Content uploaded by Luca Dal Carlo
Author content
All content in this area was uploaded by Luca Dal Carlo on Oct 17, 2019
Content may be subject to copyright.
DENTAL TRIBUNE
The World’s Dental Newspaper Middle East & Africa Edition
March-April 2019 | No. 2, Vol. 9Published in dubai www.dental-tribune.me
DENTAL PROFESSIONALS ONLY
HYGIENE TRIBUNELAB TRIBUNEENDO TRIBUNE IMPLANT TRIBUNE ORTHO TRIBUNE
ÿC1-4ÿB1-4 ÿD1-4 ÿE1-8
Interview: “Our practice has
doubled since implementing
the Insignia system...”
Interview: World Oral Health
Day with FDI President
Dr Kathryn Kell
Cherry on top in complete den-
ture prosthetics: individuality
and naturalness
ÿA1-4
Minimally invasive root canal
shaping – A new protocol
IDS reaffirms its leading position as
global dental trade fair
Digitalisation of the gold
standard of implantology
AD
By Dental Tribune International
COLOGNE, Germany: The International Dental
Show (IDS), which took place in Cologne from
12 to 16 March, fulfilled the high expectations
of the global industry and once again under-
lined its position as the leading trade fair. With
2,327 companies from 64 countries participat-
ing, this year’s event welcomed 20 more exhib-
itors compared with two years ago, as well as
160,000 trade visitors from 166 countries. The
overall number of visitors rose by 3.2 per cent
(about 5,000 more people) and the number of
foreign trade visitors by 6.0 per cent.
Gerald Böse, CEO of Koelnmesse, which stages
the show, said: “IDS is a trade fair in a class of
its own and always sets new benchmarks. It
manages to surpass the already excellent re-
sults of the previous event every time.” Both
visitors and exhibitors are impressed by IDS:
it is only here that one encounters supply and
demand of such an extent, quality and level of
internationality. “IDS is the undisputed lead-
ing global trade fair for the dental industry,” he
continued.
The official figures confirm the high level of in-
ternationality at IDS: 73 per cent of the exhibi-
tors and 62 per cent of the visitors came from
166 foreign countries, including Argentina,
Australia, Brazil, Canada, Chile, Egypt, Japan,
Korea, New Zealand, South Africa and the US.
Regarding the 6 per cent increase in foreign
visitors, IDS 2019 recorded significant growth
in the number of visitors from Asia (+23.1 per
cent), eastern Europe (+19.6 per cent), Africa
(+17.0 per cent), Central and South America
(+14.6 per cent) and North America (+5.3 per
cent) specifically.
An independent visitors’ survey reported that
the largest groups of visitors came from the
dental industry. Schools and universities were
strongly represented too. Almost 80 per cent
of those who completed the survey stated
they were satisfied or highly satisfied with the
range of exhibition offerings. More than 93 per
cent said that they would recommend visiting
IDS, and 70 per cent of the respondents were
already planning to visit the next IDS, in 2021.
Dr Markus Heibach, Executive Director of the
Association of the German Dental Industry,
which is involved in organising the event, was
also pleased with the outcome of the trade fair:
“The high level of satisfaction of our trade visi-
tors and exhibitors is for us impressive con-
firmation of our efforts to make our guests’
stay as pleasant and successful as possible by
offering them a cosmopolitan, hospitable and
perfect service.”
IDS offered the ideal business platform, es-
pecially for new companies on the dental
market seeking to establish themselves with
high-quality innovations, such as those for
improved digital workflows and additive pro-
duction, new prophylactic formulas and filling
materials, pioneering intra-oral scanners and
implant designs, as well as flexible workflows
for management of the laboratory.
The 39th IDS is scheduled to take place from
09 to 13 March 2021.
The 2019 International Dental Show exceeded the results of the previous event and the organisers attained
their goals of greater internationality and higher quality in supply and demand, boosting the satisfaction of
both exhibitors and attendees.
The 2019 International Dental Show exhibition
© Koelnmesse
See the latest innovations at the
14th CAD/CAM & Digital Dentistry Conference & Exhibition on 12-13 April 2019 in Dubai, UAE
Dental Tribune Middle East & Africa Edition | 2/2019 6mCME
By Dr Luca Dal Carlo, Dr Franco Ros-
si, Dr Marco E. Pasqualini, Dr Mike
Shulman, Dr Michele Nardone, MD,
Dr Tomasz Grotowski and Dr Shel-
don Winkler
Intraoral welding was developed by
Pierluigi Mondani1 of Genoa, Italy,
in the 1970s to permanently connect
submerged implants and abutments
to a titanium wire or bar by means of
an electric current (Fig. 1). The cur-
rent is used to permanently fuse the
titanium to the abutments in milli-
seconds, so the heat generated does
not cause any pathology or patient
discomfort.
If possible the implants are placed
without flaps. The titanium wire or
bar is bent and aligned passively to
the contour of the labial and lingual
surfaces of the implants before ap-
plying the electric current to perma-
nently connect titanium implants.
The technique follows a strict sur-
gical and prosthodontic protocol,
which includes using a number of
implants as close as possible to the
number of teeth to be replaced,
achieving primary stability by en-
gaging both cortical plates (bicorti-
calism), immediate splinting of the
implants utilizing intraoral welding
and immediate insertion of a fixed
provisional prosthesis with satisfac-
tory occlusion. The technique pro-
vides for immediate loading and
does not jeopardize the integration
process.2
Although intraoral welding has been
used successfully in Europe, especial-
ly Italy, for many years, it has yet to
achieve everyday use in the United
States.
Members of the Italian affiliate of
the American Academy of Implant
Prosthodontics, NuovoGISI, have
long and successful experiences
with immediate loading of maxil-
lary implants connected together by
intraoral welding.2
By inserting the prosthesis with ad-
equate retention and stability the
same day as the surgery, patient
complaints and discomfort can be
avoided or substantially reduced.
The instantaneous stability that re-
sults from the splinting can reduce
the risk of failure during the heal-
ing period. Intraoral welding can
also eliminate errors and distortions
caused by unsatisfactory impres-
sion making, as the procedure is per-
formed directly in the mouth.
Intraoral welding can fulfil a great
need for business and socially active
persons, as the surgical and prostho-
dontic procedures are accomplished
on the same day. Patients can leave
the dental office with a stable, esthet-
ic and retentive prosthesis.
Fig. 1. Schematic drawing of Mondani intraoral solder unit
Fig. 3. Nonrestorable teeth visible after removal of the patient’s pros-
thesis
Fig. 5. Immediate stabilization of the eight implants and two
additional implants previously inserted in the posterior regions,
by welding each implant to a 1.5 mm supporting titanium bar
Fig. 7. Healthy gingiva was observed after 90 days
Fig. 8. Lower implants welded together intraorally
Fig. 2. Preoperative panoramic radiograph of 50-year-old cauca-
sian woman
Fig. 4. Eight titanium one-piece implants are inserted.
Fig. 6. Panoramic radiograph after 90 days suggests complete
integration
Fig. 10. Seven-year follow-up radiograph shows satisfactory pres-
ervation of bone surrounding all of the implants
Fig. 9. Three-tooth mandibular fixed prosthesis
Fig. 11. Intraoral photograph of the definitive prosthesis shows
healthy gingiva
ÿPage 7
mCME SELF INSTRUCTION PROGRAM
CAPPmea together with Dental Tribune provides the opportunity with
its mCME – Self Instruction Program a quick and simple way to meet your
continuing education ne eds. mCME offers you the flexibil it y to work at your
own pace through the material from any location at any time. The content
is international, drawn from the upper echelon of dental medicine, but also
presents a regional outlook i n terms of perspective and subject mat ter.
Membership
Yearly membership subscription for mCME: 1,100 A ED
One Time ar ticle newspaper subscription: 250 AED per issue. Af ter the
payment, you will r eceive your membership number and allowi ng you to
start the pro gram.
Completion of mC ME
• mCME partic ipants ar e required to read the continui ng medical
education (CME) art icles published in each issue.
• Each art icle offers 2 CME Credit and ar e followed by a qu iz
Questionnai re online, which is avai lable on www.cappmea.com/
mCME/questionnaires.html.
• Each quiz has to be r eturned to events@cappmea.com in thre e
months from the publication date.
• A minimu m passing score of 80% must be achieved in order to claim
credit.
• No more than two an swered questions can be submitted at the same
time
• Validity of the ar ticle – 3 months
• Validity of the subscr iption – 1 year
• Collection of Cred it hours: You will r eceive the summary repor t
with Cert ificate, maximum one month after t he expiry date of your
membership. For single subscr iption cer tificates and summar y
reports wi ll be sent one month after the publication of the ar ticle.
The answers and cr itiques published herein have been checked car efully
and represent authoritative opinions ab out the questions concerned.
Artic les are available on www.cappmea.com a fter the publication.
For more in formation please cont act events@cappmea.com or
+971 4 347 6747
FOR INTER ACTION WITH TH E AUT HORS FIND THE CONTACT DETAIL S AT
THE END OF EACH A RTICLE.
Intraoral welding and lingualised
(lingual contact) occlusion: a case report
mCME articles in Dental Tribune have been approved by:
DHA awarded this program for 1 CPD Credit Points
CAPP designates this activity for 1 CE Credits
Dental Tribune Middle East & Africa Edition | 2/2019 7
The flapless technique, first pro-
posed by Tramonte3, can be per-
formed when the bony crest is wide
and an adequate amount of attached
gingiva is present. The technique al-
lows for uneventful healing, a reduc-
tion of postsurgical inflammation
and only moderate inconvenience
for the patient, who can eat efficient-
ly the same day.
Provisional prosthesis and
tooth arrangement
During the surgical session a tem-
porary resin prosthesis is inserted.
Occlusal plane height must be cor-
rect. A lingualized (lingual contact)
scheme of occlusion is recommend-
ed. The upper anterior teeth are
best arranged without any vertical
overlap. The amount of horizontal
overlap is determined by the jaw re-
lationship. A vertical overlap for ap-
pearance can be used, provided that
an adequate horizontal overlap is in-
cluded to guard against interference
within the functional range.4
Lingualized (lingual contact)
occlusion
Lingualized (lingual contact) occlu-
sion maintains the esthetic and food
penetration advantages of anatomic
teeth while maintaining the me-
chanical freedom of nonanatomic
teeth. Among the advantages of a
lingualized occlusion are occlusal
forces centered over the ridge crest
in centric occlusion, masticatory
force is effectively transferred more
“lingual” to the ridges during work-
ing side excursions, the “mortar and
pestle” type of occlusion minimizes
the occlusal contact area provid-
ing for more efficient food bolus
penetration and elimination of the
precise intercuspation that can com-
plicate the arrangement of anatomic
denture teeth.
Lingualized occlusion also prevents
cheek biting by holding the buc-
cal mucosa off the food table by
eliminating occlusal contacts on the
maxillary buccal cusps, minimizes
occlusal disharmonies created from
errors in jaw relationships, denture
processing changes and settling of
the denture base, and simplifies set-
ting of denture teeth, balancing the
occlusion and any subsequent oc-
clusal adjustment procedures.5
Clinical report
A healthy 50-year-old caucasian
woman presented for treatment at
the office of one of the co-authors
(LDC) with a mobile, painful, 12-tooth
semiprecious alloy-ceramic fixed
prosthesis (Fig. 2). The prosthesis
was removed and all of the remain-
ing abutment teeth were found to
be nonrestorable with extraction in-
dicated (Fig. 3). After removal of the
retained teeth, eight titanium one-
piece implants were inserted in one
session (Fig. 4).
Immediate stabilization of the eight
implants and 2 additional implants
that were previously inserted in the
posterior regions was achieved by
welding (Acerboni Intraoral Weld-
ing Unit, Casargo, Italy) each implant
to a 1.5 mm supporting titanium
bar (Acerboni, Casargo, Italy), which
previously had been bent to fit pas-
sively on the palatal mucosa (Fig. 5).
A provisional resin prosthesis was
inserted, which provided an accept-
able vertical dimension and lingual
contact occlusion. Oral hygiene pro-
cedures were demonstrated to the
patient and reviewed at all future ap-
pointments.
After 90 days, a panoramic radio-
graph suggested complete integra-
tion (Fig. 6) and a healthy mucosa
was observed. (Fig. 7). The definitive
full-arch gold-ceramic maxillary
prosthesis was inserted, which great-
ly pleased the patient and her family.
In the lower arch, the right first and
second bicuspids were extracted and
implants placed in the first bicuspid
and first molar regions. The implants
were welded together intraorally
(Fig. 8), followed by the fabrication
and cementation of a three-tooth
fixed prosthesis (Fig. 9).
A 7-year follow-up radiograph (Fig.
10) shows satisfactory preserva-
tion of bone surrounding all of the
implants. An intraoral photograph
of the definitive prosthesis shows
healthy gingival tissue (Fig. 11).
References
1. Mondani PL, Mondani PM. The
Pierliugi Mondani intraoral electric
solder. Principles of development
and explanation of the solder using
syncrystallization. Riv Odontostom-
atol Implantoprotesi. 1982;4:28-32.
2. Rossi F, Pasqualini ME, Dal Carlo
L, Shulman M, Nardone M, Winkler
S. Immediate loading of maxillary
one-piece screw implants utilizing
intraoral welding: a case report. J Oral
Implantol (in press).
3. Tramonte, S. A further report on
intraosseous implants with im-
proved drive screws. J Oral Implant
Transplant Surg. 1965;11:35-37.
4. Winkler S, ed. Essentials of Com-
plete Denture Prosthodontics. 3rd
ed. Delhi, India: AITBS Publishers;
2015.
5. Lang BR, Lauciello FR, McGivney
GP, Winkler S. Contemporary Com-
plete Denture Occlusion, revision 4.
Amherst, NY: Ivoclar Vivadent, 2012.
Editorial note:
This article was originally published
in implants – the international maga-
zine C.E. of oral implantology, Issue
2/2015.
Dr. Luca Dal Carlo and Dr. Franco Rossi are
in private practice in Venice, Italy.
◊Page 6
www.cappmea.com/digital-denstry-2019-conference
Final Programme Day 2 | 13 April 2019
Final Programme Day 1 | 12 April 2019
CAPP designates this activity for 14 CE Credits
Accreditation:
DHA 12.75 CME
09:00 - 09:45 | Prof Tim Joda, Swtizerland
Dual Presentation: Monolithic Implant
Reconstructions – The Keystone to Advances
in CAD/CAM Technologies
09:00 - 09:45 | Vincent Fehmer, MDT, Switzerland
Dual Presentation: Monolithic Implant
Reconstructions – The Keystone to Advances
in CAD/CAM Technologies
15:00 - 15:45 | Dr Anoop Maini, UK
Cost Eective Chairside Dentistry Utilising
a Fully Open Platform
10:45 - 11:30 | Prof Goran Urde, Sweden
Implant Dentistry “It was Better Before”
11:30 - 12:15 | Dr Martin Lebeda, Czech Republic
Aesthetics with CEREC – Design of Digital
Wax–Up, Guided Implant Surgery, No–Prep
Veneer Case
13:45 - 14:45 | Dr Jan Paulics, Sweden
Mastering the Art of Digital Impressions
12:00 - 12:45 | Dr Adam Nulty, IDDA, UK
FULLYDIGITAL: Prosthetic Driven Implant
Planning
14:45 - 15:30 | Dr Dimitris Strakas, Greece
Lasers - Cutting Edge Technology for
the Modern Dentist
16:00 - 16:45 | Lt Dr Nawaf Al-Dousari, Kuwait
Custom Made Artistic Smile
(Mix of CADCAM & Press)
16:45 - 17:30 | Dr Daz Singh, UK
Aesthetically Focused Multi-Disciplinary
Treatment Planning with Aligners
17:30 - 18:00 | Dr Eduardo Mahn, Chile
How to Choose the Most Appropriate
CAD/CAM Material for Modern Indications
09:00 - 09:45 | Dr Manol Ivchev, Bulgaria
3D Function in Occlusion –
A Key for Orthodontics
09:45 - 10:30 | Dr Bart Vandenberghe, Belgium
Pitfalls in 3D CBCT Imaging
14:15 - 15:00 | Dr Isabelle Savoye, Belgium
The Full Digital Orthodontic Patient and the
3D Application
09:45 - 10:30 | Prof Tim Joda, Switzerland
Complete Digital Workflow for Single–Unit
Implant Restorations
10:30 - 11:15 | Dr Hao-Wei Tsao, Taiwan
Clinical Application in Chair–side CAD/CAM
11:30 - 12:00 | Dr Munir Silwadi, UAE
Restoration of Endodontically Treated Teeth
with Chair Side Partial Crowns
16:15 - 17:00 | Germen Versteeg, NL
+1000 Digital Dentures Later.
A Huge Improvement in Quality and
How it Changes your Business Model
17:00 - 17:45 | David Claridge, IDDA, UK
Scanomics – The Economics of Intraoral
Scanning
Madinat Jumeirah Conference Centre | Dubai | UAE
14
th
edion
CAD/CAM & Digital Denstry Conference
WhatsApp
Enquiry
+971 50 2793711
AD
Dr. Marco E. Pasqualini is in private prac-
tice in Milan, Italy.
Dr. Mike Shulman is in private practice in
Clifton, N.J., and adjunct associate profes-
sor at the School of Oral Health Sciences,
Kingston, Jamaica.
Dr. Michele Nardone is with the Ministry
of Public Health, Rome, Italy.
Dr. Sheldon Winkler is adjunct professor at
Midwestern University College of Dental
Medicine, Glendale, Ariz., and School of
Oral Health Sciences, Kingston, Jamaica.
Dr. Tomasz Grotowski is in private practice
and professor at the School of Minimally
Invasive Implantology, Szczecin, Poland.
mCME
