we_dent1

we_dent1_EN

EDITORIAL

Marc Berendes introduces the new magazine
SHAPING THE CHANGE

Not only challenge, but also opportunity: informed patients
HOW TO FACE DR GOOGLE

Tips for dentists and practice staff for dealing with informed patients
WATCH THEIR STEP

Exploring the digital patient journey
IDS 2019

What to expect at the Kulzer booth
INTRAORAL SCANNING

Guest contribution: why intraoral scanning is the future
PRODUCT NEWS

Get to know the newest member of the cara family
3D PRINTING ON THE RISE

What already is possible today and what the future holds
IMPRESS WITH EXPERTISE

Three simple techniques for precise impression-taking

YOUR DENT MAGAZINE BY KULZER #1 iKNOW Understanding the new generation of informed patients, p. 4 FACE OFF Handling Dr Google, p. 7 MEET UP Getting inspired by our experts at IDS, p. 10 START NOW Taking a step into the digital future, p. 14

7 14 4 CONTENT 18 3 EDITORIAL 12 PRODUCT NEWS Marc Berendes introduces the new magazine Get to know the newest member of the cara family 4 SHAPING THE CHANGE 14 INTRAORAL SCANNING Not only challenge, but also opportunity: informed patients Guest contribution: why intraoral scanning is the future 7 HOW TO FACE DR GOOGLE 16 3D PRINTING ON THE RISE Tips for dentists and practice staff for dealing with informed patients What already is possible today and what the future holds 8 WATCH THEIR STEP Exploring the digital patient journey 10 IDS 2019 What to expect at the Kulzer booth 18 IMPRESS WITH EXPERTISE Three simple techniques for precise impression-taking 2 #1

DEAR READERS, Modern dentistry changes quickly and continuously. This does not only affect you as dentists, but also your patients. They expect you to give them the best possible treatment as well as the most comprehensive advice. At the same time, you, your staff, and your patients have to adapt to the constant digital change. As if that were not enough, research continues to develop rapidly. We live in the most dynamic of times where exponential progress is achieved – through science, and creativity. Kulzer has been a partner for dental practices and others in the dental industry for over 80 years. We know that these developments can be challenging. we – that means: even closer to your and your patients needs. And even closer to the challenges of the modern practice. Using our expertise, we would like to help you improve your daily workflows to restore your patients’ oral health and wellbeing. We can help by not only providing convenient products and services but also by giving you relevant information that help to advance your practice and master your skills. WE – YOUR DENT MAGAZINE BY KULZER is designed to inform you and also provide inspiration. You can expect a lot: scientific based information provided by our dental experts on latest study results and current trends, both for dental treatments, as well as in practice management and for innovative product solutions; tips and tricks from experienced users that you can try in your practice immediately. Detailed case reports from renowned colleagues from practices or science. And of course, expert interviews, industry news and information on important scientific events. The first issue of your brand new WE focuses on ‘informed and independent patients’. In times of the world wide web, patients want to take over more responsibility for their health. The information available on the internet provides patients with new possibilities in interacting with their dentist. As a dentist and a health professional, you can steer your patients towards the right direction. That is why this issue explains popular ways your patients use the internet and which touchpoints you can find on their digital journey. Find out more about how colleagues deal with informed patients (see p. 4 – 6), what tips experts have for your every- day work (p. 7) and much more. Enjoy reading! Yours Marc Berendes Chief Executive Officer Please, drop us a line! Do you have comments on this issue? Would you like to read about a special topic concerning your work? We are always grateful about your input – suggestions, questions, criticism alike – via email: we@kulzer-dental.com #1 3

Many patients google their symptoms and search the internet for information. When it comes to self-diagnoses, regular headaches could be terrible migraines – at least according to Dr Google. Whereas in reality, the migraine is a bruxism-induced tension headache. Dr Kenneth Lee, an expert from the University of Western Australia who has conducted studies on this phenomenon, explains how this behaviour can potentially be beneficial for both patient and health professional. Dr Lee, is finding information online a curse or were, if any, relatives and friends, or print media like blessing for the relationship between physicians and newspapers, books and encyclopaedias. Physicians their patients? had the prerogative of diagnosing the disease and To my mind, it is by no means a curse – although I can offering treatment. If patients disagreed, they changed imagine the new information-seeking behaviours may their physician or simply did not follow the doctor’s rec- challenge health professionals, for example, if a patient ommendations. In the rarest cases, patients talked or disagrees with the professional diagnosis. This might asked about alternative diagnoses or additional therapy leave some health professionals baffled, especially options. The growing abundance of health-related since they are not necessarily taught how to deal with information available online and its increasing accessi- situations like these during their university degree. bility via digital devices has made it easier for many Nevertheless, these new information-seeking behaviours patients to find health information by themselves. What is more important is that the digitalisation of health information provides a great opportunity for doctors, dentists, to form stronger relationships with their patients. Rather than waiting for health professionals to provide the information, nowadays patients can look for it whenever they desire. Some patients even share their knowledge at the consultation and ask for clarification. But isn’t that worrisome? Especially since so much information online the internet is not very reliable? It can be problematic if patients are misinformed and lose trust in their physician – after all, health profes- sionals want to offer their patients the best kind of care and aim to restore their health. But that is only one side of the issue. What is more important is that the digitali- sation of health information provides a great opportu- also offer huge opportunities for the patient-physician nity for doctors, dentists, to form stronger relationships relationship. The more openly and honestly both par- with their patients. My research has found that most ties approach the issue, the more beneficial it can be. patients trust advice given by health professionals. That For example, a patient gets a life-changing diagnosis. is why physicians should have open discussions with To cope with it, he or she searches online for the pre- their patients about what information they have found dicted progression and possible treatments for the and help them understand their conditions. If a patient disease. The patient finds a recently authorised medi- feels a health professional is interested in their informa- cation and brings this information to the next consulta- tion-seeking behaviour, patients may feel more com- tion. Together with the physician, they find out that the fortable with sharing their concerns. new medication might help, but additional information is needed. The health professional contacts the manu- facturer and develops a therapy plan with and for the patient. This is an example of the benefits of patient information-seeking behaviours. DR KENNETH LEE is a Senior Lecturer in Pharmacy What has changed in the past years? How has Practice at the University of Dr Google changed the information-seeking Western Australia. He researches behaviours? topics at the intersection of In the past, health professionals were the main source health information behaviour, of information for many patients. Additional sources education and technology. #1

What kind of information are patients typically Keeping all that in mind, which skills should both looking for and where? What is the motivation for parties (doctor and patient) develop, in order to patients to seek information online? ensure a good relationship create a comfortable According to my research, most patients start their situation between them? search by using a search engine, rather than going to On the one hand, health professionals should educate specific websites. The types of information a patient themselves about websites with accurate and easy-to- is seeking varies. Many patients look for information understand information, so that they can tell patients about their medical conditions, including ways to reliable sources. Professional associations sometimes manage it, diets and exercise regimens that may be offer information material for patients. Physicians can helpful and treatment options. Some patients also also suggest specific information to search for so that seek out information about medications to find out if it patients do not feel overwhelmed by the volume of causes certain side effects. Similarly, there are varia- search results. On the other hand, patients also need tions in patient motivations to seek information online. to be able to restrict their searches. The internet offers Besides educating themselves about the medical con- millions of websites with health-related information, and ditions they have, patients also want to feel prepared trawling through them all can make a person feel like before their appointment and to find out more infor- they are drowning rather than getting support. When mation after seeing a health professional. It’s about people are overwhelmed with information, they may Patients want to be informed decision-makers and active contributors to their own health management. not understand the information correctly or they may only pay attention to certain parts of it. And of course, patients need to be able to evaluate the quality and accuracy of the information they find in a critical way. The result of all these things, by the way, are informed and independent patients. How will informed and independent patients change the daily work of a physician? Health professionals will need to spend more time under- standing patients’ concerns and ensuring that patients making informed decisions about their health manage- are able to be informed decision-makers and active ment. In other cases, patients want support for coping contributors to their own health management – because with a diagnosis. At this point, getting in touch and patients expect to play a more active role. That’s why connecting with other people who have the same condi- responsibility for a patient’s health will become more tion is the main objective. There are also patients who evenly shared between the doctor and the patient. Over look for medical information as a form of entertainment time, an informed patient could mean that health pro- or enjoyment. For example, some patients want to find fessionals can treat a patient’s problems more easily, out new developments because they are interested rather than spending a long time identifying them. So, in technology and health and want to learn about new the focus of care will shift from a problem-oriented to developments. So, the information-seeking behaviours a solution-oriented process. This change will empower of patients are very complex. patients and offers the opportunity to work in partner- ship with their doctors. To conclude, what do you think the doctor-patient relationship will look like in 2050? I believe that, by 2050, the patient-physician relation- ship will be more collaborative and equal. Health professionals will still be the experts, but patients will work with them to make sure they get the best health- care possible. Digital devices will play a major role: physicians and patients will have easy access to health information and, most importantly, personalised data. This means that physicians will have to offer individual solutions and consultations to every single patient. It is important to encourage patients to share their concerns. 6 #1

HOW TO FACE DR GOOGLE TIPS FOR DEALING WITH INFORMED PATIENTS How can dentists and their teams deal with patients’ worries and doubts? And how can they help their patients to make informed decisions about their oral health management? Dr Kenneth Lee gives valuable and easy-to-implement advice. FOR DENTISTS FOR PRACTICE STAFF • Be open to change. Listen to your patients when they • There are lots of reasons why patients may feel uncom- want to share with you what they found on the internet. fortable before treatment. Sometimes it can be doubts • Teach patients which websites contain accurate and Ask the patients what they know about their condition. easy-to-understand information. If the patients feel that you are listening, they may be about the treatment after reading information online. encouraged to open up. • Suggest specific information for patients to search for so that they do not feel overwhelmed with the volume • Some patients might prefer opening up to you more of search results. than to their dentist. If patients share their concerns with you, encourage them to talk to the dentist about • Continue to develop your communication skills so you what they found on the internet. can identify and address patients’ concerns. Doubt and fear severely affect patient compliance. • Some patients may be embarrassed to admit to their • Address misunderstandings. If you do not have enough because they do not want to dismiss the searches. time during an appointment, tell the patient that and ask Let them know that one of the most important if they would like to schedule another appointment. responsibilities of their dentist is to provide more dentist that they are looking for information online information or to clarify any misunderstandings. • Empathize with your patients so they are willing to open up to you. They may reveal information that is important • Use waiting times to support patients in making in helping you to decide on the best treatment. informed decisions. If you have information resources about a specific condition or treatment, give it to the patient and encourage them to talk about it. • Take it even one step further: guide patients through the internet yourself. Use posters or flyers on frequent DO YOU HAVE ANY OTHER TIPS? indications and therapies with QR-codes or short URLs Share them on facebook.com/kulzerinternational #1 to lead patients to websites with accurate and easy-to-understand information. 7

WATCH THEIR STEP THE DIGITAL PATIENT JOURNEY 1 Laura Martin feels sick. She could ask friends and family but her laptop is closer. So she decides to first go online. She searches for information about and possible explanations for her symptoms. Like most patients she starts with the search engine Google. 2 She searches: What condition do I have? And do I need treatment? She may even be active in social media, where she can consult other people. 3 Laura finds a possible expla- nation for her symptoms. Now she wants to discuss her condition with an expert. But, where should she go? She uses search engines to find specialist doctors and care facilities. There are many experts located nearby. That is why Laura visits platforms where other patients share and rate their experiences with their health professionals. Laura makes her appointment online. In advance, she ‘googles’ what questions she can ask her doctor. 4 5 8 6 In the waiting room, she goes online again to refresh her memory about the information she found. TIP: Does your practice have free Wi-Fi? If so, give patients the log-in details and help them to navigate to your website. There you can provide informa- tion about the most common diagnoses. You can also recom- mend reliable websites where your patients will find trust- worthy information. #1

The days when doctors were patients’ only source of information are long gone. Now, a patient can find unlimited information on the internet, which is available throughout the entire care process. This makes it even more important to understand a patient’s digital journey. With this in mind, Kulzer analysed various scientific articles about patients’ journeys through the world wide web and created an overview about an exemplary patient journey. Let‘s shift perspectives and follow Laura Martin! 11 To cope with her condition, Laura turns to online resources, e.g. TIP: Do not hesitate to make recommendations. By giving advice, videos or apps for physiotherapy you can protect your patients exercises for craniomandibular against dubious offers or suspect disorders. information. TIP: Stay up to date. Create your own social media account and follow discussions online. This way, you will be more prepared for the arguments your patients may put forward during your conversations. 10 Laura looks for some online support and tries to get in touch with other patients and dental experts via social networks. 8 Laura is struggling with the diagnosis. She reads all the information she can find about the treatment and its consequences – and its alternatives. 9 What does her dental insurance cover? Laura goes through all the information available on the website of her insurance company. 7 On her way home, Laura looks up the clinical and radiological findings of the dentist. Afterwards, she googles her diagnosis. She wants to know: What does it mean? How will my lifestyle change? How will the disease progress? #1 9

IDS 2019 EXPERIENCE WELL-KNOWN EXPERTISE Whether for dentists or dental technicians: Kulzer offers a broad portfolio of solutions and supports all users in their daily routines at work. At the IDS fair, visitors can explore three areas where Kulzer presents its core competencies – with experienced experts on-site and exciting multilingual live demos. 1 2 3 4 5 HIGHLIGHTS AT THE BOOTH cara i500 Live in action: an exciting new intraoral scanner will be presented by experts on patients. Digital impression-taking has never been so easy. Treating hypersensitivities Learn how to relieve patients from their hypersensitivity and experience the effectivity of GLUMA Desensitizer in live demos. Intraoral repair Kulzer puts a focus on intraoral repairs with iBOND Universal and gives practical tips and tricks as well as live demos. Delara The new Delara tooth line complements the existing Pala product range perfectly and is undisputed one of the highlights at Kulzer's IDS booth. Its bluish tooth edge makes it particularly vibrant. HeraCeram Saphir Get to know the unique aesthetics of the new ceramic HeraCeram Saphir that was designed to support the aesthetics of restorations – live demos included. 6 6 6 3D printing Interested in innovations in 3D printing? Full denture printing, new CAM software as well as new Wash & Cure units are highlights to experience. 7 JoStage Experience the possibilities for dental photography at the JoStage, the flexible photography studio. Get practical advice from experts on how you can put your work in the limelight. Live Demo Live Demo 1 2 10 #1

DENTURE WORKFLOW LOUNGE 4 6 6 CHAIRSIDE SOLUTIONS Info Center PASSAGE CROWN AND BRIDGE WORKFLOW 5 7 3 6 5-MINUTE DISCOVERY TOUR Are you visiting IDS from March 12th to March 16th 2019? Immerse yourself in the Kulzer world and get to know our products – within 5 minutes. Book your personal guided tour of the Kulzer booth. And if you have any further questions afterwards, renowned experts are at your disposal depending on your area of interest. Book here: kulzer.com/we-ids #1 11

THE QUESTION ISN’T IF – IT’S WHICH ONE GUEST CONTRIBUTION: WHY DIGITAL IMPRESSIONS ARE THE FUTURE 12 In the course of his work as President of the German Society for Digital Oral Impressions, Dr Ingo Baresel has repeat- edly observed that many dentists remain sceptical about intraoral scanning. As a dentist and an early adopter of intraoral scanning, however, he is convinced that the technology has many advantages. In his exclusive guest contribution for the WE, he explains why and how dentists can benefit from it. While dental labs are increasingly turning to CAD/CAM production with milling and 3D printing, the use of digital impressions remains less common among dental prac- tices. In Germany, for example, only between seven and 10 percent of dentists use an intraoral scanner. Even though the trend is rising slowly, the most common concerns are that it is too expensive, too complex, and too inaccurate. Yet a number of studies, including those by Prof Daniel Edelhoff and Dr Jan Güth at the Medical Centre of the University of Munich, have shown that many intraoral scanners today are able to deliver equal or even more pre- cise results than conventional impression techniques. Furthermore, intraoral scan- ners are now highly versatile and can be used for everything from single tooth restora- tions, to treatments involving the entire jaw and large implant cases. Rapid development A great deal has changed since Cerec, the first chairside CAD/CAM system with an intraoral scanner, was introduced to the market in 1985. In recent years, scanners have been developed that no longer require the surface to be treated with pow- der first. Additionally, the recording pro- cess has become considerably faster: experienced users can scan in half the time required for conventional impressions. In light of staff shortages, saving time is increasingly becoming a compelling argu- ment. Even the handling, operation and scan routines are now smoother and more straightforward. This, in turn, delivers ben- efits in terms of patient comfort, reprodu- cibility, standardisation and quality assur- ance. In my eyes, the question is not if or when a dental practice should introduce an intraoral scanner – it’s which one. I say the same thing in all my talks: using intraoral scanning has made me a better #1

dentist. Why? Because thanks to the high Key questions to evaluate before choosing an resolution, I can see what I have done intraoral scanner more clearly. This has also significantly boosted the quality of my preparations. I believe that now is the time to adopt intraoral scanners. The opportunities afforded by the technology are now at such a high level that no major leaps for- ward are expected in terms of quality – though of course it is always good to see small improvements. Practice makes perfect One thing is clear: dentists should attend training in how to use intraoral scanners to ensure they can fully exploit their potential. After all, the accuracy of a scan relies criterion accuracy capabilities Are there independent accuracy studies available? Which scanner generation and which scanner software was tested in these studies? scanning strategy Scanning of the entire jaw including preparation, pre-prep-scan, cutting and post-scan of the preparation, single scan of the prepared dies and scan of the overall situation speed How much time does the scanner need for a full jaw scan? How quickly does the scanner find itself again after a tear? cart or laptop Structural requirements in practice, frequency of use, hygiene colour mode Colour scannable? Can the colour also be transferred to the dental laboratory? data availability Is there a certified cloud? Where is the data stored? (scanner-bound, cloud-bound)? Can a sent scan be edited again? modelling Can I order a model directly from the scanner manufacturer? Quality of the models? production chairside/ Is there a chairside option (certified workflow)? heavily on the scanning path: the scanner should not simply be moved over the sur- labside handling faces of the teeth arbitrarily. That’s why, at the German Society for Digital Oral Impres- sions, we offer specialized training and hands-on seminars. With the cutting-edge technology and the training opportunities that are available, there’s no longer any- thing to prevent dentists from successfully implementing intraoral scanning in their practices. How does the handpiece fit in the hand? Are all areas of the jaw accessible? Can I scan the soft tissue (palate)? Can I position the handpiece and then see a picture? powder, dusting Is the application of powder on the surface necessary? Can metal restorations be scanned without an application of powder? hygiene options How can the handpiece be disinfected? disposable items, sterilizable, immersion disinfection, wipe disinfection What software options are available? HD photo, follow-up, marking the preparation margin, motion capture, orthodontic evaluation, outcome simulator, appliance designer, gesture control, other price, running costs, purchase price, monthly costs, update costs, annual costs laboratory software costs for receiving software in the laboratory Author: Dr Ingo Baresel Not sure if you are ready for the step into the digital future? Simply download a more detailed worksheet of the table and find out which scanner is right for your practice: kulzer.com/we-IOS-decision-tool DENTIST DR INGO BARESEL is President of the German Society of Digital Oral Impressions, and a specialist author and speaker on the matter. He has worked in the group practice Dres. Baresel in Cadolzburg, Germany, since 1999. GERMAN SOCIETY OF DIGITAL ORAL IMPRESSIONS The German Society of Digital Oral Impressions was founded in July 2014 by Dr Ingo Baresel, his brother Dr Jens Baresel and their father Dr Wolfgang Baresel. The society, which works closely with manufacturers, aims to support the ongoing devel- opment of digital impression technology and its adoption. Find out more at dgdoa.de. #1 13

Most dental treatments start with an impression. Depending on the indication and the patient, dentists must decide whether to use an analogue or digital technique for this. As a specialist in impression-taking, Kulzer offers both. At IDS 2019, Kulzer will unveil a new, state-of-the-art handheld scanner: the cara i500. What can dentists look forward to in this new product? WE offers an exclusive preview. Like many other areas in dentistry, impression-taking is becoming increasingly digitized. To support dentists on their path to a digital future, dental manufacturers should develop and offer safe and innovative products. Despite the advanced technological develop- ment of intraoral scanners, uncertainty among dentists remains high – because scan results are often not as convincing as ana- logue impressions. However, with Kulzer’s new cara i500, this is no longer the case. The reliable, state-of-the-art scanner not only allows instant monitoring of scans, but also ensures reproducible results in a precise manner. Its convenient handling guarantees an easy entry into this new technology for practice staff. The cara i500 is also economic, offering an impressive price-performance ratio and low cost of ownership. In a nutshell: the cara i500 Kulzer makes digital working that is characterized by speed, simplicity and cost- efficiency easier. But what else makes this handheld scanner stand out? Here are the most important features at a glance: The cara i500 covers a large number of indications: • The cara i500 uses video-type scanning. With this technology, • Single custom abutments the scanner is able to capture pictures while the object is moving. • Inlays and onlays • Single crowns • The scanner is designed for easy handling: it has a small tip, is • Veneers light, fast and precise and it works without powder. This makes • Three-unit implant bridges impression-taking much more convenient, for dentists and • Up to five-unit bridges patients alike. Furthermore, the single button allows dentists to • Orthodontics start and stop the scan at any time, without reaching for the • Implant guides computer. • Diagnostic models • Digital images captured by the cara i500 have a high resolution and reliable, consistent colour authentification. In other words, the scanner produces scans with which dentists can differentiate between soft tissue, plaque and teeth. • The cara i500 is delivered with an open software architecture that is compatible with a wide selection of CAD software. • Last but not least, dentists can benefit from the support, service and training provided by impression specialists from Kulzer. Interested in testing the new cara i500? Visit us at our booth at IDS and experience live demos with this innovative handheld scanner. For more information, go to kulzer.com/we-cara-i500. #1 15

Experts are convinced that the market for 3D printing is set to grow rapidly. The dental industry is already playing an important role in use of this technology. And with 3D printing being well established in dental technology, it is becoming increasingly important for dentists, too. But how exactly does 3D printing work? Dr Sandra Kaiser, Product Application Specialist at Kulzer, explains the revolutionary technology. Dr Kaiser, everybody in the dental industry is talking about 3D printing. How does it acutally work? Often the term ‘3D printing’ is used when additive manufacturing is meant. However, there are a variety of different technologies that currently exist in industry. In dentistry besides SLS and SLM, espe- cially one technique is very common: Stereolithography (SLA) with the two main options SLA-Laser (mostly just referred to as SLA) and THREE QUESTIONS FOR DR MED DENT SANDRA KAISER Product Application Specialist Dentistry SLA-Digital Light Processing (DLP). SLA applies a laser beam that Kulzer GmbH solidifies the liquid photopolymer in one layer, point by point, while DLP works with light that illuminates the whole layer at once. This results in a higher build speed with DLP than SLA. Both techniques offer the advantages of being efficient and resource-saving. Which areas of application can currently be covered on the market? From models and drilling guides for guided surgery to impression trays and temporary to permanent crowns: the 3D printers cur- rently available on the market are able to produce a wide range of dental solutions. In practice, however, laboratories are mainly using them for models, night guards, splints and partial dentures and crowns and bridges for casting. And finally, a look to the future: which potential application are currently being tested? In the United States, 3D printing is becoming popular for creating full dentures. In the first step, the denture base is printed in pink resin, then the teeth are produced with a tooth shaded printing material. Afterwards, the two parts are bonded and glued together. The technique has already been successfully implemented in the US. And I am curious to see when this approach will be estab- lished in other markets. The general trend is towards permanent restorations. Here, the material and hardware development with filled composites and multicoloured translucent materials is just at the beginning. Furthermore, scientists such as a working group of the University Center for Dentistry in Basel, Switzerland, are conducting studies on the use of 3D printers in the area of guided endodontics. Template-guided navigation in root canal treatment could facilitate the treatment of obliterated teeth. The potential of 3D printing is wide-ranging, and we are only just beginning to discover what is possible. I am excited to see what the future brings. Watch a video to learn more about 3D printing and its potentials with cara Print 4.0: kulzer.com/we-cara-print-explain Entire dentures can be produced with the 3D printing materials dima Print Denture Base and dima Print Denture Teeth. #1 17

DOUBLE-MIX TECHNIQUE The double-mix technique is a single-stage, two-phase process. SANDWICH TECHNIQUE Like the double-mix technique, the sandwich technique is a single How it is executed depends on the number of prepared teeth. stage, two-phase process. It differs in the material that is used: If there is only one prepared tooth, the dental assistant can first Here, a kneadable impression material (e. g. Flexitime Putty) is fill a highly viscous material such as Flexitime Heavy tray into commonly used as a tray material. Then, a generous layer of the the impression tray (Fig. 1). A low or medium-viscosity material wash material, e. g. Flexitime Medium Flow, is applied to the tray (e.g. Flexitime Medium Flow) is then syringed around the prepared material (Fig. 3). The benefits of the additional material reservoir tooth. Where there are two or more prepared teeth, the dentist become particularly apparent in clinical situations with large under- and dental assistant need to work simultaneously as they need the cuts. In these situations, the viscoplastic putty material is not able material’s complete working time to syringe all the prepared teeth to sufficiently reach the undercuts, but it pushes the medium viscous and fill the tray. In any case, to ensure the impression is a success, material into the undercuts that it cannot reach itself. However, it is important to pay attention to the minimal distance between the take care to ensure the wash material is not too low in viscosity; tray wall and jaw/teeth; this should be at least 3 mm. otherwise it could be too easily displaced by the tray material. In general, the tray should be inserted into the mouth slowly. This TRIED AND TESTED: Inserting the tray into the mouth slowly ensures optimal adaption of the impression material and reduces allows optimal adaption of the impression material. the risk of flow defects. TRIED AND TESTED: To avoid air bubbles in the area around the occlusal surface, apply wash material to the occlusal surface of the unprepared teeth (Fig. 2). 1 2 3 MONOPHASE TECHNIQUE The fast and simple monophase technique is particularly suitable for supragingival preparations or for transfer and implant impres- sions. A medium-viscosity impression material (e.g. Flexitime Monophase) is usually used to fill the tray and syringe the prepared teeth (Fig. 4). Using an individual tray is recommended to achieve uniform material thickness and some pressure. Its advantage over single-stage, two-phase techniques is that only one consistency of impression material is used, eliminating any displacement effects resulting from different consistencies. TRIED AND TESTED: When it comes to transfer or implant impres- sions, the Shore A hardness of the impression material should be high enough to ensure the primary parts/implant posts are securely fixed in the impression. Did you know … that A and C-silicones are two different types of silicone that do not adhere to one another sufficiently? For this reason, they should not be combined in the same impression. GET MORE PRACTICAL TIPS for taking one-step impressions online: kulzer.com/we-flexitime-tipsandtricks-1 4 #1 19

IMPRINT Published by: Kulzer GmbH Leipziger Straße 2 63450 Hanau, Germany Editor: Legal notice: Eva Gessler (responsible), Dr Janine Schweppe, Kulzer assumes no liability whatsoever for claims in connec- Stefanie Aschmann, Trang Nguyen, Marc Berendes, tion with this magazine. PLEASE NOTE THAT NO INFORMA- Dr Andrea Leyer, Dr Sandra Kaiser, Jens Kehm, TION IN THIS MAGAZINE IS PROVIDED WITH THE INTEN- Tel.: +49 (0) 6181 9689-2000 Jenni Caputo-Kreißl, Verena Wollitz TION OF NOR SHOULD IT BE VIEWED AS GIVING MEDICAL Email: we@kulzer-dental.com External: OR DENTAL ADVICE OR INSTRUCTION ON THE CORRECT USE OF PRODUCTS MANUFACTURED OR DISTRIBUTED BY Managing directors: Dr Kenneth Lee, Dr Ingo Baresel KULZER. Despite careful preparation and selection Kulzer Marc Berendes, Hiromi Hayashida Photo evidence: cannot warrant that the contents are complete and correct. Links to third party websites and content do not mean that Chairman of the supervisory board: Medit Corp. (2, 12, 13), Marc Berendes (3), Kulzer associates itself with the content which cannot be con- Osamu Hashimoto Dr Kenneth Lee (5), Kulzer (1, 10, 11, 12, 13, 16, trolled by Kulzer and for which Kulzer accepts no liability. 17, 18, 19), Dr Sandra Kaiser (17), Dr. Andrea Content and structure as well as the articles used in this news- Companies Registration Office: Leyer (18) Head office of the company: Hanau letter text, images, graphics, files, etc. are subject to copyright and other intellectual and industrial property rights. Their dis- Court of registration: Hanau Local Court, Shutterstock: PanicAttack (1), closure, alteration, use or use in any way, in particular in other HRB 91228 wavebreakmedia (2, 4, 6), Eva Cornejo Coba (7), media is not allowed or require the prior consent of Kulzer or Andrew Rybalko (8, 9), Pan Andrii (12) the respective rights holders. VAT ID: DE 812593096 © 2019 Kulzer GmbH. All rights reserved. kulzer.com/facebook kulzer.com/youtube kulzer.com/instagram kulzer.com