray sphere
in the 1950s, continued in the following decades to set
new standards in imaging technology, image quality, diagnostic options, and treatment planning with several
generations of devices. In 2010, for example, there was a
breakthrough in 3D imaging in private practice with the
ORTHOPHOS XG 3D (above). As a hybrid device that allows
users to choose between 2D and 3D images, the system
facilitates entry into CBCT technology. Its brother, the ORTHOPHOS SL
(right) sets new standards in many
respects, for example, with the innovative Direct Conversion Sensor (DCS)
which allows for unparalleled image
quality. The success of the ORTHOPHOS
family is evident from the sales
figures: more than 100,000 dentists
around the world rely on a ORTHOPHOS
X-ray unit.
p The quality of the images has also enormously improved their
informative value. By changing the contrast or navigating through
the 3D dataset, I can detect structures that were invisible in the
analog world. This is not only a small step – it is a gigantic difference compared to analog X-rays. The increase in quality and
wealth of new options has directly resulted in higher value creation in the practice – something I didn’t expect initially. But my
range of services is now greater because I can plan everything in
my practice. In implantology, for example, I can carry out more
extensive procedures or work with surgical guides. And I know, for
example, if bone grafting is necessary before operating. This not
only makes treatments safer, but also simpler and more predictable.
Improved diagnosis and treatment quality is key
Furthermore, working with digital systems also has nice side effects: no more chemicals, no odor or noise from the fan and much
less waste to dispose of! Work is now more efficient. My assistant
no longer has to find the X-rays before treatment, and I can spontaneously consult with them during treatment without having to
wait for the film. The measurement and control images for endodontic treatments are already on hand when the patients return to
the treatment room. This has accelerated our workflows. But these
are not key effects for me. The important thing is the improved
quality of the diagnosis, which in turn improves the treatment. And
work is more fun.
After all, working with new devices is always exciting. In order to
make sure that everything goes as planned we gave quick-start
instructions to everyone after the devises were installed, and held
several training sessions in the following weeks. I also became
thoroughly familiar with the GALILEOS Implant and SIDEXIS4 software programs. In this way, we were able to implement digital X-ray
technology without losing any days in the practice. Thanks to this
positive experience, I have a completely relaxed attitude towards
further developments in digital treatment methods. Our entire team,
the devices and our practice’s network are perfectly prepared for
the future.
P
in practice — SUSTAINABLE hELPPAGE 31
When dentists Take
Social responsibility
Challenges are what Dr. Tarun Agarwal, the
CEREC dentist who works in a joint practice
in Raleigh, North Carolina (U.S.), seeks: He
provides free dental treatment for needy
patients once a year.
Dental treatment is quite expensive in the U.S. Without health
insurance a tooth extraction costs between $190 and $375 US
dollars, and a professional tooth cleaning costs around $370 US
dollars. For people without health insurance, dental care could
soon become a luxury.
For Dr. Tarun Agarwal, who works with his team in a practice called
“Raleigh Dental Arts,” it is clear that dental treatment is important
for everyone – whether they can afford it or not. This is what has
motivated him to treat needy patients for free one day a year for
the past three years. They are mostly patients who do not have
health insurance for one reason or another.
He is supported in this effort by dental students at the University
of North Carolina at Chapel Hill who work with Agarwal’s team to
provide basic dental care to patients who come to the practice on
this day. In this way, as many patients as possible can benefit
from the work of the dentists. While around 35 patients are treated
on a “normal” day, more than 100 are treated on the free day.
“North Raleigh is actually a wealthy region,” Agarwal says. The
son of an immigrated dentist from India explains his motives.
Q Dr. Tarun Agarwal offers dental treatment one day a year for free and is
supported by dental students.
“I wasn’t always aware that there are so many people here who
need help. I want to give something back to society. I know very
well that the welfare of my family is not something to be taken for
granted.” Agarwal therefore decided three years ago to offer
this “free dental day” regularly – a resounding success for his
patients.
P
SIRONA VISION — issue 02/15
page 32
Equipped for
all tasks
The new inLab software 15.0 from Sirona provides support in areas where dental technicians
generally still work by hand – at a surprisingly low price.
Digitization arrived long ago in dental labs: standard tasks such
as crowns, bridges, inlays, onlays, and veneers have for some time
been made using CAD software. But there are also still tasks for
dental labs where the computer hardly plays a role, for example,
partial framework design. When these kinds of jobs are on the order
list, many dental technicians still do the work by hand. Experience
is needed for complex tasks in particular, and there are also a number of aspects that can be quickly grasped on the physical object.
So far, computer programs have been either more expensive or not
efficient enough.
and three optional extension modules: one for implantology, one
for removable prostheses (including partial framework), and one
for the interface module for open STL data transfer between inLab
and third party providers. “Crowns and bridges, frameworks,
inlays, onlays, and veneers can be designed using the basic
module. This covers a large share of the standard tasks of a lab,”
says Hans-Georg Bauer, Director of Marketing Lab Products &
Digital Impressions at Sirona.
Sirona has now addressed both points – efficiency and cost – with
the new inLab software version 15.0. The licensing models were
simplified (see table) and the software architecture was rebuilt.
The CAD software as of version 15.0 consists of a basic package
The basic module also has additional features such as the simultaneous design of several restoration levels (“virtual insertion”),
a separate design element for gingiva design, and J.O.B.S. This
acronym stands for “jaw oriented biogeneric settings.” This sounds
Convincing initial proposals
in practice — LAB TECHNOLOGYPAGE 33
complicated, but it provides amazing initial proposals – and it
simplifies work considerably: For larger prosthetic jobs, the inLab
software automatically generates settings based on the digital
jaw information and remaining tooth substance. The software
takes parameters into consideration such as the curve of speed
for optimal occlusal alignment or the Frankfurt plane as a reference measurement. Alternatively, dental technicians can also
use data from various dental databases, for example, for jaws with
few teeth. Frankie Acosta, owner of the AA Dental Design lab in
Murrieta, California (U.S.), is one of the first users. “I am particularly impressed by J.O.B.S. The software supports my work with
precise, anatomically perfect settings. This makes my work faster
and easier.”
The technology becomes really fascinating for dental technicians
with the optional modules for implantology and removable prostheses. With the former, screw-retained bridges and bars with
implant connections can be designed, and this is also the case for
prefabricated abutments and adhesive bases. In addition, surgical
guides can be produced as part of integrated implant planning.
The “removable prosthesis” module makes it possible to design
telescopes, bars, and custom divided attachments and partial
framework for permanent prostheses. Acosta says, “The partial
framework design functions very well. Since it has been included
in the inLab software 15.0, I have come to appreciate using the
computer as a valuable tool for these cases as well.”
Intuitive operation
The new inLab licensing model
MODULES
Basic
Inlays, onlays,
veneers,
full crowns,
bridges,
copings,
bridge frameworks, multilayers
Individual
abutments
on Sirona
TiBase
All design
tools are
integrated
Screwretained
bridges
and bars on
implants
Virtual
articulator
Key
Features Smile design
Sirona Connect access
J.O.B.S.
Telescopes
Bars
Attachments
Screwretained
crowns
Interfaces
For the
flexible
integration
of the inLab
CAD software into
nearly any
existing
CAD/CAM
equipment
OPEN
GALILEOS
Implant
Interface
Surgical
guides
Dental
databases
Virtual
insertion
Gingiva
elements
Users will be enthusiastic about using the inLab software 15.0.
User guidance is much more simple, and access to tools is fast
and direct. Overall, it is more intuitive to use than generally
expected from CAD design software. This is not only an advantage
for existing users who are already familiar with the details of the
software – the revised operation is especially helpful for dental
technicians who have previously found it difficult to use modern
CAD software and preferred traditional methods. The clear, intuitive design of the inLab software 15.0 also has advantages when
training new colleagues. P
Implantology Removables
Prerequisite:
Basic
module
Prerequisite:
Basic
module
Prerequisite:
Basic
module
Find out more on www.sirona.com/inlabSW15-modules
THree steps FOR unprecedented freedom in the dental lab
CAI – Computer Aided Imaging
Model data, e.g. with the Sirona inEos X5
scanner
CAD – Computer Aided Design
Design, e.g. with the Sirona inLab software 15.0 (enables export of STL data via
the interface module)
CAM – Computer Aided
Manufacturing Production, e.g. inhouse with the inLab MC X5 production
unit /externally via infiniDent
SIRONA VISION — issue 02/15
page 34
Q
Implanting with CEREC Guide 2, the fastest and most cost-effective way to create a drilling template.
Guided Surgery for safe anD
smart Implantology
Today digital implant dentistry provides a completely integrated digital workflow incorporating
all aspects of surgical and restorative implant dentistry. Sirona’s recent introduction of CEREC
Guide 2 significantly improves the CEREC Guide process, thereby enabling the clinician to perform precise in-house milling of surgical guides with the CEREC CAD/CAM system.
Q This patient is a 64 year-old female, who was
referred for evaluation of a non-restorable tooth
#2. The initial radiographic evaluation revealed a
deep caries lesion on the distal aspect of tooth
#2. The decision was made to extract the tooth
and replace it with an implant-supported restoration. A two-phase treatment plan was devised.
Q A cone beam CT radiographic evaluation was
performed with Sirona ORTHOPHOS XG3D, and a
digital impression of the patient’s Maxillary and
Mandibular arches was obtained with the CEREC
Omnicam. A virtual restoration was designed in
the CEREC software 4.4 and the corresponding
data was exported into the GALILEOS Implant
treatment planning software merging with the
CBCT scan.
Q The treatment planning data was exported
from the GALILEOS Implant treatment planning
software as a .CMG.DXD file and imported back
into the CEREC software 4.4. The CEREC Guide 2
was virtually designed in the CEREC software 4.4.
in practice — CASE REPORTPAGE 35
Q The corresponding CEREC Guide 2 was milled
out of a CEREC Guide Bloc Maxi PMMA Block in the
CEREC MC XL milling unit.
Q Although it is not necessary, an alginate impression was obtained pre-operatively to verify
the fit and accuracy of the milled CEREC Guide 2.
The result makes implant therapy very safe.
Q The implant placement was accomplished with
a flapless guided approach. The CEREC Guide 2,
the Sirona CEREC Guide drill keys for the Straumann system, and the corresponding Straumann
Guided Surgery drills were utilized to prepare the
guided implant osteotomy according to the virtual
treatment plan in the GALILEOS Implant software.
Q A Straumann 4.8 x 10mm SLActive Roxolid
Bone Level implant was placed through the
CEREC Guide 2 in a nearly fully guided fashion in
the restoratively correct and pre-planned position. Although the CEREC Guide system is intended only for guided osteotomy preparation, it was
possible to place the implant in this case in a
nearly fully guided fashion through the CEREC
Guide 2.
Q The immediate post-operative periapical radiograph confirmed the accuracy of the implant
position according to the pre-operative plan in a
two-dimensional plane.
Q In order to verify the accuracy of the CEREC
Guide 2, a post-operative CBCT scan was obtained
and the CAD/CAM data of the optical scan of the
previously scanned stone model with an inserted depth gauge was exported and merged with
the post-operative CBCT scan. The result demonstrated that there was a high degree of
precision achieved with the CEREC Guide 2
process in this case.
This case report demonstrated the high
degree of precision that can be achieved
with the CEREC Guide 2 system. It offers
several distinct and significant advantages
and improvements over CEREC Guide 1. It
eliminates several sources of potential
operator error and allows for the economical production of in-house surgical guides
in less than one hour with a fully digital
workflow and without the need for a stone
model or a radiographic scanning appliance.
performed in the CEREC software 4.4 or the
inLab software 15.0. Specific software
tools are used to determine the overall size
of the CEREC Guide 2, to change the thickness of the guide, to remove obstructive areas, to create windows for seating
control, and to create buccal or lingual side
access for drills through the guide in sites
with restricted vertical access in the
mouth.
CEREC Guide 2 essentially follows the same
known workflow as the SICAT OptiGuide
with the user having the option to decide
between an OptiGuide and a CEREC Guide 2
in the GALILEOS Implant software after the
virtual implant position has been finalized.
The design of the actual CEREC Guide 2 is
Sirona products used:
»»
»»
»»
»»
»»
ORTHOPHOS XG 3D
CEREC Omnicam
inLab CEREC MC XL
CEREC Guide 2
GALILEOS Implant Software
profile
Farhad E. Boltchi,
D.M.D., M.S., is a Clinical
Assistant Professor
in the Graduate Periodontics Program
at Baylor College of
Dentistry in Dallas,
Texas, and also maintains a full-time private
practice in Periodontics and Dental implants in Arlington, Texas (U.S.). He teaches
and lectures extensively both nationally
and internationally on the topics of advanced Periodontics and Dental Implants.
He is a fellow of the International Team of
Implantology (ITI).
SIRONA VISION — ISSUE 02/15PAGE 36
One laser
for all cases
Laser technology opens up a world of opportunities in dentistry, particularly for surgery
and periodontology. Users from Italy and the U.S. tell us about their experiences.
Prof. Iaria, at your private clinic in Brescia, you specialize
in surgical procedures. How do you use laser technology
and what are the benefits for your work and your patients?
— Prof. Iaria: For quite a while now, we have seen a trend towards
minimally invasive techniques, both in medicine and dentistry.
We look for optimal treatment concepts which ensure the best
result and maximum comfort for the patient. I started using laser
in my treatments in 1996. In 2001, I got my first diode laser
and since this summer, I have also been using the SIROLaser
Blue. We essentially value the minimal invasive character,
the biostimulation and the decontamination of the treatment
area. Moreover, the SIROLaser Blue can be used for surgical
treatments without contact of the fiber to the tissue. Laser is
the convenient option for patients because treatment is quick
and virtually pain-free.
In practice — USER EXPERIENCEPAGE 37
Mrs. LeBeau, your specialist field is dental hygiene and therefore the initial treatment of periodontal diseases. The dental
offices supported by Pacific Dental Services, Inc. use Sirona
diode lasers at all of their locations in America. What are the
advantages of lasers compared to other types of treatment?
— Mrs. LeBeau: After laser treatment we see significantly
reduced pocket depths and improved healing. If we discover
an acute infection, we always offer the laser in addition to
­conventional scaling and root planing with instruments.
The laser allows us to quickly and efficiently decontaminate
all periodontal pockets. In the past we used local antibiotics
for acute infection but the laser is more cost effective for
the practice and the patient. With the addition of the laser we
see better outcomes and enhanced healing.
Laser itself is not a new technology. What improvements do you
see today?
— Prof. Iaria: The SIROLaser Blue gives us a new light for dentistry – it's blue! The higher absorption in the blood components
compared to infrared diode lasers leads to an impressive ability
to reach good hemostasis. It is without any doubt the “state of
the art device” in angiomas and red lesions treatment as well as
minimally invasive surgery in which hemostasis is required.
It covers all clinical procedures of the diode laser but with an
increase of selectivity in the action.
— Mrs. LeBeau: The current lasers are considerably less expensive
than the older devices and are easier to handle. The SIROLaser
­Advance is easy to use for experienced clinicians and those
who are new to lasers. In addition, the laser can be used for both
pocket decontamination and surgical indications. With the
SIROLaser Advance, the clinician can store their own personal
settings and easily adjust peak powers, average powers and
ultimately pulse widths to accommodate the specific situation
and environment they are treating.
Patients often have mixed feelings about laser treatments.
Some are worried about pain (due to the heat) or feel uneasy due
to the sounds or smells that occur. How do you deal with this?
— Mrs. LeBeau: I believe trust is crucial, and gained by the clini­
cian through communication and empathy. If patients understand that this modern technology is quick and has minimal to
no discomfort, then they are generally happy to go through the
process. With regard to the sounds and smells, I recommend
explaining everything carefully to the patient beforehand. Their
expectations are then different and they are more positive!
— Prof. Iaria: My experience with this has been different. My
patients are enthusiastic about using alternative instruments
for oral treatments. Since I started working with laser, I have had
considerably more patients, and they are loyal!
Let's talk about your experiences: What makes the laser beneficial for the patient? What is the laser like for you as the user?
— Prof. Iaria: The big advantage of the laser is that we can often
do treatment completely without anesthesia, which the patients
find very pleasant. As the user, I value the high level of precision of
the SIROLaser Blue most of all. This means I do not have to worry
about any undesired side effects when I use the laser.
— Mrs. LeBeau: The biggest advantage for me is control, being
able to decide between Peak Pulse Mode, Continuous Wave
Mode and Chopped Mode. If the laser can be adjusted to meet
the specific indication for the patient, the procedure will be very
comfortable for both the user and the patient. Sirona has given
us excellent support in really using the laser to the fullest.
The results impress us as users and especially the patients.
As with any technology, understanding and maximizing the
ability of the machine is key to user satisfaction and excellent
clinical outcomes. P
PROFILES
Jan LeBeau, a dental hygienist in
Irvine, California (U.S.), has been practicing and teaching for more than 30
years. In 2009 she joined Pacific Dental
Services as the Director of Dental
Hygiene. She is a member of the Academy for Laser Dentistry and the American Dental Hygiene Association.
Prof. Dr. Guiseppe Iaria holds
a chair at the School of Dentistry at Genoa University
(Italy) where he also teaches
the International Master
Course "Laser in Dentistry".
He is a qualified surgeon and
received his PhD in Dentistry/Orthodontics from
the University of Milan. He
is the chairman of the Italian Dental Laser Academy. In 2013
his son Matteo (left) started working with him and after two
months he became the first Italian user of the Sirona Omnicam.
Father and son use lasers and other high-tech devices
because of the benefits, workflow and great patient acceptance.
SIROLaser and CEREC: a successful team
With CEREC treatments, the use of diode lasers has proven to
be very helpful. As clinical studies show, the precision and
durability of ceramic restorations substantially depend on a
clear and dry presentation of the operating field. Sirona lasers,
with their extraordinary cutting and coagulation power, can
help to correct the preparation margin and to attain hemostasis during the optical impression, the adhesive cementation and the uncovering of implants.
SIRONA VISION — issue 02/15
page 38
How do you explain your musical
success?
It’s all About
Doing a Great Job
Dr. Alban Nazwa (55) had his own dental practice in Sweden. He
knows Sirona products pretty well and used some of them in his
practice. After having great success in the music business, he
concentrated only on his work as a musician. In our interview with
him, he showed that both the music and the dental industry have
a lot in common. Six questions for the passionate musician.
— It’s a mixture of hard work and a little bit
of luck; being at the right place at the right
time. You cannot predict what will happen
with your songs. But it is one of the most
exciting feelings when people appreciate
what you’re doing. I have sold over 16
million records – that’s quite good, isn’t it?
What do you think a dentist needs to be
successful?
— You have to be as correct as possible.
You should tell the patient exactly what you
are doing and explain to him or her what
they can expect. Just be honest and smart
because if the patient doesn’t feel that
you’re getting it right, you will never have
their trust again.
What do you think a dentist’s practice will
look like in ten years?
What motivated you to study dentistry?
— There was no special motivation. My
­family wanted me to become a lawyer
or a kind of doctor, so I decided to become
a dentist.
Did you enjoy being a dentist? Do you
have any experience with products by
Sirona?
— Oh yes, I like Sirona products. And it’s
interesting: I used products by Sirona
and was really pleased with them. But I do
not have a dental practice anymore. Music
– this is my life.
What do you see as the connection
between medicine and music?
— You work with people in both professions.
It’s all about doing a good job and about
meeting the expectations of fans or patients.
It is not as easy as it sounds but it is a really
good feeling if you manage it.
— I think we’ll see less surgery and less
prosthetics. People nowadays are taking
good care of their teeth, more so than
ever before. In my opinion there will be
much more esthetic dentistry in ten years.
profile
Dr. Alban Nazwa, born in Nigeria, immigrated to Sweden at
the age of 18. At age 23 he started dental school in Stockholm. To finance his studies, he worked as a DJ in Alphabet
Street, a nationally known disco in Stockholm. His style
quickly made him famous beyond the disco because he added his own voice to the records he put on the turntable. He
became internationally famous with the hits “It’s My Life”
and “Sing Hallelujah.” Alban finished his studies and worked
in his own dental practice before becoming a professional
musician.
good to know — MISCELLANEOUS
page 39
DIGITAL COMPANION FOR
DAILY PRACTICE ROUTINES
The internet is an endless source of information – unfortunately some information cannot always be found quickly. www.dental-cal.com is the place to go for those who are
interested in further training in the dental industry and other interesting events. Dr.
Gerhard Werling, a dentist in Bellheim (Germany), has a global collection of dates and
events on this portal. Every dentist, every dental technician, and every dental assistant
can publish their own offers there easily and free of charge. The platform is also open for
businesses, educational companies, and other institutions. Different viewing modes such
as a calendar and map view make it easy to identify interesting events. A newsletter and
extensive language support – in addition to German and English, the website is also
available in French, Italian, Spanish, Japanese and Russian – complete the offer. The
website is also optimized for mobile devices.
FIND US ON THE APP STORE AND AS E-PAPER:
LEGAL NOTICE
Publisher
Sirona Dental GmbH
Sirona Straße 1
A-5071 Wals/Salzburg (Austria)
Email: vision@sirona.com
Phone: +43 (0)662 2450-0
Fax: +43 (0)662 2450-510
www.sirona.com
ISSUE
THE NEXT
MAGAZINE
OF VISION
BLISHED
WILL BE PU
2016.
IN SPRING
www.sirona.com/topics/vision/en
Responsible under German press law
Christina Schobesberger, Marion Par-Weixlberger
Sirona Dental GmbH in Wals/Salzburg (Austria)
Editorial and design
ergo Unternehmenskommunikation GmbH & Co. KG
Venloer Str. 241 – 245
D-50823 Cologne (Germany)
www.ergo-komm.com
Editorial office
Nina Marth (responsible), Britt Salewski, Christoph Nösser, Sebastian Düring,
Dana Stepanek, Marie-Luise Olesch, Karolin Rau; Sarah Hyden (Sirona)
Design
Isabel Schaller (responsible), Daniel Sanjuan
Special thanks also to
The Sirona Sales Marketing Team, Dr. Tarun Agarwal, Jan LeBeau, Farhad E. Boltchi,
Prof. Dr. Guiseppe Iaria, Prof. Dr. Werner H. Mörmann, Dr. Alban Nazwa, Ady Palti,
Dr. Anthony Ramirez, Steven Reiss Ph.D., Tony Robbins, Dirk Rosenthal
Printing
schmitz druck & medien GmbH & Co. KG
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Publishing interval
Semi-annually
Citation, even of excerpts, only permitted with reference. Due to various certification and registration periods, not all products are available in all countries.
We reserve the right to make technical modifications, typographical errors and
mistakes.
AND THE WINNER IS ...
We have drawn the winner of a silver iPad Air 2 (64 GB) – valued at around $600
US dollars – from among the participants of our reader survey from issue 01/15
of VISION Magazine. The winner is: Dr. Rudolf Pernegger, Traunstein (Germany).
Congratulations!
References p. 4 – 5
Guiness Book of Records / 2 Statista; U.S. Bureau of Labor Statistics / 3 Aileen Lee,
Welcome To The Unicorn Club: Learning From Billion-Dollar Startups, Nov 2, 2013. AOL /
4
FOCUS Online / 5 PwC study 2013 with 1,757 corporate executives
1
Image credits
Title p ©gettyimages, Apple Inc., Contents p Fox Awards/dapamedien Verlags KG,
©plainpicture/Fancy Images, Sony Music Entertainment Finland, p. 3 p Sirona, p. 6 p
©gettyimages, p. 7 p ©Nikada / istockphoto.com, p. 8 – 9 p ©Stocktrek Images/gettyimages, ©plainpicture/Fancy Images, p. 10 p ©Corbis Photography, ©gettyimages,
p. 11 p ©gettyimages, Steven Reiss, Sirona, p. 12 – 13 p Tony Robbins, Apple Inc., p.
14 – 15 p Sirona, ©gettyimages, Dr. Tarun Agarwal, p. 16 p Dr. Anthony Ramirez, p.
18 – 19 p Sony Music Entertainment Finland, Dr. Dr. Werner H. Mörmann, p. 20 – 21 p
Sirona, Apple Inc., p. 22 – 24 p Sirona, Apple Inc. p. 26 – 27 p ©Onfokus / istockphoto.
com, Sirona, p. 28 – 30 p ©narvikk / istockphoto.com, Dirk Rosenthal, Sirona, p. 31 p Dr.
Tarun Agarwal, p. 32 – 33 p ©rangizzz/shutterstock.com, Sirona, p. 34 – 35 p Farhad E.
Boltchi, Sirona, p. 36 – 37 p Sirona, Jan LeBeau, p. 38 p Dr. Alban Nazwa, p. 39 p iCal,
©istockphoto.com, Apple Inc.
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