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1st ASIA - PACIFIC EDITION

7th CAD/CAM & Computerized Dentistry
International Conference

06 - 07 October 2012, Marina Bay Sands Hotel
SINGAPORE

Confirmed 14 CPE Points
attainable

Organized by

CAPP ASIA

Proud Supporter

SDA - Singapore Dental Association
LATEST NEWS:
Dental Tribune International Editorial (more...) | Welcome Message from Dr. Kuan Chee Keong, SDA President (more...) | Guest of Honnor: Prof. Patrick S K Tseng, BDS, MSc (more...) | Final Program >> (more...) | Conference Certification: 14 CPE Points attainable. |

Presentations



Two-Piece CAD/CAM Zirconia Implant Abutments

Dr. Peter Gehrke, Germany
show more/lessThe soft tissue around dental implants serves as a protective barrier between the oral cavity and the underlying bone. These peri-implant tissues are recurrently challenged my numerous hazards that can have adverse effects on the implant longevity, such as plaque, load, and prosthetic interference.
The implant abutment material seems to be of decisive importance for the quality of the attachment between the mucosa and the surface of the abutment. Different materials are available for the fabrication of implant abutments. Because of their dark color, metal abutments were reported to cause a grayish discoloration of the surrounding soft tissues, compromising the esthetic outcome in the esthetic zone. Ceramic abutments are of increasing interest, not only because of their tooth-like color but also for their possible biologic advantages. Although there is currently no mutual consent that ceramic abutments perform superior to titanium alloy abutments, the results of human histology studies indicate, that zirconium-dioxide may have a more favorable effect on the health of the peri-implant tissues. Today, zirconia abutments with various implant-abutment connection geometries exist for different implant types. Recent in-vitro studies demonstrated that the type of implant-abutment connection had a critical influence on the technical outcome of zirconia abutments. An internal connection of zirconia abutments can be obtained by means of a secondary metallic component (two-piece) or by the abutment itself (one-piece). Significantly higher values were achieved for CAD/CAM zirconia abutments with internal connection via a secondary titanium insert (two-piece) than for the ones with external connection. Therefore, the use of a secondary titanium insert might have a beneficial influence on the stability of zirconia abutments and appears to be clinically useful for premolar and molar single-tooth replacement. Various bonding methods to zirconia ceramic and titanium have been reported. However, limited data is available on the retention of CAD/CAM zirconia copings on secondary titanium inserts. The presentation will highlight the natural symbiosis of a functional and esthetic treatment approach with COMPARTIS® CERCON Ceramics® two-piece abutments, considering computer-assisted techniques and their laboratory and clinical aspects.

Optimizing Implant Function and Esthetics at the Perio-Prosthetic Interface: The Role of the Superstructure

Dr. Peter Gehrke, Germany
show more/lessWith increasing surgical reliability of implant dentistry and documented high success rates the standards expected of implant-supported dental restorations are rising.
Especially on the part of patients there is a growing desire for an esthetic solution equivalent to the appearance of natural teeth. The condition of the peri-implant soft tissues appears to be a critical determinant. The current presentation will address the relevant parameters influencing the final outcome of fixed and removable implant-supported restorations. A natural symbiosis of a functional and esthetic treatment approach, considering biological and restorative aspects, as well as provisionalization, abutment design and material characteristics will be highlighted. The reproducibility of newer indices allowing for a more objective appraisal of the esthetic short- and long-term results of various surgical and prosthetic implant protocols, and the influence exerted by the examiner’s degree of dental specialisation will be critically discussed.

Esthetic Engineering

Dr. Andreas Kurbad, Germany
show more/lessAn extensive treatment planning is the key for success in esthetic reconstructions. The planning should start with diagnostics. An evaluation of the esthetics is necessary. It can be based on the direct investigation of the patient, but more important is the work with photos and in the last time also videos are used. A lot of analysis can be done with simple methods, for instance using common PC programs like PowerPoint.

An excellent design and, in the second place, the predictability of results are very important when restoring teeth in the esthetic zone. In most esthetic dentistry cases, a re-design of the shape and contour of the respective teeth is required. In conventional treatment procedures, this is accomplished by means of a wax up. This also can be done digitally today. Once approved by the patient, the wax-up represents the basis for all the working steps that are carried out in the course of the treatment.

Very frequently, the wax-up is used to fabricate splints for so-called mock-ups or provisional restorations. Those temporary restorations play a more and more important role within the treatment concepts. Moreover, silicone matrices are made to ensure control of the amount of tooth structure removed during preparation. These matrices enable the mandatory minimum layer thickness to be observed and the shape and contour of the final restoration previously defined by means of the wax-up to be reproduced. To provide patients with a restoration whose appearance is very close to that originally defined in the treatment plan is crucial to treatment success.

Following tooth preparation, the new situation will be scanned again and matched with the data of the case already stored in the computer. The digital wax-up can then be used for the design of the final restoration. The modern, highly esthetic all-ceramic materials available today even allow full-contour restorations to be milled, which only need to be stained and glazed. In challenging cases, a slight cut-back can be performed to optimize the result.

Cementation is the last and a very important part of this complex. The thinner the ceramic thickness, the more important is to pay attention to the underground color and the type of cement. All in all, this is a completely new way of achieving highly esthetic outcomes in the management of restoration cases. It allows the predictability of results to be increased in a very cost-effective way.

Computer Navigated Implantology

Dr. Andreas Kurbad, Germany
show more/less3D diagnostic is state of the art in implant-cases in the esthetic zone. Cone beam technology offers a simple way to get these data today as a daily routine in the dental office. After the diagnostics and the general treatment planning the exact implant position can be determined with special computer programs. Modern computer navigated implantology offers a precise and cost effective implementation of the implant treatment plan with the planning software.

To get a drilling splint on the basis of these data it is necessary until today to have a three dimensional x-ray with special reference points. A correlation must be made between the physical model and the digital data for the implant planning. On the basis of special navigation systems templates can be produced with a very high degree of precision. For surgical guides are guaranteed and documented a production accuracy with under 500 µm at the apical end of the implant. To correlate the data of the digital planning with the physical model identical reference points on both parts are necessary. To get these reference points the 3D x-ray must be done with a special template in the patient’s mouth, which contains radio-opaque balls or similar things. Very often after the diagnostic, x-ray has to be done a second one for these things. This leads to a higher exposure to radiation for the patient. Another disadvantage is that very often the visibility of anatomical structures is disturbed by the template.

One of the latest achievements is this field is the combination of the digital 3D x-ray data with the 3D data from the scanning of intraoral surfaces, which is normally used for the dental CAD/CAM process. This possibility is offered by the import of CEREC data into Galaxis Software for Sirona. This option is a big advantage for the treatment planning. The position of the later crown is visible during the placement of the implant in the optimal position. Also the position and the thickness of the soft tissues can be much better detected. This is especially helpful in esthetic cases.

The next and latest step is, that surgical guides can be fabricated in the SICAT laboratory on the basis of optical surface scans and 3D X-ray data. There is no need for a x-ray which contains reference points. The transfer of the data is fully digital and there is no need for a radiographic template. That makes planning, implantation and treatment quicker than ever.

In combination of the drilling templates with special burs and distance pieces the implant can be placed exactly on the position determined in the 3D treatment planning. In cases with a high primary stability the consequence of this is the question of having the possibility to place a pre-fabricated temporary restoration in one step with the surgical measures. This would offer the possibility to start immediately with the soft tissue management, no other temporary restoration is necessary and the healing process is accelerated.

THEATRE PRESENTATION
One-visit chairside dentistry: How to make CAD/CAM Restorations Esthetic and Durable in Clinical Practice

Dr. Michael Dieter & Joerg Vogt, Germany
show more/lessToday our patients are asking for more esthetic and durable all-ceramic restorations. There is a strong desire for one-visit restorations without the need of a temporary. The combination of chairside manufacured all-ceramic restorations using the CAD/CAM technology with CEREC and the adhesive cementation technique facilitate long lasting restorations resulting in significant preservation of tooth structure and excellent esthetics meeting the highest patient demands.

However, small mistakes in the various clinical steps of the treatment sequence and the manufacturing process can compromise the clinical long- term success of our CAD/CAM restorations.

In a joint interactive lecture Dr. Michael Dieter and Mr. Joerg Vogt will present a predictable concept for the chairside treatment with single tooth CAD/CAM restorations taking into account all the critical steps to the final restoration.

Dr. Michael Dieter will focus on the clinical treatment sequence, e.g. indications, tooth preparation, selection of the correct color, translucency and strength of ceramic blocks, plus all the cementation options for the luting procedure. Special emphasis will be given to the perfection of the esthetic outcome of the restoration after milling.

Mr. Joerg Vogt will introduce the latest on "One-visit digital dentistry" with CEREC AC Bluecam: How to take perfect digital optical impressions, update on the latest software version including the new Biogeneric software.

Everyday CAD/CAM Usage: Preparation, Practically Possibilities, What Benefit You and Your Practice

Dr. Simon Smyth, UK
show more/lessCAD/CAM has been the core of my general practice since 2002 In my dental practice in England. The research and studies prove that CAD/CAM restorations can be the most durable and longest lasting restorations we have, however, nothing is more convincing than seeing patients return with CAD-CAM restorations that are 10+ years old looking as good as the day you did them.
In this presentation I will show how I use CAD/CAM as my everyday "treatment of choice" restorative system. From inlays, onlays, crowns and veneers to treatments unique to CAD/CAM such as Endocrowns and Copycrowns. What is practical and possible when using CAD/CAM everyday in general practice, what benefits does it offer our patients over the alternative treatment options and just as importantly, what are the benefits it brings to you and your practice.

Further Possibilities of CAD/CAM: One Visit Smile Makeovers and Permanent Bridges Chairside

Dr. Simon Smyth, UK
show more/lessSince CAD/CAM became truly 3D in 2003 we have been able to take scans of a ‘quadrant’ of teeth and make virtual 3D models to easily restore up to 3 or 4 teeth. CAD/CAM also has the unique ability to completely and accurately make a full ceramic copy of an existing tooth.
I have always felt that CAD/CAM was capable of more than just making a few inlays or crowns and in 2005 I devised a simple method of taking a complete scan of a fully anatomical diagnostic wax-up, combining it perfectly with a scan of 6-8 or more crown or veneer preparations and making an exact copy with beautiful ceramic CAD/CAM crowns or veneers. This allows for a complete one day "smile makeover". In the first part of this presentation I will walk you through my one day CAD/CAM smile makeover.

CAD/CAM has not only been available to dentists but also to dental technicians with the InLab system. With CEREC 4 and InLab 4 CAD/CAM software there is a much more similarity between the two programs, however, the InLab software has more options available and for the dentist looking to do more than just single unit restorations the Inlab software is well worth the upgrade. With incredible new materials such as the Sirona TZI blocks, Vita RapidLayer and Ivoclar CAD-On systems together with high speed furnaces from Sirona, Vita or Ivoclar it is now possible to produce full contour anatomical bridges chairside in a single visit. In the second part of this presentation I will take you through the preparation, design, milling, furnace firing and fitting of a fully anatomical and aesthetic four tooth Zirconia bridge completed chairside in just a few hours.

New Dental Hybrid Material in the CAD/CAM Technology and Its' Opportunities for New Indications

Dr. Umberto de Luca, Brazil
show more/lessBack in 1997, a Siemens representative informed that there is a new device in Germany that is able to produce ceramic restorations chairside, without the need of conventional impressions. Without any further information, Jose Umberto and Silvio, his brother, travelled to Switzerland in order to participate in a lesson given by the creator of the technique in the University of Zurich, Prof. Moermann.
Since then, they followed the technique. After the release of the CEREC 3D, it can be said with confidence that the technology has become a must-have in every dentistry office.
As the technology evolved, VITA ZAHNFABRIK was always innovative with their blocks, the first block, MARKI and right after the MARK II bloc, which is used to these days, has evolved in both strength and aesthetics until the release of TRILUXE and REAL LIFE, which unquestionably meet all of the demands of modern dentistry.
VITA will surprise the market with the launch of a brand newhybrid product that will, without doubt, change the course of dentistry. Therefore, do not miss the opportunity of learning more about the advances of this new technology.

The Esthetic Limits of CAD/CAM Restorations

Dr. Umberto de Luca, Brazil
show more/lessJose Umberto De Luca started his studies at the University of the State of Rio de Janeiro, obtaining his DDS certificate in 1978, working mainly with gold inlays, onlays and PFM for 18 years. In the year of 1997 he started using CAD/CAM technology as a participant of the course "CAD/CAM technology (Computer aided design - Computer integrated manufactory) in restorative dentistry, the CEREC method" at the Dental School of the University of Zurich, Switzerland.
At that time, someone can imagine the difficulties to run the CEREC machine in BRASIL and how the results were coming out of that amazing but really tricky machine.
As Dr. De Luca was getting confidence with the system, he started to give lessons and courses on the method and the principles of preparation and materials all over Central - and South America.
Even knowing that the adhesive idea was introduced by Buonocore around 1955, at that time the process was still a little bit confusing with Silane, acid etch, moist or dry dentin, etc..., but one point was clear: Adhesive dentistry was evolving rapidly. Two main incentives drove this evolution. Adhesive techniques combined with the use of tooth-colored restorative materials where and still are frequently requested by patients. They want us to restore their teeth not only anatomically and functionally, but also aesthetically. Although important improvements in bonding have been made in the last 30 years, note that the requirements of an ideal bonding system are quite similar to those indicated by Buonocore.
But what about the materials? Are they following this improvement? Of course they are and if we talk about aesthetics, we have to mention VITA as one of the first whom came out with aesthetic blocks for the CAD/CAM technic. In the meantime a discussion started about the dental laboratories. Would that be the end of the lab work? Would the ceramist lose their artist work because of a computer? One thing has to be clarified, for the anterior region if someone wants to have color details as mamelons, mixed with translucencies effects etc… there is no question that a ceramist will be needed, but the question is: will these effects be visible by the patient? The dentist with a macro camera and a dark background inside the mouth will see it, but what about a social photo, will that photo show all the hard work done by the ceramist?
For the anterior region, we can discuss these results but for the posterior region, I can guarantee that all these effects satisfy more the dentist’s ego rather than the patient's expectations.
Come participate and watch what a CAD/CAM restoration without characterization and glaze can do for you and your patient when we discuss time and material consumption.

The Time is NOW! CAD/CAM or Check out!

Dr. Paulo Monteiro, Portugal
show more/lessDental adhesives have evolved tremendously in the past 10 years and are still evolving. While the adhesive technologies move towards simplifying the application steps, the indications have significantly broadened.
Aesthetics and good clinical features including function and ability to adhere to cements have always been the goal of research in dental materials for indirect restorations. A new and exciting material has recently emerged from intense research and development in this area. It is called Resin Nano Ceramics. With its tooth-like characteristics and features, this material satisfies both the function and aesthetics required in indirect restorations. As a material for CAD-CAM restorations, Resin Nano Ceramics is a material that is resistant to colour change over time and is easy to finish and polish, making it ideal for chairside use (ie E4D, CEREC) and as well as fabrication via lab systems (LAVA and Straumann).

On the other spectrum of indirect restoration is the ability of dentists to communicate their requirements to the lab technicians. Besides good clinical astute and excellent replication via good impressioning, information such as type of materials to be used, colour, characterization, form and texture are to be communicated in precise manner so as not to leave anything to chance.

Topics discussed include:
  • New dental adhesives - how to utilize and maximize its use to our benefit
  • Resin Nano Ceramic - what is it and how can it benefit the patients and clients
  • Cements - what's new in the cements corridor and making the switch to the new and cool a benefit for all
  • Step by step clinical procedures (pictures and videos) to show excellent results with indirect restorative materials
  • Tips and tricks in aesthetic dentistry in daily clinical practice.

Importance of Occlusion

Mr. Peter Bausch
Topics:
  • Basic introduction into Occlusion
  • Influence of Occlusion to the stomathognathic system
  • Influence of Occlusion to the entire body (TMJ-Syndrom, posture of body)
  • Introduction to Occlusal concepts
  • Occlusal diagnosis with different materials and techniques
  • Occlusal adjustments and therapy
  • Therapy with Occlusal splints
  • Influence of Occlusal interferences on prosthodontic restorations and implants.

All topics will be visualized with graphic 3D Animations

ClearPath CAD/CAM Invisible Aligner Orthodontic Treatment

Dr. Khaled Abouseada, Saudi Arabia
show more/lessClear Aligner therapy has come under the mainstream of orthodontic treatment over the past few years. The ever-increasing demand for AESTHETIC & COMFORTABLE orthodontic treatment and ever-increasing SPECTRUM OF FEASIBLE CASES has seen plastic aligner therapy completing more than 2 million cases globally by various systems.
The session is aimed at creating awareness among orthodontists, non-orthodontic specialists as well as general dentists to enable them to perform the most esthetic orthodontic treatment effectively for even complex dental malocclusion cases.
Brief Outline for the scientific session:
  1. History & evolution of aligner therapy in Orthodontics
  2. Biomechanics of aligners
  3. Case selection parameters
  4. Monitoring aligner patients & patient care instructions

Status Quo & Future of Inhouse Production Capabilities in The Modern Dental Lab

Falco Noack, Germany
The right choice of material depending on indication/situation is key for successful treatment planning in the interdiciplinary context. Special focus will be given on material properties within the range of CAD/CAM machinable materials. Established material like Zirconia as well as highly innovative new materials for inhouse processing will be highlighted.

Key Trend Digital Dentistry - The future of monolithic ZrO2 restorations

Marcus Kieffer, Germany
show more/lessSince the introduction of the high-performance material Zirconia as a dental restorative material its functional properties have been clinically approved. The dental application of Zirconia as an esthetic framework material for ceramic veneering as well as its use as a full-contour, monolithic and functional restoration demands both translucency and tooth-colored material.

This innovative material is appropriate for both, economical monolithic crown & bridgework and for esthetic frameworks for individual ceramic layering. Therefore positive mechanical properties of the "white" Zenotec Zr Bridge were combined with the positive light-optical properties of the Zenotec Zr Bridge Transluzent material. In this way the basics for high-grade and durable restorations were created and the product was developed as Zenostar Zr Translucent which was successfully launched in 2011.

Getting an accurate restoration through conventional impression-taking can be challenging in todays D2D life.. Inconsistent quality of the impression too often leads to retakes, low clinical and esthetic results, and increased need for adjustments during seating.

Since digital technologies efficiently are able to deal with even complex clinical situations and provide consistent level and high quality restoration results. The industry is moving towards full digital dentistry "Digital impression-taking" is becoming more and more popular and will soon become the standard in dental clinics all over the world.

In combination with full contour monolithic restoration a smooth and easy digital workflow has been born. The future key trends of digital dentistry - "Intra Oral Impression Taking and monolithic ZrO2 restorations".

Computer Aided Capture, Design and Manufacturing in Dental Applications

Emidio Cennerilli, Fanin Luigi
show more/lessComputer technology’s rise to innovate and automate manufacturing tools in engineering applications is well documented, this presentation will focus on the computer technologies which have been specifically designed to transform traditional dental Labs and are pioneering the rapid acceleration of technologies used in today’s benchmark Digital dental Labs.
Covering computer aided capture devices for generating three dimensional models, computer aided design (CAD) software programs with dental specific tools to create a digital restorations of common dental lab applications and computer aided manufacturing (CAM) software which has streamlined the control of complex machining strategies for output to computer numerical controlled (CNC) milling centres for in-house production.

Patient Experience - Practice Lifestyle: How CEREC is Revolutionizing Dental Practices Around the World

Dr. Mark Morin, USA
show more/lessCAD/CAM technology is revolutionizing how we practice dentistry. Not only is it allowing dentists to have more control and be more efficient but it is also becoming a major way for dental practices to differentiate themselves from other practices. Dental “consumers” have become more educated and more connected than ever before and therefore are more discriminating when choosing a dentist.
Learn how to leverage this incredible technology in YOUR practice to create the “Ultimate Patient Experience” which will note only increase case acceptance and new patient referrals but also improve your practice lifestyle.

Objectives:
  • To be able to identify the specific practice areas that CEREC gives you an advantage in.
  • Learn how to leverage these areas for better patient acceptance
  • To learn how to create the "Ultimate Patient Experience
  • To identify the key elements to taking your practice to the next level

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