Digital dentistry in the 4th dimension

The German Society for Computer-Assisted Dentistry (DGCZ) offered an online masterclass in digital dentistry in the 4th dimension as part of its 28th CEREC Master Course from June 25-27, which was held digitally for the first time, a kaleidoscope of application options and workflows within computer-aided dentistry. The following section outlines individual highlights and key parameters that provide answers to the question of which new applications and treatment methods will really advance digital dentistry and which key technologies will make this possible.

Click here for the report...

Recommendations for restorations with all-ceramic crowns and bridges

The S3 guideline for the treatment of dental patients with all-ceramic crowns and bridges published by the German Society for Prosthetic Dentistry and Biomaterials e.V. (DGPro) and the German Society of Dental, Oral and Maxillofacial Medicine (DGZMK), newly published in March 2021, is intended as a systematically developed aid for dentists to make decisions in specific treatment situations. The recommendations are weighted by assigning an evidence level and a corresponding recommendation grade. This edition, updated and supplemented based on the latest scientific evidence, supersedes the previous version of 08/2014.

Read the current full version of the S3 guideline here.

EA report on the new S3 guideline by Dr. Annika Jerg, Dr. Frank A. Spitznagel, Prof. Dr. Petra Gierthmühlen

Navigation leads to clinical success
Dentists in private practice compare treatment data - click here for the report

Ceramic layer thicknesses redefined - by Prof. Karl-Heinz Kunzelmann, munich

Cumulatively, 690 dentists in private practice have joined the CSA field study and provided 23,767 insertion findings and 35,475 follow-up protocols over 20 years (as of Sept 2017).

Thus, this worldwide unique longitudinal study with high patient fidelity provides a lot of information from the dental practice on the clinical behavior of ceramic materials, dentin adhesives, material combinations and their survival rates.

Read the report here.

In-house, objective evaluation of new materials and methods - the best tool: CSA

We are currently inundated with a flood of new materials and recommendations on how to handle them better. It is often difficult to keep an overview, especially since some statements contradict each other. The Ceramic Success Analysis CSA offers the possibility to evaluate your own individual handling of a technique objectively. You tell us what you do. And how you do it. And we compare your approach with that of your colleagues who are already participating (based on more than 250 practices with well over 10,000 all-ceramic restorations in place).

You report on the clinical course and we compare your results with those of the entire group. Event analysis and success analysis with cumulative survival curves (Kaplan Maier) serve as objective benchmarks. Your results are immediately available to you online and you also receive annual feedback comparing your results with those of your peers (based on results for up to 30 years).

Since an individual database is created for you online, the input is very easy and can easily be delegated, while the personal benefit is very high.

Some colleagues go one step further:
You use your proven procedure on the same patient with the existing material on one tooth while a second tooth is restored with the new, highly praised material or with an alternative method. The objective criteria allow for an individual assessment.

The project is free of charge for participants thanks to the support of AG Keramik. Take part, it's worth it. And we look forward to your participation.

www.csa-online.net

In concrete terms, participation in the CSA study involves three steps for the dentist:

• Preparation of an insertion protocol for 50 patients

• Logging of follow-up examinations and events

• Evaluation of your own results by comparison with the mean values of your colleagues.

The time required for this is low and can be delegated. Data entry is done online at:

www.csa-online.net  

After entering the data, the Internet dentist can view the evaluation of the insertion findings in graphical form directly online. The individual practice data and the average values are displayed anonymously. Individual data such as the initial clinical situation, clinical procedure, special measures, size of restoration and tooth type are color-coded according to groups. Particularly conspicuous differences between individual data and average values are commented on. The dentist can use this evaluation to draw valuable conclusions for his practical procedure. In addition, there is also the possibility of direct contact with the AG Keramik in the case that important queries arise. This means the possibility of concrete feedback and exchange of experience and information. All this is done in a collegial manner, anonymously, voluntarily and on an international level.

Experiences from a pilot study with 250 colleagues, who pioneered this project and have contributed with the documentation of more than 4 4000 cases over 12 years, show howmany implications can result from the analysis of the insertion protocols alone. Not only the different indications, but above all the unexpected spectrum of possibilities in the clinical procedure were surprising.

Follow-up examinations can also be entered online. In this case, the parameters of interest are those commonly collected during a routine consultation. Events, complications, therapeutic follow-up or failures are recorded separately.

Here, too, a direct analysis is available online in graphical form. Particularly clear is the Kaplan-Meier representation of the probability of success, which directly displays the own result for each individual practice in comparison with the overall group - a unique tool in dentistry.

Consistently positive feedback from the currently 200+ project participants has confirmed that the evaluations and results are of great relevance to practitioners, and that AG Keramik's quality assurance project has now become an important platform for the collegial exchange of information. Admission to the quality assurance project is both unbureaucratic and quick: Log on to www.csa-online.net - register and receive identification, enter data. If you have any questions or problems, just call the AG Keramik office and you will be helped. The quality assurance can start tomorrow.

A certificate will be sent as recognition of voluntary participation at the end of each year after receipt of the insertion results or the respective follow-up examination results (whereby not all teeth must have been checked in each year). Furthermore, each dentist receives his or her annual evaluation. Regional subgroups, such as those formed by the pilot group participants, offer another very efficient way of exchanging ideas and experiences.

The results we have already achieved after a relatively short period of time are extremely remarkable. Very concrete consequences for individual practitioners are emerging very quickly, and the potential is far from exhausted. If, for example, you want to switch to a different ceramic or use a different material or try a new placement technique, you can compare two groups in your practice. One selects a dentist number for procedure "A" and orders a second dentist number for procedure "B". The follow-up check then quickly provides objective clarity as to whether there are any differences between the procedures, and if so, what these are. It has been shown that individual handling, one's own, treatment-specific "handling" of the materials can be a more important parameter than objective laboratory data. One's own documented clinical experience is always better than relying solely on the statements of the depot representative or colleague or scientific guru.

It is a good feeling to know what you are really doing and what comes out of it.
Dr. Bernd Reiss

Anyone interested in practice quality assurance can contact:

Arbeitsgemeinschaft Keramik e. V.
Postfach 11 60
D-76308 Malsch
Tel.: (0721) 945 2929
Fax: (0721) 945 2930
info@ag-keramik.de
www.csa-online.net

AG Keramik offers dental technicians participation in long-term study.

ETTLINGEN. – Clinical studies in dentistry are usually conducted at universities and serve as proof of the quality of treatment procedures and restorative materials. However, since dental restorations are predominantly performed in private practice, their clinical findings and follow-up results have considerable relevance for the quality standard in generalist practice. Exemplary and internationally unique in this context is the quality assurance study of the Society for Dental Ceramics (AG Keramik). Dentists practicing in private practice have been recording the findings of their all-ceramic restorations for 15 years, submitting the results to AG Keramik under www.csa-online.net and receiving a comparison with the anonymized mean results from all study participants. With the data from this "Ceramic Success Analysis" (CSA), individual dentists can compare their own clinical procedures and modify them if necessary.

Wouldn't comparative quality statements on restorative technique drawn up on an inter-company basis also be of interest to dental technicians? It is true that there are dental laboratories which document their own quality characteristics in order to be able to reconstruct the reasoning and procedures in the event of possible customer complaints. However, they lack the possibility of comparison with the experience of colleagues in other laboratories. As a result, they also lack a procedure to evaluate proven techniques on a broader basis using documented cases and to assess risks for materials and manufacturing processes in advance.

In view of the large number of new materials and treatment procedures, many dentists have joined together in quality circles to share their clinical experience. It is therefore perfectly legitimate and even strongly recommended that dental technicians also share their results anonymously on a broad platform and thus gain new insights.

The good experiences from the quality assurance project with dentists in private practice have prompted the AG Keramik to set up a platform as a "long-term quality assurance study for dental technicians" under the name "Ceramic Success Analysis Plus". On a survey form (Fig. 1) for large-unit, all-ceramic restorations, the dental technician indicates the initial conditions of the work, such as type and extent of restoration, preparation form, material used as framework material, framework design, fabrication method, connector dimensions, sintering and veneering technique, and submits the form to the AG Keramik. This places the participant in a quality-oriented network of dental laboratories that want to know how safe and durable their all-ceramic work is. The dental technician receives an evaluation back from AG Keramik, which contains his own data and the average values of all collegiate study participants. This allows each participant to analyze the selected procedures independently of the system and material and to gain experience about material and processing combinations. The identification of risks from reported failures is among the other advantages of the study. The dentist will particularly appreciate it if his dental technician methodically controls the quality of the work and gains knowledge for proven manufacturing processes trough collegial, anonymous comparisons.

Participation in the "Ceramic Success Analysis Plus" study is free of charge for dental technicians.

Registrations are accepted by the AG Keramik: Tel. (0721) 945 2929, Fax 945 2930, 
Email: info@ag-keramik.de

Contact: Cornel Weber ZTM, AG Keramik 

Email: cornel.weber@vollkeramik.de

You can download the flyer on quality assurance "Ceramic Success Analysis Plus" here.