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Cerec-zeitung_gb_rz.qxd

NO. 3 December 2005 International Edition
PERFECT VISITING CARD
CONVINCING METHOD
All-ceramic veneers are CEREC dentists and Practice profile: from unbeatable in every inLab laboratories are ivory to CAD/CAM perfect partners PAGE 3
Simply try it and see The war of the bottles
One evening recently, BONDING AGENTS. Single-bottle bonding agents offer distinct advantages in terms of handling and con-
tended to use less aggressive at a meeting of the venience. But which bonding system will win in the end? Which material is best suited to which application?
solvents to dissolve this smear layer, German Association As far as all-ceramic inlays and onlays are concerned, the three-step total-etching technique is definitely to
for fear that phosphoric acid etching be recommended.
would damage the pulp. This was Assisted Dentistry, I followed by the application of a found myself in a sports hall in front of The strength and survival pros-
hydrophilic primer and an adhesive.
pects of all-ceramic restorations To simplify matters, new primers an indoor climbing do not depend solely on the proper- were developed containing organic wall. I weigh in at around 100 kilos and ties of the ceramic material. The acids designed to dissolve the smear on the evening in question was wearing design and dimensioning of the layer, and monomers designed a sports jacket and ordinary shoes. All restoration and the bonding method to penetrate the demineralized around me climbers were demonstrating play a crucial role as well.
dentine. These adhesive systems their athletic prowess by surmounting depended on the separate etching death-defying overhangs and crawling Adhesive bonding or cementing
of the enamel and the dentine. along beneath the ceiling like flies. I hesi- If sufficient tooth substance As such a clear separation was tated until the coach standing next to me remains, adhesive bonding is the difficult to achieve, it was decided to said, "What are you waiting for?" and ideal technique. The adhesive bond adopt the total etching technique, pointed to a lady in an evening gown transforms the remaining tooth under which the enamel and the and high heels who had already complet- tissue and the restoration (inlay, dentine were etched in a single ed half of the course. Yes, what was I onlay) into a single unit. The situa- process. Unfortunately, this tech- waiting for? The general situation was tion is different with regard to nique was prone to errors and re- not going to get any better. What could crowns and bridge abutments. In sulted in postoperative hyper- go wrong? Perhaps I should give it a try. many cases little or no natural tooth sensitivity. This prompted the devel- How many people spend their time enamel remains. In this case the opment of acidic primers that waiting for something to happen? Wait- dentist can deploy oxide ceramic simultaneously condition the ing for times to improve, for new techno- frameworks, which – due to their enamel and the dentine. Today's logy, for simpler adhesive bonding tech- inherent strength – lend themselves bonding systems deploy different niques. Is it worth waiting? Not in most to conventional cementing. By con- Three-step total-etching systems have performed very well in long-term clinical trials.
strategies in order to dissolve/ cases, as experience has shown. A lot of trast, silicate ceramics with a lower These systems are indicated for all-ceramic inlays and onlays. By contrast, self-adhesive
remove the smear layer. The one things are easier than they appear at first degree of flexural strength (between cements are easier to use and create a stronger bond with the dentine. They would
strategy involves the use of self- sight – for example, adhesive bonding.
200 and 300 MPa) require adhesive therefore appear to be more suitable for crowns.
conditioning monomer solutions.
Don't be intimidated by scientific theory.
The other approach involves total Simply try it out for yourself, perhaps on The adhesive bonding of all- Dentine contains a higher concen- way for stable adhesion to the den- etching with the help of phosphoric a model to begin with. Tens of thou- ceramic restorations has meanwhile tration of organic substances. It is acid. (For an overview of the various sands of dentists have taken this first become a standard procedure in hydrophilic and hence does not adhesive bonding techniques see step and can confirm the wisdom of learn- modern dentistry. By applying 30 – bond automatically with hydropho- Less smear, better bond
ing by doing . By the way, the view from 40% phosphoric acid it is relatively bic substances such as luting com- A further obstacle to effective den- the top of the climbing wall was fantastic easy to create micro retentive struc- posite. The advent of hydrophilic tine adhesion is the smear layer.
– as was my sense of achievement.
tures on the enamel. Achieving primers in combination with hydro- Dissolving this smear layer is now PD Dr. Roland Frankenberger, Polyclinic for mechanical adhesion to the dentine phobic bonding agents represented standard practice for all bonding Conservative Dentistry & Periodontology, Dr. Wilhelm Schneider represents more of a challenge.
a real breakthrough and paved the systems. In the old days dentists Head of CEREC product marketing atSirona CEREC turns 20
CEREC Masters Symposium in Johannesburg
On 17 and 18March 2006 KNOW-HOW TRANSFER. Anterior
of Computerized Dentistry (ISCD) a single treatment session. In CEREC restorations are easy to learn
in Johannesburg last August.
typical "hands-on" fashion Rich Published by: Sirona Dental Systems GmbH,
– and profitable
During this two-day event, 59 Masek showed a new method for 20th birthday of the CEREC system at a Fabrikstraße 31, D-64625 Bensheim, CEREC users profited from the milling anterior crowns with special symposium ("20YC") in Berlin.
Tel.: +49 6251-16-0, Fax: +49 6251-16-2591, Organized in collaboration with Professor CEREC is not the sort of system in-depth knowledge of various reduced labial surfaces prior to the
that stands around unused in a CEREC experts, including Dr. application of ceramic veneering Mörmann and the Quintessenz publishing Responsible for content:
corner of the treatment room. Quite Klaus Wiedhahn (Buchholz/ Ger- material. Both processes involve company, the 20YC Symposium will be the Dr. Wilhelm Schneider, the opposite. Typically, dentists many) und Dr. Rich Masek (San just a few steps. The attendees Sirona Dental Systems GmbH perfect blend of science and entertainment, begin with relatively simple restora- Diego/California), both of whom enjoyed not only their encounters learning and celebration. Leading clinicians Editorial team: Wilhelm Schneider, Hans-
tions such as premolar crowns specialize in highly aesthetic with these exceptional teachers, Georg Bauer, Antje Casimir, Iris Hauer, Birgit and academics will describe how easy and Möller, Manfred Kern, Andrea Hamacher, and inlays. They then progress to anterior CEREC restorations. The but also the classy surroundings profitable it is to integrate CEREC into exis- Christoph Nösser, [email protected] onlays and tooth-conserving partial experts lectured on the basic prin- of the Johannesburg convention ting dental practices. There will be ample Design and production:
crowns. The final step is the crea- ciples of CAD/CAM restorations as scope for informal discussions. To this extent ergo Kommunikation, Köln/Frankfurt a.M., tion of veneers, anterior crowns and practised in Europe and North the 20YC Symposium is ideal for existing implant superstructures. CEREC is America. The attendees had ample CEREC users and for all those who want to Printing: PrintService Vertriebsgesellschaft
great fun to learn and use. This was opportunities to put what they had join their ranks in the near future. von Wirth mbH, Willy-Messerschmitt-Str. 4, very much in evidence at the recent learned into practice. In an im- Anterior CEREC Masters Sympo- pressive live session Klaus Wied- i Further information and registrations:
sium staged by the South African hahn demonstrated how four i Further information about next year's sympo-
CEREC Magazine is published every three months.
branch of the International Society veneers can be created and placed in sium is available at: www.iscd-africa.com 2 CEREC Zeitung
No. 3 December 2005
CEREC is grown up
Acceptance of new technologies
SETTING A STANDARD. It is 20 years since the launch of CEREC 1, the
become a normal procedure, taught first computer-aided system for preparing all-ceramic inlays. At the time
as standard in all universities Acceptance
few scientists or industry experts thought the new technology had a
today. Now there are materials on the market that can be worked aseasily as conventional bonding It took a little luck – and the right without framework for the anterior cements.
Maturation phase
people. The decision by Prof. Dr.
and premolar regions stay in place Werner H. Mörmann and Dr.
permanently. Since 2003 the soft- Marco Brandestini to start with ware has become much easier to Looking back it is now clear that computer-aided production of use, following the introduction of the advent of CEREC 20 years ago inlays rather than crowns, and to CEREC 3D. And the adhesive bond- opened up a new chapter in dentis- leave the detailed finishing of the ing of all-ceramic restorations has try. This is a cause for celebration.
occlusal surface to the dentist, had the effect of drastically reducingtechnology costs. By September Number of CEREC systems sold
The acceptance of new technologies follows a classic S-curve. First of all, the available
1985 an initial CEREC prototype technology and the initial applications have to come together and learn to negotiate
was ready to be patient-tested. As the market in question. The technology and the applications then mature, the technolo-
luck would have it, August Behne gy becomes easier to use, and the concept has to demonstrate that it can replace tradi-
and Harald Burger, departmental tional methods. Towards the end of this phase the technology reaches full maturity and
and regional managers in the catches on more generally. CEREC is now in this last phase.
Dental Division of Siemens AG, chose to ignore the sceptics andpress ahead with the development In association with publishers There will also be plenty of op- of the new invention. They had Quintessenz, Sirona invites you to portunities to compare notes with recognized that computer-aided a scientific symposium on 17/18 colleagues. And arrangements have dental restoration would come to March 2006 in Berlin. Here distin- been made, in collaboration with occupy a firm place in modern den- guished speakers from all over the the ISCD (International Society tistry. Today CEREC is a standard world will present their findings on of Computerized Dentistry), to procedure. A number of factors the clinical acceptance of CEREC.
have 50 practising CEREC have played their part: long-term Practitioners and scientists will "experts" on hand throughout the clinical studies have shown that all- show how easy it is to integrate the congress to answer any questions ceramic inlays, onlays, partial CEREC is now recognized as a standard procedure. More than 16,000 CEREC systems are
method into the work of a dental about CEREC, no matter how crowns, veneers and full crowns currently in use worldwide.
practice, and how profitable it is.
conditioning bonding systems con- adhesion plays a crucial role.
tain an enamel and dentine adhesive According to initial findings, One, two or three which is separate from the acidic RelyXUnicem competes effectively
primer. Examples include AdheSE with other more complicated bond- ADHESIVE BONDING METHODS. Various methods are currently in
(Ivoclar Vivadent), Clearfil SE Bond ing systems.
Silver Club use: three step, two-step and all-in-one.
(Kuraray), and One Coat SE Bond(Colténe-Whaledent). Together with To sum up: dentists should decide
CEREC Club members save
their three-step total-etching counter- on a case-by-case basis
money and are always up to
Three-step selective etching: This
between the ceramic restoration and parts, these systems have the advan- The three-step total etching method long-established and by no means the primed dentine. The adhesive tage that the bonding agent is hydro- has performed very well in long-term obsolete method is applied in combi- penetrates the demineralized den- phobic. As a consequence their clinical studies. It is the recommend- CEREC 3 is undergoing continu- nation with adhesives such as Syntac tine, where it forms so-called "tags" dentine adhesion performance is ed method for all-ceramic inlays and ous development. In the spring (Ivoclar-Vivadent) and A.R.T. Bond in the tubuli. This creates a so-called deemed to be excellent. However, onlays. The clinically proven multi- we regularly issue new updates (Colténe-Whaledent). After the ena- hybrid layer. In this way the dentine there is a lack of clinical data with ple-step procedure should be used in designed to boost efficiency and mel margins have been selectively is effectively sealed. The following regard to the stability of the enamel difficult cases, especially when the enhance the user's job satisfac- etched using phosphoric acid, the products are designed for three-step bond in cavities which are subjected enamel margin is not clearly defined.
tion. For example, we have exten- dentist applies one primer (A.R.T.
total etching: Syntac, A.R.T. Bond, to heavy occlusal stress. Simplified bonding systems (inclu- ded the spectrum of clinical indi- Bond) or two primers (Syntac) in Gluma Solid Bond, OptiBond FL and ding all-in-one adhesives) are a con- cations, simplified the user inter- order to condition and infiltrate the Adper Scotchbond Multi-Purpose All-in-one adhesives: These so-
venient and labour-saving alternative face, introduced new tooth data- dentine. The adhesive then forms a called "all-in-one" systems (self- in less demanding applications (e.g.
bases and automated the design firm bond with the enamel and the conditioning primer-adhesives) are small filling volume, low mechanical dentine. All the products belonging to Two-step total etching method:
applied in a single solution. Examples load, low retention requirements, low this generation can also be deployed The desire for greater simplicity include Adper Prompt L-Pop (3M aesthetic demands.). However, the within the framework of the total- prompted various manufacturers to Espe), One Up Bond F (Tokoyama), multiple-bottle systems have the best etching method.
develop multi-component adhesives.
and iBond (Heraeus-Kulze). These long-term clinical data.
These "one-bottle" systems are products contain a combination of Three-step total etching method:
deployed in combination with the hydrophobic/hydrophilic esters and PD Dr. Roland Frankenberger 1) Simultaneous conditioning of the total-etching method. Examples acid esters and perform the functions enamel and dentine with phosphoric include Prime & Bond NT of an etching agent, primer and adhe- acid (maximum contact time for the (Dentsply), Excite (Ivoclar-Vivadent), sive. The dentist can dispense entire- dentine: 15 seconds). 2) Application and Gluma Comfort Bond (Heraeus ly with phosphoric acid etching and The secret of success
of a hydrophilic primer. 3) Kulzer). These products combine the hence saves time. However, clinical Application of a hydrophobic adhe- functions of a primer and an adhe- studies describe the adhesive perfor- Adhesively bonded restorations are sive. The acid not only removes the sive. The principle of re-wetting mance of these products as variable.
permanently joined ("force-locked") to smear layer but also demineralizes corresponds to that of the three-step According to the respective manufac- the hard tooth substance. As a result process. However, each of these the dentine down to a depth of total etching method. Long-term in- turers, these products are not inten- tensile forces cannot act on the under- updates costs money. This is why approx. 5 mm. If the cavity is over- vitro studies have revealed that the ded for the adhesive bonding of all- side of the restoration. This prevents it's definitely worth joining the dried following the etching procedu- two-step method produces an infe- ceramic restorations. cracking. The restoration is significantly CEREC Silver Club. For a fee of re, the collagen network in the denti- rior bond with the dentine. This is more durable. Preconditions for adhesive ?99.00 (£75.00) per month ne may collapse. In such cases re- due to the fact that the monomer Self-adhesive cements: RelyX-
bonding are as follows: the etching of members are automatically enti- wetting is required in order to re- compound remains hydrophilic even Unicem is an easy-to-use self-adhe- the tooth enamel; the conditioning of the tled to all new software updates store the penetrability of the dentine after it has been cured and hence is sive cement. As is the case with the ceramic surface (etching with hydro- and upgrades, as well as all new (but only when acetone or ethanol- capable of absorbing water from a all-in-one adhesives, the strength of fluoric acid followed by silanization); and tooth databases. One thousand based adhesives are used). Water- moist environment. The adhesion to the enamel bond is subject to varia- the application of a luting composite. To dentists in Europe have already based systems contain enough water the tooth enamel is the same as in tion. By contrast, the dentine adhe- prevent postoperative problems the joined the Silver Club.
to restore the structure of the colla- the case of multiple-bottle systems.
sion performance of this product is exposed dentine must be sealed by gen network. Next, a primer is ap- very promising. In other words, means of a dentine adhesive. In addition, plied in order to enhance the wett- Two-step self-conditioning bond-
RelyX-Unicem is suitable for bond- dentine adhesives also contribute to the ability of the dentine for the adhesive ing systems: In this case it is no ing all-ceramic crowns, including
overall stability of the bond. i Authorized CEREC dealers
(bonding agent). The function of the longer necessary to etch the enamel those with a flexural strength of less adhesive is to create a uniform bond with phosphoric acid. Two-step self- than 200 MPa. In this case dentine No. 3 December 2005
CEREC Zeitung 3
In pursuit of Veneers – the perfect visiting card
total quality
Where does my practice stand?

OUTSTANDING AESTHETICS.
A perfect smile is the ideal adver-
tisement for your dental practice.

It is not always easy for dentists to
assess the quality of their treatment Harmonious anterior teeth testify
services. Many work on their own to the dentist's commitment to
and have no basis for comparison.
total quality.
There is a lack of reliable bench-marks and statistics. In addition, thehealthcare systems in most countries All-ceramic veneers are un-
beatable in terms of function impose serious financial constraints and form. They offer a permanent that run counter to the provision of and tooth-conserving therapy top quality services. Against this option in the case of multiple, background the German Ceramic defective fillings, malpositioned Dentistry Working Party ("AG-Kera- teeth, fractures, gaps, misshapen Before: Anterior teeth prior to treatment. The CEREC procedu-
After: The finished product. Harmoniously and aesthetically
mik") has developed a special quality teeth and staining (e.g. after the re is performed in a single treatment session.
designed all-ceramic veneers.
assurance system for CEREC users – administration of tetracycline).
a system that involves only a mini- Veneers can also be used for the mum input of time and effort. Each intraoral repair of crowns and participant selects a group of 30 bridges. The spectrum of indica- patients and monitors a predetermin- tions has expanded in recent years All-ceramic veneers are scientifi-
The milled veneers can be individu- ing veneers is child's play, thanks ed set of parameters relating to the and now includes palatinal veneers ally characterized in the dental to the three-dimensional visualiza- initial restoration as well as its sub- for the canines, interlocking Clinical studies extending over a practice. It requires relatively little tion of the preparation and the sequent performance. The dentist re- restorations following orthodontic period of up to 15 years have proved experience to create natural and restoration on the computer moni- examines the patients at regular treatment and – last but not least – that all-ceramic veneers are long- aesthetic results. One particularly tor. In addition, the CEREC soft- intervals and sends the findings to the use of occlusal veneers for bite lived. The survival rates according easy option is to apply composite ware boasts several user-friendly AG-Keramik. This data remains adjustment in the premolar region. to Kaplan-Meier are in excess of 90 stains to the rear surface of the functions such as a veneer database anonymous. The dentist can easily All-ceramic veneers are popular percent. As a result all-ceramic veneer. The translucency of the and the mirroring of contralateral compare his results with the average with patients, as they allow dentists veneers have been officially recog- ceramic material leads to a natural, teeth. The practical benefits are values recorded for his colleagues.
to conserve as much of the natural nized by the German Society of deep-seated shading effect. After a obvious – and are evident as soon In the case of deviations he can deter- tooth tissue as possible. A key Dental, Oral and Craniomandi- few trial runs dentists soon realize as the patient smiles. If the out- mine to what extent his treatment advantage of the CEREC procedure bular Sciences (DGZMK). After 9.5 that the secret lies in choosing the come is convincing, patients will procedures differed from those of the is that treatment can be completed years CEREC chairside veneers right degree of brightness. The so- be more willing to pay more for other participating dentists and take in a single session. There is no made of feldspar ceramic displayed called "chameleon effect" of the high-quality treatment services – corrective action if necessary. This need to fit temporaries. All-ceramic a survival rate of 93 percent. The silicate ceramic material compen- and recommend the dentist to their service is already available in veneers are durable and retain adhesion to natural teeth is better sates for any small differences in friends and family. Germany, Austria and Switzerland their pristine appearance. Above than the adhesion of intraoral the colour shade. and will soon be extended to all the all, they are "gum-friendly". Gingi- repairs to crowns and bridges.
Large numbers of CEREC users other European countries. val retraction and discolouration (Wiedhahn, Int. J. Comp. Dent.
have included veneers in their stan- can be practically ruled out.
dard treatment portfolio. Design- lion successful restorations, dentists can rely implicitly on the Building bridges with dental labs
clinical performance of the CERECceramic materials – regardless of finalizing the design on the com- whether these are processed in the TIONS. Inlays, onlays, veneers
puter, the technician logs into the dental practice or in the laboratory.
and all-ceramic crowns are typical
web portal www.infiniDent.de and Numerous clinical studies have CEREC applications in the dental
orders the abutment from the confirmed that crowns and bridges practice. But CAD/CAM technology
Strauman CARES production cen- made of zirconium oxide – correct- is capable of a lot more besides.
ly fabricated and bonded – are With the help of inLab dental tech-
easily on a par with conventional nicians are in a position to create
The right material for every
materials in terms of longevity. The crown copings, bridge frameworks,
extension of CAD/CAM technology telescopic crowns and implant
For many years Sirona has main- to dental laboratories has enhanced abutments in tried-and-tested
tained a close working relationship the clinical applications spectrum with two leading material manu- of CEREC, especially with regard to facturers. VITA Zahnfabrik and large-sized restorations. inLab is Dentists have CEREC; dental labs
Ivoclar Vivadent supply fine-struc- the perfect solution for CEREC have inLab – i.e. a clinically, ture feldspar ceramics as well as users who are under time pressure.
aesthetically and economically infiltration and oxide ceramics with And in cases where the highest convincing method for producing a higher degree of flexural strength aesthetic standards have to be met, all-ceramic restorations. Launched and fracture resistance. The inLab the dental technician has the option in 2001, the inLab system deploys 3D software now includes the Merz of applying manual layering tech- the same CAD/CAM technology as Dental artegral® tooth database.
niques after the restoration has CEREC and hence embodies two This means that dental labs can been milled.
whole decades of acquired CEREC offer prefabricated anatomically know-how. Together, the two shaped resin-based tooth restora- CEREC practices and inLab labora- systems cover a complete spectrum tions. Last but not least, Sirona co- tories are an unbeatable combina- of clinical indications. "It's in- operates with BEGO Medical in the tion for aesthetic, clinically proven credible what the small inLab area of metal alloys. Two different and cost-effective dentistry. The system is capable of," says Dr.
The dental lab takes care of the more complex restoration assignments – for example,
products are available: the high- dentists and the dental technician Bregler from Offenburg. In his dual multiple-unit bridges (here: zirconium oxide)
gold alloy Bio PontoStar++ and the apply the same basic technology.
role as dentist and dental technician cobalt-chrome alloy Wirobond C+.
This provides the basis for a perfect he is ideally qualified to assess the nium oxides are used, it is possible scanned by the inLab system.
Frameworks made of these materi- division of labour: the dentist is extent to which inLab has pushed to create bridge frameworks with Before the milling process com- als – as well as their high-strength responsible for chairside restora- back the frontiers of computerized an anatomical length of up to 40 mences the software checks that the ceramic counterparts – can be de- tions and assigns more complex millimetres. WaxUp 3D is the ideal restoration complies with the pre- signed "in-house" and then ordered tasks to the laboratory, secure in the choice for complex restorations scribed minimum wall thickness, from the infiniDent production knowledge that he or she will re- 3D software delivers extremely
(e.g. implant superstructures and thus eliminating any potential weak centre in Bensheim. At present ceive tried-and-tested CEREC quali- stress breaker attachments design- points. Unveiled at IDS 2005, the infiniDent is available in Germany, The software component Frame- ed to compensate for differing Abutment 3D software component Switzerland and Austria. In the Work 3D is intended for the fabrica- insertion axes in multi-unit allows the technician to design cus- coming months the service will be tion of crown copings and bridge bridges). In this case a conventional tom abutments for the Straumann extended to France and the USA.
frameworks. If high-strength zirco- wax model is created, which is then Dental Implant System. After On the basis of more than 12 mil- 4 CEREC Zeitung
No. 3 November 2005
From ivory to CAD/CAM ceramics
Jacques Raynal, a dentist practising in Lodève, upholds the best traditions of French dentistry
while also being receptive to modern treatment methods. He has offered CEREC restorations since 2001.
French dentists pioneered the use Parisian dentist Nicolas Dubois de viates the need for in situ impres-
of natural enamel-coloured Chémant enlisted the aid of apo- sions and temporary restorations.
materials for dentures. As early as thecary Alexis Duchateau to fire In recent years he has achieved a 1723 Pierre Fauchard wrote a stan- dentures in porcelain. Dentistry has success rate of 99.4% with the new dard work on dentistry in two vol- come a long way from ivory to method (taking into account the umes entitled "Le chirurgien den- silicate ceramics: but French den- start-up phase). tiste, ou, traité des dents". Because tists have always been receptive to it contained detailed treatment Patients and practitioner alike
instructions, the book was also benefit from the new method.
translated into German and French.
Raynal opts for the CEREC system
Today the CEREC procedure is an Fauchard showed how a mobile Jacques Raynal opened his dental integral part of Raynal's practice denture made of ivory could be practice 20 years ago, after gradu- concept. His patients appreciate the attached to the remaining jaw struc- ating from the University of aesthetic benefits and the per- ture by means of a metal socket.
Montpellier. Over the years he manence and durability of the His contemporary Claude Mouton, extended his range of treatments ceramic work, while Raynal likes official dentist to the French King, to include fissure seals for children, the reduced lab costs. The money published his "Essay d'odonto- periodontal treatments, endo- saved here is used to expand the technie" in 1746. Here he described dontics and surgical procedures technical facilities of the practice the manufacture of gold crowns involving implants. From the outset and allow him to offer additional and the treatment of root canals. In his main concern was to offer his modern treatment methods. This addition he suggested the appli- patients biologically sound and is, of course, good news for cation of an artificial enamel clinically tested dental care. In 2001 Raynal's patients, who are sprea- coating to the labial surfaces of Raynal decided to add all-ceramic ding the word fast throughout the his metal constructions. Etienne restorations to his range of treat- local region. As a result, the CEREC Bourdet, another royal dentist, ments. Having compared a number method is becoming more popular Available as an option since 2001, the CEREC method is very popular with Jacques
experimented with artificial teeth of different CAD/CAM options, he by the day in the département of Raynal's patients. Raynal charges between 200 and 650 euros for a CEREC restoration,
made from ivory. And in 1790 the chose the CEREC system, as it ob- depending on complexity.
sionalism and speed
BUILDING CONFIDENCE. Fifty UK dentists who regularly carry out
CEREC treatments attended a special refresher course at the old Formula
One racing circuit at Goodwood.

One day's training on the CEREC patients. CEREC practitioners were
system and one day's training encouraged to tackle the pre- in the cockpit of a racing car: paration of veneers with increasedthe Goodwood meeting offered confidence: it's much easier than CEREC-trained dentists in the UK one might think! And of course the perfect blend of work and plea- they were given lots of helpful hints sure.Two days, one motto: "Perfec- and tips, which is exactly what tion, professionalism and speed".
CEREC dentists want: one small On day 1 the CEREC practitioners pointer can make a huge difference, learned about the professional particularly in terms of making the bonding of inlays and onlays. For software easier to use. On day 2 i Auskunft erteilt: [email protected]
maximum security dentists are the emphasis was on fun and re- advised to use traditional adhesives creation: time to hit the race track, for this purpose. As the discussion with a choice of Ferrari, Maserati, between participants and speakers Porsche, vintage car or full-blown showed, CEREC practitioners were racing car. Whatever the vehicle, all agreed that all-ceramic crowns the driving challenge is always the without framework can be self- same – to find that ideal line adhesively bonded in place with no through the bends that gives you clinical risk. And this method also the perfect lap. And it was like saves dentists a lot of time. Another the day before: most people section of the program looked at the discover that they have hidden appeal of CEREC veneers for C O M I N G S O O N
27/28 January 2006 CEREC Advanced Training Course (with live treatment sessions)
Bensheim Course conducted in English Dr. Helmut Götte Details from: Birgit Moeller,
Tel. +49 6251 16 2096, [email protected]
17/18 March 2006 20 Year CEREC Anniversary Symposium Berlin Conference
language English with German translation More information at: www.20YC.com
8 April 2006 CEREC Veneer Course London Course conducted in English
Dr. Alessandro Devigus Details from: Birgit Moeller, Tel. +49 6251 16 2096,
[email protected]

Source: http://www.sirona.it/ecomaXL/files/cerec_zeitung_international_issue_03_2005-12.pdf&download=1

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Excretion & internal environment of the body. In vertebrates the two functions of excretion and osmoregulation are • Excretion is the elimination to waste products from performed by kidneys and their associated structures in urinary system. • Waste products are unwanted and toxic by-products • The organs which form, store and void the urine

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ESTADO NUTRICIONAL EN NIÑOS CON DREPANOCITOSIS DE UN HOSPITAL UNIVERSITARIO DE TERCER NIVEL DE ATENCIÓN DE CALI, COLOMBIA Y POSIBLES FACTORES DE RIESGO SOCIODEMOGRÁFICOS DIANA SORAYA RENDÓN-CEBALLOS, M.D. , CARLOS ALBERTO VELASCO-BENÍTEZ, M.D. , CARLOS ANDRÉS PORTILLA-FIGUEROA, M.D. , MARÍA VICTORIA BOLAÑOS-GALLARDO, Bact. ,