Innovation, Unlimited Potential Ahead for Dental Industry in 2023

Implant dentistry has reached a level of maturity such that tooth replacement with implants is now commonplace. The success achieved often exceeds the long-term success and survival of numerous other restorative treatments, but nothing is perfect. As therapies mature, we face problems. Our goal is to identify and correct the causes of those problems.

Implant manufacturers have certainly been at the forefront of major changes in design, surface treatments, and surgical protocols. Many of these changes were implemented to deal with acute problems in implant success. As the longevity of these procedures has increased, we are now faced with identifying and attempting to correct the causes of chronic implant disease. Peri-implantitis is a term used to describe the chronic breakdown of the structures that support dental implants. Often, this breakdown occurs slowly and may have multiple etiologies. Patient adherence and medical and dental health are factors, but there are also mechanical and technical issues that appear to affect long-term success.

Ditron Dental USA has identified that crestal bone support and the need for increased bone volume at the superior part of the implant increases the support needed to reduce the stress on this very important and delicate tissue. The reverse concave neck and microgrooves of Ditron’s Ultimate implant help achieve this by increasing the amount of bone at the top of the implant. The Bone Platform SwitchingTM also supports the overlying soft tissue, and when the height of bone is maintained the soft tissue interdentally can offer greater papilla anatomy. Component stability and increased tolerances minimize micromovement and microleakage, another factor in implant survival. The MolecuLockTM implant-abutment connection feature and precision adaptation of the Ditron implant components are designed to address these issues.

Recession: How mild to how bad, who knows? The truth of the matter, there is no better time than now to do a financial recheck on your practice, and here is my short list.

1. Review your fees; are they up to date? If not or you don’t know, purchase a ZIP code analysis of what the customary fees are from the ADA or your distributor.

2. Create an in-office dental plan. Yes, you all know they are a great idea, but most of you have never done it. There are many options and companies to work with, and all you have to do is create your plan and get your team behind it. My office has over 950 patients on its plan, and this is one of the best ways to beat the PPO world. Companies offer complimentary marketing, portals, and much more. As Nike’s Phil Knight would say, “Just do it.”

3. Maximize your website, verify your SEO, and put your in-office dental plan front and center on your site. Patients are susceptible to fees, and marketing an in-office dental plan on your website is huge!

4. 2D AI, yes, it’s here. In your first week, the technology will help you find more work [revenue] than a year’s payments on the technology, and boost your treatment plan acceptance because patients trust computers more than the trust us…I think. This monthly investment is the biggest no-brainer in dentistry.

5. Lastly, invest in yourself. Learn a new procedure or expand your diagnostics, for example, into the world of CBCTs.

6. Office hours: Get rid of your banking hours and offer an evening or a weekend, as patients and families find it difficult to schedule appointments during normal working hours.

The use of composites in everyday dentistry is very popular due to their numerous advantages. In combination with adhesive-based technology, it allows one to remove less tooth structure and offer minimally invasive care as well as undetectable restorations that blend into the surrounding tooth structure. Resin composites are certainly popular, but when compared with other materials, their longevity leaves something to be desired. Most experts agree that composite restorations last from 5 to 7 years, often with failure resulting from marginal breakdown and the penetration of bacteria leading to demineralization.

Infinix restoratives by Nobio are a game-changing group of restorative materials, including universal and flowable composites and a universal bonding agent. They incorporate Nobio’s patented QASi antimicrobial particle technology, which protects restorative margins from the bacteria that cause recurrent decay. These nonsoluble particles become part of the polymerized restoration and are designed to provide long-lasting electrostatic protection against cariogenic microbes.

Infinix handles exceptionally well in terms of placement and polishability as evident in the following case. A patient presented with failing MO amalgam on lower first molar (Figure 1). I did not need to change my typical approach for this restoration at all. Sound isolation with proper application times and incremental layering with optimal light curing will allow solid results (Figure 2). The power to heal and to prevent decay is meaningful to all, and Nobio provides the opportunity to take composite dentistry to a new level.

What influenced the dental market in 2022 will continue to do so in the year ahead. Artificial intelligence (AI) technology will again be at the forefront of clinicians’ minds in 2023, especially as it pertains to in-office 3D printing. Since its founding, SICAT has been providing forward-looking solutions that enhance the digital chairside workflow.

With the RAPID DIGITALGUIDE, an STL surgical guide for in-office 3D printing, SICAT provides a solution and underscores its prowess as a leader in dental innovation.

“Since the introduction of RAPID DIGITALGUIDE a year ago, this AI-based solution for in-office printing has set the standard of STL output in the dental industry,” says SICAT President Craig Hennings.

Today’s dental industry leaders all have 1 goal in common: providing solutions that allow for fast, accurate, and safe dental treatment to increase case acceptance and enhance overall patient experience. The open SICAT Suite offers dentists a variety of options because it is the only one that incorporates multidisciplinary applications, including software applications for various dental disciplines. The SICAT Suite of applications integrates directly with Sidexis, Dentrix, and many other popular imaging options. Now, all SICAT Suite applications are available on a subscription basis with the new SICAT Smart program.

“We are really delighted to introduce SICAT Smart. This subscription-based approach allows dental practices of all sizes to economically access SICAT’s robust ecosystem of software applications. These patient-oriented, outcome-based solutions allow the clinician complete flexibility to scale and customize for the individual needs of their practices. SICAT continues to lead the industry by providing the dentist with a fully digital chairside approach that maximizes case acceptance and delivers precise clinical outcome,” Hennings adds.

Whether implant planning in SICAT Implant, diagnosing and planning root canals in SICAT Endo, visualizing the upper airways to treat obstructive sleep apnea and/or snoring in SICAT Air, or planning and treating TMD in SICAT Function, dentists are now able to start smart with their application of choice. Updates will be provided free of charge, and SICAT Smart users will gain exclusive access to the SICAT eCademy, a brand-new e-learning platform featuring video tutorials on the SICAT software.

Stef Vanneste, vice president & general manager, dental, 3D Systems:

“The digital dental segment is growing rapidly. Specialists in orthodontics, prosthodontics, and implantology are increasingly embedding digital workflows in their daily practice. This year we have seen increased interest [to invest in digital applications] not only from dental labs but also from clinics.

“For 2023 we intend to build on our training and educational programs. Keeping this focus is key to ensuring better patient outcomes. With new printers and new 3D printing materials on the horizon, we hope to enlarge the number of applications and further open up the field of digital dentistry.”

Stijn Hanssen, director of dental applications and business development, 3D Systems:

“More and more practitioners are embracing digital technology in their practices, allowing an expanded scope of procedures to benefit from digital workflows. 3D printing is well established within dental laboratories, and dental offices are beginning to embrace it as well. With small, more affordable 3D printers combined with improved materials, chairside printing for crowns and bridges is becoming more popular.

“2023 promises to be another exciting year for digital dentistry and 3D printing. While hardware improvements seem to focus mainly on platform size, the material developments will be key [for long-term restorations].”

Shotaro Matsubara, CEO, Tokuyama Dental

With the challenges facing the industry, the growing popularity of single shade composites, and the innovations that add value to dental practices, we at Tokuyama Dental are excited to expand our OMNICHROMA family by launching OMNICHROMA Flow BULK.

OMNICHROMA Flow BULK will be available as of February 1, 2023. It complements our OMNICHROMA portfolio, offering dentists the ability to bulk fill with the same outstanding shade-matching capabilities, and strong physical and mechanical properties to meet all their restorative needs. We help put innovation and cost savings at their fingertips.

Having the dentists’ best interests at heart, with our innovative Smart Chromatic Technology, we are providing them with simplified solutions that streamline their workflow and save them time and money.

OMNICHROMA Flow BULK is a1-shade bulk fill composite, capable of shade matching any tooth color from A1 to D4. It is a low-viscosity, light-cured material that can be placed in 3.5-mm increments. Utilizing Smart Chromatic Technology and uniformly sized supra-nano spherical fillers, OMNICHROMA Flow BULK esthetically matches very tooth color with a single shade. Its low polymerization shrinkage, compressive strength, high polishability, and cavity line adaptation make it suitable for anterior and posterior restorations.

OMNICHROMA Flow BULK gives clinicians more options in the OMNICHROMA composite system to address their restorative needs.

Customer centricity is never a destination; it is a journey. We strive daily to deliver against the needs and desires of our customers. Most importantly, this means listening more than we speak. Listening is crucial for us to deliver the relevant innovation and great service our customers need and want. The execution of this effort is reflected in our integrated solutions composed of smart systems, advanced training & education as well as value-added services for the benefit of providers, technicians and, ultimately, patients.

Patient awareness and corresponding expectations are reflected in their strong desire for healthy, beautiful smiles. This aligns with our belief: that good oral health and a beautiful smile are fundamental to maintaining a healthy lifestyle. Making people smile has always been our objective. Although we are known in the industry as the manufacturer of IPS e.max, we have a broad range of solutions that focus not only on esthetics but also efficiency. This includes, for example, our Ivotion denture system, which has been proven to provide gorgeous, natural esthetic results while eliminating significant chair time and post-insertion adjustments.

Innovative Education

Innovation and education go hand-in-glove. This past year, we participated in over 500 learning programs. Connecting with dental professionals at this level is very important. Equally important to raising the ceiling of what is clinically possible, we continually partner with those educators endeavoring to elevate the standard of care. Our educational approach is based on inspiring and challenging each attendee to be their very best while providing solutions to achieve efficient, esthetic, reliable results in a completely repeatable way.

The Past and the Present

The year 2023 marks our 100th anniversary in the dental industry, an uncommon and exceptional achievement all thanks to our loyal customers. We will be celebrating this milestone all year, and we invite all to visit us at trade shows, education events, or our website (Ivoclar.com) to learn more, participate in the fun, and meet our team.

While the future is impossible to predict, there are some trends we expect will continue to impact the point of oral care landscape. We expect the continue.e needs and expectations of these customer groups vary a bit from those of the traditional dental practice and laboratory business. As such, we have engineered tailored solutions for these customers and continue to build bespoke solutions as required.

Finally, and perhaps most importantly, the slow expansion of care has always been and remains a concern. We can all do more to aid in this effort. We believe that good oral health and a beautiful smile are fundamental to maintaining a healthy lifestyle, and should be something available for all.

Gene Peterson, CDT, and Gordon Craig, President & CEO, Sterngold Dental

“The introduction of Guided Surgery to the TRU® and PUR® Implant System is another one of our initiatives. This, along with our current digital offerings that include the game-changing BDS digital denture, intraoral scanner, among others, reinforces support to the increasing adoption of digital dentistry. We are right here, ready as always, where our customers need us,” Gene Peterson, CDT, Director of Technical Development and Learning

“During the pandemic, we brought forth several courses on implant dentistry, digital dentures, attachments, and new practices through live and on-demand online and live courses,” says Gordon Craig, president and CEO. “We are now evolving once more. We are moving above the current noise of free, online courses, and instead will pursue customer intimacy and relevance. Practices and dental labs can look forward to experiencing focused, live, exclusive educational programs onsite and hands-on.”

Carlos Ramos, DDS

After significant development in engine-driven NiTi files instrumentation, the next step in endodontics will undoubtedly be irrigation. Although the subject is not new, the current approach focuses on delivering irrigating solutions throughout the length of the root canal, including isthmuses and anfractuosities, without running the risk of extrusion, which can lead to postoperative pain or accidents.

Currently, mechanical preparation is mainly considered to facilitate the delivery of irrigants to the apical part of the main canal to allow them to clean and disinfect as much of the root canal system as possible. Therefore, a system that incorporates the already established principles of endodontic irrigation, which is to act throughout the entire working length, to interact with the dentin walls’ surface, and to be constantly renewed seems to be the Holy Grail of current endodontic research. Many equipment, systems, and techniques have already been developed or are under development, looking for a solution that meets all 3 principles.

Introducing the iVac™ Apical Negative Pressure Irrigation and Activation System

Pac-Dent has achieved this goal by introducing the iVac Apical Negative Pressure Irrigation and Activation System. The iVac can activate the irrigant ultrasonically to penetrate the canal ramifications effectively, with negative apical pressure to avoid apical extrusion of the irrigant and a flexible, resistant, high-performance polymer microcannula to easily transport the irrigant to the working length in curved root canals. It can be used with any piezoelectric ultrasonic unit. The design allows the continuous exchange of ultrasonically activated irrigants, with constant refreshment into the root canal system throughout the procedure.

3D Resin Printing Materials Hold Great Promise

Russell Giordano II, DMD, associate professor of restorative sciences & biomaterials, director of biomaterials, and assistant dean of biomaterials & biomaterials research, Boston University Henry M. Goldman School of Dental Medicine

There are several areas in “what’s new and cutting edge [when looking ahead to 2023],” including robotics, artificial intelligence, virtual reality, and, potentially most important, the printing of fixed and removable partial and full dentures. Of particular interest is printing ceramics such as zirconia and filled polymer-based restorations.

When the ADA recoded ceramics to include materials with a “predominantly” ceramic component, there was a flood of materials for printed permanent composite resin crowns. It is important to maximize filler content by volume to produce tough materials that will resist stress in the mouth that might lead to distortion, debonding, and sensitivity. It is relatively easy to achieve a high weight percentage because of the higher MW [molecular weight] of the filler as opposed to the resin, but even some materials on the market are only 30% filler by weight. There are a limited number of materials that meet the volume percentage, such as Rodin™ 3D Resin Printing Materials from Pac-Dent. It is also important to evaluate the printer–the same material may have different properties due to printing and curing procedures.

Dentsply Sirona Chief Technology Officer Cord Staehler, PhD

We are so passionate about innovation—we want to continue to find new and improved ways to make dentistry easier and more enjoyable for everyone involved.

Also, earlier this year [2022], we released Primeprint Solution, a highly automated, end-to-end medical-grade 3D printing system for dentists and dental technicians. We also wanted to ensure that these products had the best in connectivity solutions to assist in their impact. That’s why we developed the DS Core digital dentistry platform that integrates the whole workflow of digital dentistry across all of our devices, services, and technologies.

When technology makes things easier for dentists, they can take on things like implants and clear aligners more easily. For example, with our SureSmile® Aligners, you can allow for personalization in even the most challenging cases. Precise processing of the data and thorough quality control ensures outstanding fit and aligners that are so transparent they’re hard to detect. Technology allows global practices and global connections to feel closer and more natural.

Lisa Aguirre, dental marketing manager, Roland DGA

The dental industry as a whole has gradually been making the transition from manual to digital workflows over the last 15 years or so, with the integration of practice-management software, intraoral cameras, intraoral scanners, and now chairside milling technology. Typically, this integration and adaptation has been added 1 piece at a time. With inflation and operational costs at an all-time high, clinicians are utilizing chairside milling to assist in reducing overhead costs by reducing patient chair time and the number of visits, ultimately increasing a clinician’s production dollars per hour while providing patients with a better experience.

Open-architecture chairside milling solutions like Roland DGA’s DGSHAPE DWX-42W provide an affordable, reliable, and lab-quality chairside milling solution that allows you to not only utilize and integrate existing digital workflows, ie, existing intraoral scanners, etc, but also the ability to add and integrate other digital solutions as the practice grows and continually provide patients with the latest and greatest in materials.

Ultimately, I expect to see the digital workflow trend continue to grow and expand, allowing for more efficient, profitable dental business operations, optimal patient care, and more treatment options with open-architecture systems.

Joe Pelerin, DDS

Recently, the ADA published the results of its own membership survey, echoing what I see in my Michigan practice; 70% of dentists reported an uptick in the incidence of stress-related nighttime bruxism compared to pre-COVID-19 times.

Politics, economics, and social issues have made everyone so uptight that I’m seeing a huge increase in my practice…the chipped, worn teeth, sore jaws, and even headaches.

As people come “back” to the dental practices, my go-to product for the treatment of bruxism is the GrindRelief® Pro. This 2-piece thermoplastic device features a central power bar and comfortably mitigates clenching and grinding. Since it involves no impressions or scans, laboratory fee, models, or a second appointment, I can send my patient home with a custom-fitted device the very day I diagnose the bruxism. In most cases, my dental assistant or hygienist can do the fitting in just a few minutes. I am getting the same or better adherence and outcomes as with the more cumbersome and expensive full-mouth, horseshoe splints, or even the original NTI®.

GrindRelief is small enough to even fit children well, and only covers the adult anterior teeth, and I can fit it to the upper or lower arch. Even better, should the dentition change with time, it can simply be refitted in 5 minutes with warm water.

According to a 2020 clinical evaluation by Catapult Education, 90% of patients experienced relief within 7 days of adherence. In my practice, relief comes even sooner to most.

Manabu Suzuki, director of North America Advanced Materials, Kuraray Noritake

The Kuraray Noritake difference is that we use our own zirconia powder. It’s the perfect recipe for natural beauty and workflow efficiency, all in one block.

We worked with some of our top customers to better understand how we could improve the KATANA Zirconia workflow, took that information back to research and development, and the result is KATANA™ Zirconia ONE. It is imperative for us to partner with clinicians to ensure we are offering solutions that improve restorative workflows and clinical outcomes.

As dental technology has evolved, so has zirconia, thanks to Kuraray Noritake. The dental industry has seen a rise in zirconia as a result of its powerful combination of metal-like strength and esthetic appeal. Quite simply, zirconia crowns look like real teeth. The material can be easily color-matched with a level of translucency that resembles real enamel. And patients and clinicians no longer have to sacrifice strength for esthetics.

The new and improved block, KATANA™ Zirconia ONE, is a multilayered block consisting of 4 layers of zirconia in graduated shades. The block allows the chairside fabrication of natural-tooth-colored restorations, eliminating additional sintering time. It also offers chairside efficiency with superfast milling and 18-minute sintering time with [Dentsply Sirona’s] Primemill. KATANA Zirconia ONE has an excellent marginal fit, which is essential to achieve long-term success with restorations from both the mechanical and biological points of view. The flexural strength has improved to 933 MPa. The new block offers extended bur life and allows for better inventory management.