Vol 1 Issue 3

ISSN 2077-2793

Dental Technology
Journal

Southern African

Aesthetics Issue
Anterior dental aesthetics: Historical perspective How to interpret your financial statements The difference between the SADTC & DENTASA and their roles in CPD All-Ceramics Full-Coverage Restorations: Concepts and Guidelines for Material Selection Reducing the alloy thickness of base metal ceramic restoration

CPD

IN THIS ISSUE
Content

SPRING 2009 EDITION

MAG2009-Q2

EDITORIAL BOARD
Under review

Letters Page How to interpret your financial statements

Page1 Page 2-4

EDITOR
Naomi Olivier The Dental Technicians Association of South Africa

PUBLISHED BY

Anterior dental aesthetics: Historical perspective Page 5-10 I have a dream, hope for the future All-Ceramic full-coverage restorations: Concepts and guidelines for material selection Reducing the alloy thickness of base metal ceramic restorations Page 16

LAYOUT AND DESIGN

Marcel Schoombee

Artwork: Marcel Schoombee & Photograph: Rainer Burk Naomi Olivier: pro.dentasa@gmail.com Mobile: 071 332 1188

COVER PAGE

Page 17-23

ADVERTISING ENQUIRIES

Page 25-29

Naomi Olivier: pro.dentasa@gmail.com Marcel Schoombee: dentasa.it@gmail.com Elize Morris: dentasa@absamail.co.za

CLASSIFIEDS AND ADDRESS Meeting... Mr Kapache JF Victor, new registrar of the South African Dental Technicians Council CHANGES
The difference between the SADTC & DENTASA and their roles in CPD CPD Questions Questionnaire

Page 30-32 Page 32-34 Page 35-38 Page 39 Page 40-41

CPD INQUERIES
General:cpd@dentasa.org.za Accreditation applications: apply@dentasa.org.za Credit counts: dentasa.it@gmail.com

Future Courses

ACCOUNTS
Elize Morris: dentasa@absamail.co.za Tell: 012 460 1155 Fax: 021 460 9481 Marcel Schoombee: dentasa.it@gmail.com PO Box 1081, Garsfontein, 0042 Fax: 012 998 0675 PO Box 65340, Waterkloof, 0145 Tel: 012 460 1155. Fax: 012 460 9481 952 Arcadia Street c/o Hill Street Arcadia, 995 Pretoria 0001 Tel: (012) 342-4134/4230 Fax: (012) 342-4469

STATEMENT OF INTENT The CDP magazine for the profession of dental technology is published quarterly. The main objective of the magazine is to provide the professional with the opportunity to earn CDP credits through completing the questionnaire, or writing articles. All papers in English on any aspect of dental laboratory science or related disciplines will be considered on merit and subject to the review of the editorial board and the CPD accreditation committee. EDITORIAL, ADVERTISING AND COPYRIGHT POLICY Copyrights of individual articles appearing in this publication reside with the individual authors. No article appearing in this publication (to be named at a later stage) may be reproduced in any manner, or in any format without the express written permission of its author and a release from this publication. All rights are reserved. Opinions and statements, of whatever nature, are published under the authority of the submitting author and should not be taken as the official policy of the South African Dental Technicians Council or the Dental Technicians Association of South Africa.
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DENTASA

SADTC

to the second edition of the Continuous Professional Development Magazine for the profession of dental technology in South Africa. Throughout the magazine you will find articles with questionnaires that can be completed to earn CPD credits. You will notice that this edition offers a total of 8 CPD credits. Only three magazines instead of four will be published this year, thus we have decided to bump up the next two editions to allow you the opportunity to earn more CPD credits. It is said that the only constant in life is change. The change and energy surrounding the dental laboratory industry in South Africa lately, is refreshing. Love it or hate it, the CPD programme introduced into our industry earlier this year, has shaken up our profession and introduced more communication and activity than we have experienced in years. The DENTASA Annual General Meeting, held at the Indaba Hotel in Midrand, 5-6 June 2009, has been the biggest and best attended of its kind in the history of the industry in our country. More than five hundred technicians/technologists attended the AGM over two days, with most of the traders exhibiting in the trade exhibition. Old friendships have been rekindled, new products and techniques introduced, and of course, a large number of CPD credits were earned.Overall, it has been an excellent event, surrounded by positive energy. With the beginning of spring, the SADTC also started a new chapter with the appointment of Mr Kapache Victor as the new Registrar. I had the pleasure of meeting with Mr. Victor (please see page 30 of this issue) and look forward to a long and successful working relationship with him. We welcome Mr. Victor into the profession of dental technology and wish him the best of luck with his task as Registrar. September is World Oral Health Month and the FDI World Dental Federation has announced September 12 as World Oral Health Care Day. As dental professionals we sometimes get so involved in the detail ofour profession that we forget what our work means to the general public. Oral Health Care Day is there to inform the general public, but also to remind us as dental professionals of the part we play in the Oral Health chain. In the words of Dr Burton Conrod, FDI President: A healthy smile and the ability to speak and eat without pain or discomfort are critical to general health and well being. The time for change in our profession has arrived. Let us celebrate the achievements of the past, but at the same time commit to continuously developing our skills, embracing new technology and thus ensuring a better future for all. Naomi and the team.
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Welcome

E D I T o R ' S P A G E

LE T TERs P AG E
LETTER TO THE EDITOR
Dear Editor The value of a Peer Group to nurture Continuous Learning. The Western Cape Dental Technology Peer Group was inspired by the concept of The Fossils Study Group, a dental technology Peer Group that has been established for a number of years. It has helped participants to learn from each other in a non-threatening environment where all are encouraged to participate in problem solving and brainstorming techniques. Peer Learning does more than teach - it transforms. It encourages a professional mind-set and a capacity of trust. Open exchange of information allows Peer Group members to become cost-efficient, quality-oriented and profitable technicians. Peer Groups has the potential to change the attitude of individuals in our profession. Dental Technicians have to take responsibility for our own conduct and for setting examples of professionalism. Each of us is an authority in our own right and an expert in what we do. There is a wealth of knowledge and experience within a wider group. With a positive attitude and commitment we can all add and draw from that mutual pool. Peer Groups bring together similar-minded members to find unique solutions to common barriers. Each member is equally important to the Group, each with unique legitimate value. Nobody has a monopoly on good ideas. Members take joint ownership for contributing to the knowledge base of the Group and rotate doing presentations. Presentation Topics could cover, but may not be restricted to: * Any discipline or aspect of dental technology. * A new technique, material or innovative technology. * Solving a common problem. * An interesting case, presenting an exceptional challenge. * Combination of any of the above, etc The agenda is designed around the needs identified within the group and towards meeting the concerns and issues that we face in a fast-paced, increasingly complex profession. We exchange best practices, and speak openly about any and all professional or personal issues relating to work. We have a great, cohesive group and enjoy each others company. We bookmark dates and meet quarterly, but are considering to meet monthly next year. You can get something from a Peer Group that you cant get anywhere else. Why reinvent the wheel, when one of your friends already resolved a similar challenge? The Peer Group is a key tool in our continuous improvement process and we would not give it up for anything. The interactive Peer Group concept got us off to the right start. The rewards gained from this are priceless. One of our members has reflected with enthusiasm on the camaraderie and selfless friendships he had experienced through Peer Groups, while working in other countries. Some had to make huge sacrifices to attend such meetings. He was amazed at the willingness by most, to share their experience and expertise and the culture of trust that was cultivated. Ultimately it is all about striving for excellence in serving the needs of the end consumer. There is no sustainable reason why the average dental technician could not be equally innovative and follow the example of our Gauteng and Western Cape colleagues! I would like to challenge all, to encourage a more positive professional attitude within the profession, by starting or joining a study group. What can Peer Groups do for dental technology? * Networking with like-minded associates, who are willing to share their expertise and learn from each other. * Get to know your colleagues personally and encourage camaraderie and goodwill within the profession. * Identify and prioritise your own training- and continuous education needs. * Improving leadership, management and mentoring skills. * Expand your abilities by learning how to present your work to other stakeholders in a professional evidence-based manner, using computerized presentation technology. * Learn how to record any aspect of your work using digital photography. * Develop your skills to become a potential CPD presenter. * Learn & stay ahead in a rapidly changing business environment. * Become part of the solution instead of stagnating within the problem, and earn CPD credits in recognition. Duffy Malherbe (duffym@telkomsa.net)

CONVENER - WC Dental Technology Peer Group Eds reply: Duffy, thank you for bringing the matter of peer groups to the forefront. I know that The fossils Study Group and the Western Cape Dental Technology Peer Groups had their origin prior to the introduction of the Continuous Professional Development programme, and have been a source of knowledge and fellowship to those who attended for a long time. On top of all the benefits you have rightly stated, attending peer group meetings also offers the opportunity to earn CPD credits. There are a lot of technicians/technologists who live outside major centres where CPD courses or Association meetings are regularly held. Such people will greatly benefit by starting, and attending peer groups. Areas such as Limpopo, Mpumalanga, the Northern Cape, George and East London, have voiced a need in terms of CPD activities.
We will be looking at peer groups in Under the Spotlight, in our next edition, and will discuss matters such as, setting up a peer group, guidelines for meetings, facilitation, recommended activities and peer group approval and documentation. Should anyone be interested in starting a peer group, please do not hesitate to ask for assistance from the existing peer groups, or from DENTASA. We will gladly give guidance and help facilitate, if at all possible.

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CPD

2
These articles were kindly provided by the director of Kruger and Company, Stefan Steyn and Succeed Magazine. www.succeed.com Permission of copyright has been obtained

How to interpret your financial

Statements
Part 1: Income statements
I would like to stress the importance for entrepreneurs to be able to interpret their own financials, you may not know this but the way in which you interpret your own financials to a bank manager or possible investor carries a lot of weight to secure an overdraft or to raise money. So, financials are not just pieces of paper that your accountant draws up for the receiver and charges you a lot of money for. Starting with the income statement, we will break it up into two parts income and expenditure. The best way to learn accounting is by using an example. I will use a restaurant as an example. Due to its complexity it showcases most principles of running a small business. After Peter Rogers Diner had been open for one month it had an income of R300 000. This is the amount of money it got for selling meals (output). However R270 000 went on expenditure, or input, to make this amount of money.

Stefan Steyn

inancial statements are the thermometer of a business, indicating its health as a money generating entity. I have been asked many times what the most important part of the financial statements is and the answer is normally most of it. In this series of articles we are going to take a simplistic view of financial statements to enable readers to be able to diagnose their business using the thermometer (financial statements). This series will concentrate on the three statements found in the financial statements that are produced by your accountants on an annual basis, firstly the income statement (Parts 1, 2 and 3), balance sheet (Parts 4, 5 and 6) and cash flow statement (Parts 7 and 8). It is important to follow the articles as the relationship between these statements will become clearer as we reach the end.

This is what the financial would look like: Income Statement for Peter Roger Diner Income R 300 000 100% Expenditure R 270 000 90% Surplus R 30 000 10%
In this example Peter Rogers made a 10% return on his inputs. Comparing these figures with similar restaurants in the area would show if this is good or bad. Comparing yourself to other businesses in the industry is called benchmarking and is very important in operating a successful business.

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Interpreting financial

Statements
Part 2: Income statements
he most important phrase to remember in this issue is, you can only manage what you can control and you can only control what you measure. This is the essence of the income statement. I hope you have all kept your notes from the previous issue pertaining to the introduction of interpreting financial statements, in this issue we will discuss the income statement in a bit more depth. It is important to note that an income statement must be prepared monthly. It is called the monthly Profit and Loss Statement. If you have 12 of these statements you can prepare the annual income statement. It is important that the income statement reflects your business model. A business model is the mechanics of how you make money, your income statement must be able to show this. This can be illustrated by using a restaurant. Just to recap we have the following items in our entity called Peter Roger Diner.

These articles were provided by the director of Kruger and Company, Stefan Steyn and Succeed Magazine. www.succeed.com

Now lets fill in our income statement so far. Sales R 300 000-00 Less: cost of sales (food cost) R 120 000-00 Gross profit (GP) R 180 000-00
GP percentage is this amount divided by the sales figure, therefore in this case it is R180 000/R300 000 = .60 x 100 to get to a percentage of 60%. This percentage is very important as it needs to be firstly compared to previous months that you have record of and then to other restaurants. This indicates whether the expected markup that you envisaged for your product has filtered through to the results. It is very important to know that if you cannot control your GP% then get out of business as soon as possible. The indirect or overhead costs for purposes of understanding the business model of a restaurant are administration, marketing, property and labour costs. All restaurant expenses can be placed into one of these categories. Now lets see what the income statement looks like. Remember that dividing every line item by the turnover will give you a very good measurement tool to compare month to month and restaurant to restaurant.

Income statement for Peter Roger Diner Sales Costs Surplus R 300 000-00 100% R 270 000-00 90% R 30 000-00 10%

We will break up the costs into two more sections: namely variable/direct and non-variable/indirect expenses. The overheads are described as non-variable/indirect expenses. Since this is a restaurant we can deduce that our direct expenses would be the cost of the food sold. This cost can de depicted in the following manner:

Sales Cost of sales

R 300 000-00 100% R 120 000-00 40%

Opening stock R 30 000-00 Purchases R 100 000-00 Closing stock R 10 000-00 Gross profit R 180 000-00 Less: Indirect expenses (overheads) R 150 000-00 Administration R 10 000-00 Marketing R 20-000-00 Property R 40 000-00 Labour R 80 000-00 Net profit R 30 000-00 60% 50% 3% 7% 13% 27% 10%

Food cost: Opening stock food Add: purchases Less: closing stock food Food cost is therefore

R 30 000-00 R 100 000-00 R 10 000-00 R 120 000-00

The opening stock is the amount of unsold food that has been carried over from the previous month to this month, that you could still prepare and sell, this could be meat. The closing stock is the stock available to sell in the next month.

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Interpreting financial

Statements
Part 3: Income statements
Sales R 300 000-00 Cost of Sales R 120 000-00 Opening Stock R 30 000-00 Purchases R 100 000-00 Closing Stock R 10 000-00 Gross Profit R180 000-00 Less: Indirect Expenses (Overheads) R150 000-00 Administration R 10 000-00 Marketing R 20 000-00 Property R 40 000-00 Labour R 80 000-00 Net Profit before owners expenses R 30 000-00 Owners salary and semi private expenses R 25 0000-00 Net Profit after owners expenses R 5000-00 *Tax provision R 1400-00 Net Profit after tax @ 28% R 3 600-00
*Assumption that the business is a close corporation.

his is our last look at the income statement and I hope that you have been following the progress. Lets first see what our income statement looks like thus far.

I would like to take a look at two issues, firstly the owners expenses and secondly the following months results. In many small businesses the entrepreneur has employed himself and does not exclude his salary or his semi business expenses from the business model, remember the income statement describes whether the model works or not. Semi business expenses are expenses where the owner also gets an advantage from, for example his personal cellphone that the business pays, he may have some business calls but not all would be for business. The question of whether an expense should be included in the income statement or not would be, if you employed someone to take up your role, would this be an acceptable expense? It is important to see what you are costing the business as you may be a large overhead burden to the company. In the income statement we have been looking at the Net Profit before owner expenses if we say that R30 000 is left for the owner he would have to look at his personal circumstances to determine whether this is good enough, whether he may be able to get a salary that would exceed this somewhere else with much less risk. If you have the ability to generate R300 000 from your skills of owning a business then 10% is too little,15% to 20% would be more acceptable. The final look at the income statement before moving to the balance sheet is as follows. The month following the month under review is more important than the results of the current month. We will only look at the operation portion of income statement. It can be seen from the comparison on the right, that the increase in turnover of R100 000 only had a R10 000 contribution to profit. It would be very beneficial to look at the differences, especially the indirect expenses as to why they have increased, items such as marketing would be understandable, as the turnover had to increase. When investigating the income statement one has to look at the amount of the change. For example, Property increased by R5 000 and also the percentage to turnover which defines the business model, both approaches should be done monthly.

100% 40%

60% 50% 4% 6% 13% 27%

10% 8% 2% 1%

Month 1 Month 2 Sales R300 000-00 100% R400 000-00 100% Cost of Sales R120 000-00 40% R180 000-00 45% Opening Stock R 30 000-00 R 10 000-00 Purchases R100 000-00 R 210 000-00 Closing Stock R 10 000-00 R 40 000-00 Gross Profit R 180 000-00 60% R220 000-00 55% Less: Indirect Expenses (Overheads) R 150 000-00 50% R180 000-00 45% Administration R 10 000-00 4% R 15 000-00 4% Marketing R 20 000-00 6% R 30 000-00 8% Property R 40 000-00 13% R 45 000-00 11% Labour R 80 000-00 27% R 90 000-00 23% Net Profit before owners expenses R 30 000-00 10% R 40 000-00 10%
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CPD

Anterior dental aesthetics: Historical perspective

I. Ahmad Reprinted by permission from Macillan Publishers LTD. British Dental Journal 198, 737-742, copyright (25 June 2005)
Aesthetics is neither an art nor a science, but a fusion of the two. Ancient Greeks postulated basic concepts in an endeavour to quantify beauty, including the Divine Proportion, symmetry, unity and harmony. The Gestalt Principle is a psychological theory, which can be used for unifying aesthetics in a logical manner.

In Brief

The purpose of this series is to convey the principles governing our aesthetic senses. Usually meaning visual perception, aesthetics is not merely limited to the ocular apparatus. The concept of aesthetics encompasses both the time arts such as music, theatre, literature and film, as well as space arts such as paintings, sculpture and architecture.

1. Hegel G W F. Philosophy of History. New York: Collier, 1905. 2. Lombardi R. Visual perception and denture esthetics. J Prosthet Dent, 1973; 29: 352382. 3. Plato. Republic. c 400 BC 4. Ehrenzweig A. The Hidden Order of Art. Berkley: University of California Press, 1971 5. Ahmad I. Digital and Conventional Photography: A Practical Clinical Manual. Chicago: Quintessence Publishing, 2004 (in print). 6. Stroebel L, Todd H, Zakia R. Visual Concepts for Photographers. New York: Focal Press, 1980.

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INTRODUCTION The
first point of contention regarding aesthetics is its definition. Is it an art or a science? Science has long propagated allusions to objective critical analysis, which are now unfounded and vehemently refuted. In reality, any scientific investigation is tainted by individual, philosophical and cultural biases. Art, on the other hand, has been always been portrayed as subjective, romantic and empathetic. Whilst fundamental aesthetic principles are based on Greek and Roman mathematics, nevertheless, artists conceived aesthetics for creating pleasing paintings that touched our

COLOUR, FORM AND LINES

The link between colour and form can be traced to the Greek and Egyptian empires. In fact, much of Renaissance and Medieval thinking has been plagiarised from the ancient Greek era. For a detailed analysis of the relationship between form and colour, the writings of the colour theorist Johannes Itten (18881967) are invaluable. For the purpose of dentistry, a few essential principles require consideration. Firstly, in any composition, colour is the predominant force, taking precedence over form, angles and lines. The difficulty assessing the value (brightness component) for a shade prescription is because the eyes are distracted by the colour (hue and chroma components) of the tooth.

Fig. 1 Facial perspective

Fig. 3 Dental perspective

Fig. 2 Dento-facial perspective

Fig. 4 Gingival perspective

inner souls. One can undoubtedly decipher the dichotomy of aesthetics, attracting endless debate by both scientific and artistic communities. Put succinctly, science asks how?, while art asks why? It is difficult segregating dental aesthetics into distinct units, since all variables are interdependent and interrelated. However, for the sake of discussion, this series compartmentalises dental aesthetics into compositions or perspectives, according to the viewing distance. Starting with the facial perspective, and zooming closer to the dento-facial, dental and gingival (Figs 1 to 4). Finally, the last part, on the psychological perspective, proposes a psychological link between cerebral perception and the dentition. Before embarking on individual dental perspectives, it is necessary to define fundamental guidelines, which contribute to aesthetic appraisal.

Secondly, any form can be created from the three basic shapes of a circle, triangle and square. These geometric shapes were, and are, associated with religious, mystical and esoteric connotations. For example, in ancient times, the triangle stood for impending danger, a symbol that is used today for warning signs on roads. The circle represented celestial spirituality, inferring tranquillity and egalitarianism, while a square denoted sturdiness, after the solid base of the Egyptian pyramids. The maxillary anterior teeth are a fusion of these basic shapes, a topic that is discussed further in the Dental perspective article (Figs 5 to 7). A line can be perceived, without actually been drawn. The oral cavity has ample examples of these phenomena. Consider the incisal edges of the maxillary teeth, often referred to as the incisal plane. It is the curvaceous arrangement of the teeth that implies a plane, even though none is actually present. Further

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Fig. 5 Basic shape: Triangle

solution for what was perceived as beautiful or ugly. The answer proposed by the Pythagoreans was the Golden Number, represented by the Greek symbol, [(5-1) 2]. The reciprocal of is 0.618 and has been termed the Golden or Divine Proportion. Objects, animate or inanimate, whose features or details conform to this ratio, are perceived as having innate beauty. It is important to distinguish innate or absolute beauty from subjective beauty. Absolute beauty implies that if two objects, one conforming to the Golden Proportion and the other not in this ratio, are presented to a group of individuals, 99% will affirm that the object with the

Fig. 6 Basic shape: Circle

Fig. 8 Imaginary anterio-posterior line of the incisal edges/cusps tips representing the curve of Spee

Fig. 7 Basic shape: Square

Fig. 9 Roman statues based on the Golden Proportion.

examples are the curves of Wilson and Spee (Fig. 8). The direction of lines can also create optical illusions. Prominent vertical lines on the facial surface of an anterior tooth will infer a longer tooth, while distinct horizontal lines have the opposite effect, (wide and short tooth length). DIVINE PROPORTION Proportion in a composition is analogous to harmonies in music. When proportions of even harmonies on a musical scale are adjusted equally on both sides, the result is a rhythmic and harmonious auditory perception. Similarly, repeated or recurring ratios in the visual arena are viewed as artistic and aesthetically pleasing, e.g. the repeated width ratios of the maxillary anterior teeth. Ancient Greeks were preoccupied with seeking methods by which beauty could be quantified and predictably reproduced by artisans and artists. Their goal was to discover arithmetic simplicity, which could signify beauty and harmony. This led Pythagoras in 530 BC, accompanied by his followers, to seek refuge in Croton in southern Italy. The objective of this clandestine gathering was to discover a mathematical

Golden Proportion is beautiful. The second type is subjective beauty, which is a psychological concept, colloquially referred to as beauty in the eyes of the beholder. The affirmation that the Golden Proportion signifies beauty has been exemplified by its ubiquitous prevalence in both the plant and animal kingdoms, e.g. the logarithmic spiral. The beauty of flowers, or attractiveness of faces, has been attributed to features, which conform to a ratio of 0.618. Architects and sculptors in antiquity exploited the Golden Proportion for creating buildings, e.g. the Parthenon in Athens, and statues having eternal appeal (Fig. 9). Numerous artists have also slavishly used the Golden Proportion to create masterpieces. For example, Piero della Francescas The Baptism of Christ and The Flagellation and illustrations by Leonardo da Vinci for Luca Paciolis Divina Proportione, all demonstrate rigid adherence to this ratio. The Golden or Divine Proportion is true for emulating Olympian beauty, but in nature, such beauty is neither prevalent, nor desirable. If all animals and plants displayed such exactness, we would be surrounded by clones. However, even if a plant or animal does not display features conforming to such

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UNITY AND HARMONY In addition to divine proportion and dynamic symmetry, unity in a composition is achieved by incorporating balancing forces as well as a dominant key element. It is important to realise that teeth are arranged with tectonic spacing. Tectonic refers to an arrangement that is both functional and aesthetic. For example, the maxillary anterior teeth are arranged with specific proportions and repeating ratios not only for aesthetic appeal, but also for proper function during
Fig. 10 Static symmetry represented by identical reflections of teeth in this contrived arrangement

dogmatic dimensions, its beauty is not compromised. What is the reason for this apparent disparity? To create diversity and individuality, repeated or recurring proportions are more significant than a specific ratio. Consequently, the ratio for beauty of 0.618 signifies an ideal. Nevertheless, other ratios, e.g. 0.577 or 0.8 are also perceived as aesthetic, with the proviso that there is repetition, or recurrence in a given composition. SYMMETRY Symmetry is defined as static or dynamic. Static symmetry is evidenced by repetition in inanimate objects such as crystals or contrived arrangements (Fig. 10). Dynamic (radiating) symmetry refers to repeated proportions in animate, living or vital beings, such as flowers (Fig. 11). This monumental discovery was attributed to the American architect Jay Hambidge, and concurrently by the English scientist Sir DArcy Thompson in the 1920s. The art deco movement of the 1930s, epitomised by the Chrysler building in New York, is a classic example where dynamic symmetry has been extensively used. The significance of dynamic symmetry provided the missing link between nature, buildings, crafts, and works of art dating back to ancient Greece. Analysis of Greek architecture and craftwork confirm identical repeated ratios and proportions found in the natural world. This was affirmation that geometry alone was inadequate for explaining natural and artistic beauty, and aesthetic
Fig. 12 Anterior view of teeth in centric occlusion

Fig. 13 With an anterior protrusion of the mandible the shorter maxillary lateral incisors avoid interferences with the mandibular canines.

protrusion of the mandible, the upper laterals are shorter, thereby avoiding interference with the mandibular canines (Figs 12 and 13). There are two types of visual forces requiring consideration. The first are cohesive forces, which provide unity and harmony, e.g. two parallel objects (Fig. 14)

Fig. 11 Dynamic symmetry of a sunflower

elucidation was only apparent when combined with the principles of dynamic symmetry.

Fig. 14 Parallel arrangement of identical tooth sections, emphasising cohesive or unifying forces of the composition. Balance is also evident by the opposing incisal edges arrangement, creating equilibrium and visual stability

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or an encircling frame (lips bordering the anterior teeth). The opposite are segregative forces, which convey tension and

Fig. 15 (top) Perpendicular arrangement of teeth, emphasising segregative forces in a composition

is related to single units, e.g. wide and prominent maxillary central incisors. Segmental dominance, usually preferred by patients, is dominance of a group of objects, e.g.prominence of the maxillary anterior sextant, often portrayed by the fashion & cosmetic industries and haute couture magazines. An item, whose position is central to the optical axis, is perceived as the centre of attention, and hence dominates a composition. Colour is another method exploited for creating dominance, especially complementary colours of an object and its background, e.g. blue object with a yellow background (Fig. 17). THE GESTALT PRINCIPLE This theory combines the above principles of aesthetics in a coherent and logical manner. Dr Max Wertheimer initiated the Gestalt theory of psychology in Germany around 1912, and put succinctly, its definition is the whole is different from the sum of its parts. For example, the teeth, made of organic and inorganic matter, have a profound impact on an individuals personality and well-being, which is significantly remote from the substance from which they are constructed. In concurrence with the Pragnanz law, the Gestalt theory implies that the mind organises the outside world so that it can come to terms with it. This involves creating meaning, stability, balance and security. These concepts allow the observer to achieve a better object-background (figureground) relationship by encapsulating the following four constituents: Proximity Similarity Continuity Closure. Incorporating the above entities in a composition results in stability and harmony. Also, applying the above four constituents for an aesthetic makeover creates a good Gestalt, enhancing psychological appraisal. The four constituents of a good Gestalt are discussed below. Proximity facilitates association, linking, grouping, learning, and therefore adds interest. Segregation, on the other hand, implies disassociation, complexity, isolation, un-grouping and leads to frustration, rejection or boredom. A dental example is teeth arranged adjacent to each other, without diastemae, avoids detachment and aloofness. However, a degree of segregation is essential for mitigating repetitiveness. Similarity ensures objects have similar form, colour, position and line angles, e.g. teeth with similar shade, form and arch alignment. Continuity ensures progression, e.g. recurring or repeated ratios from the maxillary incisors to the canines. Closure assures cohesiveness, such as a frame or border, e.g. lips surrounding the teeth (Fig. 18). Closure is particularly important for our satisfaction (visual and otherwise) and learning process. If conclusions are vague, ambiguous or open-ended, the Zeigarnick effect is prevalent. The latter is when a task or sequence is incomplete, the short-term memory recall is superior, but the

interest, e.g. objects that bisect each other in a perpendicular arrangement (Fig. 15). Segregative forced are essential for avoiding monotony and adding curiosity andvariety to a composition. Balance ensures equilibrium and stability. This is similar to a weighing scale, with both sides having equal weight distribution. In a pictorial form, the forces should be balanced for conveying stability and equilibrium

Fig. 16 (bottom) The coloured effusions on either side of the tooth are located at the top right and bottom left opposing corners, creating balance and equilibrium

Fig. 17 Colour dominance the blue tooth is of a complementary colour to the yellow background

(Fig. 16). Finally, the protagonist or salient point of a picture should be dominant. This is achieved by size, position or colour. A larger object, compared to surrounding elements, conveys prominence. In dentistry, two types of dominance are evident: individual or segmental. Individual dominance

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message is lost after about twenty-four hours. The result is that the mind is left in a state of confusion, detachment, and if unable to resolve these conflicts [by conjuring the missing sequence or stages]; it forgets them to avoid mental tension and frustration. Closure is highly dependant on the id, if an individual is confident, assertive and selfassured (greater coping abilities), they are likely either to dismiss or come to terms with an incomplete event. Conversely, an

anxious, timid and ambivalent personality (low coping abilities), is unlikely to resolve the predicament, resulting in consternation. To complicate matters further, an individuals coping ability varies at a given time or place. Nevertheless, closure, as a psychological concept, is extremely important for mental stability by ensuring equilibrium between our conscious and unconscious states of mind. A dental analogy is teeth of different shades, irregular form and erratic positions causing disharmony and visual dissatisfaction, and therefore preventing closure. CONCLUSION This article has highlighted some aesthetic principles relevant to clinical practice. In the rest of the series, these principles will be used for achieving a pleasing outcome for aesthetic dental treatment. The next part, Facial Perspective discuses ideal facial features as well as analsing other factors relevant to this perspective.

Fig. 18 A good Gestalt: Proximity of teeth Similarity of tooth colour and form Continuity of size and proportions Closure by a frame

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GENER
Association President Tel: 012 347 7409 Fax: 012 347 7409 E-mail: axel.dentasa@gmail.com

Axel Grabowski

Executive Committee Contact Detials

Council Matters Tel: 087 720 6296 Fax: 086 5030 640 E-mail: duradent@netactive.co.za

Dave Owen

Vice President & AGM Portfolio Tel: 012 998 2988 Fax: 012 998 0675 E-mail: mariaan@dentiworks.biz

Mariaan Roets

Employee Matters Tel: 031 309 1282/84 Fax: 031 309 1286 E-mail: acelab@worldonline.cp.za Marketing Portfolio & Education E-mail:scroobydoo@absamail.co.za

Prasni Rattan

Anso Scrooby

Chairman WC Tel: 021 851 2858 Fax: 021 531 0212 E-mail: davidve@mweb.co.za

David Van Eyk

Chairman Eastern Cape Tel: 041 360 7590 Fax: 041 360 7590 E-mail: baydental@progen.co.za

Donovan Pickard

Student Portfolio Tel: 012 382 5115 Fax: 012 382 5099 E-mail: boshoffar@tut.ac.za

Dries Boshoff

Student Representative Cell: 083 279 7583

Andr Ferreira jr.

Chairman Free State Tel: 051 522 0601 Fax: 051 522 2765 E-mail: l.steenkamp@hotmail.com

Lukie Steenkamp

Chief Financial Officer Tel: 011 789 6383 Fax: 011 326 3845 E-mail: bdental@cybertrade.co.za DENTASA Office: Secretary Tel: 012 460 1155 Fax: 012 460 9481 E-mail: dentasa@absamail.co.za

Peter Kapp

Chairman Kwazulu Natal Tel: 031 309 1282/84 Fax: 031 309 1286 E-mail: acelab@worldonline.co.za

Harry George

Elize Morris

Chairman Gauteng North & Council Matters Tel: 012 333 2184 Fax: 012 333 2294 E-mail: ptadent@lantic.net

Andr Ferreira

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I have a dream that one day soon, local dental technicians that so desire, will be granted the option to specialize and get further training to become direct denture providers, to fulfill their calling

By Duffy Malherbe

I HAVE A DREAM - HOPE FOR THE FUTURE

I have a dream that one day on the Cape Flats in the Western Cape; all dentists will cease to extract healthy anterior teeth for cultural demands, well-aware that dentists themselves have the monopoly to supply dentures to those teenagers for life. This monopoly and unrealistic profit should be challenged in the market by healthy competition from denture experts, globally called denturists. I have a dream that one-day there will be no more demand for the unsavory services of unregulated Quacks, because their essential service will have been replaced by the affordable services of a professional category properly educated and regulated for the specific purpose. All health care providers should be accountable to scrutiny. I have a dream that dentists will one-day stop sending their failed attempts at providing dentures to the dental laboratory to sort out - without charge. I have a dream that one day all oral health clinicians will be granted access to appropriate training to become efficient gatekeepers of oral health. Denturists routinely recognize oral pathology and conditions for referral to the appropriate specialists. I have a dream that one day soon, local dental technicians that so desire, will be granted the option to specialize and get further training to become direct denture providers, to fulfill their calling. That principle of career development is exactly the same philosophy as the laddered approach to education and training applied to other members of the Oral Health Team. The spirit of the Older Persons Act is underpinned by the sense of compassion that denturists in other parts of the world consistently demonstrates by providing rehabilitation services to the elderly and other edentulous people in need of having their dignity restored by dentures! In many countries of the world, denturists are the only denture service available in rural areas, due to their flexibility and mobility. This is especially also the case for institutionalized or hospitalized geriatric patients. I have a dream that one day soon, all denture wearers in South Africa will have the luxury of the freedom of choice, that includes the option of a specialized denture expert that provides a personal service of consultation, clinical procedures and the making of the denture itself without the frustrations of working through a go-between. There can be no argument about the superior efficiency of denturists. There is good reason for the gradual globalization of Denturism. The latest additions to the 40 international pieces of legislation that provides for direct practice of clinical dental technicians was the UK in 2005 and Ireland (Eire) in 2008. The success of the examples of our overseas colleagues continues to inspire us to reach our full potential and serve the needs of our people.
Duffy Malherbe is the Secretary of The Society for Clinical Dental Technology, affiliated to the IFD. For more information visit www.denturism.co.za

D uring his historical speech at the Lincoln Memorial in Washington in 1963, Martin Luther King, Jr. laid down the

foundations of an irreversible civil movement, which deeply changed not only the American society but also greatly influenced and changed relations between all of mankind. More than anything else, it also greatly influenced the principles upon which our own new political dispensation and young democracy in South Africa was formulated. Our future vision represents hope and justice, it is a symbol of improving things and progressing forward; you have to believe in your dreams and sometimes they will become your life goals. The global recession is taking its toll and causes havoc amongst the poor and the elderly. More than ever we need a health care plan that will provide accessible, affordable services for all, and reduce health care costs for families. Many in search of equitable, basic, health services will do well to consider the introduction of denturists to meet the needs of our edentulous population. The time is long overdue to revisit the definition of a Clinical Dental Technologist in the Dental Technicians Amendment Act of 1997 and its implementation. I have a dream that edentulism will one day be acknowledged as a dental disability and the rehabilitation of denture wearers be recognized as a Basic Human Right. One doesnt need special skills to diagnose that the elderly who has lost all their teeth (dentally disabled) needs dentures to rehabilitate the disabling effects to their speech, mastication and oral health function. The toothless elderly needs basic prosthetic services. This intervention will have a major revitalizing effect on almost all aspects of their standard of life, nutritional health, oral health and general health. The Society for CDT aspires to embark on a Humanitarian Outreach Program to provide free dentures to impoverished communities. Practicing denturists from Canada and Australia have indicated an interest to come to South Africa on their own expense to come and serve this cause. The majority of denture wearers are amongst the poor and the elderly and it would therefore be well deserved for any Government to give serious thought to the granting of social grants or some form of subsidy for basic prosthetic care. I have a dream of a united Oral Health Team, regulated under one Registration Authority, where all members are mutually recognized and respected as irreplaceable experts with intrinsic value. I have a dream of the day when the Dental Association will cease to be perceived of manipulating and polarizing relations with other members of the Team to further their own vested interests. The business of dentistry and conduct of all OH professionals should refocus on patient-centered dentistry.

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Restorations: Concepts and Guidelines for Material Selection

Ariel J. Raigrodski, DMD,MS Reprinted with permission courtesy of Montage media Corporation 2005. Raigrodski A. Concepts of material selection for all-ceramic full caverage restorations. Practical Procedures & Aesthetic Dentistry 2005;17(4): 249-256.
High-strength, all-ceramic system for full-coverage restorations use All-ceramic core materials for the fabrication and processing of infrastructure (eg, crown copings, fixed partial denture frameworks) that are then veneered with porcelain. Not all of these all-ceramic core materials are alike, and as such, they present with different properties that may affect their indications and limitations, the laboratory procedures used for their processing, and their clinical handling. This article reviews their clinically relevant properties and discusses the effect of these characteristics on their indications and recommended clinical procedures. Learning Objectives: This article provides an overview of the clinically relevant properties of high-strength, all-ceramic systems used for aesthetic restorative dentistry. Upon reading this article, the reader should: Be able to differentiate among the principle all-ceramic material systems. Understand the Clinical indications for contemporary, high-strength ceramics. Key Words: All-ceramics, aesthetics, core, fracture toughness.

2 All-Ceramics Full-Coverage

CPD

Ariel J. Raigrodski, DMD, MS, University of Washington School of Dentistry, Department of Restorative Dentistry, D780 Health Sciences Center, 1959 NE Pacific Street Box 357456, Seattle WA 98195 Tel: (206) 543-5923 - E-mail: araigrod@u.washington.edu
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Introduction
High-strength all-ceramic systems for full-coverage restorations such as crowns and fixed partial dentures (FPDs) are available for clinicians for use. These systems use various core materials for the fabrication of full-coverage tooth- and implant-supported crowns as well as tooth- and implantsupported FPDs. The various core-materials used present with different mechanical and optical properties. In addition, different systems use different technologies such as heat pressing, slip-casting, and computer assisted design computer assisted machining (CAD/CAM) technology for the fabrication of core materials. With the advent of CAD/CAM technology, various fabrication techniques have been developed for enhancing consistent and predictable restorations in terms of strength, marginal fit, and aesthetics, and for processing high-strength all-ceramic core-materials that could not otherwise be processed. The continuous evolution in adhesives systems and composite-resin cements also plays a major role in the ability of clinicians to deliver predictably high-strength all-ceramic restorations with considerably adequate longevity.

Polycrystalline ceramics have no glassy components and all atoms are densely packed. They cannot be processed to shapes without the use of computer assisted machining.1
3.

Fig. 1. Facial view of a failing metal-ceramic fixed partial denture. Note the ridge-lap type pontic and the visible metal margins.

Fig 2. An occlusal view of the abutment teeth after removal of the failing restoration. Note the severe decay and the Seibert Class II defect.

As a general rule, the higher the glass content the better the optical properties of the material. However, the mechanical properties may be diminished. Some of these core materials can be etched with 9.5% hydrofluoric acid and than silaneted to create a favorable substrate for the bonding ceramic core-material more predictably to the tooth structure. These materials relay on successful adhesive cementation procedures for increasing the strength of the restoration and the tooth-restoration complex to provide adequate function and longevity.2 Thus, the importance of immaculate gingival health is amplified to facilitate the creation of an optimal bonding environment with minimal difficulties in moisture control and contamination.

The long-term stability of ceramics is closely related to subcritical crack propagation and stress corrosion caused by water in the saliva and dentinal tubules reacting with the glass. This reaction results in decomposition of the glass Fig 3. View demonstrating the resolution of the Seibert Class II de- structure and in increased fect, and the maturation of the tissue at the ovate pontic site. High-strength ceramics crack propagation in glasscore-materials may be classified containing systems.3 However, into three major groups. This is polycrystalline ceramics cores one classification which may be employed in-order to are glass-free and do not exhibit this phenomenon.4 The differentiate between the different materials: lower the glass content the better the mechanical properties of the material such as a higher flexural-strength. More 1. Glass-ceramics which are multiphase importantly, the lower glass content results in a higher materials that contain an amorphous glassy fracture-toughness a mechanical property describing phase and crystalline constituents. the resistance of brittle materials, such as ceramics, to the 2. Glass-infiltrated ceramics which is the catastrophic propagation of flaws under an applied stress. product of infiltrating molten glass to In contrast, the optical properties of these materials, such partially-sintered oxides (such as aluminum, as their translucency, are diminished magnesium-aluminum, aluminum with zirconium).
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Materials Overview
Leucite-reinforced glassceramics (LRG)

The Empress I system (Empress II; Ivoclar North America, Amherst, NY) uses leucite crystalline filler to reinforce glass ceramics. These restorations are highly therefore translucent, and Fig 4. View of abutments after endodontic therapy, postal-and-core provide the potential for a highly buildups, and preparation. Note the adequate gingival levels. aesthetic restoration. However, due to their high translucency, Glass-infiltrated alumina the use of these restorations is (GIA) not recommended for those cases were the underlying The In-Ceram alumina abutment is a discolored tooth, system (Vita Zahnfabric, Bad a metallic-core build-up, or Sackingen, Germany) uses a a metallic implant abutment. high-temperature, sinteredThe flexural strength of the alumina glass-infiltrated core material is 105-120 MPa copings for anterior and and the fracture toughness (K) posterior crowns, as well as for ranges between 1.5-1.7 MPam. three-unit anterior FPDs. The The results of a long-term flexural strength of the core clinical studies demonstrated material ranges from 236 to 600 Fig 5. A lingual view of the framework. Note the space between the a very high success-rate for MPa, and the fracture toughness intaglio surface of the pontic and the ovate site. these restorations when used ranges between 3.1- and 4.61 for fabricating crowns in MPam. To fabricate the coping/ the anterior segment. These framework the ceramist can use restorations rely on a successful either the slip-casting technique bond to the tooth structure or copy milling technique with for strength and, therefore, prefabricated partially-sintered must be adhesively cemented. blanks of the material. While preparing teeth for such restorations it is recommended Glass-infiltrated magnesium that the finish line be placed alumina (GIMA) either at the free gingival margin or slightly below it to facilitate The In-Ceram Spinell the maintenance of a healthy (Vita Zahnfabric, Bad gingiva with the provisional Sackingen, Germany) uses Fig 6. Using the Y-TZP framework and acrylic resin, an impression of high-temperature, GIMA for restoration. Excellent health the edentulous site is made. Note the blanching of the soft tissue. of the gingiva will enhance fabricating crown copings. The moisture control and facilitate flexural strength of the core predictable bonding procedure. material ranges from 283 to 377 MPa. To fabricate the Copings may be fabricated either using heat-pressing coping, the ceramist uses the slip-casting technique. procedure or via the use of CAD/CAM technology out The Spinell core material is twice as translucent as the of prefabricated blanks. In-Ceram Alumina core and therefore may be used in those clinical scenarios where maximum translucency Lithium disilicate glass-ceramics (LDG) is required. However, the spinell cores are weaker than the conventional GIA cores and therefore recommended The Empress II system (Empress II; Ivoclar North for use only for anterior crowns. Under these conditions, America, Amherst, NY) uses a LDG core material. The these restorations have been proved to be successful over flexural strength of the framework material demonstrated a relatively long-term follow-up. a range of 300-400 MPa. For the LDG core material the fracture toughness (K) ranges between 2.8 and 3.5
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MPam. It is recommended that these restorations be etched and adhesively cemented to enhance their strength and longevity. The system is recommended for anterior and posterior crowns as well as for three-unit FPDs confined to replacing a missing tooth anterior to the second premolar. The core is fabricated with either the lost-wax and heat-pressure technique or is milled out of prefabricated blanks.

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Glass-infiltrated alumina with 35% partially stabilized zirconia (GIAZ) The In-Ceram Zirconia system (Vita Zahnfabric Bad Sackingen, Germany) combines the use of glass-infiltrated alumina with 35% partially stabilized zirconia for the core material for posterior crowns and FPDs. The flexural strength of the core material demonstrated a ranges from 421 to 800 MPa. For the GIAZ core material the fracture toughness (K) ranges between 6 to 8 MPam. As with the In-Ceram Alumina system, the ceramist may use the slip-casting technique or copy-milling technique. A recent study demonstrated that in terms of translucency the In-Ceram Zirconia core is as opaque as a metalalloy core.6 Since the primary rational for using all-ceramic restorations is to enhance the light transmission and depth of translucency, the advantage of using of these types of cores may be questionable. Densely sintered high-purity aluminum-oxide (DSHPA) The DSHPA core material, which is one of the two polycrystalline ceramics available, is used by the Procera AllCeram system (Nobel Biocare, Goteborg, Sweden). It is a glass free high-strength ceramic core material. The flexural-strength of the core material demonstrated a range from 500 to 650 MPa, and a fracture toughness (K) that ranges from 4.48 to 6 MPam. The system is recommended for anterior and posterior crowns as well as threeunit FPDs. Being a polycrystalline ceramic, CAD/CAM technology is used for the fabrication of ceramic infrastructures. Yttrium tetragonal zirconia polycrystals (Y-TZP)

Fig 7. A frontal view of the definitive restoration

property known as transformation toughening and to the small grain structure which ranges between 0.3 to 0.5 micrometer. In vitro studies of Y-TZP specimens demonstrated a flexural strength of 900-1200MPa 29 and a fracture toughness (K) of 9 to 10 MPam, which is almost double the value demonstrated by aluminabased infrastructures, and almost three times the value demonstrated by LDG cores. Infrastructures may be designed using either conventional waxing techniques or CAD technology. Several Y-TZP-based restorative systems are available for full-coverage crowns and FPDs. The Cercon (Dentsply Ceramco, Burlington NJ), the Lava (3M ESPE, St. Paul, MN), the Cerec inLab with vita YZ blocks (Sirona Dental Systems, Charlotte, NC and Vita Zahnfabric, Bad Sackingen, Germany), and the Procera AllZirkon ((Nobel Biocare, Goteborg, Sweden) systems, are all using partially-sintered Y-TZP-based blanks for milling crown and FPDs infrastructures. The size of partiallysintered milled infrastructures is increased to compensate for prospective shrinkage (20-25%) that occurs during final sintering. The DCS-Precident, DC-Zirkon (Smartfit Austenal, Chicago IL) infrastructures are milled from fully sintered Y-TZPbased blanks. While no shrinkage is involved in the process of milling a fully-sintered blank, the milling of partially-sintered blanks is faster and the wear and tear of hardware is reduced. Moreover, a recent study demonstrated that micro-cracks may be introduced to the substructure during milling of fully-sintered blanks.31

Fig 8. A facial view of the patients new smile (with Dr. Marriana Pascuitta, LSUSD).

Fig 9. Transillumination demonstrate light transmission through the restoration.

Fig 10. A buccal view of a temporary implant abutment replacing tooth #11(23) and a failing metal-ceramic crown on tooth #12(24)

Clinical Considerations
Regardless of the type of all-ceramic material used, some general concepts, related to the preparation design of full-coverage all-ceramic restorations, must be maintained. All-line angles should be rounded, all sharpedges eliminated, and the recommended finish-line is

The most recent ceramic core material is Y-TZP. It is a glass-free high-strength polycrystalline ceramic material indicated for the fabrication of anterior and posterior crown copings and FPD frameworks. The superior strength of Y-TZP is attributed to both a physical

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either a deep chamfer or a 90 rounded shoulder. The finish line may be placed at the free gingival margin or slightly below it to maintain adequate gingival health and predictable bonding when required. However, although desired, in many clinical cases such finish-line placement may not be possible due to a deep previous restoration, a deep core build-up, or a cervical decay.

A well-designed preparation is required to provide a well designed infrastructure that will promote a uniform thickness for the veneering porcelain to impede the formation of unsupported porcelain which may fracture (Figures 1-2). As with In the case of the cement-retained any full-coverage restoration, a implant-supported restorations, preparation with adequate foundation clinicians may use a temporary with resistance and retention form cementation protocol for metalis a must. In cases were clinicians ceramic restorations. However, present with failing restorations with Fig 12. A occlusal view demonstration the masking since removal of implant-supported inadequate resistance and retention ability of Y-TZP copings on a metal implant abutment all-ceramic restorations (either with form, a new foundation restoration and adjacent nondiscolored tooth. or without a ceramic abutment) is must be fabricated to provide not predictable and fracture of the adequate resistance and retention restoration may occur, definitive forms (Figures 3 and 4). In addition, cementation is recommended. In as with any other type of implantthose cases, especially when metal supported restorations or a tooth abutments are used, highest-strength supported FPDs, concepts of accurate ceramics is recommended if allrecording of the soft-tissue must be ceramics is the restorative material of employed to allow the ceramist to choice. (Figure 13) Most all-ceramic have the optimal information for core materials present with dentinthe fabrication of an esthetic and a like radiopacity. However, Y-TZP functional restoration (Figure 5). Fig 13. A Lateral view of the definitive restoration. infrastructures present with metal like Therefore, any required additional radiopacity that enhances radiographic procedures must be employed to evaluation of the restoration (Figure ensure a successful restoration (Figures 6-8). 14). When patients present with parafunctional habits, the use of all-ceramic restoration must Generally, these core-materials be carefully evaluated. However, if a patient allow light transmission at different levels. insists on being restored with a metal-free Polycrystalline ceramics such as the DSHPA restoration the highest-strength core material and the Y-TZP allow light transmission (Figure should be selected with optimal preparation9). However, they also successfully mask and core- design. Such patients must be underlying discolored abutments. As such, they committed to the use of an occlusal guard. can be successfully used for their respective indications to conceal underlying discolored Fig 14. A postoperative When selecting the core material teeth, metallic cores, and metal-alloy implant radiograph of the definitive for a full-coverage all-ceramic restoration, abutments (Figure 10-12). GIA cores present zirconia-based restoraclinicians must make an independent decision a similar masking ability as well. Other core tions. Note the metal-like for anterior and posterior crowns, for anterior radiopacity of the core materials such as GIMA, LRG, and LDG present material, FPDs, and for posterior FPDs. Generally, when with a higher level of translucency and should selecting the core-material three principal be used when high translucency is required. clinical circumstances should be weighted: Cementation protocol is related both to the 1. Is the finish-line above, equal, or slightly composition and strength of core materials. Glassbelow the free gingival margin? This
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Fig 11. A buccal view of the custom metal abutment #11 and the preparation of a full-coverage crown #12 (Surgery: Micheal S. Block, DMD, LSUSD).

ceramic cores can be etched and bonded to the tooth structure. Due to their relatively low strength, adhesive cementation is mandatory for the longevity glass-ceramic corebased restorations. This is not the case with glass-infiltrated ceramics and polycrystalline-ceramics. These cannot be etched due to the lack of glass in their microstructure. However, because they present with a higher strength related to their respective indications, they may be conventionally luted, and adhesive cementation using other techniques than the one used for glass-ceramics is optional.

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Figure 18

Y-TZP DSHPA

No

Finish-line above, equal, or slightly below the FGM Yes

No

Y-TZP

Y-TZP

Y-TZP DSHPA

No

Excellent gingival health Yes

No

Y-TZP

LRG: Empress I LDG: Empress II DSPHA: Procera AllCeram

*LRG *GIMA LDG GIA DSHPA Y-TZP

No

Discolored abutment Yes Yes

No

LDG GIA Y-TZP

GIA: In-Ceram Alumina GIMA: In-Ceram Spinell Y-TZP: Cercon, DCS DC-

Y-TZP DSHPA GIA

Y-TZP GIA

Zirkon, Lava, Procera AllZirkon

Fig 15. A flowchart demonstrating the decision-making process in selecting the type of all-ceramic restoration.

will affect the predictability of moisture selected, such as in the case of a full-mouth reconstruction, control and contamination during adhesive a special challenge is presented to the ceramist in terms cementation procedures. of color-matching all-ceramic restorations with different 2. Is the gingival health adequate? This will types of core materials. also affect the predictability of moisture Another major question clinicians must ask is: control and contamination during adhesive FigureAre 19 the resistance and retention form adequate? In cementation procedures. those cases were the patient presents with a short and 3. Is the abutment tooth colored or not? Is tapered preparation due to a previous restoration and the high translucency a requirement? Or rather interocclusal distance is not restricted, clinicians may concealing the color of the abutment is of not rely on boding procedures only, and the foundation
Restricted interocclusal distance Short tapered preparation Yes

Yes

Inadequate resistance/retention form

No

Metal-ceramics with metal occlusals/linguals

Go back to previous chart

Modify build-up

Fig 16. A flowchart demonstrating the decision-making process in selecting restorative materials when a clinician is presented with a clinician is presented with less-than-ideal abutments in terms of resistance and retention form.

major consideration? Based on knowing the advantages and limitations of the different ceramic core-materials and by answering the three above questions, clinicians may select the appropriate material for each individual clinical scenario (Fig 15). If several core materials are

restoration must be modified while applying basic concepts of preparation design. If a patient presents with a restricted interocclusal distance and inadequate resistance and retention form, the use of a metal-ceramic restoration with metal on the occlusal/lingual surface should be considered (Figure 16).

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Conclusion
To date, clinicians are exposed to a variety of high-strength all-ceramic core-materials. These materials present with different properties which affect their indications and limitations, the laboratory procedures for their use, and their clinical handling. By no means should clinicians abandon basic concepts of preparation design and foundation restorations and rely only on adhesive cementation for long-term success. The color of the underlying abutment and the translucency required, as well as the predictability of different types of cementation procedures, should play a major role in the decision process of clinicians selecting all-ceramic materials for successfully and predictably restore their patients.

15. Quinn JB, Sundar V, Lloyd IK. Influence of microstructure and 16. 17. 18. 19. 20. 21. 22.
chemistry on the fracture toughness of dental ceramics. Dent Mater 2003;19:603-611. Sorensen JA. The IPS Empress 2 system: defining the possibilities. Quintessence Dent Technol 1999;22:153-63. Sorensen JA, Knode H, Torres TJ. In-Ceram all-ceramic bridge technology. Quintessence Dent Techonol 1992;15:41-6. McLaren EA. All-ceramic alternatives to conventional metalceramic restorations. Compend Contin Educ Dent 1998;19:307-25. Giordano, RA, Pelletier L, Campbell S, Pober R. Flexural strength of an infused ceramic, glass ceramic, and feldspathic porcelain. J Prosthet Dent 1995;73:411-418. Chong KH, Chai J, Takahashi Y, Wozniak W. Flexural strength of In-Ceram Alumina and In-Ceram-Zirconia core materials. Int J Prosthodont 2002;15: 183-188. Guazzato M, Albakry M, Swain MV, Ironside J. Mechanical properties of In-Ceram Alumina and In-Ceram Zirconia. Int J Prosthodont 2002;15:339-346. Wagner WC, Chu TM. Biaxial flexural strength and indentation fracture toughness of three new dental core ceramics. J Prosthet Dent 1996; 76:140-144. Seghi RR, Denry IL, Rosenstiel SF. Relative fracture toughness and hardness of new dental ceramics. J Prosthet Dent 1995;74:145-150. McLaren EA. All-ceramic alternatives to conventional metalceramic restorations. Compend Contin Educ Dent 1998;19:307-325. Magne P, Belser U. Esthetic improvements and in vitro testing of In-Ceram Alumina and Spinell ceramic. Int J Prosthdont 1997;10:459-466. Fradeani M, Aquilino A, Corrado M. Clinical experience with In-Ceram Spinell crowns: 5-year follow-up. Int J Periodontics Restorative Dent 2002:22(6):525-533. McLaren EA, White SN. Glass-infiltrated zirconia/alumina-based ceramic for crowns and fixed partial dentures: clinical and laboratory guidelines. Quintessence Dent Technol 2000;23:63-76. Chiche GJ, Pinault A. Esthetics of anterior fixed prosthodontics. Carol Stream: Quintessence; 1994. p. 97-114. Oden A, Andersson M, Krystek-Ondracek I, Magnusson D. Fiveyear clinical evaluation of Procera AllCeram crowns. J Prosthet Dent 1998;80(4):450-6. White SN, Caputo AA, Li ZC. Modulus of rupture of the Procera Ceramic system. J Esthet Dent 1996;8(3):120-6. Zeng K, Oden A, Rowcliffe D. Flexure tests on dental ceramics. Int J Prosthodont 1996;9(5):434-9. Christel P, Meunier A, Heller M. Mechanical properties and short term in-vivo evaluation of yttrium-oxide-partially-stabilized zirconia. J Biomed Mater Res 1989;23:45-61. Raigrodski AJ. Contemporary materials and technologies for allceramic fixed partial dentures: a review of the literature. J Prosthet Dent 2004;92(6):557-562. Luthard RG, Holzhuter MS, Rudolph H, et al. CAD/CAMmachining effects on Y-TZP zirconia. Dent Mater 2004;20:655-662. Edelhoff D, Sorensen JA. Light transmission through all-ceramic framework and cement combinations. IADR 2002 (abstract 1779).

151.

Acknowledgements:
The author would like to thank Andreas M. Sltzer Laboratoire Dentaire S.a.r.l. 5, Rue des cavaliers, Wissembourg, France, for fabricating the restorations presented in this article.
References:

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4. Kelly JR. Dental Ceramics: Current thinking and trends. Dent Clin N 5. McLean JW. Evolution of dental ceramics in the twentieth century. J
Prosthet Dent 2001;85:61-66. 6. Drummond JL. Ceramic behavior under different environmental and loading conditions. Eliades G, Eliades T, Brantley WA, Watts DC. In Dental materials In Vivo: Aging and Related Phenomena. Carol Stream: Quintessence; 2003 p. 35-45. 7. Sorensen JA. The Lava system for CAD/CAM production of highstrength precision fixed Prosthodontics. Quintessence Dent Technol 2004; 26:57-67. 8. Hefernan MJ, Aquilino SA, Diaz-Arnold AM, et al. Relative translucency of six All-ceramic systems. Part II: core and veneer. J Prosthet Dent 2002;88(1):10-15. 9. Hefernan MJ, Aquilino SA, Diaz-Arnold AM, et al. Relative translucency of six All-ceramic systems. Part I: core materials. J Prosthet Dent 2002;88(1):4-9. 10. Campbell SD. A comparative study of metal ceramic and all-ceramic esthetic materials: Modulus of rupture. J Prosthet Dent 1989;62:476479. 11. Seghi RR, Sorensen JA, Engelman MJ, et al. Flexural strength of new ceramic materials. J Dent Res1990:69:299. (Abstract 1348). 12. Seghi RR, Sorensen JA. Relative flexural strength of six new ceramic materials. Int J Prosthodont 1995;8:239-246. 13. Fradeani M, Redemagni M. An 11-year clinical evaluation of leucitereinforced glass-ceramic crowns: a retrospective study. Quintessence Int 2002;33(7):503-510. 14. Schweiger M, Hland W, Frank M, Drescher H, Rheinberger V. IPS Empress 2: a new pressable high-strength glass-ceramic for esthetic all-ceramic restorations. Quintessence Dent Technol 1999;22:143Am 2004;48:513-530.

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CPD
ABSTRACT
Statement of problem: Reduction in base metal alloy thickness will permit additional porcelain depth and improved aesthetics but unfortunately little information exists regarding the thickness to which base metal alloys may be reduced in comparison to noble metal alloys for metal ceramic restorations. Even with comparison of noble metal alloys the aesthetic benefits are restricted to improving aesthetics in base metal restoration further, since noble metal alloys are generally regarded as providing superior aesthetics to base metal restorative alloys. Purpose: The objective of this study was to determine whether a significant reduction in thickness could be achieved using a base metal alloy as compared to a noble metal alloy and the thickness to which base metal alloy substructures could safely be reduced while still providing the same resistance to fracture of the porcelain. Material and methods: Tensile strength tests (N) of the modulus of rupture of the porcelain were performed on 40 base metal alloy (Wiron 99, Bego, Germany) and 12 noble metal alloy rectangular specimens (5.8 mm wide and 15.0 mm long) bonded to a standardized 1.0 mm thickness of dentine Creation porcelain. The base metal alloy thickness varied in 0.1mm increments from 0.1 to 0.4 mm. The results were compared to 12 noble metal alloy (Bio Y 81, Argen, South Africa) specimens of recommended minimum thickness (0.3 mm). Data for the results was obtained using a universal tensile testing instrument, which was set to operate at a cross head speed of 0.5mm (Instron Mini 44, Instron corporation U.S.A). The applied force (N) that measured the modulus of rupture of each specimen was printed from a computer connected to the Instron Mini 44 that operated on a 95% level of confidence. Instron Agents (Durban, South Africa) performed the calibration and setting up of the machine prior to testing the specimens. Results: The results indicated a permissible 33.33% reduction in the base metal alloy specimens as compared to the noble metal alloy control specimens. This was deduced from the reduction in alloy thickness of up to 0.2 mm for base metal alloy specimens as compared to the 0.3 mm noble metal alloy specimens. The recommended thickness to which the base metal alloys could be reduced without distortion of the alloy was also 0.2 mm. The one-way ANOVA showed a level of significance of (=05).
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Reducing
the alloy thickness of base metal ceramic

restorations

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INTRODUCTION
Base metal alloys have become popular as an alternative to noble metal alloys and are being used more extensively than any other metal alloys.1 Although initially introduced mainly because of the high increase in the cost of gold, the success experienced when using base metal alloys due to their superior physical properties regarding yield strength and modulus of elasticity may have added benefit.2-5 This in vitro study was designed to determine the extent to which these properties can be beneficial in allowing a reduction in base metal alloy thickness.3 The method of porcelain fracture is a complex phenomenon and experiments of this type are complex in vitro, and even more taxing in vivo.6-14. This study compared a base metal alloy of varying thickness (increasing linearly in 0.1 mm intervals from 0.1 mm to 0.4mm) to a noble metal alloy 0.3 mm thick. The reduction of thickness for base metal alloy samples as The objective of this study was to determine whether a significant reduction in thickness could be achieved using a base metal alloy while providing equivalent fracture resistance to recommended thickness of a noble metal alloy. It is hoped that the results of this study will also produce an awareness of the difference that an additional small reductions in tooth preparation might make to the final strength and aesthetic requirements of the restoration as opposed to just solving the problem of providing sufficient alloy support for the porcelain by replacing noble metal alloys with base metal alloys. compared to noble metal alloys was established by finding the base metal alloy specimen group that provided the same support to resist porcelain fracture as the noble metal alloy specimen group. Comparing the thickness of these base metal alloy specimens to those of the noble metal alloy specimens gave an indication of the thickness to which base metal alloy substructures can be reduced. This study compared a base metal alloy of varying thickness (increasing linearly in 0.1 mm intervals from 0.1 mm to 0.4mm) to a noble metal alloy control 0.3 mm thick (Table 1). All the specimens including the noble metal alloy were cast (Using a gass oxygen torch and centifugal casting method) from 0.4 mm thick smooth wax (Dentaurum, Germany). Each specimen was then carefully trimmed to the desired thickness and rectangular size (5.8 mm wide and 15.0 mm long). Table 1. Number of specimens
Number of specimens Group of specimens Control group A group B group C group D group Alloy thickness 0.3mm 0.1mm 0.2mm 0.3mm 0.4mm Porcelain thickness 1.0mm 1.0mm 1.0mm 1.0mm 1.0mm Combined thickness 1.3mm 1.1mm 1.2mm 1.3mm 1.4mm

with the porcelain surface facing downward. The sample rested on two flat smooth metal surfaces 10mm apart on either side with a third point, measuring the fracture resistance in N, being lowered from above onto the middle of the alloy surface of the sample. As this third point started bending the sample in the direction of the porcelain surface, this surface was bent outward placing the porcelain in tension. The samples were not deformed after the test, showing only a hairline crack produced as a result of just reaching the modulus of rupture value. The Instron 44 tensile testing machine was set to operate at a cross- head speed of 0,5 mm per minute. The samples were placed with the porcelain surface facing downward resting between two smooth metal plates 10mm apart, to allow free rotation during testing. As soon as the porcelain cracked at the modulus of rupture, a reading of force resisted in N was recorded for each sample.

MATERIAL AND METHODS

A total of 40 base metal alloy specimens (Wiron 99, Bego, Germany) and 12 Noble metal alloy specimens (Bio Y 81, Argen, South Africa) were tested using a universal tensile testing instrument (Instron Mini 44, Instron corporation U.S.A; With loading parameters of 0-500 N). The tensile strength of porcelain was measured. This strength is maximized in the lower curved surface of the loaded beam. Hence this study used the 3-point bending test whereby the third point of the loaded beam contacted the metal alloy surface, thereby exposing the ceramic material to maximum tensile force. In order to measure the tensile strength and not compressive strengths of porcelain, it was necessary to place the samples

12 Noble metal 10 Base metal 10 Base metal 10 Base metal 10 Base metal

All samples were fired in sample batches in order to allow identification and to prevent mixing them up. They were

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stored in containers marked clearly with the alloy thickness. Layering was performed using a layering depth gauge into which the alloy specimens just fitted. This allowed exactly the same dimensions of porcelain to be applied regarding length and breadth of sample, resulting in consistent amounts of porcelain for each sample group. The opaque specimen was placed in the depth gauge, after zeroing the digital display of the depth gauge when the plunger was level with the outer surface. As the plunger descended, the depth was indicated on the LCD display. The depth gauge was used to get more consistent amounts of porcelain on the metal alloy surface to ensure that firing shrinkage and porcelain thickness for each sample group were consistent. The technique used allowed the correct amount of porcelain to be built up so that after firing the samples had marginally thicker porcelain depths than was planned for after the one bake method used. This was necessary because the centre of the samples seemed to shrink slightly more and the edges were then trimmed slightly to create the constant thickness of porcelain required.
Table 2: Strength of porcelain to resist fracture (N) measurements of High Mean Low Std. Deviation Coefficient of variance CONTROL 41.60 N 35.67 N 28.09 N 4.01 11.24% A 39.72 N 33.32 N 26.75 N 4.61 13.84% B 42.75 N 35.17 N 28.46 N 4.50 12.79% C 44.72 N 38.86 N 32.21 N 4.26 10.96% D 47.73 N 45.77 N 43.70 N 1.46 3.19%

of 28.09 N. Since this lowest value just fell within the low strength value of the control group, all the base metal alloy specimens above 28.09 N were accepted as having strength values above that of the noble metal alloy control group. The base metal alloy specimens with lower strength values than 28.09 N would allow the porcelain to fracture with less applied force than the noble metal alloy control group. Only group B, table 2 therefore provided values, which could indicate the permissible thickness reduction of the base metal alloy specimens when compared to specimens of the noble metal alloy control group.

The depth gauge chosen utilized a modified digital vernier with an LCD display and accuracy of approximately 0,03mm. By subtracting the thickness of the alloy porcelain depth could be calculated and the desired thickness of alloy and porcelain combination was obtained. These measurements were confirmed using a thickness gauge.

specimens for metal alloy thickness variations

RESULTS
Figure 1.shows a graphical representation of the strength values of porcelain when the alloy thickness was varied. The mean values N for each specimen group are shown. The results from each specimen were compared with those of the control group (Table 2). All values are expressed as high, mean and low. The control group (0.3 mm alloy thickness and 1.0 mm porcelain thickness) was used to determine the possible reduction in thickness of base metal allows compared to noble metal alloys. Figure 1 shows the mean strength values in N of base metal alloy thickness variations while the porcelain thickness was constant at 1.0 mm. The control group gave a mean result of 35,67 N with a lower end value of 28,09 N and a highest value of 41,60 N. The standard deviation of the control group was 4.01 N. The control group produced a lowest value The 0.4 mm base metal alloy specimens, being the thickest, provided more than an adequate strength as all the specimens were above 40.00 N. The 0.2 mm and 0.3 mm alloy specimens also showed strength values above the control groups lowest value of 28.09 N, with the 0.2 mm base metal alloys lowest value being 28.48 N and the 0.3 mm specimens having a lowest value of 32.21 N. The 0.1 mm specimens had a low strength value of 26.75 N, and did not meet the minimum strength values of 28,09 N established by the noble metal alloy control group. The 0.1mm specimens were also the only specimens
Figure 1. Strength values N and standard of deviation, for the ability of porcelain to resist fracture.

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that distorted to an unacceptable extent during working and firing procedures. One way ANOVA statistics that compared the strength values of the noble metal alloy control group and that of the base metal alloy specimen groups differed significantly (=05). The results (Table 2), did not present a linear progression in the ability of porcelain to resist fracture as a linear increase of base metal alloy thickness was tested. In order to test the hypothesis it was necessary to establish which group most closely represented the same results as the noble metal control. Only group B presented similar strength values to that of the noble metal alloy control (Table 2). reduce the percentage of unexplained clinical fractures through increased reproducibility. The permissible reduction of base metal alloy did not allow a without risk reduction of up to 0.1 mm as Weiss32 suggests is possible, as the minimum strength values for some specimens were below that of the clinical standard of the control group. These 0.1mm base metal alloys were also observed to distort due to working and firing procedures and are therefore not recommended for practical use. It cannot however be said with certainty that reducing the metal alloy to 0.1 mm will result in fracture, since this may depend on design and in vivo function. From the results obtained it could be argued that the alloy thickness is the main contributing factor to enhancing the The hypothesis, that a significant reduction in thickness can be achieved using a base metal alloy when compared to the strength of a noble metal alloy was accepted. The results in Table 2 show that if the porcelain thickness is at the minimum permissible thickness to match a shade of 1.0 mm the alloy should not be reduced to below 0,2 mm. This allows a significant 33.3% reduction of 0.1 mm from the thickness of the noble metal alloy control group (of 0.3 mm). Specimens were limited to one design that was tested in vitro and not in vivo. The results in Table 2 further show that increasing the metal alloy thickness increased the metal ceramic restorations strength markedly even though there was not a linear relationship regarding strength values and alloy thickness when the metal alloy thickness was increased linearly and the porcelain thickness remained constant (figure 1). The importance of the coefficient of variation values was that they indicate the minimal variation of the specimens (Table 2). The quality of manufacture was influenced by the thickness of the base metal alloy. The 0.4 mm specimen group showed smaller Standard of deviation than the other specimen groups of only 1.46 as compared to 4.26 and above for the 0.1, 0.2, and 0.3 mm specimen groups (Figure 1). This indicates that if sufficient base metal alloy thickness of a minimum of 0.4 mm is allowed for the alloy thickness, it allows the restoration to resist porcelain fracture better (with a smaller standard of deviation). As a result, 1.4 mm of space would be required to be able to start producing more predictable results and hopefully The nature of tensile strength measurement was simplified to a one specimen design. Therefore no information was provided about the performance due to variations of design, material and Using base metal alloys may result in a substantial reduction in alloy thickness provided that the thickness is not reduced to below 0.2 mm. This reduction may improve aesthetics in base metal alloys but will not necessarily be an improvement on noble metal alloy aesthetics. Knowing the minimum permissible thickness for base metal alloys is important where space constraints are extreme but should not be utilized as a rule since adequate space for alloy and porcelain will improve the ability of porcelain to resist fracture and provide a smaller standard of deviation. Thus the quality of manufacture of the metal ceramic restoration will be improved. strength of metal ceramic restorations. The alloy thickness needs to be as thick as possible when the porcelain thickness is at a minimum of 1.0 mm in order to just be able to gain satisfactory reproducibility in strength. Where there is sufficient space available, indications are to maximize the alloy thickness as soon as there is sufficient porcelain depth for aesthetics. From the results it would appear that less than 1.2 mm of available space is insufficient to obtain required strength and aesthetic characteristics. Future research needs to be conducted in vivo to establish clinical performance and the strength contribution of porcelain thickness variation.

DISCUSSION

CONCLUSION

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type of loading, or the long-term performance of restorations in vivo.
15, 16

. The base metal alloy specimens could be reduced

3. Chul-Whoi K, Sang-Won P, Hong-So Y. Comparison of the fracture

strength of metal-ceramic crowns and three ceromer crowns. J Prosthet Dent 2002;88:170-175.De Hoff PH, Anusavice KJ, and Vontvillu SB. Analysis of tempering stress in metal ceramic disks. J Dent Res.1996;25:743-751. De Hoff PH, Anusavice KJ, and Vontvillu SB. Analysis of tempering stress in metal ceramic disks. J Dent Res. 1996;25:743-751. Denry IL, Mackert JR, Halloway JA, Rosentiel SF. Effect of cubic leucite stabilizer on the flexural strength of feldpathic dental porcelain. J Dent Res. 1996;75: 1928-1935. Fisher H, Rentzsch W, Marx R. R-Curve Behaviour of Dental ceramic materials. J Dent Res. 2002;81:547-551. Gardner FM, Tillman M, Gastron M, Runyan DA. In vitro failure of metal collar margins compared with porcelain facial margins of metal ceramic restorations. J Prosthet Dent. 1997;8:1Griggs JA, Thompson JY, Anusavice KJ, Effects of flaw size and auto glaze retention on porcelain strength. J Dent Res . 1996;75:1414-1417. Halloway JA, Denry I, Rosentiel SF. Surface layer characterization after dual ion exchange of a leucite reinforced dental porcelain. Int J Prosth. 1997;10 :136-141. Mackert JR, Williams AL. Microcracks in dental porcelain and their behavior during multiple firing. J Dent Res. 1996;75:1484-1490. Petridis H, Hirayama H, kugel G, Habib C, garefis P. Shear bond strength of techniques for bonding esthetic veneers to metal. J Prosthet dent. 1999;82:608-613. Marker JC, Goodkind RJ, Gerberich WW. The compressive strength of nonprecious ceramometal restorations with various frame desighns. J Prosthet Dent. 1996;55:560-567. Moffa JP, Jenkins WA, Ellison JA, Hamilton JC. A clinical evaluation of two base metal alloys and a gold alloy for use in fixed prosthodontics : A five year study . J Prosthet Dent. 1984;52(4): 491-499.

London: Quintessence; 1983.p.231-257.

to 0.2 mm and still resist fracture of the porcelain to a similar extent as the 0.3 mm noble metal alloy specimens when a tensile force was applied. This would suggest that the base metal alloys specimens could be reduced by 33.33% in alloy thickness as compared to the noble metal alloy specimens. This possible reduction in thickness using a base metal alloy as opposed to a noble metal alloy was only applicable to the 0.3 mm noble metal alloy specimens and the 0.2 mm base metal alloy specimens.
8. 4. 5. 6. 7.

There was not a linear relationship regarding strength values and alloy thickness, even though the metal alloy thickness was increased linearly and the porcelain thickness remained constant. As a result possible alloy thickness reductions when using base metal alloy instead of noble metal where the noble metal alloy thickness varies from the 0.3 mm thickness could not be deduced from the results. Comparing a base metal alloys with of a noble metal alloy resulted in establishing a substantial permissible increase in porcelain depth and reduction in based metal alloy thickness, provided that the thickness is not reduced to below 0.2 mm. The clinical implication of this study would therefore be a possible 0.1 mm reduction from 0.3 mm thickness. Although this permissible reduction in base metal alloy doesnt seem to be much, it might be half the thickness of a 0.2 mm opaque layer and is important in establishing minimum thickness safety guidelines. It is hoped that the results of this study will produce an awareness of the difference that an additional small reductions in tooth preparation might make to the final strength of the restoration as opposed to just solving the problem by reducing the base metal alloy thickness to a permissible minimum.

9. 10. 11. 12. 13.

Choose a name for your new mag and win!

The new CPD magazine will be an integral part of the dental tech profession in South Africa in future. Through this magazine you will be kept up to date of new developments in the industry, learn about new materials and techniques, earn CPD credits, read about interesting people in the profession and express your own views.

Competition

Help us name the new magazine and win great prizes.

to the value of R950.00 sponsored by Metal Free Dental or To the value of R1 000.00 Sponsored by Zennith Dental The competition is still open.

The winner will be able to choose between:

2 Zirconia Copings Castavaria Flasks

REFERENCES
1. Bertolotti, R. L 1988. Rational selection of casting alloys. In: Mclean, 2. 1. 2. 3.
J.W. International Symposium on dental ceramics. London: Quintessence Co. pp41-72. Geis-Gertorfer J, Sauer K, Pressler K. Ion release from Ni-Cro-Mo and Co-Cr-Mo casting alloys. Denteksa . 1994;15:30-34 Whataha J. Biocompatibility of dental casting alloys: a review. J Prosthet Dent. 2000;83:223-233. Weiss PA. New design parameters:Utilizing the properties of nickelchromium superalloys. Dent Clinic North America. 1977;21: 769-784. Weiss PA. State of the art metal ceramics. Utilizing nickel chromium super alloy frameworks. In; Mclein JW. Int Symposium Dent ceramics.

E-mail your suggestions to name the magazine to: agm@dentasa.org.za

Terms and conditions apply.

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MEETING...
By Naomi Olivier

Mr. Kapache JF Victor

Mr. Victor has been appointed the new Registrar of the South African Dental Technicians Council. He came into office on Aug 3rd, 2009. We went to meet him and would like to introduce him to you.

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Q: Mr Victor, where were you born, and where did you grow A: I was born in Windhoek, Namibia, and grew up there. Q:
What is your academic background? A: After school, I enrolled for my LLM degree at the University of Stellenbosch and completed the degree. I also completed an Executive Development Programme at the University of Stellenbosch Business School. I am currently registered for the Masters degree in Development Finance, also at the University of Stellenbosch. up? lab assistants. The strong and effective enforcement of the CPD programme is one of my priorities. I will also be looking at marketing the council, and industry more, by setting up a web site. After that we will be looking at visiting school career days to raise awareness of our industry. you have for our industry? A: I would like to see technicians more professional and assertive, and I would like to see the whole of the profession taken more seriously by other professions and the public.

I would like to see technicians more professional and assertive,...

Q: What vision do

Q: Where has your career path taken you prior to your

Q: What is the biggest life lesson you have learnt? A: I have learnt to live honest and with integrity. I believe in
open communications and to stand by your word.

appointment by the SADTC? A: In 1998 I was appointed public prosecutor at the Department of Justice in Krasburg, Namibia I was then offered a position at the Bank of Namibia (equal to the Reserve bank in South Africa) where I initially served as a Senior Legal Analyst. I was then transferred and promoted to the position of Legal Advisor at the Corporate Service Department. In 2005, I moved to South Africa where I worked as a Financial Investigator, employed by the Western Cape Racing and Gambling Board. During the last quarter of 2006, I was appointed the Head of Department: Leal Services at the Western Cape Nature Conservation Board. (CapeNature).

Q; What do you dislike in people? A: Dishonesty and people who do not honour their word. Q: What makes you happy? A: Success makes me happy. But true happiness is when you
see happiness in the eyes of those you love. It also makes me happy to add happiness unexpectedly to strangers lives, by giving to those who do not ask, but who is in desperate need.

Q: I have heard that

Q: What is your favourite food?

you have worked as Advisor to the Minister in Namibia. Is that true? A: Yes, I have been the advisor to the Namibian Minister of Finance (2003-2004) during the Eastern and Southern Africa Anti-Money Laundering Group Council of Ministers Meeting held in Kampala, Uganda Aug 2003, and in Mauritius, Aug 2004. I have also been advisor to the minister of Finance during the drafting and presentation of the Financial Intelligence Bill to the Cabinet Committee on Legislation, 2004, Windhoek.

I believe that Council must be more assertive and visible.

A: I always enjoy
tripe, and skaapkop. I would like to know where I could find a restaurant that serves good tripe.

The strong and effective enforcement of the CPD programme is one of my priorities.

Q: Who is your A: Reading is a

favourite author?

hobby of mine. I enjoy reading and have written a book myself. My book is called On the run and was published by New Namibia Books Ltd in 1994. It is a Pre- independence novel about the student activists of that time in Namibia.

Q: For some time the SADTC did not have a registrar. What

do you see as some of your most important tasks as the newly appointed registrar. A: The synergy between the SADTC and DENTASA is important to me. I would like to have positive energy and open communication between the council and the association. I would also like to have an open communication to the industry. I will be focusing on the core functions of the council at the beginning and after we have created a solid foundation as far as that is concerned, we will expand to include some soft functions as well. I believe that Council must be more assertive and visible. I will be looking into the matter of registration of

where I feel closest to my Maker. You can feel the presence of God in the desert.

Q: What is you favourite place in the world? A: The Namib desert, close to Swakopmund. This is the place

As the dental technicians/technologist of South Africa, we would like to welcome Mr Victor to our industry. We are looking forward to the future under your leadership.

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The difference between the SADTC & DENTASA and their roles in CPD
By Naomi Olivier

CPD

During the last few months it has become apparent that a lot of technicians/technologist do not understand the difference between the South African Dental Technicians Council (SADTC) and the Dental Technicians Association of South Africa (DENTASA), and the roll each plays in the Continuous Professional Development (CPD) programme. The objective of this article is to take a closer look at each of these entities, their powers, objectives, composition, and thus highlighting the differences.

The South African Dental Technicians Council.

The Dental Technicians Association of South Africa.

Who is the SADTC? The SADTC is a statutory council established in terms of Act 19 of 1979 (i.e. by government.) They fall under the National Department of Health, but receive no funding from Government. They are semi-autonomous. All dental technicians/technologists and dental laboratories, by law, have to be registered with the SADTC in order to practise legally. What are the objectives of the SADTC? The objectives of the SADTC is to protect the public through regulating the practises of dental technicians/technologists as far as manufacture or repair of, or alterations to any dental appliances is concerned. They control all matters of education and training of dental technicians/technologists, and promote the standard of such education in the Republic. They promote good relationships between dental technicians/technologists, dentists, clinical dental technologist and all supplementary healthcare professionals. The SADTC advises the Minister about any matters falling within the scope of its act and communicates matters of public interest and professional development to the Minister.(Act No. 19 of 1979; 1.4) The composition of the SADTC The South African Dental Technicians Council is structured as follows: The Registrar is Mr Kapache Victor. The sitting council is made up of: Five persons appointed by the Minister, One dentist attached to a university with a dental faculty. One dental technician/

Who is DENTASA? DENTASA is a voluntary organisation open to all dental technicians/technologists in South Africa. It is a Section 21 company (non-profit) registered at the Department of Trade and Industry in South Africa.

What are the objectives of DENTASA? The objectives of DENTASA are to protect and promote the interests of the industry and its members. DENTASA interact on behalf of the dental technicians/technologists with other organizations like The South African Dental Technicians Council, which is the first priority, the South African Dental Association, and other dental stakeholders. DENTASA encourages settlement of disputes by conciliatory methods. The association administer a trust fund. Proposed legislation on the industry will be promoted, supported or opposed by DENTASA as deemed necessary in the best interest of technicians/technologists. The composition of DENTASA

The composition of DENTASAs Executive Committee is made up of 14 members elected by members of the DENTASA countrywide. The 14 members are elected and according to the constitution 4 of these members has to be practicing in KZN, the Eastern

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technologist attached to a training institution. Three members of the public who are not registered in terms of any oral health related Act, one of whom shall be appointed on account of his/ her knowledge of the law. Two dental technician/technologist contractors who are nominated and elected by dental technician/technologist contractors. Two dental technicians/technologists employees who are nominated and elected by employees. One dentist nominated and elected by dentists. Cape, Western Cape and the Free State. Members from the areas mentioned will only be elected from members practicing in these areas. A member of the executive committee holds office for 3 years after being elected. Members can be re-elected once there period of office has come to an end.

The sitting members are as follows:

President of the SADTC Adv Mandla Mnyatheli Vice President of the SADTC Finance Committee EXCO Committee Mr Andre Ferreira Appointed

The current members of the executive committee are as follows:

President Vice-President Elected Treasurer Chairperson Gauteng North Chairperson Gauteng South Chairperson Kwa-Zulu Natal Chairperson Freestate Elected Chairperson Eastern Cape Chairperson Western Cape Student matters Marketing Mr Rainer Pittroff Mr Andre Ferreira Mr Peter Kapp Mr Harry George Mr Lucas Steenkamp Mr Donavan Pickard Mr David van Eyk. Mr Dave Owen Mr Dries Boshoff Ms Anso Scrooby Mr Prasni Rattan Mr Andre Ferreira (jr) Mr Axel Grabowski Ms Mariaan Roets

Treasurer Prof Phumzile Hlongwa Chairperson Finance Committee EXCO Committee Dr Johan Smit

Appointed

Representative of the Minister

Permanent

Education Committee Mr Dave Owen Conditions of Service Committee Disciplinary Committee Council representative of the Dep. of Health EXCO Committee Conditions of Service Committee Education Committee Chair person of Education Committee Ms Maritia Burger

Elected

Dr Phineas Molgotho Mr Dries Boshoff

Appointed

Employee Matters Student representative

Appointed

Disciplinary Committee Ms Catherine MokgatleCPD Accreditation Makwakwa Committee Employee technician Vacant

Appointed

Elected

Dentist Vacant (Act No. 19 of 1979; 1.6)

Elected

*For more detailed information on the composition of the EXCO, please see the constitution of DENTASA. Document published in the open access part of the website: www. dentasa.org.za (www.dentasa.org.za/documents/dentasa-Constitiution.pdf) (DENTASA Constitution - 2006; 4-6)

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Continuous Professional Development

History: CPD had its birth in the ISO rating of International companies. When looking at the success rate of the companies that performed well in the ISO rating programme it was found that professionals who complied with a continuous development programme, performed much better than those who did not subscribe to such programmes. The documentation of these programmes was refined and internationally implemented. In 1998 the first CPD programmes were implemented in South Africa, over a vast spectrum of professional occupations.(D. Owen, pers.comm.) Definition: Continuing Professional Development (CPD) can be described as, the means by which members of professional associations maintain, improve and broaden their knowledge and skills, and develop the personal qualities required in their professional lives.

The accreditation committee at present; Mr. Louis Steyn. (CPUT) the accreditation committee Mr. David van Eyk technician in private practise Mr. Harry George technician in private practise Ms. Catherine Makwakwa Person not affiliated to Oral Health Head of

What is CPD?

Dental

Dental

Impartial

Dental technicians/technologists must collect 30 CPD credits over a period of one year. The CPD programme is calculated to obtaining 3 credits per month for a period of 10 months with a rest period of 2 months. The CPD year runs form 28 January to 28 January from year to year. No credits will be carried over from one year to the next, as the programme runs over a one-year period only. At the CPD is defined as the holistic commitment to structured skills end of each year data will be forwarded from DENTASA enhancement and personal or professional competence. to the SADTC for enforcement of the programme.There are various ways in which technicians/technologist can CPD can also be defined as the conscious updating comply to the CPD programme. of professional knowledge and the improvement of professional competence throughout a persons working life. It is a commitment to being professional, keeping This includes, attending courses, attending the Annual up to date and continuously seeking to improve. It is the General meeting as well as branch meetings as held by key to optimising a persons career opportunities, both DENTASA, joining a study group, filling in questionnaires today and for the future.*(http://en.wikipedia.org/wiki/ in the on-line publication on the DENTASA website, continuining_proffesional_development) writing articles, giving presentations etc. To view the complete document on how to obtain your CPD credits, How CPD is structured, and what is the roll of visit the DENTASA website.Dental technicians are individually responsible for the administration fee of DENTASA and the SADTC? R30.00 per credit. This admin fee is purely to cover costs incurred by DENTASA in the administrative process such The programme was initiated by the National Department as permanent personnel, computers and programmes, of Health (i.e. Government) and is an industry driven internet, copyrights releases on articles etc. programme for which the South African Dental Technicians Council is accountable. As the statuary body, the roll of the SADTC is to oversee, and enforce the programme. This admin fee is tax deductible and receipts issued by DENTASA must be submitted to your auditor at the The roll of DENTASA as representative association for end of the financial year. The Continuous Professional technicians/technologists is to accredit, administer and Development programme was introduced to add value to supply information for audit of the CPD programme. our industry and benefit all involved. It is an opportunity Accreditation is done through the accreditation committee, to increase your professional knowledge and creates jointly appointed by the SADTC and DENTASA. camaraderie amongst peers. The accreditation committee consists of four members, two dental technicians/technologists, elected by the Executive Committee of DENTASA, two dental technician/ technologist elected by Council, and one person who is not associated with any oral health care profession. One of the two technicians elected by DENTASA must be from an educational institution and one must be from private practise.
Reference: 1. Act. No. 19 of 1979; 1.4-1.5 2. Act No 26 of 2005; Part 1, Chapter 3 3. Owen, D. Continuing Professional Developmant;1-2 4. Policy document. Department of Health. Policy on Quality Health CAre in South Africa. April 2007; 15-16. 5. Wikipedia: http//en.wikipedia.org/wiki/continuing_professional_develop ment

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Questions on How to interpret your financial statements
Questions 1.1 A good indicator of your business health and money generating ability is: A. Your financial statements B. The car you are driving C. Your income tax return form D. All of the above Question 1.2 What is the importance of being able to interpret your own business financial statements to the entrepreneur? A. To submit to SARS B. To use as security when you want to purchase something C. To procure an overdraft or to raise money. D. All of the above Question 1.3 What is the essence of the income statement? A. You can only borrow from the bank what you can measure on your income statement. B. You can only spend what your income statement allows you. C. You can only manage what you can control and you can only control what you can measure. D. You can only measure your debt Question 1.4 Overheads are described on the income statement as: A. variable/indirect expenses B. non-variable/indirect expenses C. variable direct expenses D. non-variable/direct expenses Question 1.5 Gross profit of your income is determined by: A. deducting the cost of sales from the sales B. dividing the cost of sales by the sales C. deducting the available stock from the closing stock Question 1.6 The GP percentage is important because: A. it indicates that you are doing better than your opposition B. it indicates whether the mark-up that you envisaged for your product has filtered through to the results C. it indicates that your business is healthy D. it indicates that your mark-up is too high Question 1.7 Owners expenses includes semi business expenses that can be defined as follows: A. expenses where the owner also get an advantage from B. expenses that only benefits the business C. expenses that only benefits the owner of the business D. expenses that benefits neither the business nor the owner Question 1.8 A good measure for determining a salary for an entrepreneur who earns a Net Profit of R30 000 would be: A. 10% B. 15-20% C. 30% D. 50% Question 1.9 When reviewing your income statement, A . it is important to view every month in isolation B. the month following the month under review is more important than the results of the current month C. it informs you of your fixed assets D. none of the above Question 1.10 A necessary monthly exercise would be to review the; A. similarities in income on your statements B. similarities in expenses from one month to the next C. differences in your direct expenses D. differences in the indirect expenses, the amount of change and reasons thereof

Anterior dental aesthetics: Historical perspective

Question 2.1 The predominant force in composition is: A. form B. colour C. angles D. lines Question 2.2 The maxillary anterior teeth are: A. triangular B. round C. square D. a fusion of the above Question 2.3 Prominent vertical lines on the facial surface of an anterior tooth will infer the illusion of a: A. wider tooth B. shorter tooth C. longer tooth D. none of the above Question 2.4 The ancient Greek who, through mathematical quantification of beauty came up with the Golden or Divine Proportion was; A. Plato B. Pythagoras C. Caesar Question 2.5 The ratio objects animate or inanimate has to conform to, to be considered innately beautiful is: A. 6.180 B. 1.680 C. 0.861 D. 0.618 Question 2.6 The Golden or Divine Proportion is true for perfection, but in nature such beauty is neither prevalent, nor desirable. In order to create individuality and diversity in nature, the following will be most important: A. A specific ratio B. Irregularities C. Repeated or recurring proportions D. Angulations

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Questions
C. D. core build-up or a metal implant use in the anterior segment of the mouth for full coverage crowns

Question 2.7 Aesthetic elucidation is only apparent in natural and artistic beauty when combined with the principles of: A. dynamic symmetry B. static symmetry C. asymmetrical proportions D. geometry Question 2.8 The tectonic arrangement of teeth refers to an arrangement that is: A. according to the curve of Spee B. following the Golden or Divine Proportion C. allows the anterior teeth to form a straight insisal line D. both functional and aesthetic Question 2.9 The Gestalt principle conveys the idea that the whole is different from the sum of its parts. The significance of this principle in dentistry is that: A. B. C. D. anterior and posterior teeth are used to create an aesthetically pleasing smile teeth has a profound impact on an individuals personality and well-being it has an influence on the proportion of anterior maxillary teeth it creates harmony and unity in the smile

Question 3.3 DECOMPOSITION of glass-containing systems is mainly due to: A. the 9.5% hydrofluoric acid used to etch the restoration B. water in the saliva and dentin tubules that react with the glass C. insufficient cementation procedures D. crack propagation due to external forces implied on the material Question 3.4 Select the phrase that INCORRECTLY describes Glass-Infiltrated materials: A. may contain up to 35% partially stabilized zirconia B. may have a flexural strength of up to 800Mpa. C. may demonstrate a high opacity D. may not be etched with hydrofluoric acid Question 3.5 What is the flexural strength of LDG, of which IPS Empress 2 is an example? A. 105 MPa 120 MPa B. 300 MPa 400 Mpa C. 283 Mpa 377 Mpa D. 500 Mpa 650 Mpa Question 3.6 Polycrystalline ceramic material used in frameworks for dental application: A.. is created using CAD/CAM technology exclusively B. has a maximum flexural strength of 650Mpa C. contains no glass particles and cannot be etched D. can only be used for full coverage crowns and fixed partial dentures Question 3.7 General concepts relating to clinical considerations when using all-ceramic systems, where inadequate resistance and retention exists will focus on: A. fabricating a new foundation restoration B. insuring that finish lines are 90-degree rounded shoulders C. placement of finish lines at or slightly below the free gingival D. including undercuts in the preparation to compensate for the loss of retention Question 3.8 The all-ceramic material that has a radiopacity similar to metal, allowing the clinician radiographic evaluation of the restoration is: A. GIMA B. Y-TZP C. DSHPA D. LRS Question 3.9 When an all-ceramic core material has to be selected, which of the following factors WILL NOT BE a primary consideration? A. mechanical properties of the material B. finish line and gingival health as this will affect moisture control C. the transformation toughening of the material

Question 2.10 Teeth of different shades, irregular form and erratic positions causing disharmony and visual dissatisfaction are dental examples of the A. B. C. D. Zeigarnick effect where closure cannot be obtained Wertheimer effect that combines aesthetics in a coherent and logical manner. Pragnanz effect that implies that the mind organises the outside world. Sir DArcy Thompson effect that introduces the concept of art deco into dentisty

All-Ceramic Full-Coverage Restorations: Concepts and Guidelines for Material Selection.

Question 3.1 As a general rule, when discussing all-ceramic materials, one could say that: A. all of these materials contain glass particles B. all of these materials depend on successful adhesive cementation for strength C. all of these materials should be etched and silanated before cementation D. higher glass contents leads to higher aesthetics, but diminishes strength Question 3.2 Leucite-Reinforced Glass-Ceramics are glass structure core materials reinforced by leucite crystalline fillers. The contra-indications for this material are: A. where a high aesthetical result is needed B. where the underlying abutment is discoloured has, a metal

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D. whether or not the abutment is toothcoloured Question 3.10 Where a patient presents restricted interocclusal distance and inadequate resistance and retention form, what material does the author recommended? A. Zirconia restoration B. Metal-ceramic restoration with metal on the occlusolingual surfaces C. Glass-Infiltrated Alumina restoration D. Densely Sintered High-Purity Aluminum Oxide C. D. b; c; d and e b and e

Reducing the alloy thickness of base metal ceramic restorations.

Question 4.1 The three point bending test placed the porcelain under A. Compressive stress B. Occlusal stress C. Tensile stress D. Flexure A. B. C. D. a and b above are correct b and c above are correct c and d above are correct a; c and d are correct

Question 4.5 In order to match the noble metal ceramic control the following happened: A. The base metal ceramic specimens tensile strength was equal to or slightly greater than that of the noble metal ceramic specimens B The base metal ceramic bond strength was equivalent to the noble metal ceramic specimens strength C. The base metal ceramic specimens overall thickness was equivalent to that of the noble metal ceramic specimens D. The base metal ceramic specimens porcelain thickness was equivalent to that of the noble metal ceramic specimens The following statements are correct: A. a and d B. c and d C. b and c D. a; b and d Question 4.6 From this study: A. Aesthetics of base metal ceramic restorations can be better than noble metal alloys B. Base metal ceramic aesthetics can be improved by adhering to the recommendations C. Aesthetics of Noble metal ceramics can be improved D. Strength and not aesthetics was tested The following are correct: A. a; b; c; and d B. a and c C. b and c D. b and d Question 4.7 A smaller standard of deviation of base metal ceramic specimens means that: A. Specimen manufacture dimensions were inconsistent B. More predictable results are expected C. The differences between results were small D. The differences between results were more inconsistent The following answer is the most correct: A. a only B. b only C. a; b and c D. b and c E. b; c and d Question 4.8 Which one of the following statements is correct according to the article: A. Design variation for invivo results was not tested B. Permissible 33.3% reduction in tensile strength was established C. A minimum reduction of 1.0 mm of enamel is recommended for metal ceramic restorations D. A 0.1 mm base metal alloy thickness will certainly result in metal ceramic failure

Question 4.2 According to the article, the metal thickness of noble metal ceramic restorations can confidently be reduced to a minimum of: A. 0.1 mm B. 0.2 mm C. 0.3 mm D. 0.4 mm Question 4.3 The literature on metal ceramics in the article reports that base metal alloy thickness can be reduced to however the article --------recommends a minimum thickness for base metal alloys ------- A. 0.1 mm B. 0.2 mm C. 0.3 mm D. 0.4 mm The consecutive answers to the above statement is: A. b and then c B. a and then b C. a and then a D. b and then b Question 4.4 This study evaluated strength of variation in thickness of the following: A. Noble metal alloy B. Base metal alloy C. Enamel D. Opaque E. Dentine The correct answer is: A. a and b B. b

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Questions
Question 4.9 Which of the following statements are not correct according to the study: A. It is recommended that the influence of porcelain variation in thickness be evaluated B. Strength of base metal ceramic restorations increased in linear proportion to the alloy thickness C. This study evaluated strength of metal ceramic specimens from 1.1 to 1.4 mm thick D. The lower strength values were considered Question 4.10 The article provides a realization for the need to: A. Provide enough space for metal ceramic restorations when preparing the teeth B. Provide adequate base metal alloy thickness for metal ceramic restorations C. Provide a minimum porcelain thickness for metal ceramic restorations D. Provide a minimum noble metal alloy thickness for metal ceramic restorations The following answer is the most correct: A. None of the above B. a and b above C. b and c above D. b; c and d above E. All of the above Question 5.5 Who are the body holding regulatory powers as far as the CPD process is concerned? A. DENTASA B. SADTC C. Health Professions Council D. SADA Questions 5.6 I am aware of an unregistered laboratory in my area. Who can I contact in this regard? A. DENTASA B. SADTC C. Heath Professions Council D. The Department of Health Question 5.7 Which of the following will exempt a qualified technician/ technologist from the CPD programme? A. Pregnancy B. Unemployment C. Recession D. None of the above. Question 5.8 Who is responsible for the accreditation, administration and supply information for audit of the CPD programme for dental technology in South Africa? A. DENTASA B. SADTC C. Heath Professions Council D. The Department of Health Question 5.9 I am still waiting for my laboratory registration certificate, who should I contact in this regard? A. DENTASA B. SADTC C. Heath Professions Council D. The Department of Health Question 5.10 Who do I contact, should I want to get a course accredited for the CPD programme? A. The Universities B. The Educational Committee of the SADTC C. DENTASA D. Dental suppliers

The difference between SADTC & DENTASA and their roles in CPD
Question 5.1 Who is the registrar of the SADTC? A. Adv Mandla Mnyatheli B. Prof Phumzile Hlongwa C. Mr Kapache Victor. D. Dr Phineas Molgotho Question 5.2 Who initiated the CPD programme for dental technology in South Africa? A. DENTASA B. SADTC C. The universities D. The Department of Health. Question 5.3 I would like to suggest a new item to be placed on the National Reference Price List. Who would be the correct contact in this regard? A. DENTASA B. SADTC C. The Health Professions Council D. The Department of Health Question 5.4 Who meets with the South African Dental Association (SADA) to discuss issues on behalf of the dental technician/technologist? A. DENTASA B. SADTC C. The Health Professions Council D. The Department of Health

From A 1970 Popular Mechanics

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MAG09-Q2

Questionnaire
You can also do your Questionnaire online and receive your results faster. Name:____________________________________________ Surname:_________________________________________ SADTC Registration No:_____________________________ Tel:______________________________________________ Fax:_____________________________________________ E-mail:__________________________________________
Participation in CPD activities on our web site is completely free and can be used by students and practitioners to update and improve their profesfee is, however, charged for the issuing and processing of CPD credits. Please note an 70% pass rate is required.

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sional knowledge and skills without acquiring credits. A very reasonable

You will receive your marks once proof of payment has been received and naire: Q2

your questionnaire marked. Please use this code to identify the questionBe sure to include your Initials and Surname as well.

Submit answers online at www.dentasa.org.za or Fax to: 087 9417 335

Credits:

Online and Fax submissions: R30-00 (incl VAT) per credit. Hard copy of the magazine: R40 (including postage, excluding 8 credits x R30 + R40 = R280 all inclusive. credits). 8 Credits x R30 = R240

You can pay per: Direct Deposit: ABSA Brooklyn

Or Credit Card at www.dentasa.org.za

Branch code: 630345 Account name: DENTASA CPD Account number: 407 434 8626 (Please quote Q2 and initials + surname as reference)

Deadline for this issue: 31 October 2009

5.1 5.2 5.3 5.4 5.5 5.6 5.7 5.8 5.9 5.10 A B C D E

4.1 4.2 4.3 4.4 4.5 4.6 4.7 4.8 4.9 4.10

A B C D E

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Venue Contact Tel No WEB/Email Dental Science, DUT 031 373 2044 andrelr@dut.ac.za Dental Science, Tygerberg Campus, Sar021 993 1048 leh Dollie Building, Computer Room. 3-11 Tand & Mond Hospitaal UP Prinshof Kampus 11:30 - 13:30 R60 14 Orchard Ave, Bordeaux, Randburg 011 476 1759 East London, Port Elizabeth Bloemfontein, Florida Johannesburg, Pretoria Durban, Nelspruit, Middleburg Klerksdorp ,Mafikeng Polokwane, Kimberley Upington, Bellville Tygerberg Campus, George Stellenbosch, Worcester Windhoek For more info see page 41 Peet van der Walt pvdw2@hotmail.com 1 approved CPD Credits 3applied for

Future courses

Date Sept. 2009 15/09/2009

bbokma@global.co.za 7 approved

Function Lazer Welding Dental Technicians and Technologists are invited to become experts at powerpoint presentations. 23/09/2009 Lecture on mouthguards for the prevention of injuries (Manufacturing) By Prof FA de Wet 9-10/10/2009 Basic Surgical course in implant placement for the dental team 15/10/2009 Satellite CPD Update for Dental Technicians 021 993 1048 truterm@cput.ac.za

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Satellite CPD Update for Dental Technicians

Location Main Road Amalinda City 13 Amaway Centre East London Seats 20 Number of Region Eastern Cape Location NRE House 2de Floor 161 Zastron Street Westdene Port Elizabeth 30 Eastern Cape Bloemfontein Location Embury Institute for Teachers Education Embury House City Florida Number 60 Region Gauteng Morningside Durban City Durban Number of Seats 20 Region Kwazulu Natal City Bloemfontein Number Of Seats Region 12 Free State & Northern Cape

41

1st floor, Suite 6 Hurd str.

c/o 5th Avenue and Newport Park

Port Elizabeth Location Florida Campus

119 Windermere Road

Of Seats

C/O Christiaan de Wet & Pioneer Avenue 2nd Floor G Block, Room G23

Location Standard Bank Centrum 1st Floor

City Nelspruit

Number of Seats 50

Region Pretoria & Mpumalanga

Brown street 31 Old Johannesburg Stock Exhange Bluiding 1 Kerk Street(c/o Kerk & Diagonal street) New Town 1st Floor, Room 104 Johannesburg Unisa Sunnyside Campus c/o Mears Street & Walker Street Bulding 15, Room G16 Ground Floor Pretoria Pretoria 60 Pretoria & Mpumalanga Jhb 30 Gauteng Nelspruit Town Square Damane Street Middelburg 50 Pretoria &

Cnr Church & Bhimy

Mpumalanga

Middelburg

Location West End Building 41 Leask Street Room 308 Klerksdorp

City Klerksdorp

Number of Seats 30

Region Jhb & North West

Location 23a Landros Maree Street Satelite delivery venue Polokwane Location Unisa Liberty Life Building c/o Chapel & Vurrey Street Kimberley

City Polokwane

of Seats 40

Number

Region Northern Province

Plot 2586 (Opposite Mafikeng ABSA Bank) 29 Main Str Mafikeng Location Bellville Park Campus Room 102 Bellville

30

North West

City

Number of Seats 90

Region Western Cape

Van Der Horst Building Bellville City Kimberley of Seats 25 Number Region Northern Cape

Room F334

Fisan Building

Tygerberg Kampus

42

Western Cape

Fransie van Zijl RD 21 Northern Cape Tygerberg Kampus Shamrock Place 97 York Street Ground Floor Room 34 A George DEN TAS A

Roman Catholic Church Upington Vaal University of Technology Upington Le Roux Street

George

30

Western Cape

DENTAL TECHNOLOGY ASSOCIATION OF SOUTH AFRICA COPYRIGHT