Is there room in the Australian market for a new clear aligner system? Southern Cross Dental has three good reasons why it does.

By Danny Chan

Few dental labs, if any, can boast 35 years of experience servicing Australia’s orthodontic community or claim 10 years of providing treatment planning support and organising educational programs for clear aligner dentist providers. Southern Cross Dental (SCD) celebrated both milestones last year.

Just as the confetti begins to settle, the dental lab is already heralding their support of a new clear aligner system: TrioClear. This is exciting news coming from a lab that has reviewed and provided treatment-planning support for over 15,000 clear aligner treatment plans.     

TrioClear is a brand new clear aligner system, developed by SCD’s parent company, Modern Dental Group (MDG). The Group’s Hong Kong-based team is responsible for all the system’s development, case design and manufacture. 

“Although the product is new, it builds and improves on a number of concepts already in the market,” says Dr Albert Sharp, General Manager Clinical at Southern Cross Dental.

“The market for clear aligners is growing rapidly, and we see aligner treatment becoming a standard for most general dentists. We see a gap in the market for a truly great innovative aligner system, available at an affordable price made possible by the Modern Dental relationship.”

TrioClear offers a three-step clear aligner solution that uses clinical simulation software to accurately predict alignment and movement in advance. According to the company, TrioClear’s three-step solution allows more movement per step than most other systems. Allowing a quicker, high quality result with fewer attachments and stains.

The trays progress from soft to medium to hard, with aligner thickness (0.5mm-0.6mm-0.7mm) increasing in correspondence to days spent per set (4-7-10 days).

“The unique 3-step approach is the ultimate in patient comfort and predictability without compromising the results,” Dr Sharp enthuses.

“There is a huge comfort advantage for patients to start off with a softer layer before progressing to medium then hard. It really helps those ligaments stretch and initiate the bone remodelling in the most gradual way possible. Also, fewer attachments helps.”

Thanks to TrioDim Force, the aligners stay in place with few attachments. TrioClear uses carefully designed and placed TrioDim divot spots to create highly targeted rotation forces.

Despite offering similar benefits to other clear aligner systems on the market, Dr Sharp says SCD can provide support services to TrioClear at more competitive prices.

“In general, it is more competitively priced than other premium systems for a like case. To have our own line of aligners allows us more flexibility with pricing and promotions to our customers.”

SCD has had a long-standing relationship with Invisalign, providing both treatment planning and training support for the popular aligner brand. Dr Sharp was one of the first general dentists in Australia to be accredited for treating patients with the Invisalign System and for many years was the primary presenter for the Invisalign Training Course for GP dentists.

But the experienced clinician maintains that there is no conflict of interest.

“SCD is still a distributor, and a big fan of Invisalign, and we will continue to support that product. Trio Clear is a great alternative option for those dentists who wish to use that instead.”

Dentists and orthodontists can also look forward to a fast and efficient workflow. They may submit intraoral scans or traditional impressions to TrioClear, along with a prescription form they will need to fill. TrioClear would review the files, prepare a treatment plan and send it back for approval. The trays are 3D printed in medical grade FDA approved materials.

An optional advanced feature for root simulation – available to all practitioners with access to low dose CBCT technology – is offered for cases where predicting clinical crown movement is not enough. Ideal for cases that have poor root configuration or thin buccal bone, the feature allows predicting root movement and limitations with accuracy.

“The fantastic option to integrate a cone beam study of bone and root anatomy can help the dentist plan more accurately and safely,” Dr Sharp adds.

As Southern Cross Dental charts a new course in the clear aligner space, they have also opened up an avenue of choice for Australian dentists. If practitioners are looking for a reliable solution backed by the right expertise and experience, that’s what Dr Sharp says he and his team have put on the table.

“SCD has over 10 years experience in teaching and supporting dentists in the clear aligner space. We will continue to support their Trio Clear cases and provide options catering to their level of confidence,” he says.
​
“Some will prefer to do all the planning themselves. Other dentists will prefer some extra treatment planning assistance, and we have the expertise to guide them through this.”
 

As part of Ivoclar Vivadent’s International Expert Symposium, Prof. Dr Petra Gierthmühlen gave an online presentation titled “Digital Chairside: Myths and Reality”.
 
By Danny Chan
 
The webinar provides insight into the emerging technologies for chairside dentistry – mainly that which highlights the advantages of modern CAD/CAM materials and comprehensive digital workflows.
 
Dr Gierthmühlen is the Professor and Chair of the Department of Prosthodontics at the Heinrich Heine University in Duesseldorf, Germany. Her lecture takes a look at the current state of chairside milling that enables faster fabrication times with protocols that are adjusted to the respective CAD/CAM material.
 
Based on the digital treatment concept of the Heinrich Heine University, Dr Gierthmühlen provided scientific evidence for the clinical success of CAD/CAM materials and the corresponding preparation designs.
 
The webinar began with a single tooth restoration case, and moved to each new case with increasing level of complexities.
 
The first case, focusing on the chairside CAD/CAM enabled placement of inlays and onlays, shows the digital design of the occlusal anatomy and digital fabrication process.
 
Dr Gierthmühlen then provided comparison study between CAD/CAM fabricated onlays and press fabricated onlays – showing high survival rates and hardly any discernible differences in split-mouth study survival rate (100% press fabricated vs CAD/CAM fabricated 97.5%) after long-term performance (7 years).
 
For her next case, a Lithiumdisilicate Anterior Crown Restoration, the Professor presented on how chairside dentistry was employed to restore two fractured central incisors using a straightforward digital workflow.
 
Dr Gierthmühlen showed that reasonable aesthetic outcomes and high survival rates (based on long-term studies) were obtained for the endodontically-treated incisors.
 
The following case for Lithiumdisilicate Posterior Screw-retained Implant Restoration related to a patient who had presented with molars that needed to be extracted due to endodontical complications.
 
Using guided surgery along with chairside CAD/CAM dentistry, Dr Gierthmühlen showed how proper angulation of the implant and ideal screw channel axis were achieved in the digital workflow, with help from a newly acquired CEREC Omnicam.
 
Long-term clinical studies, based on a 7-year recall, showed the restorations remain in very good shape with no fractures at all.
 
The lecture also moved on to more complex cases – including that of a Lithiumdisilicate CAD/CAM Anterior implant crown.
 
Case: An implant that was placed to replace central incisor developed peri-implant mukositis and needed therapy to control the peri-implant infection. Once accomplished, the patient needed a new anterior crown as there was also misfit of margin within the old implant crown.
 
After removing the implant crown and scanning the peri-implant tissue to get an outline for the restoration, scan posts were inserted to determine location of implants. The scan posts were then transferred into software for production of zirconia abutment. At the try-in of the abutment, zirconia abutment was scanned to produce the chairside implant crown for this zirconia abutment.
 
The 5axis-milling machine PMOne produced a very precise crown margin.
The fit and form was excellent in blue and try-in stage followed by surface characterization, to create a beautiful final restoration.  
 
Finally, the lecture moved on to the highest level of complexity: Full Arch cases.
 
Case: Patient treated more than 5 years ago presented with caries lesions; dramatically changed occlusal anatomy; dentin exposure on teeth; and suffering from hypersensitivity due to erosion.
 
To obtain orientation, Facescan was used to capture digital orientation of patient’s upper/ lower jaw, then on position of teeth to get full orientation of new vertical dimension of occlusion to design reference for tooth shade.
 
Digital mock-up and try-in was also used to develop a digitally milled prototype. This high-predictability, 100% digitally simulated workflow lets the patient decide whether he wants to proceed with treatment, based on the digital results.
 
The digital lab-side CAD/CAM workflow – because chairside CAD/CAM was not available at the time – was able to restore occlusal anatomy and function for patient in both upper and lower jaw and increase his vertical dimension of occlusion.
 
The 5-year clinical result shows high predictability for the complex full arch case: there were no fractures, gingival recession, or debonding in lower jaw. The patient also retains a similar smile line.
 
This is an excerpt of a webinar presented at the International Expert Symposium (IES). The IES is a digital platform Ivoclar Vivadent launched to host a series of free live-steamed and on-demand webinars.
 
For more information, visit: www.ivoclarvivadentacademy.com
 
 
 
 
 

What would a safe practice look like in the post-pandemic future? Vatech Australasia gives a tour of its “human-oriented innovations” to help dentists transition into the New Normal practice.
 
By Danny Chan
​
In the midst of the COVID-19 pandemic, the dental practice has been navigating various measures put in place to safeguard the health and wellbeing of their patients and staff.
 
In so doing, they are coming to terms with what has been called the New Normal, which involves a rethink of how a practice is being managed daily – with particular emphasis on hygiene and infection control.
 
During this critical transitionary period, Vatech Australasia has provided a list of essential products and services – from its comprehensive range of “human-oriented innovations” – to assist the Australasian dental practice on the road to recovery.
 
Extra-oral x-rays the way to go – Vatech’s Premium Panoramic Solutions
 
To minimize the risk of transmission, several global organisations, including the American Dental Association, have recommended the taking of extra-oral radiographs where possible – because as the Association puts it, “intraoral techniques may induce coughing”. The Royal College of Surgeons of England suggested that “oblique lateral (extraoral) radiographs may be employed where this facility is available.”
 
Vatech’s OPG units are built to assist with easy and efficient radiographs.
 
In times like these, their fast-scan times, versatile capture modes (partial pano, bitewing, bitewing left, bitewing right, etc.) and easy patient positioning features do more than simply promote efficiency. They allow your staff to get accurate diagnostic results while minimising contact with patients, hence reducing their exposure to infection risks.
 
Vatech’s proprietary Insight Pan feature, with its 41 multi-layer PANO technology, provides depth-added information. It is the classic example of how technology can help to reduce the number of intraoral x-rays taken without compromising your diagnostic ability.
 
Less referrals improve patient safety – Green CT
 
The Green CT is Vatech’s kid- and eco-friendly 3D CBCT. Its Green Technology –embodied by its low-dose, fast-scan and superior image quality – is something that every dentist can appreciate.
 
As a child-friendly imaging equipment, the Green CT allows rapid scans and flexible patient positioning without compromising image quality or patient comfort. Again, this translates into an overall fast and efficient radiographic workflow that minimises patient contact.
 
As importantly, having a Green CT unit installed in-house has the added advantage of eliminating patient referrals to radiography centres. Apart from the obvious convenience factor, having an in-house 3D imaging facility dramatically reduces your patient’s exposure to infection because they don’t have to travel to multiple places for their dental treatment.
 
Breath of fresh air – EzPure UV
 
On 7 July, the World Health Organisation acknowledged emerging evidence of airborne Covid-19 transmission, following an open letter signed by 239 scientists in 32 countries, urging the agency to take the matter more seriously.
 
The issue of in-office air-quality contamination is now new, but the COVID-19 airborne threat would likely be more acutely felt by dental patients in the coming months and years. 
 
Designed with the dental environment in mind, the Vatech EzPure UV is an air-purifying solution that helps to protect against the invisible enemy.
 
Equipped with 4 UVC lamps, the germ-fighting innovation boasts a high and efficient treatment capacity at 120m^3/hour. It uses Ultraviolet Radiation at controlled wavelengths to perform intensive microbicidal and virucide activity on numerous microorganisms.
 
More importantly, it is safe for use. The shorter wavelengths of the UVC means the rays are particularly effective at killing airborne pathogens, yet are safer for people because they are absorbed by the proteins in the outer layer of dead skin cells before reaching the DNA in the living cells.
 
An article in the World Economic Forum looking at the occupations most exposed to COVID-19 risk, unsurprisingly, found dental hygienists to have “one of the riskiest non-hospital jobs during a pandemic”. Dentists are near the top of the list.
 
By using Vatech EzPure UV, you are protecting your most important resource – you and your staff.
 
Pro-active and advanced customer service – Remote check-up
 
In keeping with social distancing protocols, Vatech is providing advanced services including remote check-up service.
 
Even before their customers turn to them for help, the company has taken the pro-active approach by contacting them and assisting them regarding the safe use of their products. This is important during the lockdown period when certain equipment may be used less frequently or have missed their maintenance cycles.
 
Through the remote check-up system, Vatech has been checking the usage history of its products and offering tips on using their products in a smarter and safer way.
 
“It is important for manufacturers to develop ‘untact’ (online) service methods to maintain high quality service regardless of any sudden challengeable situation,” says Esther Lee, Managing Director at Vatech Australasia.
 
The ‘untact’ service, enabled by smart digital devices and advanced technologies, is a new concept of facilitating customer encounters without the need for face-to-face contact.
 
Accessible training – E-learning Centre
 
To promote contactless training, Vatech has established its E-learning Centre on Facebook exclusively for its users.
 
“Facebook is easily Australia’s most widely used social network, which more than 80 per cent of Australian adults visit. We wanted our users to visit our learning platform easily with less sign-up barriers, so established our E-Learning Centre on this popular site,” says Roy In, Sales & Marketing team manager at Vatech Australasia.
 
Through the easy-to-navigate online Centre, dentists can find software demonstration videos of actual clinical cases such as implant treatment, TMJ, wisdom tooth extraction, and so on. They can also find positioning guide videos to capture X-ray images more clearly and safely.
 
Taking the necessary precautions
 
During the launch of the Vatech Assurance Program last year, Esther was commenting on how the company was taking the preventive approach in product training.
 
“The idea is to build a training program that helps dentists predict what may go wrong and taking necessary precautionary steps to make sure that they don’t,” Esther explains. “Why wait until it’s too late if you can nip it in the bud?”
 
In the same way, Vatech is playing a constructive role to their partners and customers during the pandemic crisis.
 
They are highlighting the ways in which their innovative products and services can usher the Australasian practice into a COVID-Safe work environment, and by providing the kind of reliable support that is badly needed in a time of uncertainty.
 
Just like their maxim for maintaining an Vatech equipment, a COVID-Safe practice is ultimately one that takes the necessary precautions – now, before it’s too late.
 
For more information, contact Vatech Australasia (1300 789 454).

By Danny Chan
 
Dr Derek Mahony is a world-renowned Registered Specialist Orthodontist and expert in Dentofacial Orthopaedics who has trained thousands of dentists. He is also the Owner and Practice Principal at Full Face Orthodontics & Dental Sleep Medicine, a group practice based in NSW with six locations.
 
In this interview excerpt, Dr Mahony shares his insights on what orthodontic practices can do in advance of lowered restriction levels in the post-coronavirus environment.
 
Most, if not all, of the ideas and examples shared by the Specialist Orthodontist are drawn from pre-existing and enhanced infection and hygiene control protocols adopted in his own clinics:
 
1. Call patients
 
We make the effort of ringing every patient to say that we have re-opened and inform about the changes that they can expect. We’ve got a prepared script/checklist that our staff use when making these calls.
 
The calls are designed to:

• Reassure patients by providing an overview of our sterilisation and sanitisation procedures.

 

• Point them to our social media posts and emails to help them stay informed of latest practice updates.

 
2. Book short appointments
 
With 5000 patients in active treatments, we’re making short in-person appointments (each lasting about 5-10 minutes) to provide them an update, evaluate where they are in their treatment, and advise on what the next step is.
 
This way we’re seeing all of them without too much of a delay. We have stopped our operations for six weeks now and the patients are getting a bit antsy.
 
3. Re-organise office

• Most orthodontic clinics have an open plan in which multiple chairs are positioned right next to each other. Due to social distancing rules, our dental chairs are moved apart by a minimum 6-foot (1.8 metres) distance.

 

• Re-organised our waiting room such that all the non-essential items – like magazines, toys, coffee/tea station, etc. – are stowed away. This is to minimise the potential spread of infection through contaminated objects so anything that people are prone to touch is put away.

 

• Limit certain procedures in the office. For orthodontists, the only procedure that we do that has the potential to generate aerosols is the removal of braces, so we’ve put a hold on that for the moment.

 

• Incorporate the use of a new electric motor handpiece (for removal of braces) because it generates lesser aerosols than a high-speed handpiece.

 

• Upgraded waterlines using ozone, which effectively provides sterile water in every dental chair.

 

• Stagger the scheduling of patients in such a way that abides by social distancing regulations.

 

• All patients need to sanitise their hands at the sanitisation station located near the entrance of every clinic, before entering the premises. 

 

• Patients are asked to rinse their mouths with a 1% hydrogen peroxide rinse that reduces the bacterial flow of saliva.

 

• Instead of checking in via a computer terminal at the clinic, which is our usual practice, patients now check-in via a text message – usually done in their cars. We also respond via text to inform them when it’s their turn to come inside. 

 

• We see a lot of young patients who are accompanied by adults. To maintain social distancing measures, we now limit each appointment to allow only one adult per child.

 

• We’re now using N95 masks, which is an expensive change (from $1– $10 per mask). The clinicians and nurses are required to change an outer mask for each patient they see, and an inner mask every hour.

 
4. Pre-screening
 
Before patients come to the office, we will pre-screen them over the phone.
 
We ask patients whether they:

• Have recently participated in any large gatherings.

 

• Travelled outside of Australia.

 

• They or any member of their family have been sick or had a fever in the last 14 days

 
We would consider re-scheduling anyone who answers ‘yes’ to these questions. The only exception applies to high-school students answering the first question, because some children were still going to school during this period of time.

Combining ergonomics, reliability and aesthetics in a very competitively priced package, Swident’s Friend Easy has all the makings of a BFF

By Danny Chan

The dental unit has been an indispensable tool of a dentist’s trade since the dawn of the teeth-fixing profession. Gone are the days when dental patients received treatment in modified versions of barber chairs. Today’s dental units come in an assortment of colours, constructions and configurations. Amazingly, an ever-growing dental armamentarium has done nothing to diminish the central role played by the dentist’s chair, whether as the surgery’s centrepiece equipment or in the daily functions of the practice. To say that the dental unit is a dentist’s ‘best friend’ is hardly an exaggeration. 

Just like a friend, choosing a dental unit comes down to a personal choice. There is no one-size-fits-all chair, which explains why dentists still agonise over chair selection in a seemingly saturated dental unit market. Still, every now and then, you come across a dental chair that strives to serve a broader market – offering more ‘friendship benefits’ than what the price tag suggests.

Swident’s Friend Easy is the aptly named treatment unit that combines the key attributes of ergonomics, reliability and aesthetics in a very competitively priced package. In other words, it has all the makings of a BFF.

If a Europhile lurks inside of you, you’d be pleased to know that the Swident chair boasts Swiss Precision and Italian Design. Swident is a manufacturer and designer of innovative products that are durable and easy to maintain.

Dr Peter Wilkinson, Owner of Wilkinson Orthodontics, is someone that found all the attributes he wanted in a Swident chair. Last year, the Specialist Orthodontist celebrated 15 years of establishing his Gold Coast practice that offers traditional outside braces, Incognito lingual braces and Invisalign.

Operating out of two purpose-built practices – one located on Ashmore Rd in Benowa and the other on Discovery Drive in Helensvale – Wilkinson Orthodontics has grown from a team of four to its current strength of 22. 

Opened in October 2019, the Helensvale Practice is a double-storey, 450-sqm Specialist Clinic with five clinical chairs located on the lower level and two consultation rooms upstairs as well as an onsite dental laboratory. Having an onsite and dedicated orthodontic lab technician allows the practice to offer custom-made appliances and the ability to make immediate onsite adjustments as needed throughout treatment.
 
The Gold Coast practice purchased their first Swident Friend Easy chair from Ampac Dental in 2018 before moving to the Helensvale location. They installed another two Swident Friend Continental delivery system chairs the following year after the new building had opened.
 
Dr Wilkinson’s reasons for making both purchases boil down to the unit’s user-friendliness and straightforward functions:
 
“Due to our clinic being open, we needed a compact chair that was aesthetically pleasing since they are always on show. Functionally the chairs are simple to use and, according to our dental maintenance technician, parts can be easily sourced.”

Whether you choose the Traditional or Continental delivery system, the Swident unit comes equipped with a well-balanced arm that provides smooth manoeuvrability. The operator has access to a control panel with four distinct user programs that manages all of the unit’s functions.

The dentist table on the Swident Friend Easy is equipped with Luzzani triplex syringe; one high-speed fibre optic line, one low speed line and space to accommodate a scaler. An optional second fibre optic line can be configured. The unit also comes with: Faro LED dental light (optional wall or ceiling mounted lights are available); pneumatic foot control that allows progressive regulation of the micro motor as well as spray and chip blower.

Regarding patient comfort, Dr Wilkinson compliments the ergonomic design: “The patient headrest easily adjusts and supports the neck. It is easy to adjust the lay down position and program this into the touch pad.”

To fit into his open-planned clinic, Dr Wilkinson wanted a chair that has a small footprint and "wasn’t bulky”.

"The Swident chair ticks this box as well as being aesthetically pleasing," he attests.

The smaller price tag of the Friend Easy was also a decisive factor, says the Orthodontist:

“Initially price played a large factor in the process. In Orthodontics we don’t require a lot of the features available on most dental units. Ampac dental were able to customise our order and provide us with a dental delivery system that suits our requirements at a competitive price.”

The Gold Coast Orthodontist says the purchase decision was helped by Ampac’s “exceptional customer service and support” from the outset.

“Their product knowledge and punctuality in communicating from enquiry to installation has been excellent. They tailored a package to suit our needs with no aggressive sales pitch – they really put us first as customers.”
​
Dr Wilkinson’s satisfaction with the Swident chairs and Ampac’s service is instinctively conveyed by his consideration to replace the practice’s existing chairs with new Swident units in the future – when the former units have reached the end of their lifespan. Sounds like another dentist has made a new best friend.
 
 

AVANT Dental Leaders challenges the “business-as-usual” mindset of dentists left behind the technology curve
 
By Danny Chan
 
What’s in a company name? It’s often the first point of differentiation between your business entity and those of your competitors. It also reflects your corporate identity, which means that it should succinctly capture the outlook, ethos or function of your business.
 
That is true of Avant, the lab formerly known as Australian Dental Lab. Most commonly used as a subset of the term “avant-garde” – defined as “new and experimental ideas and methods” – the new moniker suggests a breaking away from old ways of doing things and taking them to another level. This name change reflects the bold direction the established lab of 40-plus years has embarked on.
 
Besides an embodiment of their future-oriented business plan and outlook, Richard Salter, Avant’s Managing Director, says there’s another practical reason for the name change:  
 
“Most brands in our space have the words “dental lab” in their names and many get abbreviated like ADL. We wanted to define our own position in the market.”
 
Richard believes that in step with building brand awareness, Avant must also ensure a smooth transition for existing customers.
 
“We have very strong relationships with our current customers, some of which have been sending cases to our team for over 40 years. We leverage 40-plus years of experience and relationships to always treat our customers as the first priority.”
 
As well as helping dentists adapt to an evolving marketplace, the rebranding exercise heralds Avant’s enthusiastic adoption of cutting edge digital equipment, business processes and delivery platforms. 
 
Ian Feigen, Avant’s General Manager, says the growing impact of digital dentistry precludes dentists and labs from having a “business-as-usual” mindset:
 
“High quality dental materials like Zirconia are increasingly being made with CAD milling and 3D printing in mind. Digital technology is revolutionising the way dentists prepare and transmit their cases while enhancing the speed and accuracy with which cases are being processed and delivered.”
 
“Dentists and dental labs that remain on the old paradigm will find it harder to compete. Whichever industry you’re looking at, the trend tends to favour the more tech savvy – and the dental industry is no exception.”
 
One of Avant’s responses to the tech revolution is to partner with a Chinese lab, which Ian claims is one of, if not the most, digitally focused manufacturing labs in the world. Based in Shenzhen, the Mainland’s high-tech hub, the lab’s level of technological sophistication is difficult to match or replicate in Australia.
 
“Due to the sheer size of their international volume, output and manpower, our Chinese manufacturer can afford to invest in the very latest and most advanced equipment available.”
 
“That’s the kind of leverage that Avant will use to support Australian dentists who are looking for high quality products with speedy turnarounds.” 
 
Richard proffers that not only labs are bracing themselves for the digital impact, dentists too are required to reinvent and adapt:
 
“From the way they market themselves to how they on board a patient to how they capture an impression, dentists must embrace technology, or they will be left behind. Patients assume the best dentists will embrace this technology.”
 
Outsourcing dental work to emerging economies like China remains a sticking point, especially with regards to the question of quality control and technical oversight. Both Richard and Ian contend that times have changed.
 
“30 years ago, the offshore labs were not as good and used inferior products. That is not the case today. Modern digital lab processes have levelled the playing field to the point where you would find increasingly negligible quality differences between digitally-equipped manufacturers,” Ian explains.
 
Richard adds: “This digitisation has meant that offshore providers through greater scalability and access to technology and materials have surpassed the quality of what can often be produced onshore. Avant gives access to this. Dentists must embrace this change and pass on these advantages to their patients.”
 
Still, in terms of quality control, Avant leaves nothing to chance. Local lab technicians check every case before it reaches the customer. This serves as a final checkpoint to provide customers an additional layer of assurance, as with production-side QC stipulations.
 
“Although the quality of work at the offshore lab is very high, we stipulate to all the manufacturers that they must use the exact same products and materials as we use in our own labs. All these products must have accreditation certificates that conform to international standards,” Ian emphasises.
 
To fully embrace the opportunities and cost benefits that outsourcing provides, Richard believes, demands a shift in mindset:
 
“The question of outsourcing must be viewed in the context of a dental lab and their relationship with dentists. Dentists must be open-minded to modern technology and materials and think more-so on a global scale.”
 
“Globalisation and technology have opened up the ability for a dentist to send a dental restoration case digitally to China, America or Europe in minutes – what in the past would have taken a couple of days.”
 
To help dentists navigate a dynamic business environment, he believes that Avant customers have a distinct competitive edge. Banking on the lab’s scalability, quality products and assurance as well as close client communication – led by Ian, formerly a Ceramist with 43 years of experience – Richard supports his claim with dollars-and-sense reasoning:
 
“Quality restorations means patients will be happy. Serviced by, and access to experienced technicians saves critical clinical time which, in turn, saves money. Competitive pricing allows dentists the flexibility to be more competitive or increase margins.”
 
 
 
 
 
 
 

Smilefast educator Dr Geoffrey Hall has developed a comprehensive Mini Masters program for dentists taking on orthodontics
 
By Danny Chan
 
OrthoED Institute is a Melbourne-based orthodontic training company that focuses on general practitioners seeking to carve a new career path in the lucrative teeth straightening market. Designed with GPs in mind, the Institute has been running a 9-module, 2-year Mini Master’s Program since its inception about two years ago.
 
“If you’re thinking of getting into orthodontics but do not wish to put your life on hold for three years, this program was designed for you,” Dr Geoffrey Hall rationalises, comparing his brainchild program to undertaking a full-time post-grad qualification at the University. Stretched over two years to accommodate lengthy case study review processes, the program effectively boils down to 21 days of full-day lectures in 2-day blocks.
 
Despite a less hectic schedule, Dr Hall says at the end of the orthodontic course, dentists are poised to deploy their newly minted skills on the vast majority of orthodontic cases.
 
Delivered by specialist orthodontists, including Dr Hall, and other specialist lecturers, the course incorporates a broad suite of lectures, online materials, case management mentoring support, as well as an optional in office immersion program. Guest lecturers comprise of relevant field experts, including oral surgeons, prosthodontists, practice managers, TMJ and sleep apnoea experts.
 
Filling the gap
 
Backed by 30 years and over 10,000 cases of orthodontic experience, Dr Geoffrey Hall is one of the leading orthodontic educators for general dentists in Australia. He is better known as developer of Smilefast, a digital indirect bonding system touted to achieve predictable treatment results in just 6-9 months. Smilefast is also the name of a short-term cosmetic orthodontic course that has trained over 700 dentists on the proprietary system since 2012.   
 
 “Without a shadow of doubt, the Smilefast training course is the best introductory course out there that allows general dentists to easily integrate into the field of orthodontics,” the Specialist Orthodontist asserts.
 
While the 2-day course purportedly gives general practitioners the ability to straighten teeth in 75% of adult orthodontic cases, the experienced clinician acknowledges a limitation of his highly condensed training session.
 
“Many of our Smilefast course attendees have gone on to provide orthodontic services in their practices, however there are those who lack the confidence to take on actual patients due to insufficient practical experience.”
 
This is precisely the training gap that the Mini Master’s was designed to fill. Three years in development, Dr Hall believes the Mini Master’s course would equip graduate GPs with the knowledge, skills and confidence to treat 95% of all orthodontic patients – without having to refer them to specialists.
 
Affording a clearer picture of his motivations as the program’s chief designer, Dr Hall identifies several hurdles that GPs regularly encounter in pursuing the practice of orthodontics:
 
Risk analysis
 
As a practicing Specialist Orthodontist with decades of experience, he advocates the 80-20 rule for GPs: Treat 80 per cent of patients and refer 20 per cent of difficult cases. Making that distinction, he says, is “not as easy as it sounds” and requires in-depth risk analysis.
 
Citing examples of difficult cases such as “severe class 3 malocclusions that requires a lot of tooth movement”, Dr Hall reasons: “The beauty of being a GP is that you don’t have to treat everyone that walks through your door.”
 
One unique aspect of the course training is helping dentists make risk-based patient selection that considers such criteria as case difficulty, amount of chairside time and profitability.
 
“I hate it when I hear ‘profit’ being used as a dirty word”, he adds, “we’re all here to make a living and dentists are no different... there’s no reason to base your entire practice on difficult cases.”
 
Precise bracket positioning
 
Dentists often find it challenging to fit the braces in the correct position, which Dr Hall acknowledges takes a lot of experience to get right.
 
“To make (bracket positioning) easier for GPs without compromising accuracy, we’ve developed a digital workflow for indirect bonding that puts brackets on the model in the digital world. Similar to Invisalign’s digital set ups, our system is able to predict where teeth will move and digitally change the position of braces to precisely match the movement.”


Confirming the brand agnostic technology can be used with nearly any bracket system on the market, Dr Hall says that it will allow dentists to exercise more control over treatment outcomes while eradicating miscommunication between dentist and lab technicians.
 
Professional and Peer Support
 
Passionate about supporting the course graduates in practical ways, Dr Hall says the Institute provides a secure online portal for general case support as well as a digital computerised indirect bonding service. The portal also includes a peer group forum for course alumni to exchange ideas and help one another.
 
After they graduate, Dr Hall and his experienced staff team can even assist course graduates to set up their orthodontic service and provide onsite staff training.
 
“We have a suite of deliverables to optimise orthodontic workflow that can be adapted to most types of practice environment. At the moment we haven’t charged anyone for this service but that may change,” he advises.
 
Stepping stone
 
GPs who wish to enrich their résumés – if only to put patients at ease – can further use the standalone Mini Master’s course as a springboard to a Postgraduate Diploma in Orthodontics from a UK accrediting body. The Diploma is available as an optional extra stream (with additional fees) to full course registrants. According to Dr Hall, almost everyone from the graduate class took up the option – the only dentist that didn’t was apprehensive about meeting the exam criteria.
 
Course participants or graduates can also look forward to a 3-day limited attendance in-office course, available on first-come-first-served basis for those who have completed or are doing their Mini Master’s. One highlight of this additional module is a full-day hands-on photography lesson conducted by world-class photography lecturer Dr Peter Sheridan.
 
Dentists can choose whether to attend individual modules or the entire Mini Master’s Program. The full program is priced at A$22,499 + GST or $A27499 + GST for the full program including the Postgraduate Diploma In Orthodontics. Australasian Dentist readers stand to enjoy a special offer if they call OrthoED at 1300 073 427 before registration closes on March 10th 2020.
 
OrthoED Institute’s Mini Master’s Program is currently open for 2020-2021 intake registration. The program’s Module 1 (Diagnosis, treatment planning, risk management and case presentation) commences from 19th March 2020. For more course details, visit https://orthoed.com.au
 
 
 
 
 

Dr Hetal Patel’s entrepreneurial skills and vision helped build a successful English practice and turn around a floundering investment in Australia.

By Danny Chan

“Learning is a lifelong process”. The adage holds true whether you are a dental entrepreneur with a proven track record or a practice aggregator with a stable of thriving dental businesses.

It took equal doses of humility and ever willingness to learn from mistakes that led Tony Coulepis, Executive Chairman of Ekera Dental, to engage the management expertise of Dr Hetal Patel. It was Dr Patel’s spirited contribution, turning around a declining practice that Ekera Dental had acquired as its first dental practice in October 2013, that still serves as a useful template for the corporate entity’s unique acquisition model.

Living up to Ekera Dental’s reputation as a “non-corporate corporate”, Tony did not hide behind a corporate veil that is prone to mask inefficiencies and inflate profitability. In fact, he heartily endorses this article’s premise of how his company still benefits from backing the right visionary dentist, and providing him with the necessary tools and investment to restore Ekera Dental’s first practice to its former glory.  

Praising Dr Patel’s efforts for steering the company’s maiden acquisition in the positive direction, Tony says: “Dr Patel was the right person at the right time for the challenges we were facing at the time.”

“It was an excellent learning opportunity for the Ekera Dental team and I believe we have come away more knowledgeable and better prepared for future challenges.”

Guts and gumption

Before moving to Australia in 2008, Dr Hetal Patel was running a successful 5-chair practice with his brother in England. From 2000, the Patels had built their practice from scratch with a simple formula: “Treating every client as we would members of our own family and surpassing our patients’ expectations – not just meeting them.”

Values of honesty, integrity and humility were ingrained in their day-to-day operations. The practice thrived and within 6 years, grew to a team of four full-time dentists and 2 hygienists servicing 14,000 clients – seeing up to 150 patients a day.

Dr Patel recounts pulling out all the stops to establish points of difference from competing practices. While many of the ideas may seem commonplace now, the passionate entrepreneur insists they weren’t so for England in the early 2000s.

From simple things like greeting every customer on first-name basis to sound-proofing all treatment rooms to using expensive plasma TVs as promotional vehicles to installing digital x-rays and setting up snack bars in the waiting room, these were considered fancy inclusions that no one was doing at the time.

Careful deliberation permeated every facet of the clinic, including its scent (using wood to absorb the clinical smells) and ambience (incorporating a cafe-like waiting area). As a testament to how uncommon these ideas were, they used an optical store fitter to build the practice as “dental fitters hadn’t gotten to this level of fit outs just yet.”
Still, the most innovative concept had to be their membership-type business model, where patients signed on as members of the practice – paying a monthly fee by direct debit. Over 12 months, the fee would cover the cost of two check-up appointments and two to four hygiene appointments.
“There was an in-built insurance premium that also covered them for free out of hours emergency treatment,” he adds.
The membership program not only provided a steady cash flow but also converted the practice into a preventative focused clinic ensuring a constant stream of patients.
“Patients would leave on the day not paying which made them feel like they were getting this great service for free,” Dr Patel enthuses.
At the crossroads
While Dr Patel found running a successful practice both exhilarating and rewarding, he also realised that it was taking a toll on his personal life. “Something had to change or I was heading for a heart attack at 45.”

This epiphany soon gave way to the major turning point of his life and career: In 2018, he sold the practice and migrated to Australia with his family. “It was a big call and a scary one but again I was up for the adventure. I was cashed up and debt free. I felt a huge burden had come off my shoulders.”

For 9 years, Dr Patel would work as part-time associate, judiciously keeping a work-life balance. However, when the practice he was working in was taken over by a mainstream insurance provider, frustration crept in. “Once you’ve been a boss, it’s hard to fall in line,” he remembers feeling trapped, “I couldn’t control my clinical environment.”

It was around this time Ekera Dental was looking for someone to manage Smile Style Dental. At the crossroads of whether to change employment or buy a new practice, Dr Patel decided he would give the Ekera Dental challenge a shot. 

“Ekera Dental was transparent and acknowledged that its first acquisition proved a learning curve for them and mistakes had been made but they were passionate to invest time, resources and money towards fixing it.”
 
Another turning point
Challenging Ekera Dental’s model from the outset, Dr Patel recalls making tough decisions – even ruffling feathers – pushing through with a new vision and philosophy. Dr Patel took over the management reins in August 2018 and wasted no time to revamp the clinic with a new modern image – one that he says “portrayed the calibre and standards we aspire to”.

Mission statements were scribed onto the walls for all to see. New systems and processes were implemented to ensure day-to-day operations were “purposeful, repeatable and efficient”. From a re-activated patient database, along with Dr Patel’s loyal patients from his previous clinic, the practice was energised with a fresh momentum as were the practice staff who enthusiastically followed Dr Patel’s “hands-on” model.

As good word of mouth began spreading, Ekera Dental continued investing in new technology and equipment. Dr Patel believes that investments such as the 55-inch screens connected to HD intraoral cameras, have proven to be invaluable in patient education and getting treatment plans approved:

“When a patient sees the problem and then owns that problem, they ask for a solution – without the sense of a sales agenda. It’s so powerful.”

Hooked up to these new screens were other diagnostic aids like Diagnocams and Diagnodent along with popular entertainment channels like Netflix. Dr Patel was also instrumental in bringing 3D scanning into the Ekera Dental group. “We had one of the first trios units in the group and now have digital workflows throughout our practice in all treatment modalities.”

Once the practice was moving in the right direction, the focus shifted to providing on-the-job training for clinicians. “We invested in ourselves and attended courses to improve communications with patients. We spent hours on time management and better treatment planning for them to get more from their clinical practice.”

Ekera Dental facilitated training in Invisalign and implant placement so that the Smile Style Dental team was equipped to provide a comprehensive range of services, significantly reducing outside referrals. The clinic would also rely on Ekera Dental’s marketing and administrative expertise to take care of all back-end duties, including payroll, HR and P&L reports.

“Throughout the process, Ekera Dental was open to my ideas and supported me whichever way they could.’

“The results have been amazing. We’ve experienced massive growth. The practice is thriving and its fortunes have turned around. Smile Style is now amongst Ekera Dental’s top performing practices and takes pride in being the jewel in their crown once again.”
 
Family of practitioners
Dr Patel’s experience working with Ekera’s operations team has been nothing but positive. Once again, alluding to their “non-corporate corporate” style of management, the dentist says Ekera Dental has an inclusive family-oriented culture that promotes healthy cross-practice interaction.

“Their model of allowing clinics to run without interference but taking on the administrative duties is very powerful and really allows the Principals to focus on clinical and day-to-day issues.”

“The group as a whole encourage Principals to mingle, share resources and provide a supportive network. Many of the more experienced practitioners offer their time to mentor other practitioners within the group – in this regard, Ekera Dental is like a family of dental practitioners.”

For someone who has built and sold a successful practice, Dr Patel firmly believes in Ekera Dental’s current model, to which he can claim positive contributions: “I cannot recommend the Ekera Dental model more to Principals looking to sell their practices.”
 

Gallant Autonome is a fully integrated dental unit that practice owners with limited floor space have been dreaming about. 
 
By Danny Chan
 
The feature “plug-and-play” has never been used to describe the attributes of a dental unit – until now. That’s right. Imagine a dental unit that practically works out of the box, with no complex installation process necessary. The Gallant Autonome is a dental unit that does not require connections to air supply mains; vacuum mains; water supply mains; and sewerage system. The truly standalone unit includes a built-in compressor, suction system, aspirator and container for secretions. Housed within a soundproof cabinet, the oil-free compressor and suction system is exceptionally quiet.


Judging by the main features alone, there are two scenarios that immediately spring to mind where this chair would be a great fit:
 
Scenario One: If space comes at a premium cost to you, this high-tech Italian dental chair offers a unique space-saving solution that can also potentially save thousands in annual rental expenditure.
 
Scenario Two: If new space for a non-plumbed suite suddenly opens up in your clinic, you no longer need to engage a plumbing expert to extend the existing pipe-works into the room – which entails yet more savings. All this dental unit needs is an Australian standard 240-volt power plug.
 
Tecnodent is the Italian chair maker of Gallant Autonome. Founded in 1966, Tecnodent has a long tradition of chair designs for the dental/medical market that are renowned for their fine Italian craftsmanship. Tecnodent purportedly pioneered several innovations, including: Seamless upholsteries, knee-break seats (Linda Chair); as well as memory foam moulded upholsteries without seams.
 
In case you’re not entirely familiar with Tecnodent, perhaps you would be with the ensemble of European brand-name products that the unit comes integrated with:
 
Dürr Dental: Amalgam separator CAS 1; filter and place selection valve; Dürr Comfort assistant block with large and small suction hoses and extension capacity with any instrument; intraoral camera; modular suction tips; suction hoses (11mm/17mm)
 
Bien Air: Brushless micromotor
 
Satelec: Ultrasonic handpiece
 
Luzzani Dental: Suction unit with a bactericidal filter mounted in the hydroblock ; Minilight 6-way syringe with hot/cool water, air and spray.
 
Ekom: Oil-free compressor with a stainless-steel body, 5-litre corrosion-resistant tank and an automatic condensate drain
 
Tecno cer: Ceramic swivel spittoon bowl with flush and electric glass refill
 
Mectron: LED polymerization light
 
These branded wares are housed within a 10mm-thick, glass-reinforced polyester shell, alongside other modular parts like: 2-litre clean water system; 6-litre water tank; 5-litre capacity for secretions.
 
The sleek modern appearance of the chair is accentuated by the glossy surface of the ceramic cuspidor with anti-bacterial coating and luxurious Italian upholstery. Available in two versions, dentists can select between the “Sting” dental chair (available in suspended and floor-mounted models) or “ECO.next” dental chair (floor mounted version). Both versions offer a great selection of colours and upholstery to provide users what the company calls “chromatherapy”.
 
For all its whiz-bang tech and pleasing exterior, the biggest drawcard of the Gallant Autonome is undoubtedly the fully integrated solution it offers. That is certainly the feedback from Dr Kevin Morris, Specialist Periodontist at Northern Periodontics & Implants.  Dr Morris worked as general dentist for 15 years before becoming a Specialist and currently co-owns NPI, a six-location group practice with two other periodontists.
 
He purchased the Gallant Autonome from local reseller INZ Dental for his second permanent clinic location in South Morang, an old 200-sqm residential house that was converted into a single-chair practice. To avoid damaging the rental property with a view for future expansion, Dr Morris found the Gallant Autonome tailored for his needs.
 
“I believe INZ Dental is at present the only supplier of fully integrated dental chairs in Australia that features built-in suction and compressor.”
 
“With this chair, under-floor plumbing is not necessary which represents some savings in terms of build cost.”
 
Pleased with his purchase, Dr Morris is impressed by the “great chair ergonomics and operator comfort”, while surprised by the small footprint, being “only slightly larger than a “traditional chair””.
 
The periodontist is just as complimentary about his buyer’s experience:
 
“(INZ Dental) is a very attentive and responsive company. Their after-sales support is excellent and they offer honest advice. The price of the chair is VERY (emphasis Dr Morris’) competitive. The installation was fast with minimal delays. The chair looks great and was well installed.
 
“I like to support emerging businesses to ensure that there is competition in Australia. Both Borys and Nadiya (owners of INZ Dental) are fantastic to work with.”
 
As well as great support, he reiterates the main feature that makes the Gallant Autonome the ideal chair:
 
“I believe the chair can fit a normal size dental clinic very easily. The fully integrated system, along with all the equipment, is compatible with Australian connections.”
 

“They are always there for you... It’s just like they are a part of your business”. If that sounds like corporate insurance ad copy from a bygone era, it’s not. It’s the genuine appraisal of a satisfied customer who whole-heartedly endorses his equipment supplier (Ampac Dental) and technical support team.
 
By Danny Chan
 
More than 20 years spent in private and public practice has sharpened Dr Mahmoud Bacher’s acumen in shopping for new dental chairs. The dentist’s purview of various brands and models gleaned from personal experience as well as exposure to informal peer reviews, coupled with a keen eye for design aesthetics as a hobbyist painter, makes him an astute – and he admits, demanding – dental chair buyer. The Principal Dentist of AZ Family Dental has also dealt with enough equipment supply companies in his career to know how elusive the good ones are.   
 
Some negative past experience with dud product choices and lousy after-sales service also makes Dr Bacher more appreciative whenever he comes across a reliable equipment seller or dental hardware that delivers as promised. That has certainly been his experience with Ampac Dental – the NSW-based dental reseller that eventually became his one-stop equipment destination.
 
When he stopped by Ampac Dental’s showroom in April, it was supposed to be one of many visits to compare available chair makes as part of his exhaustive pre-purchase research. There initially to test the Swident Partner chair, a European model that he has heard excellent first-hand reviews about, Dr Bacher ended up fitting out his entire Parramatta clinic with Ampac Dental’s equipment range, including: Suction (Dmega); compressor (Nardi); autoclave (Melag); x-ray unit (Trident); and ultrasonic cleaner (L&R).
 
While the chair’s classic Swiss design, luxurious upholstery and simplicity were pleasing attributes, Dr Bacher says that it was Ampac Dental’s genuine customer service that sealed the deal.
 
“From the moment I stepped into the showroom, (Ampac Dental’s equipment specialists Moe and Elizabeth) made me feel very welcomed and looked after.”
 
“Although I was quite the demanding customer, they were utterly professional and patiently answered all my questions. Their product knowledge is extensive and that is important for any serious buyer who is familiar with the product category and has specific questions to ask.”
 
Four months after the purchase, Dr Bacher is happy to report that the positive experience did not terminate at the cash register. As per research, the dental chair and the rest of the equipment have been performing impressively even under constant stress, delivering all the operator/patient ergonomic comfort and functional attributes that he could have hoped for. The after-sales experience was just as good, if not better.
 
“No matter how good a product is, you are bound to encounter some issues. It’s great to have helpful and knowledgeable equipment specialists to turn to when you do,” Dr Bacher says of Ampac Dental’s responsiveness.
 
 
The tech support equation isn’t complete without including the supplier’s outsourced technical team – that installed all the equipment at AZ Family Dental. “It was like a giant puzzle with so many intricate parts but the installation team was so efficient, they made it look simple.”
 
One of Ampac Dental’s trusted technical crew in the Sydney area, LR Dental comprises Louis Rouessart and Louis Rouessart Jr, the father-and-son team that has earned several noteworthy mentions in this magazine. Dr Bacher manages to raise the bar with the most effusive thus far: “If you haven’t dealt with them, you are really missing out.”
 
Having encountered his fair share of irresponsible equipment installations, Dr Bacher cannot be happier with LR Dental’s work rate and ethics:
 
“Most technical guys come in, install an equipment and that’s it. With (LR Dental), they won’t leave until they make sure that everything is functioning properly.”
 
Dr Bacher is still impressed that on one occasion, Louis Rouessart Jr had responded to his call at 11pm, then promptly came onsite to assist the in-house IT guy. “He didn’t have to but that’s the kind of commitment level I’m talking about,” he adds gratefully. “It’s just like they are a part of your business.”
 
The clinician experiences the same genuine concern from Moe and Elizabeth every time he reaches out with an issue – even though he knows that they are very busy people.
 
“I’ve had several bad experiences when it’s hard to locate the supplier or when the technician promised to come but never showed up or came very late... all these things impact your business negatively.”
 
“With Ampac Dental, it’s quite the opposite. They are always there for you.”