Considering the uncertain economic climate over the last couple of years, alongside public health concerns, you may have found yourself worrying about your family’s financial security in the future.

Now is a good time to seek advice on life assurance policies, to help ease your mind and plan for your family’s financial future after you’ve passed away. Life assurance will enable you to leave a consistent income for your family, and even pay off your mortgage, to ensure your family are well looked after.

The award-winning team at money4dentists have decades worth of expertise in advising dentists on the right life assurance policies for them. They understand dental finances, and will be able to help you make the right decisions for you, and your family.

For more information, please call 0845 345 5060 or 0754DENTIST.

Email info@money4dentists.com or visit www.money4dentists.com

Dr Amit Patel is a Specialist Periodontist with extensive experience in dental implantology. He recently used the new Neodent^® Zi Zirconia Implant System and here shares his case. 

As dentists, our goal is to get patients out of pain and provide them with beautiful and functional solutions that will last them as long as possible. However, our work is just as much about meeting patient expectations and working with them to find solutions that fulfil their personal preferences and desires – whether that is providing fixed or removable restorations, identifying treatment options that fit into their lifestyle, or using products from preferred materials.

The case presented here was a female, 56-year-old patient who presented to the practice looking for a solution for her failing UR3. She was keen to explore non-metal options having done some research online about the potential benefits and availability of certain products. This particular request is becoming more and more common among patients that I see – a growing number of people are increasingly aware about what is being put into their body and there is a clear demand for metal-free dentistry.

In this situation, a comprehensive assessment was conducted, confirming that the patient was fit and healthy with a clear medical history. The intraoral examination revealed no abnormalities, no active disease and generally good oral hygiene. The patient had a few existing restorations, but the main issue was the fractured roots of the UR3, which had a failing post crown in place.

All possible treatment options were discussed with the patient in detail. The prognosis of the UR3 was poor, so extraction was indicated. Restoration could then be achieved either with a removable bridge or an implant-retained crown. All benefits, risks and limitations of the different options were described in detail, but the patient remained most interested in the fixed option, where it could be achieved with a metal-free solution. A ceramic implant and crown were suggested and the patient gave informed consent to proceed.

The existing UR3 was extracted as atraumatically as possible and left to heal for 6-8 weeks. The patient then returned for surgical treatment, which was planned using a CBCT scan to ensure minimal complications.

The implant placement technique selected was typical of a simple implant procedure and followed the manufacturer’s instructions. A 4.3 x 11m Neodent^® Zi Ceramic Implant System was chosen to fulfil the patient’s desire for a metal-free restoration. A flap was raised and the implant placed at the predetermined bone level position and chosen angle, torqued to 60 Ncm. Guided bone regeneration (GBR) was performed to replace the missing buccal bone following extraction of the fractured roots, using a synthetic grafting material, as per the patient’s preferences. The flap was closed and sutured without tension. All the appropriate post-operative instructions were given to the patient, with special emphasis on maintaining oral hygiene around the surgical site. 

During the 3-month surgical review, healing had been good and the site looked healthy, with good soft and hard tissue attachment. An Implant Stability Quotient (ISQ) was taken to measure and confirm the stability of the implant and the strength of the integration.

The implant was uncovered and open tray impressions were taken and sent to the laboratory to fabricate the restoration. This was a screw-retained, zirconia crown loaded onto a zirconia abutment, maintaining the patient’s wishes to stay metal-free.

The patient loved her smile and was very happy with the outcome of treatment. Given her positive experience with the ceramic implant and restoration, she is considering a similar implant treatment to replace her now also failing UL4.

The new Neodent^® Zi Ceramic Implant was an excellent choice for this case, not only because it catered to the patient’s desire for a no metal, but also thanks to its unique design and manufacture process. Unlike other zirconia products often made in a machine, the Zi Ceramic Implant is constructed using an injection moulding technique, which reduces the risk of microscopic fractures in the material for superior strength and reliability. It also facilitated beautiful tissue healing, with the zirconia abutment encouraging gingival attachment for no probing depth and optimised aesthetics. Plus, there are various diameters available to suit different cases.

This case demonstrates the importance of having a diverse armamentarium behind you that allows you to meet the needs and desires of your patients. It’s their mouth and their treatment, so we must find solutions we trust to deliver good clinical results that operate within our patient’s preferences. When my patients request metal-free options, I will only place Neodent^® implants because of their simplicity.

Figure 1a – Post extraction and 6-8 weeks healing

Figure 1b – Post extraction and 6-8 weeks healing

Figure 2 – Implant placement

Figure 3 – Implant in situ

Figure 4 – Grafting material packed around implant

Figure 5 – Soft tissue closed without tension

Figure 6 – Radiograph immediately post placement

Figure 7 – 1 week post-op

Figure 8 – 3 months post op

Figure 9 – 2 months post op radiograph

Figure 10 – post treatment

Figure 11 – post treatment UR3

Figure 12 – post treatment UL4

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

Author bio:

Dr Amit Patel is a specialist in periodontics. He graduated in dentistry from the University of Liverpool in 1997 and obtained his Membership of the Faculty of Dental Surgeons at the Royal College of Surgeons in Edinburgh in 2000. Dr Patel also underwent a 4-year training programme in periodontics and implantology at Guy’s, Kings and St Thomas’ Dental Institute, achieving his Masters in periodontology and clinical dentistry. Passionate about providing specialist dentistry to the highest degree, Dr Patel also trains other dental professionals. As Associate Specialist in periodontics and Honorary Clinical Lecturer at the University of Birmingham Dental School, he teaches at undergraduate and postgraduate level. He also lectures both nationally and internationally.

Have you been confronted with a challenging case where your patient requires zygomatic implants? They are in safe hands when you refer them to the team at the Centre for Oral-Maxillofacial and Dental Implant Reconstruction, a ZAGA centre based in Manchester.

Led by Professor Cemal Ucer, a Specialist Oral Surgeon, the highly skilled team are able to take on cases with insufficient residual bone in the maxilla for conventional implant treatment. The practice team have many years of experience between them, so rest assured that your patients will be in expert hands throughout the entire process.

The Centre is able to provide all stages of zygomatic implant treatment, including implant placement surgery and any required prosthetic work. The Centre even gives you the option to request a surgeon to come to your clinic to perform the surgery and place the implants – this will allow you the opportunity to observe and learn, and will mean your patient can remain at your clinic throughout the procedure.

Get in touch today to refer your patients to the only certified ZAGA experts in Manchester.

Centre for Oral and Maxillofacial & Dental Implant Reconstruction and ZAGA Centre

ICE Hospital, Manchester UK 

For referrals or training opportunities in maxillary sinus grafting and or ZAGA Zygomatic Implant techniques, please contact Professor Ucer at cemal.ucer@icedental.institute or Mel Hay at mel@mdic.co

01612 371842

www.ucer-clinic.dental

You can save time whilst ensuring that your instruments are expertly cleaned and disinfected using a washer disinfector, ready for sterilisation in an autoclave.

The Miele PG8581, the most popular washer disinfector solution from Eschmann, is a large capacity, free-standing system, with configurations specifically designed for dental practices. The dental cycle is fully validated and compliant to HTM01-05 and SDCEP guidelines, and the system can accommodate up to 360 instruments per cycle for ultimate convenience. In just under an hour,* outstanding cleaning, disinfection and drying can be achieved. The Miele PG8581 washer disinfector is also WRAS approved, and comes with a Little Sister autolog for real-time recording of all cycles.

To protect your investment and ensure your systems are always fully compliant, Eschmann washer disinfectors can be supported by Care & Cover. This exclusive service offering from Eschmann includes unlimited breakdown cover (including call-outs, parts and labour) and nationwide on-site support. Also included is technical telephone support and Enhanced CPD User Training, delivered by Eschmann engineers.

To discover more, get in touch today.

For more information on washer disinfectors from Eschmann, please visit www.eschmann.co.uk/dental-health-solutions/dental-washer-disinfectors/ or call 01903 875787

*All times depend on the size of the load

One thing you can rely on is the service offered by specialist dental indemnity provider Howden.

Choose Howden for contractual cover and policies that are broad and inclusive, also the reassurance that you will have the right people on your side, when you need them most.

Protect your career, livelihood and wellbeing for whatever might come your way. In the event of a claim being made against you, a policy with Howden means having Confidence of Cover that is Cost-competitive – the 3 Cs!

Don’t have sleepless nights because you were unprepared. No matter what stage you are at in your career, or the type of dentistry you practise, you can feel secure with Howden.

For added value, we offer our clients access to medico-legal and mental wellbeing helplines, if you need advice or just want to vent.

Switching is easy, and we have a 10-year run off for work completed.

Get in touch today, for a free, no-obligation quote.

For more information, please visit www.howdengroup.co.uk or call 020 3918 9127

END

Howden Insurance Brokers Limited is authorised and regulated by the Financial Conduct Authority in respect of general insurance business. Registered in England and Wales under company registration number 725875. Registered Office: One Creechurch Place, London, EC3A 5AF.

You’ll have heard it before, but it is sometimes easy to forget just how unique every single patient who enters your practice is. After all, each individual leads a completely different life and will have their own habits, quirks and other foibles as well as beliefs and other unique characteristics.

However, these differences can present as challenges in practice, especially if their behaviours impact the state of their dentition. It is partially this that makes restorative dentistry so complex, especially if you have to restore teeth that have become stained over time or through previous treatment.

But what are some of the more challenging aesthetic defects that dentists have to overcome and how can this be achieved?

Masking metal

Although the use of dental amalgam is on the decline in the UK, it still remains a prolific material in the mouths of the general population. The general consensus in dentistry is that the material is going to be phased out (potentially as soon as 2030)[i] but that doesn’t change the fact that a vast number of individuals will already have amalgam in their mouths.

Indeed, statistics suggest that, on average, in 2018 over 90% of the UK adult population had one filling.[ii] This number is likely to have grown throughout the last four years, especially when we consider the impact of the pandemic and the lack of access that people had to dental services during this time.

Dental amalgam, though perfectly serviceable, does come with some aesthetic disadvantages. As well as looking unnatural, these types of fillings can also stain the dentition, leading to marks on the surviving natural tooth structure that can be difficult to mask with composite. What makes this a concern for modern dental professionals is that more and more patients are opting to switch their dental amalgam filling for composite alternatives. Though there are no concrete figures indicating just how many patients are making this switch, it’s definitely a priority for people who want to improve their smiles and embrace a more natural look.

As the main ideology behind this behaviour is the quest for a more aesthetic result, patients will want to feel confident that if they do have their fillings redone, their teeth won’t have any residual stains.

Everyday habits can stain over time

There are many patient behaviours that may lead to tooth-staining. While the vast majority of these are just superficial stains that can easily be solved before restoration, there are certain scenarios where these stains are deeply ingrained and may compromise the aesthetics.

For instance, if a patient chews tobacco or uses recreational drugs – these habits can lead to long-term staining that can be deeply situated within the enamel.

Plus, the development of cavities may also result in stained dentition. As cavities often present as dark grey, black or brown spots, and any dentine that is affected by caries may be discoloured, even after the decay is cut away – these scenarios can provide professionals with challenging cases.

Medications make a difference

Interestingly, there are a few medications that can result in stained dentition. Tetracycline, for instance, has been proven to cause tooth staining and marks that look like discoloured lines forming along the tooth. This phenomenon usually occurs when children are given these antibiotics, which has led to the medicine being restricted for use in younger age groups. However, with it being a popular medication years ago, there are still patients who have tetracycline-stained dentition and will need extra attention when it comes to restorations.[iii]

Everyday adjuncts to oral hygiene including some mouthwashes have also been linked to tooth staining, while certain antihistamines, antipsychotic drugs and antihypertensive medicines have been found to discolour teeth too, creating stains that are difficult to remove.

Your key to aesthetics

Finding composites that can reliably cover stained dentition isn’t always straightforward. Depending on the opacity and shade of the composite being used, stains can persist and remain visible, leading to poor final aesthetics that will likely impact patient satisfaction.

As such, one way to overcome these challenges is to find a product that has been clinically proven to mask stains. Filtek Universal Restorative from 3M is an excellent option. Its Pink Opaquer shade covers stains and eliminates dark areas,* meaning that you can then complete the restoration with your shade of choice for long-lasting, aesthetic results.

Prepared for all eventualities

Restorative dentistry brings a number of challenges, but stained dentition can be simple to overcome. By investing in products that can reliably mask any staining, you can feel confident that you are giving your patients the natural-looking results they require.

*3M internal data

For more information, call 08705 360036 or visit www.3m.co.uk/Dental 

3M and Filtek are trademarks of the 3M Company.

[i] British Dental Association. Dental Amalgam. Link: https://bda.org/amalgam [Last accessed May 22].

[ii] Statista. Share of Adults With At Least One Tooth Filling in England 2018, By Region. Link: https://www.statista.com/statistics/1131889/adults-with-tooth-fillings-in-england-by-region/#:~:text=In%202018%2C%2090.2%20percent%20of,London%20have%20a%20tooth%20filling. [Last accessed May 22].

[iii] Healthline. How Tetracycline Affects Teeth and What To Do about it. Link: https://www.healthline.com/health/tetracycline-teeth [Last accessed May 22].