Richard Palmer

	While the centerpiece Chicago Dental Society Midwinter Meeting may be a day shorter, the schedule of collateral dental industry happenings remains as full as ever. With plenty of opportunities to learn from leading experts on materials, equipment, technology, and business operations; chances to view and test the newest innovations for restorative and cosmetic dentistry; and networking options to exchange ideas with colleagues, you’ll need to plan you days carefully to take full advantage of your time in Sweet Home Chicago.

	Condensing the Chicago Dental Society’s Midwinter Meeting experience into a tighter package, the CDS has eliminated Sunday from its Midwinter schedule and shifted the exhibit hours to a Thursday-Friday-Saturday run to match the academic program Feb. 25-27.

	In addition, the entire Midwinter Meeting will be held in the new McCormick Place West Building so attendees will be able to participate in workshops, learn at lectures, and discuss the latest products with vendors without walking the vast McCormick Place floor.

	The educational portion will feature more than 200 courses covering all areas of interest for technicians, clinicians, and all specialists and auxiliaries; a number of courses also will be presented in Spanish. All scientific program events are ticketed, though more than half are free.

	Filling out the 460,000 square feet of exhibition space in the West Building, Level 3, Hall F, more than 600 vendors will showcase the latest equipment and supplies for dental practices and laboratories each day from 9 a.m. 5:30 p.m.

	For the first time, this year’s Midwinter Meeting will offer free health screenings for attendees presented by BlueApple Health. Located in the exhibit hall, the Midwinter Meeting Wellness Center will feature 10 tests. Preregistration is required for screening, which will be by appointment only.

	Balancing business with pleasure, the CDS has a full schedule of social events planned as well. Thursday’s Opening Session reception from 4:30 p.m. to 5:30 p.m., followed by author and comedian Rita Rudner. Entertainment Friday starting at 8 p.m. at the Park West with Blood, Sweat & Tears and Chuck Negron, formerly of Three Dog Night. Moda Latina is the theme for the annual Fashion Show and Luncheon Friday at noon at the Hilton & Towers in the Grand Ballroom. Saturday, the Don Cagen Orchestra will provide musical entertainment at the President’s Dinner-Dance at the Hilton & Towers Grand Ballroom.

	A searchable schedule of speakers and topics as well as an interactive floorplan of the exhibits is available online; for additional information, call 312-836-7300.

	Once again this year, the CDS and the National Association of Dental Laboratories will co-sponsor a course specifically for technicians and clinicians to attend together for cooperative team learning. Don Iman, CDT, and Dr. Tif Qureshi will present “A Revolution for Cosmetic Dentistry” Saturday morning with an emphasis on cutting-edge orthodontic treatments. Contact the CDS for program and registration details.

	Although the Midwinter Meeting doesn’t officially start until Thursday, a small number of events will take place Wednesday, Feb 24. The Dental Trade Alliance will host the World Dental Trade Conference from 8 a.m. to noon at the Hyatt Regenct McCormick Place with featured speaker Michael Treacy followed by the DTA Preview Show from 1 p.m. to 5 p.m. The Preview Show brings together hundreds of domestic and international distributors of dental equipment and supplies. For information, call 703-379-7755 or e-mail info@dentaltradealliance.org.

	The 20th annual Oral Health America Gala & Benefit will be held in the historic Union Station Great Hall Wednesday evening from 6 p.m. to 11 p.m. For details on the limited-attendance, black-tie-optional fundraiser, call 312-836-9900.

	The Midwinter Meeting may be the showcase entree event, but to get the whole experience, you need to get out of McCormick Place and shuffle off to other venues for additional programs.

	Starting Thursday and continuing Friday. The Cal-Lab Group will host its business-focused meeting at the Westin Michigan Avenue with ballroom presentations on the state of the industry, managing costs, regulatory standards, digital dentistry, purchasing high technology, team building, and marketing as well as a panel discussion on materials with representatives from Argen, Dentsply, GC, Heraeus Kulzer, Ivoclar, and Vident.

	Shaun Keating, CDT, will present the keynote address, “Growth in a Declining Economy,” Friday morning. Meeting attendees are invited to stay on for “The Evolution of Esthetics and New Innovative Materials” presented by Drs. David Garber and Gui Cabral as part of GC’s Edu-Tech Day (see below) following the Cal-Lab meeting Friday afternoon.In addition, the exhibitor showcase and reception will be held Thursday from 3:30 p.m. to 6:30 p.m.

	Also running Thursday and Friday will be Technology for Today and Tomorrow, presented by The Barnes Group, at the Hilton Suites. The seminar will include focused technology and business-building presentations by Gary Fichtner, CDT; Mike Girard, Mike Spray, Mark Seiter, Eli Ganon, Dr. Mark Abramson, Chad Rogers, and Alan Barnes. The program also will feature the U.S introduction of a cutting-edge intraoral digital impression system. For details, call 800-252-6279.

	The American Prosthodontic Society also will host its annual meeting Thursday and Friday, at the Westin Chicago River North. The scientific session will feature multiple presentations on zirconia, implants, and technology integration as well as table clinics and commercial exhibits. Lee Culp, CDT, will present “Digital Dentistry: Beyond Imagination” Thursday afternoon. Call 312-981-6780 or e-mail aps@prostho.org for details.

	The American Academy of Fixed Prosthodontics will hold its annual scientific program Friday and Saturday at the Chicago Marriott Downtown with lectures addressing implants, all-ceramics, esthetics, and case design. Just some of the outstanding presentations will be Dr. Daniel Edelhoff, “Light transmission through all-ceramic framework materials;” Dr. Dan Nathanson, “High-strength ceramics vs. PFM: The good, the bad, and the ugly;” and Dr. Dianne Rekow, “Reliably predicting performance of new ceramic restorative materials.” Call 866-254-0280 or e-mail aafpjordan@bellsouth.net for details.

	Spectrum Dialogue will host its annual Spectrum Techno-Clinical Day Friday at the Wyndham Hotel. The lineup of speakers includes a faculty of international experts discussing everything from material handling to the latest technologies. To register, call 905-489-1970.

	With thousands of dental professionals trekking to Chicago, it’s no wonder that dozens of manufacturers and suppliers organize their own events or host day-long programs that provide targeted education while simultaneously providing a forum for their own brand-new or well-known products for technicians and clinicians to take back to the lab and practice to get started Monday morning.

	GC America will hold its annual Edu-Tech Day at the Westin Michigan Avenue in the Cotillion Ballroom. In addition to the presentation by Drs. David Garber and Gui Cabral, Pinhas Adad, CDT, MDT, and Luke Kahng, CDT, will conduct separate lectures focusing on materials, and Rick Sontag, CDT, will offer his expertise on production. Call Lisa Gray, CE Specialist, at 800-323-7063, ext. 4027, to register. Registration deadline is Feb. 20.

	BEGO USA and Preat Corp. will again join forces this year for the Creative Edge Symposium Friday at the Sheraton Hotel & Towers. Preat’s Tom Bormes, CDT, will present a pair of back-to-back courses, “Fiber is good for you” and “Precision attachment retained removable partial dentures: The lost art” followed by BEGO’s Martin Schmid, CDT, on “Become an expert in crown & bridge.” Bormes and Schmid will be joined by Bruce Keeling for a one-hour Q&A session on removable, fixed, and implant cases. Call BEGO at 800-342-2346 or Preat at 800-232-7732 to register.

	Jensen Dental's Education Day “Clarity: Strategies for Sustainability” will actually comprise Friday and Saturday at the Swissôtel. Don Cornell will moderate a series of short programs Friday from presenters Sascha Mein, MDT, Oral Design; Dr. Robert Winter; Michel Magne, MDT Oral Design; Aki Yoshida, MDT; and Olivier Tric, MDT as well as a keynote address by Jürgen Mehrhof, MDT, Oral Design. Breakout sessions Friday will include small-format lectures and hands-on demonstrations. Saturday will consist primarily of a limited-attendance day-long panel discussion, “Technology, process and profit.” To register, call 800-243-2000.

	In addition to a series of lectures and workshops Saturday at the Sheraton in conjunction with Lab Day, Vident will host a pair of special panel discussions moderated by Dr. Mark Murphy: “All you need to thrive in a competitive environment” Friday and “Keys to understanding modern materials: Esthetics, function, and use” Saturday.

	Speaking of Lab Day, the ballroom level of the Sheraton (two flights up from the River Exhibition Hall) will be abuzz as with educational opportunities as 3M ESPE takes up ballroom 6 on Friday and both 4 and 5 on Saturday, Nobel Biocare occupies ballroom 8 both days , and Vident has ballroom 8 Friday. Saturday’s dance card also includes Straumann USA in ballroom 1, Ivoclar in 6, Shofu in 8, and Zahn Dental in 9 and 10. Each company has a full schedule of programs.

	In addition to the well-publicized events, others are tucked in smaller rooms and venues but worth checking out. Just two examples are Renfert USA's “From a Clinician’s Point of View” program Saturday in the Sheraton Hospitality Suite 830 with up-close presentations by Michael Kessinich, CDT; Jim Collis, CDT; Luke Kahng, CDT; and Robert Kreyer, CDT. To register, call 800-336-7422.

	Amann Girrbach will present its newest innovation, the Ceramill Mall CAD/CAM Concept, in the Odgen Suite of the Sheraton. To arrange a private demonstration, call 800-851-3719.

	There’s more...lots more. But part of the fun of a meeting as large and comprehensive as Chicago is in finding those spontaneous activities where you learn more about the hows and whys of improving your business and your skills. Search them out, and make the most of your time in the Windy City.

Articles

 While the centerpiece Chicago Dental Society Midwinter Meeting may be a day shorter, the schedule of collateral dental industry happenings remains as full as ever. With plenty of opportunities to learn from leading experts on materials, equipment, technology, and business operations; chances to view and test the newest innovations for restorative and cosmetic dentistry; and networking options to exchange ideas with colleagues, you’ll need to plan you days carefully to take full advantage of your time in Sweet Home Chicago.  Main Course

Chicago Midwinter condenses to three days

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 Information provided by DENTSPLY Midwest   The lightweight, ergonomic Midwest® Stylus™ ATC highspeed air-driven handpiece delivers an exceptionally smooth, powerful and efficient cutting performance.

Midwest Stylus ATC in your practice

	The Endo Pulse RCT handpiece (EP) is designed to eliminate file separation during root canal therapy (RCT). It is a “non rotary” reciprocation adjunct to help create the optimal glide path and make RCT safer, faster and more predictable.

 Using Vertical Reciprocation, EP and Master Files have zero “torque stress,” which is the cause of rotary file separation. EP Vertical Reciprocation moves the file between 1 mm and 0.30 mm depending on resistance. You can cut through all curves and calcifications to the apex and eliminate hand filing fatigue.

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 EP comes with a small, lightweight, detachable E-type 20K rpm motor. Use the motor for other contra-angle or straight attachments.

 The Endo Pulse RCT handpiece (EP) is designed to eliminate file separation during root canal therapy (RCT). It is a “non rotary” reciprocation adjunct to help create the optimal glide path and make RCT safer, faster and more predictable.

Applying Endo Pulse in your practice

	Nuance appears translucent at incisal edges but mimics dentin-like depth when applied to the tooth body. 

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Subtle made simple

	The surge in the demand for removable prosthodontics may be taking some dental laboratory owners somewhat by surprise, but others had the foresight to prepare for a rise in denture caseloads through formal education and training as well as their own day-to-day working experience. Tom Zaleske, AS, owner of Matrix Dental Laboratory & Consulting in Crown Point, Ind., has spent the past 25 years perfecting his denture craftwork as well as his business management philosophy so that each meets his personal and professional specifics.

	"The reason I'm in removable prosthetics has nothing to do with anything other than me looking at demographics of what the 20-year window was going to look like for me when I hit 50 and where I was going to be," said Zaleske. "I chose in school to specialize in removable prosthetics because I saw that there was going to be a dire need for it. And it turned out that I was right."

	Working exclusively in removable prosthodontics, Zaleske shares his experience and knowledge through lectures around the country as well as in his role as Technical Coordinator for Keystone Industries, providing telephone support for technicians. He emphasizes that technicians need to position themselves as the "go-to technical resource" for their dentist-clients not only to strengthen the technician-clinician partner relationship but also to ward off competition.

	"Every large megabox lab has got a denture department. If they don't, they're getting one. If you're going to compete by buying equipment, you're done. You'll never win that battle because all a guy's got to do is buy the same thing you have and now you're at the same level," he warned. "You have to develop techniques and offer services that take time and a learning curve, which eliminates 95% of your competition because now most labs don't have the time or the inclination to want to do that. So now you're dealing with 5% of the guys who understand the equation, and those are the guys you compete against."

	In his courses, Zaleske gets right down to the very elemental makeup of denture materials, laying the groundwork for working with the materials. “You've got to understand the chemistry of the product,” he said. “Understand that denture base acrylics form molecular chains, polymer chains. The longer the chains, the fewer the breaks in the chains, obviously the stronger the product. All of that is involved in time. What's critical is that technicians understand that there are basic time-involved procedures that when they are shortcut, they eliminate that baseline strength and start to compromise in areas where you can't track down where the problem might be coming from.”

	He advocates using a heat-cure acrylic that affords more control over the polymerization process by the technician. “The big thing to understand is the differences between a cold-cure and a heat-cured resin is that polymer chains develop because there's heat induced the product. The auto-curing material uses chemistry to produce heat that forms the chains, but once the chemistry burns out, that's it,” he said. “The heat-cured acrylic does have some initiation chemicals that get the reaction going, but the actual polymerization chains develop through outside heat source, which then you can control the duration and the intensity. By being able to go low and slow, you're able to extend the duration of the polymerization and also the amount that it produces. You are able to form longer chains, and you're able to drive off any of the chemistry that might remain after polymerization has occurred.”

	He added that auto-cure resins can be very technique sensitive and require care in mixing the correct ratios. In addition, it is likely to have some leftover residual monomers that can cause problems when leftover monomers aren't used up by either the chemistry or heat, which can lead to various problems.

	Zalaske’s “low and slow” approach to heat-curing starts with hand-mixing just enough acrylic that he can pack within the recommended working time. “You have roughly about 9 minutes before the material reacts to where it’s ready to pack, and you only have a window of 4 to 5 minutes between the time that it’s ready and the time that you start to enter where the product starts to get stiff and dry and doesn’t bond well to teeth.”

	His advice to technicians facing 10 or more cases that need packing is to take it in stages. Mix enough acrylic for 4 or five cases, let it react and get ready, then mix up another batch; while the second batch reacts, the technician has enough time to pack the molds properly using the first batch, all before the second batch is ready for packing.

	Once the acrylic is ready for packing, Zaleske hand packs the mold a bit at a time, using pneumatic flask pressure between increments, then lets it bench set for 20 minutes to allow the heat caused by the initial chemical curing to dissipate before placing the clamped flask into a water bath for heat curing.

	He strongly warns against placing a prepared flask directly into a heated water bath rather than heating the water after placing the flasks inside. “A lot of guys have water that's warm because they don't want to wait for it to reach 165°F. They pack the flask by overfilling it, then squeeze it a bunch of times until it doesn't squeeze out any more. Then they clamp it and stick in water that's 165°F. One of the biggest reasons you have porosities is because the acrylic on the inside of the mold that you just packed is going through its initial stage, which generates its own heat initially and kicks the reaction off. When they drop it in 165°F water, it's now getting heat from the outside, and it's generating heat from the inside. All of this has to do with climb rate accelerating; it reaches 163° or above inside the mold a lot quicker because it's already generating heat itself on the inside.”

	Next, it’s time for it to sit in the hot water. “Nothing comes out of my lab that isn’t cured 8 hours at 163°F,” said Zaleske. “It goes long, and it never goes into ice-cold water to cool it at the end of the cure. It’s always brought down at a slow temperature.”

	This extended, controlled process is designed to allow material to transform from monomers to longer polymer chains than possible in faster auto-cure resins. The shorter cure time causes more breaks in the polymer chains, which results in porosity that can in turn cause malodor and discoloration.

	“I would say that 80% of the problems out there with acrylics-whether it’s the bonding of teeth, a patient has a bad taste in their mouth, porosity-all have something to do with the technician trying to cut time,” said Zaleske. “They don’t know how to be proactive. The doctor says he needs it tomorrow, and they are trying to find a way to get it done as quick as they can. A lot of times, that means using 20-minute monomer, which does not allow enough time for good polymerization.”

	Which is where knowledge and skill come into play. By being the resource of information that clinicians not only want but often need, the lab can be proactive with clients. “Labs want to be amenable to the doctor. There’s so many labs that are hungry out there that they’ll do anything to get an account” said Zaleske. “They feel if they can’t do it in a day, then the doctor will find somebody who can. I cannot do what they expect me to do if I’m always pushed into a corner to perform in the shortest period of time.”

	By being strong with clients, he has set the rules for them, not the other way around. “I don’t let time dictate quality. Quality dictates time.”
	 

 The surge in the demand for removable prosthodontics may be taking some dental laboratory owners somewhat by surprise, but others had the foresight to prepare for a rise in denture caseloads through formal education and training as well as their own day-to-day working experience. Tom Zaleske, AS, owner of Matrix Dental Laboratory & Consulting in Crown Point, Ind., has spent the past 25 years perfecting his denture craftwork as well as his business management philosophy so that each meets his personal and professional specifics.

The science behind removables

	Designed to simplify workflow between practice and lab, the CARES (Computer Aided REstorative Solutions) Digital Solutions represents a complete dental solution, from digital impression taking using intraoral scanning to the CAM production of prosthetics. Each individual step is well-coordinated, seamlessly interlocking and is designed for high quality. The system comprises the Scan CS2 3D laser scanner that scans solid master models, section cuts and antagonist models and the CARES Visual software that provides automatic prosthetic design and an expanded database library of teeth, pontics and connectors as well as connectivity with the Cadent iTero®5 intraoral scanning technology for data transfer from chairside.