The success of restorative dental procedures is determined by their resulting functionality and aesthetics.[i]Aesthetics are more important to people than ever as we live in a digital age where photographs are uploaded to social media frequently. An obvious restoration can have a detrimental effect on a person’s confidence.

Colour dimensions

According to the Munsell colour system, colour can be described in terms of hue, value, and chroma.ⁱ

Hue: This is the quality that determines the difference from one colour to the next. It is the dominant range of wavelengths visible in the colour spectrum and drives forward the perceived colour.

Chroma: This relates to the intensity of the hue, usually referred to as the saturation. An example of this is if you added a coloured dye to water and kept adding more the intensity (chroma) increases while the colour (hue) remains the same.  

Value (brightness/luminance): This refers to the amount of light returned from an object. Munsell described this as a grey scale of white-to-black and explained that brighter objects have lower amounts of grey, whereas darker objects have larger amounts. In reference to the brightness of a crown, the brightness is usually increased by either lowering the chroma or increasing the reflectivity of the surface. Essentially, lowering the value of an object means it illuminates less light.

Breaking down colour in this way reveals that it’s a little more complicated than what you see in front of you. 

The nature of colour

The first circular colour diagram was designed by Isaac Newton in 1666 and it has become the basic tool for combining colours.ⁱ Colour is determined by light – it is seen when light is reflected from an object and stimulates the visual cortex of the brain for it to interpret what it’s “seeing”. However, the natural process of seeing colour isn’t something people can rely on to be accurate, as studies have shown that men and women perceive colour differently. A study confirmed that men have a higher chance of struggling to distinguish between hues and one in 12 men are colour blind compared to 1 in 255 women.[ii] This indicates that when it comes to colour matching in dentistry the biology of a clinician can hinder their performance.

Challenges with shade selection in practice

Whether you can see colour perfectly or not, there are still challenges that any dentist can face when it comes to shade selection. Some common issues include poor quality lighting in the surgery, taking too long to select a shade, oversaturated backgrounds, and using outdated shade guides. There are other factors that can result in a challenging shade selection process but one commonly found in the literature is the quality of communication between the dentist and technician.[iii] A dentist’s understanding of colour can influence the communication between them and the technician as a lack of comprehension can result in a miscommunication; ultimately producing a mismatched colour shade.

A study consisting of 58 participants revealed that many subjects were not consistent in their approach to shade matching.[iv] This indicated that if these participants were working on a real case then they would likely end up with a restoration that doesn’t look natural. However, digital colour matching has been studied and seems to offer benefits.[v] A study that compared the shade matching success using conventional methods and digitals methods revealed that over 60% of matches were correct when using a computer method. In contrast, just a 43% success rate was recorded with a conventional method.

Colour matching can be complicated but there are materials available to make life a whole lot easier, and support successful outcomes with every patient. Designed for everyday use, BRILLIANT EverGlow^® from COLTENE is a universal hybrid composite that excels through its sculptability, form stability, polishability, and long-lasting high lustre. As well as all this, the sophisticated and versatile shade system offers three translucency levels and enhanced Duo Shades allow for flexibility in single-shade and multi-shade restorations. What’s more, BRILLIANT EverGlow^® now has a new and improved tip for more accurate application.

In summary, colour is complex and, in dentistry, conventional shade matching methods come with a fair few challenges. Due to the inaccuracies of the human eye and the advancements in technology, a digital method has become the gold standard for many. But there are also materials that will support better shade matching, for restorations that are highly aesthetic and will blend beautifully with the surrounding teeth.

Nicolas Coomber COLTENE  National Account & Marketing Manager

For more on COLTENE, visit www.coltene.com,
email info.uk@coltene.com or call 0800 254 5115.

[i] Sikri, VimalK. “Color: Implications in Dentistry.” Journal of Conservative Dentistry, vol. 13, no. 4, 2010, p. 249, www.ncbi.nlm.nih.gov/pmc/articles/PMC3010031/, 10.4103/0972-0707.73381. Accessed 4 Nov. 2021.

[ii] Ayman, Shahenda. “Do Women See More Colors than Men?” SCIplanet, 23 Nov. 2017, www.bibalex.org/SCIplanet/en/Article/Details.aspx?id=10304. Accessed 4 Nov. 2021.

[iii] Fondriest, James. “Shade Matching in Restorative Dentistry: The Science and Strategies.” The International Journal of Periodontics & Restorative Dentistry, vol. 23, no. 5, 1 Oct. 2003, pp. 467–479, pubmed.ncbi.nlm.nih.gov/14620121/. Accessed 4 Nov. 2021.

[iv] Alomari, M., and R. G. Chadwick. “Factors Influencing the Shade Matching Performance of Dentists and Dental Technicians When Using Two Different Shade Guides.” British Dental Journal, vol. 211, no. 11, Dec. 2011, pp. E23–E23, 10.1038/sj.bdj.2011.1006. Accessed 4 Nov. 2021.

[v] Jedynakiewicz, Dr N M. “Digital Colour Matching in Restorative Dentistry.” British Dental Journal, vol. 199, no. 1, July 2005, pp. 33–33, 10.1038/sj.bdj.4812556. Accessed 4 Nov. 2021.

Dr Ferhan Ahmed shares a recent case where he provided planning and surgical support to a colleague – Dr Melanie Edwards of West Parade Dental care in Lincoln – for an implant case as part of the training programme he offers.

A female, 67-year-old patient presented seeking an alternative solution to her existing upper denture. She was struggling with movement of the denture while speaking and eating and it was beginning to affect her confidence and ability to communicate with others. She was very conscious of the denture moving around and slipping down, and this was having an increasingly negative impact on her quality of life.

A comprehensive medical history and clinical assessment was conducted. Aside from being a well-controlled asthmatic, the patient was fit and well, with no other health concerns. Her oral hygiene was good and there were no abnormalities detected.

After discussing the patient’s concerns with her, four treatment options were presented:

• No treatment
• A new removable denture
• A removable, implant-retained denture
• A fixed implant-retained prosthesis

The patient was most interested in the fixed solution due to the convenience and peace of mind this would provide. 

Treatment planning

A full set of clinical photographs, intraoral scans and a CBCT were deemed appropriate and taken. This information was used to assess the patient’s smile line, lip support requirements and bone availability – including bone height, width and distribution as well as its suitability for multiple implant placement.

It is always important to combine the anatomy and clinical requirements with the patient’s desires to find the most viable solution. As part of the treatment planning process, digital technology can be used to further engage the patient, determining any changes to the tooth shape, length and width for the restorative phase.

All of this information is shared with the dental technician, who provided a restorative guide and interim denture for the day of surgery in this case. Every aspect of treatment was planned virtually, involving both clinicians, the technician and the patient to ensure the best possible result. In the end, the plan was to perform an alveoloplasty and place four dental implants with maximum anterior-posterior spread for same day teeth. A final FP3 prosthesis would ultimately be delivered. 

Surgical treatment

Four Neodent Grand Morse Helix dental implants of 4mm x 13mm and 4mm x 11.5mm were placed in the maxilla at the pre-determined positions. I use these as my preferred implant system for full arch immediately loaded cases due to their highly predictable, reproducible results. They enable high primary stability and are simple for clinicians who are new to immediate load full arch implants to develop their skills with, which is why I choose them when training and mentoring.

A full thickness flap was extended from the distal aspect of the second molar on one side to the distal aspect of the second molar on the other side. This was done with respect for the anatomical landmarks identified, the nasal floor, maxillary sinus bulbosities, nasopalatine canal and the palatal shelf.

An alveoloplasty was carried out, as determined in the planning. This bone reduction is important for restorative success – adequate restorative space must be created for the final restoration in order to deliver the most functional and aesthetic results for the patient. In this case, we planned for a FP3 metal acrylic final restoration.

The patient left the practice on the day of surgery with her fixed interim bridge in place. Once healing has occurred and the patient has had time to become accustomed to the interim bridge, a definitive prosthesis will be fabricated.

Review

Full arch rehabilitation is an advanced implant procedure, so it’s important to have a mentor when you first enter the field. Whether a colleague offers a second opinion and support virtually or is by your side during surgery will vary according to your clinical experience and confidence. 

Even full arch implants can be made simpler with innovative products and careful planning – as demonstrated by this presentation. Case selection is really important for the best result, especially when starting out with this type of treatment modality. It is just as crucial to really understand the patient’s psychology and desires for treatment. As clinicians, we need to deliver solutions to the patient’s concerns, meeting their aspirations as well as the clinical requirements of their anatomy.

Treatment planning is integral for this. Everything will work on the day of surgery if the planning is appropriate. This means that the clinician(s), technician and patient must align their aspirations and expectations so they work towards a common goal. This allows a streamlined surgical process and more predictable results. When you can reproduce high quality outcomes day in day out, it also gives patients confidence in your skills and your team.

For more information, please visit https: www.neodent-uk.co/efficiency

About the author:

Dr Ferhan Ahmed is dual-qualified in dentistry and medicine. His current practice is limited to dental implants and surgical dentistry. He qualified from the University of Glasgow (UK) with a BDS in 2005 and from the University of Liverpool (UK) with an MBChB in 2012. Since completion of vocational training, he has exclusively focused training and research in the area of oral and maxillofacial surgery. Dr Ahmed is involved in teaching and mentoring within the field of dental implants and surgical dentistry. His practice in dental implants involves conventional implants, complex bone grafting and extra maxillary implants such as pterygoids and zygomatics.

Images:

Fig 1

Fig 2

Fig 3

Fig 4

Fig 5

Fig 6 -surgical phase incision and flap reflection

Fig 7 -exposure of the alveolar ridge illustrating ridge reduction right side

Fig 8 -exposure of the alveolar ridge illustrating ridge reduction right side

Fig 9 -prothetic guide in place

Fig 10 -Multiunit healing cap in place

Fig 11 – Wound closure

Fig 12

Fig 13

Fig 14

Fig 15

Fig 16-post-operative smile shot with temp-restoration in

Fig 17

Fig 18

Fig 19

Fig 20 -final prosthesis in left lateral view

FIg 21 -final prosthesis in right lateral view

Fig 22 -final prosthesis in occlusal view

Fig 23

The ‘Perio plus’ Regenerate oral rinse does more than simply clean your patients’ mouths – it also helps to support soft tissue health.

Chlorhexidine has been shown to aid in the regeneration of tissue,[i] so it’s no wonder that dentists have trusted it for almost 70 years! When paired with CITROX®, a natural bioflavonoid extracted from bitter oranges, patients can experience an optimal oral care solution, enhanced by nature!

The formula is also bleach- and alcohol-free, with a pleasant taste, thanks to the know-how of Swiss flavour specialists Givaudan.

The ‘Perio plus’ Regenerate oral rinse is truly a powerhouse of beneficial properties, that really packs a punch without being too harsh on the teeth and gums.

Visit the website for more information, or contact the team today!

For more information, please call 01480 862084, email info@curaprox.co.uk or visit www.perioplus.com/uk

[i] BMC. In-vitro antibiofilm activity of chlorhexidine digluconate on polylactide-based and collagen-based membranes. Available online. https://bmcoralhealth.biomedcentral.com/articles/10.1186/s12903-019-0979-y. Accessed 14 Oct. 21.

Choosing from the plethora of courses available can be overwhelming but knowing you could be working with a specialist can give you confidence in your education.

Dr Asif Chatoo received specialist training in Lingual Orthodontics in 2002 and holds a Masters in Orthodontics, as well as being the only orthodontist accredited by both the World and the European Lingual Orthodontic Societies. Now presenting the IAS Academy Lingual Braces Course you could receive incredible tips and advice from Dr Chatoo himself.

On this one-day course you will learn how to tackle challenging cases and when to refer. In the afternoon you’ll embark on a hands-on session with expert assistance. The support doesn’t stop there either; life-long mentoring is available to you with every case moving forward so you can always come back for advice! 

Don’t miss out on the chance to work with some of the best! Choose your preferred course date today.

For more information on upcoming IAS Academy training courses, please visit www.iasortho.com or call 01932 336470 (Press 1)

Colosseum Dental UK would like to mark International Women’s Day 2022 – 8^th March – by thanking all the females throughout the business that help to make our organisation what it is today!

We are big believers of equality and we are proud to have a diverse and highly ambitious team of professionals caring for our patients and supporting our practices from operational and managerial roles. This is just one of the ways in which we aim to create supportive, collaborative and inclusive working environments for all our professionals.

At Colosseum Dental UK, we care more. We care more about our people, our patients and our commitment to equality. Thank you to everyone who has demonstrated passion and dedication to our patients and our business – and Happy International Women’s Day!

For more information, about Colosseum Dental, please visit http://www.colosseumdental.co.uk/careers/

#WeCareMore

The new Lyla steriliser from W&H is here to offer professionals a sustainable, streamlined approach to infection control.

The Lyla steriliser facilitates everyday actions with cycle times from 23 minutes, an automatic water filling option, excellent reliability and an intuitive user interface. However, what really sets the Lyla steriliser apart from the crowd is the option to upgrade the system to suit your individual requirements.

From changing the system to a B-type steriliser or enhancing traceability, to adding remote data storage, the upgradeability of the Lyla means that it can adapt to the needs of your practice whenever you need it to. The Lyla truly offers an unbeatable price-performance ratio.

Find out more today.

To find out more visit www.wh.com/en_uk, call 01727 874990 or email office.uk@wh.com

Childhood and early adulthood are filled with learning. Increasing knowledge, broadening horizons, and stretching our minds was all in a day’s work whether it be at school, college, or university. Upon entering the world of work, education can often take a back seat as we prioritise executing the job at hand and tackling any challenges the day throws at us. COVID-19 has certainly presented plenty of challenges for dental professionals to concentrate on over these past 18 months.

But working and learning can and should go hand in hand. Studies show that undergoing additional development can not only result in an increased performance in one’s role, [i] but it can also improve job satisfaction, morale, and motivation. ⁱ Therefore, ongoing education is clearly a key driver for the clinician in the pursuit of a happy, fulfilling, and successful career.

Boost your career with a Personal Development Plan

Developing your Personal Development Plan (PDP) is a useful tool in helping to consolidate your learning goals and ensure you stay on track. The concept of the PDP was added as a key requirement for registrants when the Enhanced CPD scheme was introduced in 2018. It seeks to encourage dental professionals to carefully consider where they want their career to go and then create a plan for the coming years.

Create and maximise your plan

The creation of a PDP can be considered as a four-step process of continual refinement and improvement. [ii]These steps are outlined below, together with tips on how to maximise each one.

1. Review
   To kickstart the process, it is advisable to reflect on previous learning and current performance to help identify areas for further development.
   It can be useful to break your review down by topic, whether it be clinical, management, communication, or personal. [iii] Also consider your future job aspirations and any training requirements you need to achieve these.
2. Prepare
   Evaluate what needs to be actioned and when to achieve your learning needs.
   It helps to use the SMART framework: being specific, measurable, achievable, relevant and time-bound [iv] to ensure that objectives are achievable and the plan is a success. Using the terms ‘about next year’ or ‘ongoing’ is not defined enough and should be changed. ⁱⁱⁱ
3. Action
   Carry out your pre-planned learning objectives.

There are a number of activities that can help you to achieve and maximise the completion of your objectives. These could include:

• Attending regional, national, or international dental conferences to network, receive insights from expert speakers, and hear the latest updates.
• Participating in suitable courses or events, whether online or in person, to learn new skills.
• Completing workplace-based assessments or other forms of clinical assessment, for practical experience.
• Learning from colleagues through observation or shadowing to witness treatment in action.
• Completing log books of clinical work carried out, to evidence your progress.

Ensure that you keep a record of the learning produced by your provider including course notes and handouts as evidence of your attendance ⁱⁱⁱ and a useful reminder for the future.
It’s important to assess if the action adequately fulfilled your objective, and also take note as to whether it opened your eyes to any other related learning needs that can be fed into your PDP as a new objective. ⁱⁱⁱ

4. Outcome
   All planned learning activities should be evidenced with a certificate and evaluated in terms of how it has benefitted yourself, and others.

Include a written reflection of what you have learned and how it has been applied. This is helpful to check your understanding, provide feedback to the course provider which they can factor in to subsequent sessions, and perhaps also to review your learning with a colleague so you can share your ideas and reinforce learning. ⁱⁱⁱ

Reboot your career with Rodericks Dental

Rodericks Dental understands what is needed to enhance and diversify your clinical expertise to deliver the best patient care and feel fulfilled in your career. The senior management team includes several individuals who have worked as practising clinicians and so know what dentists need to thrive. Their experience is used to create the educational advancement and career progression opportunities on offer to the full team.

Whether you’re looking to broaden your current skill-set, transition into a new discipline, or find a new role that challenges you to reach your full potential, consider joining Rodericks Dental!

Laying the foundations with learning

A solid base of clinical expertise is essential to laying the foundations of a long-lasting career and as with any structure it requires continual care and maintenance. Treat your Personal Development Plan as your checklist to make sure that no cracks begin to show in your knowledge and identify where any extensions or reinforcements are required to ensure your clinical skills and understanding remains strong both for now and the future.

For more information on the career opportunities available at Rodericks, please visit www.rodericksdentalcareers.co.uk,

or contact Ashley Lillyman at recruitment@rodericksdental.co.uk or on

01604 970988 (option 1)

#wearerodericks

[i] Elnaga, D.A., & Imran, A. (2013). The Effect of Training on Employee Performance. European Journal of Business and Management, 5, 137-147. Available at: https://core.ac.uk/download/pdf/234624593.pdf. [Last accessed 08.09.2021].

[ii] Maguire, W., Blaylock, P. Preparing a personal development plan for all members of the dental team. Br Dent J 223, 402–404 (2017). Available at: https://www.nature.com/articles/sj.bdj.2017.730. [Last accessed 08.09.2021].

[iii] NHS Health Education North East. ‘A guide to personal and professional development planning’. Available at: https://madeinheene.hee.nhs.uk/Portals/13/PDPguidanceApril14inctemplate.pdf. [Last accessed 08.09.2021]

[iv] Doran, G. T. (1981). There’s a S.M.A.R.T. Way to Write Management’s Goals and Objectives. Management Review, 70, 35-36. Available at https://community.mis.temple.edu/mis0855002fall2015/files/2015/10/S.M.A.R.T-Way-Management-Review.pdf [Last accessed 18.08.2021].

The first ever ClearCorrect^® SmileAward will take place this year, providing an opportunity for orthodontists and GDPs around the globe to showcase their cases. The mission is to change people’s lives by giving smiles back, supporting pro bono cases and charity donations while celebrating clinical excellence.

Initial submissions are open until 20^th April – just upload a case report and video testimonial to the ClearCorrect^®Case Gallery. The top 25 eligible cases will be selected via public voting on the Case Gallery tool. Eight finalists will be chosen by a panel of world-renowned experts and announced during the ClearCorrectXP (CCXP) 2022 Global Virtual Event in June 2022.

The winner can choose between a VirtuoVivo™ intraoral scanner, all materials (including aligners and treatment set-up) for 5 complete pro bono cases, or a charitable donation in their name to a non-government organisation worth CHF 10,000. The remaining seven finalists will receive similar benefits of varying values, helping to give back, change lives and boost clinician’s practices at the same time.

For more information and to enter, please visit

www.clearcorrect.com/smileaward