CUSP ON THE. Tips & Trends: Creative Solutions. Cementation Procedures for Dental Implants. Upcoming Innovations in Digital Dentistry

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1 ON THE SPRING 2014 CUSP Trends, Tips nd Technology 2 Tips & Trends: Cretive Solutions 4 Cementtion Procedures for Dentl Implnts Permnent & Retrievble Options for Cementtion 6 Upcoming Innovtions in Digitl Dentistry from DENTSPLY Implnts Compliments of Town & Country Dentl Studios 7 Permnent Gme Chngers Opportunities for New Dentists

2 2 TIPS & TRENDS TipS & TrenDS Cretive Solutions Thebigbuzzisscrew-retined.It usully goes likethis: Ittended seminrndwsdvisedtodo screw-retinedimplntrestortionsndnottousecement. Excess cement is leding cuse of implnt filure. Stock butment with improper mrginl depth nd emergence profile Cement die jig creted from intglio of restortion. Blue mousse or impression mteril cn be used s well. The question is: Whyisexcesscementleft inthesulcusre,endngeringthelifeofthe implnt? Should we be tossing cementble restortions out with the irrigtion wter? Of course not! Creful cementtion technique,suchstheuseof cement die jig to express excess cement outside the mouth, nd plcing just the right mount of cement in the restortion, should eliminte excess cement or minimize clenup. But poorly designed restortions or improperly chosen stock butments will not provide the emergence profile or mrgin depth tht is needed to prevent cement from creeping into the sulcus. And once cement is set severl millimeters below the gingivl mrgin,it mybe there tosty. Don t despir help is on the wy! WithTown&Country ssimplsystem,wecustomdesignnd mill n butment with the proper emergence profile nd nturl contour of the tooth being replced, nd the correct mrginl depthndwidthforthecrownthtisdesired.weknowthtnot every implnt cn be restored with screw-retined restortion. Implnts cnnot lwys be plced where the ccess hole for the screw is fvorble, or my be ngled too severely to provide the necessry pth of insertion or contct re. Cementble restortions reoftennecessrynddesiredbyptientsnddentists. Thenthere stheneedforretrievbility. Wht if the screw loosens? is common concern. Why does the screw loosen? Is it due to insufficient ATLANTIS Abutment in gold-shded titnitum nd PFM (high noble yellow gold) torque? Too much torque? Occlusl interferences? Improper seting of the butment? The million dollr question. Andifthescrewloosenswith cementble restortion, must the crown or bridge be scrificed to get t tht nstyloosescrewcretingllthese problems?mybenot.withtheuseof temporry cement you my not need to destroy the crown, nd possibly the butment, in serch of the elusive screwhole.joeapp,cdtndgenerl Mnger t Town & Country, is the uthor ofnrticleinthisissueddressing cementtion issues nd offers suggestions for choosing the right type of cement. Screw-retinedoptionscontinuetogrowsmterilsnd componentshvebeendevelopedndusedsuccessfully.while PFMutilizingUCLAbutmentisthemostcommonndoften prcticl wy to restore single or multiple implnts, our offerings hveexpndedtoincludescrewretined zirconi restortions such szirlux,zirlux-plusndzircd, ndourverypopulremxcrown. When occlusl clernce is limited ndmyrequiremetlocclusionor bite stop, screw-retined cermic restortion my be possible for more esthetic result. The interfce with the implnt is titnium nd hs substntil bse tht is bonded tothecermiccrown.thetitnium my be gold-shded to enhnce theshdeofthecermicmteril. Screw-retined Emx Press crown Cover in this issue Upper nd lower hybrid prostheses fbricted with CAD/CAM titnium brs, nd processed with IVOCLAR Blueline teeth nd IVOBASE. Town & Country Dentl Studios Permnent & Retrievble Options for Cementtion Upcoming Innovtions in Digitl Dentistry from DENTSPLY Implnts Specil thnks to DENTSPLY Implnts for their support in the development of this issue Town & Country Dentl Studios Opportunities for New Dentists T s

3 TIPS & TRENDS 3 or s n Screw-mentble restortion utilizing Atlntis custom CAD/CAM titnium butment nd Zirlux full contour zirconi crown Ifyouwnttheretrievbilityof screw-retined restortion, but the ese of insertion of cementble one, we hve just the thing. It s screw-retined. It s cementble. It s screw-mentble. A SIMPL custom butment combined with crown of your choice is fbricted, but the crown will hve screw ccess hole in the smepositionsinthebutment. Youcnsetthebutmentnd then the crown, llowing you to mkedjustmentstothecrown if needed without hving to unscrew the restortion s you would with one-piece screwretined crown. Cementtion of the crown to the butment mybedoneoutsidethe mouth, so no worries bout excess cement in the sulcus. Designingthe right restortioncnbechllenge whenconfronted with limited occlusl verticl dimension, prticulrly when n entire rch is being restored. Incresing theovdisnotlwyspossibleormy be insufficient to llow the necessry clernce for the restortion of choice. A screw-retined restortion on multiple implnts mybetheonlyvible option, nd idel implnt plcement is criticl to void unfvorble positioning of screw ccess holes, such s on the fcil or buccl surfces of the teeth. Hybrid prosthesis CAD/CAM titnium br When implnt plcement does not llow fvorble ccess hole positions for hybrid br, double structure my be the only option. The interocclusl spce then becomes even more criticl s every frction of millimeter hs to be llocted to thevriousrestortivemterils. A milledcad/cambrcn be designed with vrious ttchments depending on the spce vilble for ech individul tooth. For exmple, there my be roomfor LoctororEqutorttchmentinthemolrre, but only enough room for gold clip in the nterior region. CAD/CAM titnium br with combintion of loctor butments nd hder clips Echcseisuniquend deserves thoughtful plnning nd cretive solution. We recently fbricted restortion for young ptient following mndibulr resection. Implnts were plced where bone ws vilble, significntly fcil nd buccl to idel positions. The nterior implnts were close to thevermilionborderofthelip. CAD/CAM titnium br Montrel design Andthedistncebetweenthe lower ridge nd upper teeth ws excessive. The ptient desired fixed prosthesis. With hybrid prosthesis, the potentil problems were visibilityofscrewholeson the fcil surfces of the teeth,ndscrewccessholes so deep tht driver would bottom out before the screws Completed prosthesis reched the implnts. A double structurehddvntges inthtthescrewholesofthebrwouldbehiddenbythe overdenture,buttheoverdenturewouldneedtobesecured directly to the br with screws in order to be fixed. However, even with the superstructure kept to miniml thickness, it likelywouldcusethelowerliptoprotrudeunnturlly. After dignostic records werecompletedndthetril setup ws pproved, we werebletovisulizethe ccessholepositionsnd selectthebestoption.the finl design ws Montrel stylehybridbr.thescrew holeswereplcedinthe pink Ivobse crylic with the exception of the two most nterior implnts. Tht segment of the br ws left highly polished to llow the lip to rest comfortbly. Pink composite will be used to fill the holes in the Finl insertion. Dr. Nicole Sklin, NY bse mteril. An implnt plced in the #19 position ws restored s single screw-retined Emx crown. Whether you re restoring single implnt crown or n entire rch, there re mny options to consider. Let us help you determinethebestoptiontorelizeyourtretmentgolsnd your ptient s expecttions. Todiscussnexistingorfuture cse,plesecontctjerilynt ext. 213 or jspoznick@tncdentl.com. Jerilyn Spoznick Implnt Deprtment Director Town & Country Dentl Studios The CAD/CAM titnium superstructure Finl overdenture

4 4 CEMENTATION A new prdigm: Cementtion procedures for Dentl implnts Prt II: Permnent & Retrievble Options for Cementtion The success of implnt restortions depends not only on the sound osseointegrtion of the implnt fixtures, but lso on the integrity of the connection of the prosthetic superstructure to these fixtures. In screw-retined designs, loosening or brekge of the screws my led to filure or replcement of the whole implnt. For cement-retined designs, dissolution of cement my led to loss of the bond between the finl prosthesis nd implnt butment, thus requiring recementtion. 1 Although the use of cemented superstructures limits the retrievbility of the prosthesis, it hs been successful in simplifying the restortive phse of tretment. An dvntge of cemented superstructures is tht conventionl prosthodontic procedures my be used during the clinicl nd lbortory phses of restortive tretment. Moreover, the cement-metl interfce llows for smll discrepncies which re not cceptble in screw-retined restortion, nd my even ct s shock bsorber. 2 One more dvntge of cemented superstructure is tht minor divergence of implnts cn be esily corrected during butment design which mkes it even esier to ccomplish esthetic restortions, s the butment bulk cn be more fvorbly mnged. 3 On the other hnd, permnent cementtion of implnt-supported restortions should only be considered when future retrievbility of the prosthesis for repir or modifiction is not desired or when surgicl correction of peri-implnt tissue problems is not nticipted. 4 Permnent cementtion my become gret disdvntge in cses of loosening of the butment screw, porcelin frcture or even if frmework frcture occurred. 5, 6 Sometimes, conventionl cst fixed prostheses re recommended to be provisionlly cemented to butment teeth in order to evlute occlusion nd tissue rections nd hs been dvocted for up to two months. 7 This lso pplies to implnt-supported nd implnt-tooth-supported prostheses which re sometimes provisionlly cemented to evlute occlusion nd occlusl loding of the implnt fixture. Provisionl cements my lso be used s finl cements in cses of implnt supported restortions. 2 The type of provisionl cements selected for given clinicl sitution controls the mount of retention obtined. 2, 8, 9 However, provisionl cementtion is unpredictble to some extent, due to the mny different fctors tht influence the retentiveness of restortion 10, 11 nd cn result in difficult retrievl or premture loosening. For implnt systems in which the butments re cemented to the fixtures, the provisionl cement must be strong enough to resist functionl forces, but wek enough to llow esy removl of the superstructure when necessry 2, 12, 13 without hrm to the butment nd implnt fixture. Implnt supported fixed restortions my be cemented to butments with provisionl luting gent to enble removl of the restortions. The tensile bond strength of the cement must be gret enough to resist lterl nd verticl forces during function. The tper, surfce re nd texture of preprtions ffect the retention of the csting. 14 With regrd to potentil retrievbility of cement-retined implnt restortions, the retentive strength of the luting gents is criticl. Nejtidnesh 11 evluted the retention vlues of implnt-supported metl copings using different luting gents. He concluded tht the dul cure resin modified glss ionomer; zinc phosphte, zinc polycrboxylte, nd Pnvi F hd sttisticlly the sme retentive qulity nd re recommended for finl, definitive cementtion of single implnt-supported restortions. The provisionl cements nd glss ionomer my llow retrievbility of these restortions. In n in vivo study, Singer nd Serfty 1 reported success when implnt-supported cst restortions were retined with provisionl luting gents. Retrievbility of the cst restortion is desirble if intervention therpy is required nd for the mintennce of the supporting tissues nd implnts. The use of either provisionl luting gent or screw should llow retrievbility; however, provisionl cement should eliminte problems noted with screwretined prostheses. When cemented superstructure is used, conventionl prosthodontic procedures my be completed in both the lbortory nd clinicl phses of restortive tretment. Tensile bond strength of permnent dentl cements, such s zinc phosphte nd glss ionomer, hs been reported with both nturl butments nd implnt butments. However, published bond strength dt for provisionl luting gents used with cst restortions cemented to implnt butments is limited. The tensile strength of the luting gent should llow retrievbility when required, yet be sufficient to retin the prostheses during function. The results of the study showed tht thermo-cycling cused significnt reduction in the retentive vlues of ll provisionl luting gents investigted. This is in greement with the results obtined by Michlkis 16 nd Kokubo. 17 Michlkis 16 concluded tht therml cycling hd detrimentl effect on the retentive properties of ll cements investigted. Also Kokubo 17 stted tht the retentive force of TempBond NE decresed significntly fter therml cycling. They concluded tht TempBond NE my not be pproprite for the retention of single-tooth zirconi butments nd coping restortions. This is in greement with our results s TempBond nd TempBond NE hd the lowest retentive lod. Also Rmp 18 found tht Temp Bond nd Provilink temporry cement exhibited the lowest men tensile bond strengths, while Neo Temp cement exhibited tensile bond strength more thn three times tht of Temp Bond. Nejtidnesh 21 evluted the retention vlue of implnt-supported zirconium oxide cermic copings using different temporry cements nd concluded tht the retention of zirconi cermic restortions over ITI solid butments my be influenced by the type of cement. Michlkis 22 evluted the filure lods of four provisionl luting gents used for the cementtion of FPDs supported by 2 implnts or 4 implnts. Nogenol luting gent exhibited the lowest retentive vlues in both types of FPD while ImProv (polyurethne) ws the most retentive of ll cements tested, possibly relted to its higher compressive strength. They found lso tht Temp Bond NE nd Temp Bond presented significntly different vlues (P<.05) for the 2-implnt prostheses but not for the 4-implnt model. 22 The demnd for long term provisionl cementtion of implnt supported restortions hs resulted in some stndout solutions by dentl mterils mnufcturers: GC FujiTemp from GC Americ Telio CS CEM Implnt from IvoclrVivdent ImplntLink from Pret

5 CEMENTATION 5 GC FUjITEMP Fetures nd Benefits: Esy nd ccurte plcement nd seting due to thin film thickness nd moisture tolernce After 1 minute seting, esy removl of excess cement while still rubbery Finl 3 minute set to complete provisionl luting of the fixed prosthesis Gret hndling with no runny consistency in moist environment Ability to continully rechrge fluoride Biocomptible mteril tht is non-irritting to the tooth structure or soft tissue mking it n idel choice to help prevent peri-implntitis Excellent insultion (helps prevents therml sensitivity) Ionic bonding to tooth structures nd metls to optimize mrginl sel Tooth-like coefficient of therml expnsion to mintin mrginl sel Esy to clen-up with no dverse residul effect on finl cementtion which is common with eugenol cements Low film thickness (6 microns) High bond strength nd mechnicl properties for cses needing high retention TELIO CS CEM IMPLANT Telio CS Cem Implnt is self-curing luting composite cement with light-curing option for the esthetic temporry / semipermnent cementtion of metl-supported long term provisonls (e.g. Telio Lb), metl-free long term provisonls (e.g. Telio CAD) nd temporry nd definite crowns & bridges Fetures nd Benefits: Avilble in two different shdes, trnsprent nd opque Eugenol-free so suitble for use in conjunction with llcermic restortions or lb-fbricted composite restortions which re permnently cemented in the dhesive technique Comptible with ll conventionl temporry C&B mterils (e.g. Telio CS C&B) Suitble for temporry cementtion of long term provisionls s well s for definite crowns & bridges (metl, zirconium oxide) on implnt butments Good retention (esy removl), reversible, semi-permnent Rdiopcity Excellent esthetics, even where cement mrgins re visible Effective bcteri mngement due to ntimicrobil components Ese of use due to the convenient utomix double-push syringe Indictions: Semi-permnent / temporry cementtion on implnt butments mde of titnium, gold, or zirconium oxide IMPLANTLINk FROM PREAT Fetures nd Benefits: Long term provisionl cement specificlly engineered for implnt restortions Dmge free removl of implnt restortions using common stndrd ids (e.g. Crown Butler, Coron Flex) Thin (8 micron) film thickness for gret fit Dul cure for esy removl of excess cement Flexible processing times with the dul curing system llow for controlled gel phse nd esy removl of excess cement (lrge pieces, no crumbling!) Extremely low film thickness (8 μm) llowing for relible nd precise positioning of the restortion Secure dhesion, high compressive strength High cross-link density of the cement preserves mrginl gp sel, preventing penetrtion of bcteri nd swelling or detchment of the cement If you hve ny questions regrding cement choices nd cementtion procedures, plese contct Joe App, t ext. 228 or vi emil t jpp@tncdentl.com. Joe App, Generl Mnger Town & Country Dentl Studios REFERENCES 1. Singer A, Serfty V (1996) Cement-retined implnt-supported fixed prtil dentures: 6-month to 3-yer follow-up. Int J Orl Mxillofc Implnts 11: Breeding LC, Dixon DL, Bogcki MT, Tietge JD (1992) Use of luting gents with n implnt system: Prt I. J Prosthet Dent 68: Block MS nd Kent JN (1995) Endosseous implnts for mxillofcil reconstruction. pp. (l97-200) W.B Sunders Comp Phildelphi. 4. Chiche GJ, Pinult A (1991) Considertions for fbriction of implntsupported posterior restortions. Int J Prosthodont 4: Gnor Y, Indig B, Gross M (1996) Retrievble cemented crown options on implntsupported ngled butments: cse report. Quintessence Int 27: Hebel KS, Gjjr RC (1997) Cement-retined versus screwretined implnt restortions: chieving optiml occlusion nd esthetics in implnt dentistry. J Prosthet Dent 77: Rosenberg MM, Ky HB, Keough BE, Holt RJ (1988) Periodontl mngement for dvnced cses. Chicgo, Quintessence, Crter GM, Hunter KM, Herbison P (1997) Fctors influencing the retention of cemented implnt-supported crowns. N Z Dent J 93: Schiessl C, Schefer L, Winter C, Fuerst J, Rosentritt M, et l. (2013) Fctors determining the retentiveness of luting gents used with metl- nd cermic- bsed implnt components. Clin Orl Investig 17: McGlumphy EA, Ppzoglou E, Riley RL (1992) The combintion implnt crown: cement- nd screw-retined restortion. Compendium Nejtidnesh F, Svbi O, Ebrhimi M, Svbi G (2012) Retentiveness of implntsupported metl copings using different luting gents. Dent Res J (Isfhn) 9: Chee WW, Torbti A, Albouy JP (1998) Retrievble cemented implnt restortions. J Prosthodont 7: Lepe X, Bles DJ, Johnson GH (1999) Retention of provisionl crowns fbricted from two mterils with the use of four temporry cements. J Prosthet Dent 81: Shillingburg HT, Sther DA, Wilson EL, Cin JR, Mitchell DL, et l. (2013) Fundmentls of fixed prosthodontics, Quintessence Pub Co (4th edn), Chicgo. 15. Felton DA, Knoy BE, White JT (1987) Recementtion of dentl cstings with zinc phosphte cement: effect on cement bond strength. J Prosthet Dent 58: Michlkis K, Pissiotis AL, Kng K, Hirym H, Grefis PD, et l. (2007) The effect of therml cycling nd ir brsion on cement filure lods of 4 provisionl luting gents used for the cementtion of implnt-supported fixed prtil dentures. Int J Orl Mxillofc Implnts 22: Kokubo Y, Kno T, Tsumit M, Skuri S, Itym A, et l. (2010) Retention of zirconi copings on zirconi implnt butments cemented with provisionl luting gents. J Orl Rehbil 37: Rmp MH, Dixon DL, Rmp LC, Breeding LC, Brber LL (1999) Tensile bond strengths of provisionl luting gents used with n implnt system. J Prosthet Dent 81: Bldissr P, Comin G, Mrtone F, Scotti R (1998) Comprtive study of the mrginl microlekge of six cements in fixed provisionl crowns. J Prosthet Dent 80: Hunsker KJ, Christensen GJ, Christensen RP, Co D, Lewis RG (1993) Retentive chrcteristics of dentl cementtion mterils. Gen Dent 41 Spec No: Nejtidnesh F, Svbi O, Shhtoosi M (2013) Retention of implntsupported zirconium oxide cermic restortions using different luting gents. Clin Orl Implnts Res 24 Suppl A 100: Michlkis KX, Pissiotis AL, Hirym H (2000) Cement filure lods of 4 provisionl luting gents used for the cementtion of implnt-supported fixed prtil dentures. Int J Orl Mxillofcil Implnts 15:

6 6 INNOVATIONS Upcoming innovtions in Digitl Dentistry p Enhnced connectivity with introrl scnning DENTSPLY Implnts provides technologies tht mke it esier for ll members of the tretment tem to connect nd chieve the restortive results they expect every time. In ddition to the existing lb-bsed scnning options, the introduction of introrl scnning cpbility llows for incresed verstility. Introrl scnning with itero the first introrl scnning service for ordering ATLANTIS Abutments * : Clinicin cptures digitl impression nd trnsmits it to the dentl lbortory Dentl lbortory reviews the cse nd orders the ATLANTIS Abutment Esy to chieve prllelism Elimintes need for stock butments Fster restortive procedure Semless digitl workflow between clinicin, dentl lbortory nd DENTSPLY Implnts Improved order communiction No need for trditionl impression techniques Expnded verstility with solutions for edentulous ptients With ATLANTIS, DENTSPLY Implnts offers outstnding freedom of choice in cement-, screw- nd ttchment-retined restortions, fulfilling every ptient s requirements for esthetics nd functionlity. An dditionl solution for prtil or completely edentulous ptients now includes: ATLANTIS Conus Abutment two options for removble prosthetics: ATLANTIS Conus Abutment overdenture. A solution for removble overdentures ttched using ANKYLOS SynCone cps ATLANTIS Conus Abutment custom. A solution for removble bridges/overdentures with more individul design options I L t G D o Extended comptibility with new implnt interfces Incorporting ATLANTIS for ll mjor implnt systems into your portfolio offering is now even esier with expnded comptibility for the following implnts: ASTRA TECH Implnt System EV Zimmer Dentl Tpered Screw-Vent friction fit Introducing Immedite Smile feturing ATLANTIS Abutment for immedite individulized temporiztion in one single visit through fully digitl workflow. The Immedite Smile concept combines the proven benefits of SIMPLANT guided surgery nd ATLANTIS ptient-specific butments into solution tht delivers considerble clinicl nd ptient vlue. SIMPLANT Now prt of the DENTSPLY Implnts portfolio of solutions D O c p w T t 1 W I e W f * Currently, itero introrl scnning is only vilble for ATLANTIS cement-retined solutions. DENTSPLY Implnts does not wive ny right to its trdemrks by not using the symbols or. All trdemrks, compny nmes nd implnt designs re the property of their respective owners.

7 GAME ChANGERS 7 permnent Gme Chngers INTRODUCTION Levin Group hs identified 8 Permnent Gme Chngers tht re hving nd will continue to hve profound impct on the creers of dentists nd specilists cross the country: 1. The Gret Recession nd Uninspiring Recovery 2. Chnges in Consumer Purchsing Hbits 3. Opening of New Dentl Schools 4. Decrese in Insurnce Reimbursements 5. Expnsion of Dentl Service Orgniztions (DSOs) 6. Higher Dentl School Student Lon Debt 7. Fewer Associteship Opportunities for New Dentists nd Specilists 8. Dentists nd Specilists Prcticing 8 10 Yers Longer Gme Chnger #7 (Fewer Associteship Opportunities for New Dentists nd Specilists) is unique concern for new dentists nd specilists. As prctices struggle with reduced production, decresing number of offices hve the bility to expnd nd hire n ssocite. With fewer young dentists becoming ssocites, some re opting to join DSOs while mny others re opening their own prctices sooner thn they hd plnned. DEALING with GAME ChANGER #7 Dr. Roger Levin is third-genertion dentist nd the Chirmn nd CEO of Levin Group, Inc., the lrgest OMS prctice consulting firm in North Americ. Levin Group ws founded in 1985 when Dr. Levin recognized vitl missing link tht ws preventing orl surgeons from incresing prctice production. As leding uthority on OMS prctice mngement nd mrketing, he hs developed the scientific systems-bsed consulting method tht will increse prctice production nd profitbility, while lowering stress. He hs uthored 65 books nd more thn 3,200 rticles. Dr. Levin sits on the editoril bords of five prominent dentl publictions, serves s the prctice mngement editor of Compendium nd is the mnging editor of Dentl Business Review for Surgicl Prctices. He is regulr contributor to the Journl of the Americn Dentl Assocition. Owning prctice hs never been more chllenging. Dentists re expected to mnge stff, operte successful business nd communicte with other doctors while providing exceptionl ptient cre. Adding to these pressures is wek economic recovery, which hs mde it more difficult thn ever to grow prctices. To succeed in tody s competitive world of dentistry, new dentists need to concentrte on becoming better leders. Levin Group recommends: 1. Be Visionry Where do dentists wnt to tke their prctices in the next three yers? If they wnt to become successful prctice leders, they will need to estblish vision by sking the following questions: Where m I now? Where do I wnt to go? How m I going to get there? The nswers form the bsis of their vision sttement nd gols for the prctice. 2. Shre Ides Once dentists hve developed their vision sttement, they must let others know bout it. They ve worked hrd to crete it, so they should shre it with the tem. Red it out loud t monthly meetings. Hng it in the brek room. The vision sttement helps the tem see their future in the prctice. 3. Implement Systems Erly Mny doctors think they hve systems when wht they ctully hve re merely hbits mny of which re bd hbits developed over time. Younger dentists hve n opportunity to estblish strong systems for long-term success. Once systems hve been put in plce, the tem should be trined to use them properly. 4. Communicte with the Tem Dentists will spend mny hours ech dy with their tem. They must be informed bout wht s going on with the prctice. The doctor should sk for suggestions nd listen to their concerns. Too mny dentists fil to communicte effectively with stff, nd then wonder why confusion nd conflict hve tken over the office. Good communiction keeps everyone on the sme pge. 5. Strt off the Dy Right Begin the dy with morning meeting. This meeting will encourge n open dilogue nd llow the tem to discuss keys to mintin nd improve ptient cre. Dentists will lso hve n opportunity to uncover dditionl items such s how to: Prepre for the dy re emergencies or complex cses scheduled? Increse efficiency nd reduce stress 6. Let Go With step-by-step systems in plce, dentists cn hnd off non-clinicl responsibilities without worry. When tem members re given proper trining nd llowed pproprite decision-mking uthority, they will feel sense of self-confidence nd connection to the prctice. 7. Develop Cler Job Descriptions Dentists should be sure tem members know wht is expected of them. Write job descriptions nd keep them updted. Doctors cn lso use job descriptions to improve performnce nd better trin the tem. CONCLUSION The 8 Permnent Gme Chngers re trnsforming dentistry. Mny younger dentists who hd hoped to lern the ropes s n ssocite hve insted been thrust into prctice ownership sooner thn they expected. As newer dentists settle into their creers, they must decide how they wnt the next few yers to unfold. Strong ledership cretes frmework for future success. These seven ction steps cn help younger dentists rech their ledership potentil nd grow their prctices quickly even in difficult economy. Roger P. Levin, DDS Reprinted with permission from Levin Group To lern how to run more profitble, efficient nd stisfying prctice, visit the Levin Group Resource Center t free online resource with tips, videos nd other vluble informtion. You cn lso connect with Levin Group on Fcebook nd Twitter (Levin_Group) to lern strtegies nd shre ides. 1 Specil report: An in-depth look t new dentl schools, ADA News, September 5, 2011, eight new dentl schools hd opened since 2001, with two others plnning to do so. 2 The Levin Group Dt Center houses proprietry dt collected nnully from thousnds of dentl prctices, including clients nd other dentists worldwide. 3 Americn Dentl Eduction Assocition s Survey of Dentl School Seniors, for the Grduting Clss of 2011

8 The Right Fit It s not just the precise fit of our implnt restortions, it s how well our dentl lbortory fits you nd your prctice. With SIMPL nd Town & Country, I hve the confidence nd the bility to restore ny implnt cse. Dr. Jones SIMPL restortions from Town & Country fit so well, I cn set cse in just 15 minutes. Dr. Glssmn Give us try, you won t be disppointed. Cll to lern more or visit Estblished 1962