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Espertise ™ Nr. 13 | APR 2008 © Andy Dean - Fotolia.com magazine EDITORIAL Dear Readers, A long time ago, Leonardo Da Vinci has stated that “Simplicity is the ultimate sophistication”. In the present time of globalization, computer technology and virtually endless opportunities and impulses, this wisdom is more essential than ever. Since everything seems to become increasingly complex, people are looking for products which are simple, convenient and reliable, which they can trust, like the selfluminous license plate of 3M. 3M ESPE has made the development and manufacture of products which enhance the ease of use a core business: materials like adhesives, devices such as the Pentamix™ Automatic Mixing Unit and packaging designs, e.g. the Clicker™ Dispenser or L-Pop™ Blister, which will all be introduced in this issue. You will CONTENT have the opportunity to learn how simplicity makes life easier and more pleasant for dentists as well as patients. Dentists benefit decisively from a more efficient workflow, while both profit from an improved hygiene, and more accurate, reliable results. The guiding idea behind innovations of 3M ESPE: “Genius is the ability to reduce the complicated to the simple”. (C.W. Ceran) Enjoy reading! Gerhard Kultermann, Editor Simplicity: adhesive solutions ........................................... 2 Expressions of simplicity ................................................... 4 Simply fast mixing ............................................................. 5 Perfect combination – simplification in product and package ............................ 6 The easy way to long-lasting posterior restorations .......... 7 Digital workflow improves productivity for dental technicians ........................................................ 8 Straightforward innovative technologies ........................... 9 Smart solution for temporary restorations ...................... 10 Simple and safe – if you know how to handle it .............. 12 Automatic procedure for dentists .................................... 14 Offering the most elementary dental emergency supply on a Philippine island .............. 15 Pioneer work in delivery systems .................................... 16 Uncomplicated therapy approaches ................................. 18 Rapid diagnostic test as weapon against MRSA .............. 19 Product Information Two new Adhesives – Adper™ Easy Bond Self-Etch Adhesive and Adper™ Scotchbond™ SE Self-Etch Adhesive Simplicity: adhesive solutions Heike Fürst, 3M ESPE, Seefeld, Germany With a busy patient schedule, dentists deserve to use products that help make their work easier. Today, that means simplicity and convenience. Incorporat- One component, one coat, one step ing 25 years of adhesive experience into its new products, 3M ESPE offers Advancing upon the chemistry of predecessor products, the single-bottle two new options in self-etch dental adhesives: Adper™ Easy Bond Self-Etch product Adper Easy Bond Self-Etch Adhesive provides fast and easy applica- Adhesive (Fig. 1) and Adper™ Scotchbond™ SE Adhesive (Fig. 2). In addition tion along with the reduced risk of post-operative sensitivity offered by a self- to convenience, high bond strength and reduced risk of post-operative sensi- etch adhesive. The “one-component, one-coat” convenience of the new tivity, there is a long list of other advantages in employing the two new adhe- adhesive expunges virtually every redundant step, while delivering reliable sives. bond performance which demonstrates the predominance of 3M ESPE in adhesive technology. Adper Easy Bond adhesive is available in the easy-touse L-Pop™ unit dose delivery system that offers convenience and speed, leaving minimal time for contamination during procedures. The use of the L-Pop is easier than unpacking a lollipop (Fig. 3), since no unwrapping is necessary for the L-Pop: the larger blister is simply pressed in order to transfer the adhesive into the smaller blister enclosing the applicator. After having turned the applicator around briefly, the brush is simply pulled out and used. Fig. 1: Adper™ Easy Bond Self-Etch Adhesive © sam richter - Fotolia.com 2 Fig. 3: Lollipop Another benefit of Adper Easy Bond is the utilized filler technology for optimized bond performance. Unlike total-etch adhesive systems, Adper Easy Bond adhesive simultaneously etches and bonds to dentin and enamel in one step. This implies that only one component, one coat and one step are required to achieve a strong and reliable bond. In the case of dentin bonding, simultaneous etching and adhesive penetration eliminates dependence on “moist” Fig. 2: Adper Scotchbond SE Adhesive ™ ™ bonding which is characteristic of previous “one-bottle” systems and which is Nr. 13 | APR 2008 Espertise ™ magazine associated with post-operative sensitivity. The result is a satisfactory penetra- Nanoleakage, resulting from an insufficient penetration depth of the adhesive, is tion depth and the forming of a hybrid layer. Nanoleakage, resulting from an significantly impacted by this mechanism. Furthermore, the product has a high insufficient penetration depth of the adhesive can be prevented by this mech- moisture tolerance and also acts as a root surface desensitizer. 3 anism. The moisture tolerance is high: it works on wet as well as on dry enamel or dentin. Performance in independent studies has shown that its bond strength is equal to or higher than that of one-bottle and even of two-bottle self-etch adhesives. The new self-etch adhesive is perfectly suited for root desensitization. Fig. 4: Color indicator, courtesy of Dr. Jorge Perdigao, University of Minnesota Additionally, a study performed on Class V restorations by Professor Dr. B. Haller, University of Ulm, indicates a high marginal integrity, while the micro- © Mario Bongen - Fotolia.com Simply variegated Adper™ Scotchbond™ SE exhibits the characteristics of a strong bond and a reduced risk of post-operative sensitivity. The patented bonded nanofiller offers optimized bond strength and the product is characterized by a good © Gina Sanders - Fotolia.com leakage turned out to be very low. Fig. 5: Painting of a wall: white on white as opposed to yellow on white stability without cooling or shaking. To prevent hydrolysis during storage and assure stability, the aqueous component is kept separate from the acidic resin until it’s combined on the tooth. The Scotchbond SE adhesive offers a totaletch performance in a self-etch adhesive and a color-change indicator. The ideal workflow Since increasing numbers of dentists are opting for self-etch adhesives for a simpler procedure and reduced risk of post-operative sensitivity, the scientists The indicator is used to ensure proper placement and activation. The pink at 3M ESPE have looked at ways to take the confidence in self-etch to a whole primer solution is a visual indicator of coverage. This is comparable to painting new level. They have succeeded with both products, the Adper™ Easy Bond a wall: when painting white on white, you cannot see which parts are already and Adper Scotchbond SE Adhesives. painted and the risk of neglecting some spots is high. A visible color prevents this. As the adhesive is applied over the primer, the color disappears to show Both innovative products have achieved a simplification of the dentists work adhesive coverage, and let the dentist know the etch is activated. This con- processes. Adper Easy Bond impresses through its packaging and the simple cept strongly facilitates the dentist’s work process (Fig. 4 and 5). one-component, one-coat, one-step performance, while the simplicity of Adper Scotchbond SE lies in its color indicator and the total-etch perform- Moreover, Adper Scotchbond SE contains a surface-modified, bonded zirconia ance. Both exhibit the features of a strong bond and reduced risk of post- nanofiller which provides radiopacity and thus helps to prevent misdiagnosis of operative sensitivity as well as moisture tolerance. Long-lasting, excellent a pooled adhesive as secondary decay. When bonding to dentin with Adper results with less risk of contamination can be achieved with both adhesives. Scotchbond SE, etch and adhesive penetration occur simultaneously and at the The new adhesives result in confidence and maximum convenience for the same depth. Also here, the dependence on “moist” bonding is eliminated. clinician and improved circumstances for the patient. Lifestyle Sometimes, less is more Expressions of simplicity Heike Fürst, 3M ESPE, Seefeld, Germany the motto “Less is more” to describe his esthetic way of arranging the numer- 4 © Niko Vujevic - istockphoto.com ous necessary components of a building to create an impression of extreme simplicity. Minimalist design and architecture uses relatively simple structures with unnecessary lines hidden or made barely visible. Cubic forms and reduced designs are typical. In art, minimalism strives for objectivity, schematic clearness, logic and depersonalization. Reduced, clear, simple and basic geometrical structures are representative for simplicity in art as well. In modern paintings, simplicity is perceived as esthetic. Literary simplicity is characterized by a reduction to the most essential words This issue is devoted to the topic of simplicity, a matter which, at present, is of high relevance for diverse areas of life. Simplicity is defined as the property, condition, or quality of being simple or uncombined and stands for the clarity of expression. It can also mean the absence of luxury or showiness, affectation or pretense. Nowadays, many people strive for simplicity of their lifestyle, e.g. with respect to food or during their holidays as opposed to the modern and a focus on surface description. Minimalist authors avoid adverbs and let the context dictate meaning. Rather than reacting to directions from the author, readers are expected participate in the creation of a story. The characters in minimalist stories and novels tend to be unexceptional; they may be athletic coaches or sales people rather than wealthy people and famous detectives. work life, which is often described as complex and intransparent. Minimalistic and simplistic movements in architecture and art, literature and philosophy are found in diverse periods throughout history. 3M ESPE and simplicity Thus, simplicity has always played a decisive part in human life. Its importance is found in many areas of life. Today, expressions of simplicity are often Simplistic philosophical thought Ancient philosophers asked for theories which were not only harmonious and functional, but also simple. Albert Einstein, for example, was in line with this mental attitude. According to him, “Everything should be made as simple as possible, but not simpler.” The entry for simplicity in the Stanford Encyclope- a reaction to the hectic and complex course of life. 3M ESPE adopts this trend into its own philosophy. Reduced and clear structures are plain and convenient and therefore user-friendly. In concentrating on aspects which are really necessary, time can be saved and productivity is increased. Products from 3M ESPE facilitate work and everyday life. Sometimes, less is really more. dia of Philosophy is that “Most philosophers believe that, other things being equal, simpler theories are better.” There is a widespread philosophical pretheories are preferable appears in many guises and is accepted by many philosophers such as Kant, Galileo and Newton. Esthetic simplicity © Claude Dagenais - istockphoto.com sumption that simplicity is a theoretical virtue. The presumption that simpler In architecture and design, simplicity plays a decisive role as well. Minimalism is an architectural style which is characterized by simple stylistic elements and a lack of decorative details. Architect Ludwig Mies van der Rohe adopted Nr. 13 | APR 2008 Espertise Product Information ™ magazine Launch of Pentamix™ 3 Automatic Mixing Unit Simply fast mixing Thomas Klettke, 3M ESPE, Seefeld, Germany The Pentamix™ 2 Automatic Mixing Unit for electronic mixing (in Pentamix 2) compared to impression materials has clinically proven itself hand mixing. Participants rated their level of pref- thousands of times amongst dentists throughout erence for five questions: ease of mixing, control the whole world. The unit is used to electronically of loading, quality of mixing, level of cleanliness mix the necessary materials for virtually every and overall rating. The duration of mixing was also indication and every technique. The system exhib- measured. 5 its various advantages: since only the required amount of paste is used, almost no material is The results of the study showed that all partici- wasted. The consistent quality of the mixed mate- pant groups preferred electronic mixing to mixing rial makes the process reliable. Moreover, the use with a hand-dispenser or manual mixing. Previous of a machine for mixing is highly hygienic: direct studies have shown that compared to hand mix- filling of the tray and syringe reduces the risk of ing, both mixing with a hand-dispenser and elec- cross-contamination. Finally, it is maximally effi- tronic mixing techniques enhance the quality of a valuable counter space. Furthermore, it handles cient, since the push button activation makes it definitive impression. According to the ratings of easier and more convenient with the ambidex- fast and easy to handle. The results are excellent the participants, electronic mixing offers better trous one-button operation, and an easier car- and the use is straightforward. The strengths of ease of mixing, control of loading, quality of mix- tridge exchange as well as easy-to-attach mixing Pentamix 2 are a homogeneous and void-free ing and level of cleanliness. Thus overall, dentists, tips. With the touch of a button, it mixes and dis- mixing, simple dispensing by just pressing a but- dental assistants, and dental students prefer penses a completely homogenous mix which is ton, and a filling of the tray directly from the Pen- electronic mixing over hand mixing. free of voids that interfere with the accuracy of Fig. 1: Pentamix™ 3 impression details and the fit of the restoration. tamix Mixing Unit is ensured. Pentamix™ 3 – A faster star is born Due to the high speed, a longer working time is The strengths of the Pentamix 3 Mixing Unit are increased working time and less distortion of the A clinical study conducted by J. Nam, A. Raigrod- improved handling, speed, convenience and accu- impression, reducing stress and benefiting every- ski, J. Townsend, X. Lepe and L. Mancl (2007) racy. The new mixing unit (Fig. 1) dispenses one from patients to the dental and lab profes- provides information regarding the preferences of Penta™ Materials twice as fast as its predecessor sionals”. users for different impression mixing techniques Pentamix 2 and faster than any and duration of mixing. One purpose of this study electronic mixing unit. All types of was to compare the preference of mixing with 30 impression materials from light experienced dentists, 30 dental assistants, and body to putty viscosity can be 30 inexperienced first-year dental students used. Faster mixing and tray filling employing different mixing techniques. The par- means longer working time, which ticipants evaluated mixing heavy-body material enables the dentist with quick- using electronic mixing (in a Pentamix 2 Auto- setting materials more often With matic Mixing Unit) compared to mixing with a the smallest footprint of any hand-dispenser, and putty material employing devices on the market it saves gained. According to Bernd Gangnus, Global Category Manager, 3M ESPE, “a faster mix allows for © Dev - Fotolia.com Persuading quality and ease of mixing Fig. 2: A new dimension of speed Product Information Ketac™ N100 Light-Curing Nano-Ionomer Restorative in the Clicker™ Dispenser Perfect combination – simplification in product and package Maria Bauer, 3M ESPE, Seefeld, Germany 6 The benefit of glass ionomer restorations is well- ning (Fig. 2) Clicker™ Dispenser which implies sim- usual packaging designs. In an observational known: they release fluoride and protect from sec- plified mixing and dispensing with accurate, repro- study, the participants rated the handling of Ketac ondary caries. However, their weaknesses – lack- ducible dosing. The Clicker dispenser is a N100 above average compared to the usual glass ing strength and esthetics of the substance – are dual-component dispenser with two separate ionomers they used. Furthermore, excellent clini- familiar as well. Ketac™ N100 Light-Curing Nano- channels of material. This offers a simple and fast cal results are achieved with Ketac N100. The Ionomer Restorative (Fig. 1) developed by 3M ESPE hygienic solution to the employ- is different: it is the first-ever nano-ionomer. ment of two pastes. The use of 3M ESPE has combined its highly regarded reputa- the Clicker dispenser is easy: the tion for expertise in nanotechnology and its tradition clicker lever simply has to be of glass ionomer innovations to obtain a product depressed fully in order to dis- with outstanding characteristics. pense one click of substance onto the mix pad. Release the The straightforward nano-ionomer lever when the paste is extruded Ketac N100 Light-Curing Nano-Ionomer restora- repeated and thus, the amount tive excels by a combination of wear resistance, of material which is dispensed polish and esthetics. Moreover, it offers fluoride can be chosen freely. The paste release similar to conventional and resin-modified is automatically dispensed in equal volumes. For surfaces remain smooth and outstanding esthet- glass ionomer restoratives. The product is indi- usual implementation, two clicks are adequate. The ics is obtained. Ketac N100 in the Clicker dis- cated for a broad range of restorations, namely pastes can easily be mixed together with a plastic penser presents a perfect combination of package primary teeth restorations, small Class I as well as or cement spatula. Thus, the material is brought and product: an esthetic, fluoride-releasing Class III and V restorations, transitional and sand- directly from the Clicker to the pad and is ready to restorative solution, with superb polish along with wich restorations and core build-ups. The benefits apply after mixing. No additional devices such as a simple, clean, hygienic appliance of the product for the dentists and their patients are multisided: mixer, activator, appliers or mixing tips are needed. in the Clicker which always offers an exact dos- it is simple to create a high initial gloss and to The Clicker dispenser makes it faster and easier to ing. obtain a smooth final surface; the use of the prod- dispense and mix the perfect dose every time the uct is time-saving in situations such as Class V product is needed. Clean up is significantly reduced restorations, where polishing is difficult, and it since less mess is produced. Thus, routine cemen- features the ability to create a caries inhibition tation is simplified, reliable and convenient. completely. For additional substance, the process is simply Fig. 1: Ketac™ N100 in the Clicker™ Dispenser zone, as in vitro studies have shown. Reduced to essentials Practioners fascinated by product and packaging A further great advantage is the packaging of Ketac Dentists are satisfied: the paste formula in the N100. The product is available in the award-win- Clicker dispenser is faster and easier to use than Fig. 2: Award-winning: the Clicker™ Dispenser Nr. 13 | APR 2008 Espertise Results ™ magazine Filtek™ Silorane Low Shrink Posterior Restorative The easy way to long-lasting posterior restorations Oliver Kappler, 3M ESPE, Seefeld, Germany For more than 40 years, 3M ESPE has been supplying resin composite filling in natural-looking restorations to be obtained with an easy single-shade tech- materials to the dental profession – longer than any other manufacturer. The nique. Simple shade selection is possible from the four popular shades A2, ultimate goal of 3M ESPE is to offer innovative products which are easy to use. A3, B2 and C2 provided in one opacity. Last but not least, even under full Filtek™ Supreme XT Restorative is based on nanotechnology and is ideal for surgery light, the unique cationic ring-opening chemistry allows a working use in both anterior and posterior restorations, fulfils the need for a highly time up to 9 minutes for shaping the filling and restoring the tooth to its natu- durable universal composite with excellent polish characteristics and a facili- ral function (Fig. 2). The product is long lasting and ensures an excellent tated handling. Now, the successful product has received a strong partner, look. Filtek™ Silorane Low Shrink Posterior Restorative. Both have evolved from 3M ESPE’s rich innovative tradition and can be employed complementary in The ease of use is confirmed by dentists: In an independent blinded test by 60 restorations. They are part of a complete line of high-performance products dentists the handling of Filtek Silorane was compared with market leading for restorations. composites. The authors concluded that Filtek Silorane could be a “good alternative for the posterior region for dentists who like to work under full Silorane chemistry operatory light and prefer a non-sticky material that holds its shape” (Taschner et al. 2007, ZWR). Filtek Silorane Posterior Restorative is based on the long-standing customer need for low shrinkage in combination with simple handling characteristics, enabling dentists to realize superior posterior restorations in an easy way (Fig. 1). The key to success is a completely new approach to the resin matrix: silorane chemistry. This technology for the first time allowed reducing volume shrinkage below 1%1). Furthermore, Filtek Silorane helps to minimize problems associated with polymerization stress such as enamel fractures and marginal gap formation. The product demonstrates physical and mechanical properties equal or superior to clinically proven posterior composites. Fig. 1: Extensive MOD restoration with Filtek Silorane 5 months after placement, courtesy of Dr. Krastl, University of Basel A solution of striking simplicity build strong contact points and to create a natural shape. Additionally, the dentist is provided with a surface free of an inhibition layer which enables fast and easy polish of the restoration. The pronounced chameleon effect results 1) According to Watt’s bonded disc method 0 TP H® Fil 3 tek ™ Sil ora ne stress. The non-stickiness and the excellent ability to hold shape facilitate to an dio ® sophisticated layering due to intrinsically low polymerization shrinkage and 2 Gr through its ease of use. During build-up of the restoration, there is no need for 4 Qu Pre i Xf il ™ mi se ™ pa ck ab Sp le ec tru m® TP H® and Bond. This Filtek Silorane System (Composite and Adhesive) convinces 6 the tX ® Fil tek ™ Z2 50 Fil tek ™ P6 0 its dedicated Silorane System Adhesive which consists of a Self-Etch Primer 8 Es ment. Optimal bonding of Filtek Silorane Restorative to the tooth is ensured by Ambient Light Stability [Min] tial adaptation to the bond film allows for easy placement of the first incre- Te tric Ev oC era m® Especially conspicuous is the simple handling of Filtek Silorane: excellent ini- 10 Fig. 2: Ambient light stability of Filtek™ Silorane Low Shrink restorative and methacrylate composites at 8000 Lux (Method based on ISO 4049) Source: 3M ESPE, internal data 7 Production Information Industrial fabrication of restorations – Lava™ Precision Solutions Digital workflow improves productivity for dental technicians Dieter Klasmeier, 3M ESPE, Seefeld, Germany 8 Lava™ Precision Solutions from 3M ESPE have Effortless production of frames been established as state of the art for CAD/CAMproduced zirconia restorations. The success of With Lava Precision Solutions, it becomes easier Lava Precision Solutions is based on an ingenious for dental technicians to attain perfect results of combination of high-quality materials and innova- their work. The digitalized workflow implies a sig- tive devices which work together in harmony. 3M nificant improvement of their productivity. For ESPE brings vast expertise in materials science, Fig. 1: Lava™ art technicians, it becomes easy with Lava to create high-quality all-ceramic restorations in just a few digital technologies and systems integration to create products that consistently meet the high ware from 3M ESPE to do the planning and con- steps. They can leave the production of the resto- standards dentists and laboratories expect. Preci- structing themselves. They have the opportunity ration to a supplier and thus have the benefits of sion solutions from the Lava™ brand provide the to increase profitability and to generate additional lower costs for investing and increased flexibility. advantage of a digital workflow which improves revenue by making use of the total digital work- Excellent results are achieved which satisfy den- the productivity for dental technicians. flow. The veneering is done in the own laboratory. tists as well as patients. Due to saved time by outsourcing the fabrication Let others do the work for you of restorations, a redirection of resources becomes possible. By outsourcing the fabrication of the restorations, the technician significantly simplifies his work process. Lava™ products, which are fabricated in the Superfluous work steps laboratory through a digitalized process, fit per- Increasing digitalization of the production process fectly into the technician’s work routine. With Lava, makes life for Lava™ milling centers simple as it is not necessary to purchase or maintain an well. In the authorized Lava milling centers, the inventory; the customer pays only for the frame- computer is a valuable assistance for the staff. work materials which are required for each individ- First, the Lava™ scanner, using sophisticated ual order. This broadens the options of technicians technology, makes the scanning step simple and for restorations, while they benefit from a reliable at the same time ensures a high accuracy of the on time delivery. In the own laboratory, no scanner results. The scanner automatically records and is needed or software use has to be learned. The digitizes the saw-cut model with its dies and scanning and constructing is done by the milling ridges, while manual changes are always possible center, which does not even require a wax model. if desired. The Lava™ milling unit also uses CAD/ The technician simply sends in a saw-cut model CAM technology which offers perfect results with and gets back a complete zirconia frame. minimal manual intervention. Before sintering, the Fig. 2: Lava™ scanner frame is colored using one of eight shades. Finally, If dental technicians want to make their own way the frameworks undergo sintering and attain their into the digital future in order to increase their exact dimensions in the high-temperature fur- competitive ability and control of the design pro- nace. This gives them their density and final cesses, they can also purchase scanner and soft- strength. The sintering step is fully automatic. Fig. 3: Processing of the Lava™ frames Nr. 13 | APR 2008 Backstage Report Espertise ™ magazine Self illuminating license plate Straightforward innovative technologies Johannes Petit, 3M, Neuss, Germany 3M was founded in 1902 in the town of Two Harbors, Minnesota, when five 9 businessmen agreed to mine a mineral deposit for grinding-wheel abrasives. It was years, however, until the company managed to attract investors and quality production was mastered. In 1910, 3M moved to St. Paul and early technical and marketing innovations began to produce successes. Since then, innovative products with high quality standards have been produced. Even today, innovations have first priority for 3M, always focusing on simplicity of workflows and convenience for the user. An example of a resourceful idea of 3M is the innovation of a self illuminating license plate. Fig. 1: Self illuminating license plate as opposed to usual license plate License plates and their illumination Usual license plates are illuminated by two or three externally placed lamps, Brilliant technology which are directed towards the front face of the license plate. These estab- The solution is provided by an internal light source which is made up of lished external lamps, however, are suffering from a non-uniform illumination numerous light-emitting diodes (LEDs). The main benefits of the new license of the license plate and hence, their visibility is limited. The electrical input plate are the brightness of the light due to LED technology, its low energy energy is high. A further weakness of the external light sources is that they consumption and an esthetic appearance, since it is slim. By discarding exte- limit the design freedom of car designers. rior lighting elements, it allows more freedom in designs of automobiles. Mounting of the plates is easy. Last but not least, the self illuminating license These factors made 3M think about an innovative solution of a back-lit license plate contributes to an increased safety in road traffic: the high illumination plate being of a simple and reliable construction for homogeneous internal power supports early recognition and thus helps to avoid rear-end collisions. illumination. The fundamental idea to increase safety in road traffic through Studies have revealed that with self illuminating license plates of 3M, visibility visibility was of great importance to 3M. Desires of the automobile industry as is increased up to 50% as opposed to common license plates. Especially with well as of car owners were taken into account. problematic visibility conditions, the new plates can be a great help. Fig. 2: Mounting simplicity Clinical Results Protemp™ Crown Temporization Material Smart solution for temporary restorations Peggy Wolter, Kaltenkirchen, Germany 10 The fabrication of a temporary solution after an exhausting preparation session is a time-consuming task of the dental profession. Inaccurate impressions, temporary acrylics which shrink during ligation and the strenuous cleaning of rigid interproximal spaces at adjacent teeth – all this is known by as giving every practice staff a hard time. Now, 3M ESPE has developed a comprehensive range of composite crowns for the temporary restoration of canines, premolars and molars (Fig. 1). They persuade by an amazingly easy handling and their fabrication is simple; hence they easily satisfy the economic requirements of life in the practice. Fig. 2: Initial situation at tooth 37 after crown loss Fig. 1: Protemp™ Crown Temporization Material Patient case During his holidays, a new patient from a foreign practice came to our consultation hour. He had lost his crown restoration of tooth 37 and asked for help Fig. 3: The foil can be removed by carefully tearing it apart. (Fig. 2). The abraded, now unprotected tooth was very sensitive and made ingestion a painful matter. A sufficient temporary restoration was required. Step-by-step procedure To select the right size of the Protemp™ Crown, a measuring tool is inserted into the space the crown will fill to find out the appropriate size of the tooth gap. Then, the lightproof protective cube is opened and the thin plastic film is removed by carefully tearing it apart (Fig. 3). After a first fitting in the mouth, the malleable composite crown is trimmed to the optimal size with a small scissor (Fig. 4). The cervical marginal fit can be optimized easily by adaptation with a Heidemann-spatula. The occlusal profile of the crown is fitted by letting the patient bite onto the crown. Fig. 4: Trimming of the still malleable crown with a small scissor for the fabrication of an optimal crown height Nr. 13 | APR 2008 Espertise ™ magazine Great importance is attached to the subsequent exact light curing. Since the 11 still malleable crown might be pressed too hard during extraction, a complete extraoral polymerization can lead to unpleasant surprises. A little patience and intermitting behavior turn to account – a surface should be light-cured intraorally for about 20s, then, the crown should be lifted shortly before continuing in the same manner with the remaining surfaces. After polishing, the crown is cemented (Fig. 5 and 6). Due to its perfect fit and in order to simplify the subsequent removal of the restoration, it is useful to apply only little temporary cement. Fig. 6: Optimally treated, the patient can leave the practice after a short time. stump mounting. Inadequate marginal fit or missing approximal contacts are almost preassigned. If one has an inventory of the new composite crown, the tooth is simply prepared for a crown restoration, a Protemp Crown is cemented and the patient is able to leave the practice with an attractive restoration. A while ago it would have been possible to restore without stump mounting and impression taking only with help of a laboratory. Thus, time and external costs are saved in a smart manner. Due to the optimal wear resistance and excellent long term stability, even a medium-term restoration of posterior teeth with reduced substance is conceivable as alternative to a transitional denture, e.g. Fig. 5: Polishing of the margins to bridge a certain healing time after an endodontic and periodontal pretreatment. Esthetic losses do not have to be accepted – the overall optimal wall Conclusion Protemp™ Crown is able to do more than just make the usual fabrication of temporaries more convenient and time-saving. For teeth with a highly reduced tooth substance, the limits of matrix-technique are met quite quickly for the thickness provides a natural color effect without translucent temporary cement. With Protemp Crown, the fabrication of temporaries can even be fun! The three golden rules: 1. When in doubt rather choose the smaller size for a snug fit. 2. Trim the crown short rather than leaving it too long. 3. After tack cure and before final cure put crown back in situ a couple of times. Product Information Pluraject™ 2 Simple and safe – if you know how to handle it Annika Meyer, 3M ESPE, Seefeld, Germany 12 General problems in dental regional anaesthesia are often attributable to an the front. This will cause the rubber membrane of the flange cap to be pressed unintentional intravenous or intra-arterial injection. Effect failures can also inside by an appendage in the ampoule fixation (Fig. 2). The pressure in the occur due to unintentional intravascular injections since the local anaesthetic needle increases, forcing some local anaesthetic through it. When the pres- is quickly carried away from the injection site. In the retromaxillar area and sure is released from the thumb ring, the rubber membrane returns to its ini- nerve-block anaesthesia in the lower jaw, intravascular injection is most fre- tial position, creating a vacuum in the ampoule (Fig. 3). An unintentional quent1. A study on this topic showed that a blood vessel was penetrated in intravascular injection will become apparent by the appearance of a thin about 20%2 of the 250 study participants. The state-of-the-art aspiration thread of blood in the cylinder ampoule. The comfort of this self-aspirating check which is now available largely prevents injection into blood vessels. mechanism is the reason for most dentists why they prefer this way of aspirating. Several studies have wiped away the initial scepticism about the reliability Are you the active or passive aspiration type? of this mechanism. The new Pluraject™ 2 (Fig. 1) syringe, manufactured by 3M ESPE, was developed to address the issue of reducing the risk of intravascular injection. With the syringe, both, active and passive aspiration is possible. Aspiration should always be performed in different levels next to the area where the local anaesthesia are placed. The ability for aspiration is based on a solid connection between the hollow stopper of the cylinder ampoule and the piston rod of the syringe which is able to transfer pressure and tension. For active aspiration, the thumb ring back is simply pulled back. The cock-free adjusted connection then retracts the piston rod, creating a slight vacuum in the cylinder ampoule. Blood will enter the needle lumen and become visible in the ampoule, if the needle tip rests within a blood vessel. Administrators of the active type prefer this way of aspiration because it gives them the feeling of controlled aspiration as they define the pressure they exert on the surrounding tissue. Other dentists dislike this way of aspiration because they have to readapt their fingers to the aspiration position which in their opinion is uncomfortable. Fig. 1: The new Pluraject™ 2 syringe Self-aspiration does not mean the dentist has to do nothing The term “self-aspiration” may be somewhat misleading for passive aspirating systems. It seems to imply that the dentist does not have to do anything and that aspiration is performed by magic. The dentist just has to depress and release the thumb inside the thumb ring. For the system, however, there is something more happening than that: The cylinder ampoule is pushed towards Nr. 13 | APR 2008 Espertise ™ magazine Proven Reliability Different independent studies show that self-aspiration syringes are very efficient and offer secure aspiration, irrespective of pressure and needle diameter3. In modern self-aspirating systems the detection of hematic aspirations was also independent from length or gauge of the needles used, anaesthetic technique performed or operator who exercised the block4. So no matter which way to aspirate you prefer – with Pluraject™ 2, you are on the safe side. Fig. 2: Ampoule before aspiration References: 1) H.H. Horch (Hrsg.), Zahnärztliche Chirurgie. Kapitel 6: Jürgen Becker. Urban und Fischer. 2003. 2) F. Frangiskos, Stavrou E., Merenditis N., Tsitsogianis H., Vardas E., Antonopoulou I., Incidence of penetration of a blood vessel during inferior alveolar nerve block. In: British Journal of Oral and Maxillofacial Surgery. 2003; 41, 3, 88-89. 3) J.K. Petersen, Efficacy of a self-aspirating syringe. In: International Journal of Oral and Maxillofacial Surgery. 1987, 16, pp. 241–244. 4) E. Delgado-Molina, Bueno-Lafuente S., Berini-Aytés L., Gay-Escoda C., Comparative study of different syringes in positive aspiration during inferior alveolar nerve block. In: Oral surgery, oral medicine, oral pathology, oral radiFig. 3: Representation of the ampoule during self-aspiration ology, and endodontics. 1999, 88, 5, pp. 557-560. 13 Lifestyle Simple recognition of professional qualifications Automatic procedure for dentists Annika Meyer, 3M ESPE, Seefeld, Germany In the European Community, the free movement of persons and services is a regulated. Throughout the EU, improved mobility is possible due to the fundamental principle. One of its advantages for Community nationals is the enhancement of the system of mandatory and automatic recognition of diplo- right of establishment as a self-employed or employed person in each Mem- mas, by which the dentist profession is covered. ber State of the European Union. Before being allowed to work in another EU country, however, the professional qualification has to be acknowledged by The procedure is as simple as this: the competent national authority has to be the host country. contacted – useful addresses can be obtained at the website www.//ec.europa.eu/youreurope/nav/en/citizens/index.html (working in Europe – recognition of qualifications) – and the relevant diplomas and qualifications are handed in. The examination of the material is done by the authority: the system of recognition is based on concerted minimum training requirements. The requirement for dental training is the completion of a five-year full-time theoretical and practical course including certain commonly agreed subjects. It has to be ensured that the dentist has acquired the settled knowledge and skills. © breack - Fotolia.com Lack of regulations Non-regulated professions are subject to the rules and behavior of the labor market. Clear legal constraints with regard to the professional qualifications do not exist. The profession is not subject to any formal EU restrictions. This © .shock - istockphoto.com 14 implies that no authority at the European level is responsible for affairs concerning non-regulated professions. In theory, everybody is free to practice his profession in the host Member State with the same rights and obligations as its nationals. In reality, however, there seem to be various practical restrictions in this area, since insufficient knowledge of qualification requirements in Diplomas from each Member State which serve as evidence of having com- other countries constitutes a barrier to free movement. This can lead to prob- pleted dental training accordant with the minimum training requirements are lems when applying for a job. listed in a directive. These diplomas have to be acknowledged by the EU Member States and the holder is allowed to practise in the European Union. In Straightforward procedure general, it is easy for persons who are a national of a European Member State For dentists who want to work in an EU Member State other than their state origin to receive an acceptation. When the diploma is officially recognized, of origin, authorization and registration procedures are simple, since they are there are no barriers to start work in the new country. and which are fully qualified to work as a dentist in their Member State of Nr. 13 | APR 2008 Espertise People ™ magazine Aid with the simplest resources Offering the most elementary dental emergency supply on a Philippine island Annika Meyer, 3M ESPE, Seefeld, Germany A patient sitting on a plastic chair under palm trees; forceps, sponges, medi- Kühne and her team have worked under the most primitive circumstances. cine and germicides lying on a table. No electricity, no light, no running water. A torch light is used as surgery lamp. This or a similar strange scene could be During the last years, it was possible to improve the conditions of work. Lawn observed when Dr. Birgit Kühne first came to Mindoro to help. and rocking chairs are now used as dentist’s chairs. The practice is situated in a bamboo patio; the helpers thus have a roof over their head and even a temporary luxury of running water and electricity. Once a year, the in the meantime constantly growing group of volunteers comes to Mindoro to help the poor. 150 – 200 patients are treated each day. The manufacturing of simplest prostheses poses a great challenge. Under the prevailing tropical conditions, the work of the volunteers is honoured by a deep gratitude of the lucky people. On medium term, tooth-maintaining activities, prophylaxis and trainings for the inhabitants are planned. 3M ESPE is one of the sponsors of the project: seeing that it serves the public good, 3M ESPE donates various products and devices for the project. Particularly 3M ESPE’s Atraumatic Restorative Treatment (ART) approach, which includes prevention as well as treatment of caries, is suited for work in devel- Fig. 1: Dr. Birgit Kühne helping in Mindoro oping countries, since the technique is simple and the equipment can be provided at low cost. Removal and excavation of caries are possible even with On a holiday trip to the Philippines in 1998, the dentist Dr. Birgit Kühne hand instruments. The tooth is then easily restored with adhesive filling mate- together with a small party around the Philippine healer Lino Guinsard became rial like Ketac™ Molar. acquainted with the living circumstances of inhabitants of a small village on the island Mindoro. Life has an extremely poor, rural character in the village. The people, mostly peasants, make their simple living from fishing or rice cultivation; a trip to the next city to visit a doctor is unaffordable. For health care, support is missing in every respect. Experiencing this situation of poverty, Dr. Birgit Kühne came to a decision: she wanted to help by offering the most elementary dental emergency supply. Half a year later, she came back to the island with a few assistants in her holidays, with medical equipment, such as forceps and anaesthetics in their luggage. A torch light served as surgery lamp. At first, they had to learn to prioritize without thinking too much in western terms. This meant to eliminate pain in the easiest way: to extract numerous teeth. During their first visit, Dr. Birgit Fig. 2: Ketac™ Molar Glass Ionomer Restorative Material 15 Ask the Expert Simplicity in innovative delivery systems Pioneer work in delivery systems Heike Fürst, 3M ESPE, Seefeld, Germany 16 Interview with Dipl.-Ing. Marc Peuker (Fig. 1), relevant. For the development of new delivery sys- graduate mechanical engineer, who has tems, simplicity is always crucial to us. worked for 3M ESPE, in Seefeld, Germany for more than 12 years. He is head of the Packag- Our main goal is to improve the simplicity and reli- ing and Delivery Systems group in the Techni- ability of our dental products. They often consist cal Research and Development department. of two components which have to be mixed in a well defined mixing ratio before use. Pre-sized portions ensure compliance with the optimal mixing ratio, and thus are important for reproducible and consistent results. Moreover, hygiene standards have to be fulfilled and shelf-life of the products has to be guaranteed. We at 3M ESPE have developed three different application systems which optimally satisfy these requirements: • Clicker™ Dispenser • Aplicap™ and Maxicap™ capsules • L-Pop™ Blister Fig. 1: Marc Peuker Please outline the functions and use of the Clicker™ Dispenser. Fig. 2: Ketac N 100 Clicker™ Dispenser Mr. Peuker, you are responsible for the development of new delivery systems with The Clicker Dispenser (Fig. 2) is a double-barrel material. Furthermore, there is no need for addi- innovative functions at 3M ESPE, Seefeld. dispenser which offers hygienic and fast delivery tional appliers, mixing tips or other devices which, What significance do innovative delivery of the required quantity of two pastes. The mixing in total, makes the Clicker Dispenser a very eco- systems have for 3M ESPE and what are the ratio is always reproducible (1:1) and the pastes nomic, “ready-to-go-dispenser”. main goals of developing new designs? can be easily mixed on a pad. Consistent material properties are ensured by simple and accurate Dentists are highly satisfied with this delivery sys- Since innovative delivery systems can increase the dosing, and easy paste-mixing. The desired tem due to its simple use. For this reason the user friendliness and avoidance of mistakes, as amount of dispensed material is simply selected Clicker Dispenser has convinced several juries well as, productivity and hygiene, they are highly by clicking either once, for a small dose, or a few that it deserves top honors: the delivery system important to the user and thus also to 3M ESPE. In times, for more extensive restorations. As an has won the Medical Design Excellence Award in order to satisfy our customers, the consistent advantage over automix systems no static mixer is 2005 and is winner of the Top Dispensing System improvement of our delivery systems is especially needed, which reduces the amount of wasted of 2008, an award from THE DENTAL ADVISOR. Nr. 13 | APR 2008 Espertise ™ magazine Let us now talk about the Aplicap™ and cementation voids. For larger restorations, e. g. for Maxicap™ capsules. Please outline the use multi-unit bridges, the Maxicap capsule contains of the products and the advantages for the two to three times the volume of an Aplicap. 17 user. Finally, there is a unitdose system named Aplicap and the larger Maxicap are capsules for L-Pop™. Which characteristics and functions intraoral use which contain two components, a have to be mentioned here? powder and a liquid. After the capsule is activated, Fig. 4: Adper™ Easy Bond Unitdose in the L-Pop™ Blister been available on the market for eight years with the liquid and powder combine before being thor- The Adper™ Prompt™ L-Pop™ blister package is a more than 130 million sold applications and won a oughly mixed in a capsule mixer. The product is time saving “push-a-button-unit-dose”. The series of awards: the German Packaging Award in now ready for use and can be directly dispensed by unique design contains the adhesive and a brush- 1999, the World Star Award for Packaging Excel- means of an applicator. The strengths of this deliv- tip applicator, all in one. The package consists of lence in 1999, the Medical Design Excellence ery system are the high reproducibility of the vis- three different chambers. Two chambers are filled Award in 2001 and the Alufoil Trophy 2006. How- cosity due to an exactly pre-dosed amount of pow- with liquids. The user only has to press the first ever, the L-Pop™ delivery system also exists with der and liquid, and the hygienic unit dose capsule, chamber to open the path to the second chamber only one component, since the benefit of wetting which can be used intraorally. The most recent and combine the two liquids. Then, the user folds a brushtip applicator directly by pressing a blister innovation concerning the Aplicap is the RelyX™ the L-Pop and the second chamber is pressed in means a great improvement in hygiene and ease Unicem Aplicap Elongation Tip (Fig. 3), a tip which order to release the components into the brush of use. Adper™ Scotchbond™1 XT, as well as, extends into a dental root canal and applies the reservoir. The mixing happens through this activa- Adper™ Easy Bond (Fig. 4) are unitdose products cement from the bottom to the top, eliminating tion process and through subsequent spinning of with one component only. the brush tip applicator in the reservoir. Then the mixed material is ready for intraoral application. What makes the 3M ESPE innovative delivery systems so successful? The main advantage of this delivery system is again its simplicity. It is a hygienic foil package The success of our delivery systems is based on with an integrated applicator for practical and the aim to satisfy the needs of the customers. The time-saving use which also provides exact quanti- simplicity of our delivery systems is key. Optimal ties of fluids due to pre-sized amounts of liquid in ease and reliability of use is a decisive aspect in the chambers. choosing a dental product. Moreover, with timesaving delivery systems, the dental professional Fig. 3: RelyX™ Unicem Aplicap™ with Elongation Tip for voidfree fiber post cementation Moreover, there are no bottles to be opened and increases his productivity. An improvement in closed and no additional pouch or mixing well is hygiene is an increasingly important aspect for necessary. The L-Pop™ unitdose package has the dentist, as well. Lifestyle Helicobacter therapy Uncomplicated therapy approaches Annika Meyer, 3M ESPE, Seefeld, Germany “Helicobacter pylori” is a genus of spiral small biotic treatments. Therefore, various researchers bacteria that are able to survive the severe acidity are constantly searching for solutions. of the stomach. The existence of such bacteria was found in 1889 but it wasn’t until 1983 that the significance of these bacteria was realized. Marshall and Warren described the development Olive oil might be the simple answer of ulcer in the stomach due to an infection with C. Romero, E. Medina, J. Vargas, M. Brenes and A. Helicobacter pylori. De Castro have discovered that Helicobacter, being resistant to many antibiotic treatments, does not Widespread infection like virgin olive oil. The oil contains a considerable About 50% of the world’s population is infected from the oil into the gastric juice under stimulated with the bacterium Helicobacter. It survives in the conditions. In this amazingly acidic environment, extreme acidity of the stomach by using enzymes. the phenolic compounds can be stable for hours. In The bacterium generates inflammation in the an in-vitro experiment, they have developed a stomach tissue, which can lead to the formation of strong bactericidal activity, even against strains of ulcers. Helicobacter infection may cause stomach Helicobacter pylori which are resistant to antibiot- cancer in human beings: The risk for the develop- ics. The bactericidal concentration is much lower Since precise information regarding infection- and ment of cancer is increased by 400% for people than those found for phenolic compounds from transmission paths is still missing to a large who are infected. In fact, in about 90% of duode- wine, tea, and plant extracts. The effect of olive oil extend, the study of Dr. Bürgers is of great impor- nal and 70 – 80% of stomach ulcers of humans, is not yet confirmed in vivo, but the results of the tance. The evidence indicates that the oral cavity a chronic mucosa inflammation stemming from study open the potential of employing virgin olive oil is a potential reservoir and area of transmission of infection with Helicobacter bacteria is found to be as a chemopreventive agent for peptic ulcer or gas- the infection for Helicobacter. This can indeed be the base for the development of ulcer. Therefore, tric cancer. The study was published in the Journal of decisive importance for future strategies of a consequent therapy is essential. of Agricultural Food and Chemistry (2007, vol. 55, infection-prophylaxis and therapy. The study no3, pp. 680-686). results are probably a first step in identifying per- amount of phenolic compounds which can diffuse Until the 1980’s, stomach ulcers were treated with antacids, since it was common belief that © Natalya Korolevskaya - Fotolia.com 18 Fig. 1: Is olive oil the simple answer? sons with a high risk of stomach cancer by a saliva Early diagnosis swab test. ulcerative infection is treated both with antacids Another genius, award-winning discovery was Both discoveries are simple but genius ideas as well as antibiotics specifically directed against made by Dr. Ralf Bürgers, Regensburg, Germany which contribute to a better understanding of bac- Helicobacter, which is then successfully defeated. who has succeeded in finding evidence for the teria and to a possible treatment and prevention of However, the infection cannot always be cured, existence of Helicobacter pylori in the oral cavity infection respectively. They exhibit a great future since Helicobacter is sometimes resistant to anti- without having the stomach colonized as well. potential. excess acid had caused the ulcer. Currently, this Nr. 13 | APR 2008 Espertise Backstage Report ™ magazine 3M BacLite™ Rapid Rapid diagnostic test as weapon against MRSA Heike Fürst, 3M ESPE, Seefeld, Germany 3M has been a global leader in developing health 19 care products and services addressing infection control for more than 30 years now. 3M, with its business segment Health Care, is a highly successful provider of solutions for medical, oral care, drug delivery and health information markets. Its main goal is committed to improving the practice, delivery and outcome of patient care. Recently, 3M has developed a rapid test for the identification of MRSA. Fig. 1: Microscopic photograph of MRSA Characteristics of MRSA MRSA stands for Methicillin-resistant Staphylococ- The simple, practical solution cus aureus. Staphylococcus aureus is one of the Traditional culture-based screening or molecular high diagnostic sensitivity. It is thus the first rapid most important pathogens in human beings and diagnostics are time-consuming or expensive. culture test that can effectively and reliably detect can lead to various types of infections. Methicillin- Therefore, 3M has launched BacLite™ Rapid, a the absence of MRSA in just five hours. “We are resistant Staphylococcus aureus is a leading cause culture-based rapid MRSA test which delivers very excited about these results which represent of nosocomial infections (= infections acquired in reliable, fast, and accurate results within five an important advance in the fight against MRSA,” the hospital. It is spread by hospital staff or patients hours. According to Professor Dr. Jan Kluytmans, said Steve O’Hara, microbiologist and lead author who carry MRSA on their skin. According to diverse Consultant Hospital of the study. “These results show that the 3M studies, hygiene measures like e.g. hand hygiene Breda/Oosterhout and VUmc Medical University BacLite Rapid MRSA test could be a valuable are the most effective measures to control MRSA. Amsterdam, the Netherlands, “The launch of this laboratory tool to help hospitals meet tough gov- new test represents an important advance in the ernment targets and control the spread of war against MRSA”. MRSA.” While in 1990, less than two percent of the bac- Microbiologist, Amphia teria were resistant to antibiotics such as Methicillin, the resistance rate is now about 27% in Ger- A UK-based study conducted by many and about 44% in the UK. Thus, the situation O’Hara, Gregory, Taylor, Gough and is more than just problematic. Since tests have Foote (Evaluation of the 3M BacLite revealed that early identification of the patients Rapid MRSA test for the Direct which are carriers of the bacteria can contribute Detection of MRSA from Nasal and to a significant reduction of the spread of MRSA, Groin Surveillance Specimens), pre- a fast and reliable test method is needed. It is fun- sented at the Infectious Diseases damental to take appropriate action as early as Society of America 45th annual possible. Delays obtaining MRSA screening meeting in October 2007, confirms results have been identified as a major barrier to that the 3M BacLite Rapid MRSA more effective infection prevention strategies. test provides consistent results with Fig. 2: Average infection rate with Staphylococcus aureus in hospitals Espertise General Information ™ magazine Calendar of Events 2008 E D I T O R I A L Information Date Event Location Website 22.04.2008 25.04.2008 30.04.2008 04.05.2008 01.05.2008 03.05.2008 Stomatologia Kiew Expo Dental AMIC Mexiko City www.medvin.kiev.ua Medvin www.amicdental.com.mx AMIC British Dental Conference & Exhibition 2008 Manchester 16.05.2008 17.05.2008 28.05.2008 30.05.2008 29.05.2008 31.05.2008 WID 2008 Wien German Dental Symposium Fuzhou / China Swiss Dental Exhibition Montreux 05.06.2008 08.06.2008 27.06.2008 29.06.2008 30.06.2008 05.07.2008 20.08.2008 23.08.2008 03.09.2008 06.09.2008 09.09.2008 12.09.2008 24.09.2008 27.09.2008 25.09.2008 27.09.2008 02.10.2008 04.10.2008 08.10.2008 11.10.2008 16.10.2008 19.10.2008 16.10.2008 18.10.2008 29.10.2008 01.11.2008 29.10.2008 02.11.2008 14.11.2008 16.11.2008 25.11.2008 29.11.2008 30.11.2008 03.12.2008 02.12.2008 05.12.2008 Sino-Dental 2008 SIDEX 15.TDA - International Dental Congress Expodent Stomatologia Dentalexpo FDI World Dental Congress CEDE 2008 BDTA Dental Showcase Expodental ADA Annual Session DENTEX DENTECH China Expo Dental AMIC Japan Dental Show 2008 ADF Congrès Greater New York Dental Meeting Expodental 2008 3M ESPE AG ESPE Platz 82229 Seefeld · Germany E-Mail: [email protected] Internet: www.3mespe.com Beijing-Beijing Exhibition Centre Seoul Istanbul Editors: Gerhard Kultermann Annika Meyer Editorial team: www.wid-dental.at Österreichischer Dentalverband VDDI www.dentalexpo.ch Abeitgeberverband der Schweizer Dentalbranche www.sinodent.com.cn IHEC www.sidex.or.kr Seoul dental Association Turkish-Dental Association (TDA) Buenos Aires www.expodent.com.ar CACID Kiew www.medvin.kiev.ua Medvin Moskau - Krokus Ex- www.dental-expo.ru hibition Center Dentalexpo Ltd. Stockholm www.fdiworldental.org FDI Poznan www.cede.pl Exactus ExCel London www.bdta.org.uk BDTA Mailand www.expodental.it Promunidi Srl San Antonio TX www.ada.org ADA Brüssel www.dentex.be C.V. Dentex International S.C. Shanghai www.showstar.net Showstar Exhibition Mexiko City www.amicdental.com.mx AMIC Yokohama www.japan.dental-show.jp JDTA Paris www.adfcongres.com Association Dentaire Francaise New York City www.gnydm.com Greater New York Dental Meeting Kiew www.medvin.kiev.ua Medvin Dieter Klasmeier Maria Bauer Laslo Faith John Rafelt Andreas Syrek Heike Fürst Coordination: Heike Fürst Production: www.eberl.de · Immenstadt/Germany Design and typesetting: Comcord GmbH · Düsseldorf/Germany Global circulation: 170,000 We accept no liability for unsolicited manuscripts or photographs. Court of Jurisdiction: Munich Published by: 3M ESPE AG ESPE Platz · 82229 Seefeld E-Mail: [email protected] Internet: www.3mespe.com 3M, ESPE, Adper, Aplicap, BacLite, Clicker, Filtek, Ketac, Lava, L-Pop, Maxicap, Penta, Pentamix, Pluraject, Prompt, Protemp, RelyX and Scotchbond are trademarks of 3M or 3M ESPE AG. EsthetX, EvoCeram, Grandio, Premise, QuiXfil, Spectrum and TPH are not trademarks of 3M or 3M ESPE AG. © 3M ESPE AG 2008. All rights reserved.
