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Carestream Dental Announces New Integration with exocad Smile Creator





ATLANTA—Carestream Dental is empowering practitioners to plan an ideal smile from a digital impression thanks to a preferred partnership with exocad Smile Creator, a state-of-the-art smile solution that’s now integrated into the Carestream Dental’s product portfolio.


Once a patient’s teeth have been scanned with either a CS 3600 or CS 3700 intraoral scanner, the Smile Creator can be directly accessed from Carestream Dental’s CS Imaging and CS ScanFlow software, streamlining and simplifying the smile design process. Users can also upload patient photos that can be aligned with their digital impressions.


Then, the smile can be designed using realistic 2D tooth shapes from exocad’s extensive tooth library. Facial analysis with help lines and proportional guides help the user design the ideal smile for the patient’s individual anatomy. Aesthetic relationships between the patient’s teeth, smile and face can be easily evaluated, offering practitioners a realistic perspective for a restorative treatment plan.


“Doctors must consider all angles of a case, from whether it’s prosthetically possible to how natural-looking the final restoration is,” Ed Shellard, D.M.D., chief dental officer, Carestream Dental said. “This new integration with exocad Smile Creator gives doctors complete control over design and serves as the perfect foundation for future prosthetic work while impressing and exciting patients with what their new smile could look like.”    


The 2D designs can then be viewed in 3D in real time from different angles, providing maximum predictability and letting patients approve their new smiles before agreeing to treatment. The advantage is clear: Highly predictable esthetic and functional results.


“The future of dentistry lies in technology and partnerships like this,” Shellard said. “Data is captured, assessed and interpreted in ways that give doctors more confidence and gets patients excited about digital dentistry.”


“This product sets the new benchmark for future communication between dental technicians, dentists and patients – particularly when it comes to designing esthetic anterior restorations,” Tillmann Steinbrecher, CEO, exocad, said. “The collaboration with Carestream Dental supports our goal of providing technology that helps clinicians take maximum advantage of digital processes”.


Smile Creator is fully integrated into exocad’s CAD software platform.


This new integration with exocad Smile Creator enhances Carestream Dental’s CS Solutions portfolio, its CAD/CAM line, to give practices more options for their restorative workflow. To learn more about CS Solutions, visit To learn more about exocad, visit



About exocad

exocad GmbH is a dynamic and innovative software company committed to expanding the possibilities of digital dentistry and providing OEMs (Original Equipment Manufacturers) with flexible, reliable, and easy-to-use CAD/CAM software for dental labs and dental practices. exocad software has been chosen by leading OEMs worldwide for integration into their dental CAD/CAM offerings, and thousands of exocad DentalCAD licenses are sold each year. For more information and a list of exocad reseller partners, please visit


About Carestream Dental

Carestream Dental is committed to transforming dentistry, simplifying technology and changing lives. In this pursuit, we focus on providing the latest in high-quality scanning technology, the smartest chairside systems, the most intuitive practice management software, incredibly accurate imaging software and the data intelligence that helps continually refine patient outcomes. And we offer these solutions for the full range of dental and oral health professionals. For more information please visit




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An alternative method for immediate implant-supported restoration of anterior teeth assisted by fully guided templates: A clinical study

The Journal of Prosthetic Dentistry

Available online 30 September 2020

The Journal of Prosthetic Dentistry


Statement of problem

Immediate implant-supported restorations have become a common treatment strategy in the esthetic zone; however, improvements are necessary in the techniques used to fabricate interim prostheses.


This clinical study evaluated an alternative method for the immediate restoration of anterior teeth by using a fully guided template.

Material and methods

Twenty-five participants were enrolled, and 30 implants were inserted by using fully guided templates. Eleven participants and 14 implant sites were treated with immediate implant placement. Fourteen participants and 16 implant sites were treated with delayed implant placement. The same method was used for immediate restoration in all the participants. A postoperative cone beam computed tomography (CBCT) scan was compared with the preoperative planning to measure the deviation between the placed and the planned implants. The independent t test was used for the comparison of immediate and delayed implant placement (α=.05). Any complications occurring in the following 3 months were also recorded.


None of the interim prostheses needed significant adjustments and were successfully installed on implants after the surgery. The overall mean deviations in 3D coronal, buccolingual coronal, mesiodistal coronal, 3D apical, buccolingual apical, mesiodistal apical, depth, and angle were 0.6 ±0.3 mm, 0.4 ±0.2 mm, 0.2 ±0.1 mm, 1.0 ±0.4 mm, 0.7 ±0.4 mm, 0.3 ±0.2 mm, 0.4 ±0.3 mm, and 1.9 ±1.1 degrees, respectively. The linear and angular deviations exhibited no significant differences (P>.05) between immediate and delayed implant placement. No complications developed in the follow-up period.


In the anterior esthetic zone, this alternative method appears to be suitable for immediate restoration. The accuracy of fully guided surgery was clinically acceptable for the prefabricated interim prostheses and helped reduce postoperative chairside time.


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Longevity of posterior composite restorations in children suffering from early childhood caries—results from a retrospective study



This retrospective study aimed to evaluate health status as a new patient risk factor and analyze its influence on the survival of posterior composite restorations in patients with early childhood caries (ECC).

Materials and methods

Patients who received dental treatment of ECC under general anesthesia (GA) and attended at least one follow-up visit were included in this study. A total of 907 patient records were evaluated retrospectively through patient examination forms and panoramic radiographs. Kaplan-Meier survival probability analysis with log-rank test was used to assess the posterior composite restorations’ longevity up to 24 months. Furthermore, risk factors were determined using Cox regression multivariate analysis.


A total of 5063 posterior composite restorations were assessed. Following the Cox regression analysis to determine the effect of risk factors on longevity of composite restorations, findings revealed that the survival probability of composite fillings was significantly lower in patients with systemic disease (p = 0.00). Filling materials were compared based on the survival probabilities and results were further discussed. There was no significant relationship between age, gender, and the survival of the restoration; however, the child’s health status (p = 0.00) and caries risk status (p = 0.05) significantly affected survival. Moreover, the type of arch and pulp intervention influenced the restoration’s survival.


Systemic disease has a detrimental influence over longevity of composite restorations. Therefore, considering the reduced survival rates of the composite restorations for children who have systemic disease, alternative non-invasive treatment options should be considered.

Clinical relevance

This study’s novelty is the observation of drastically reduced survival of composite restorations in children with systemic disease.


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The ADA Virtual Conference October 15-17. Sign up now. Free and paid courses. Get CE credit.

 Dear Colleague

Here is the link to sign up 


The ADA FDC Virtual Connect Conference, Oct. 15–17, is a live and on-demand experience packed with new features and engaging activities designed to make the most of the virtual environment. ADA FDC 2020 will integrate our members’ professional and personal growth needs with their daily lives. How they engage in the virtual conference is up to them. Attendees can enjoy live events with others and interact with speakers. Or, if they have a busy day, attendees can catch up later with on-demand access and still be in-the-know about the latest in dentistry. 


Here are some top reasons to attend the ADA FDC Virtual Connect Conference:

1. Convenience and flexibility—Enjoy from your personal space, the local café, or the office—on your own time! And best of all … most sessions remain available on demand through Dec. 31, 2020. Browse our Virtual Exhibit Hall 24/7 featuring the 2020 Cellerant Best of Class Technology Award winners.
2. Amazing ContentLearn from the top thought leaders in dentistry:
Frank Spear, DDS, MSD
Lee Ann Brady, DMD
Gary DeWood, DDS, MS
Jose-Luis Ruiz, DDS
Technology Thought Leaders
▪ Paul Feuerstein, DMD
▪ John Flucke, DDS
▪ Marty Jablow, DMD
▪ Pamela Maragliano-Muniz, DMD
▪ Chris Salierno, DDS
▪ Lou Shuman, DMD, CAGS
3. Camaraderie
Get with like-minded people at our Community Meet-ups. Enjoy beer tasting, wine tasting and a book club.
Enjoy a concert by multiplatinum, five-time Grammy award winning group Lady A.
Play games like trivia and earn points/win prizes.
Join the virtual 5K and run, walk or cycle for Give Kids a Smile.
Participate in morning wellness programs.
4. Great Value 
For less than $200, ADA members get all the available CE, networking events, and speaker sessions. 
We are investing in the future by giving students, grad students, and dental team students a rate of just $19!
▪ Members $199
▪ Non Member & Other Allied Health Professional $299
▪ Team & Guest $119
▪ Student, Grad Student, Dental Team Student 


For your convenience, here is a schedule of events:


4–5:30 p.m. Staffed Exhibit Hall

5:30–6:15 p.m. Evening Opening Session

6:15–7:15 p.m. Virtual Concert with Lady A


7 a.m. Virtual Exhibit Hall opens

7–8 a.m. Morning Wellness Activities

9 a.m.–Noon CE Sessions

Noon–2 p.m. Staffed Exhibit Hall

2–4 p.m. Speaker Chats

2–4:30 p.m. Afternoon Workshops

4–5:30 p.m. Staffed Exhibit Hall

5:30–6 p.m. Evening Session

6:30–7:30 p.m. Community Meet-ups-Wine tasting, beer tasting, book club


7 a.m. Virtual Exhibit Hall opens

7–8 a.m. Morning Wellness Activities

9 a.m.–Noon CE Sessions

Noon–2 p.m. Staffed Exhibit Hall

2–4 p.m. Speaker Chats

2–5:30 p.m. Afternoon Workshops

4–5:30 p.m. Staffed Exhibit Hall

5:30–6 p.m. Evening Closing Session

6:30–7:30 p.m. Live Trivia


ADA FDC Virtual Connect Conference will be the premier digital event in the industry, and we’renot done yet—we have a big announcement coming during the Evening Opening Session on Thursday night!

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Fever and Other Clinical Indicators May Fail to Detect COVID-19—Infected Individuals

Journal of Evidence Based Dental Practice



Many people infected with COVID-19 display no symptoms. Improving estimates of the asymptomatic ratio, the percentage of infected individuals with no symptoms, might improve the understanding of COVID-19 transmission. This information will also allow us to determine the effectiveness of using fever and other symptoms to screen people for COVID-19 infection. This asymptomatic ratio can be determined by using seroepidemiological data obtained from large populations. Instead, the authors examined a sample of people at risk for COVID-19 infection, a group of Japanese nationals evacuated from Wuhan, China, to Japan.


A total of 565 Japanese nationals evacuated from Wuhan, China, to Japan.

Key Study Factor and Outcome Measure

All 565 evacuees were assessed for symptoms including fever determined by temperature screening and interviews to collect information concerning cough and other nonspecific symptoms that are consistent with COVID-19 infection. COVID-19 reverse transcription polymerase chain reaction (RT-PCR) was also performed on all evacuees. The authors used Bayes theorem to determine the asymptomatic ratio within this population.

Main Results

Among 565 passengers who were evacuated from China, 63 (11.2%) were symptomatic. RT-PCR testing revealed that there were 4 asymptomatic and 9 symptomatic people who tested positive for COVID-19. The sensitivity of symptoms-based screening was 69.23%, and specificity was 90.3%. Probability was determined that 30.8% (95% confidence interval = 7.7%-53.8%) of infected individuals are asymptomatic.


Asymptomatic infections cannot be determined if they are not confirmed by being tested with RT-PCR, and symptomatic cases may not be detected if they do not seek medical attention. These results indicate that symptom-based screening of COVID-19 is likely to fail to detect many infected individuals.

Commentary and Analysis

When the severity of the COVID-19 pandemic was recognized in March 2020, in-office dental treatment came to a virtual halt. At our dental school, only emergency services were available during this shutdown period. These services were supplemented by teledentistry, which acted as a gateway to in-person dental intervention. At that time, education switched from live classes to online instruction, and few faculty, staff, students, or patients entered the facility. During this period, ingress to the dental school was restricted to an entrance where all persons entering underwent questioning concerning flu-like symptoms and body temperature checks. The rationale behind COVID-19 screening by assessing temperature and self-reported flu-like symptoms is to identify individuals who are likely to be infected. Similar screening programs take place at airports and other public facilities. Before the COVID-19 pandemic, fever and symptom screening were used to contain other communicable diseases such as Ebola and severe acute respiratory syndrome, which similar to COVID-19, is a coronavirus-caused illness.1

Because many dental procedures result in aerosols, COVID-19–infected patients pose an infection risk to staff and other patients even with infection control practices. As dental care resumes during the summer of 2020, it is important to detect infected individuals. Access to COVID-19 testing is still limited. At our school, COVID-19 testing of personnel is available, but patients are not tested by the school. In the coming weeks, the number of individuals screened daily by symptom checking will increase. The goal of this commentary is to describe the limitations of symptom-based screening.

Published in the early months of the disease, the report by Nishiura et al. illustrates the limitations of identifying COVID-19–infected individuals based on fever and other symptoms.2 This study was conducted on Japanese citizens being evacuated from Wuhan, China. All evacuees were assessed for fever or other nondescript symptoms and had an RT-PCR test for COVID-19. Of the 13 subjects found to be COVID-19 positive, 4 (30.8%) were asymptomatic.

Among the 63 symptomatic evacuees, there were 54 individuals (85.7%) who were found to be free of COVID-19 infection. This false positive group outnumbered the true positives (symptomatic individuals testing COVID-19 positive).

Because the travelers in this study were under observation for a minimum of 30 days, it was concluded that none of the subjects were still in the disease’s incubation period. This study documented individuals who were infected, potentially capable of spreading the disease and asymptomatic. In the report by Nishiura et al.,2 fever was not defined, nor was the method of temperature measurement. Also, the source of material and other information pertaining to the RT-PCR procedure was not described. Despite these limitations, these results and other observations call into question the effectiveness of symptom-based COVID-19 screening as a means of preventing infected persons from having contact with unexposed populations.1,3

Several other studies have examined the relationship between detailed assessment of symptoms and odds of having a COVID-19 infection in healthcare workers (HCWs) serving populations with high infection rates. In a study of 1573 HCWs in Milan, Italy, who underwent nasopharyngeal swab sampling for COVID-19 testing, 36.0% of the COVID-19–positive HCWs had none or only one symptom.4 Among the HCWs with symptoms, fever was positively associated with infections with an odds ratio of 9.12% (95% confidence interval = 5.61-14.8), however, as was observed by Nishiura et al., the false positive rate for fever was high (62%), and 43.9% of infected HCWs were fever free. Loss of smell and taste were not commonly observed symptoms, being observed in only 14.4% of the COVID-19–positive subjects. These symptoms were however predictive of infection, with a low false positive rate of 23.1%. Other studies conducted on populations of HCWs indicate that having multiple symptoms increased the odds of being infected with COVID-19, especially having loss of taste and smell. In contrast, nasal congestion was not indicative of COVID-19 infection.5

Several publications have estimated the effectiveness of symptom-based COVID-19 screening by mathematical modeling.6,7 One key variable predicted to increase the proportion of asymptomatic individuals, who would be missed in symptom-based screening, is the fraction of the infected population within the disease’s incubation period. In populations where the disease is spreading rapidly, as is currently the case in many areas of the US, the effectiveness of symptom-based screening would be less than in areas where the spread of the disease is limited.7 Currently, there are calls to quarantine individuals traveling from highly affected areas to areas of lower prevalence.

Although symptom-based screening does identify COVID-19–infected individuals, many factors can impact its effectiveness. The reliability of the methods and equipment used to detect fever may be poor. People to be screened may not be truthful about symptoms and may have taken antipyretic medications. Unlike the surveys given to HCWs in studies, the questions given to members of the public may yield little useful information.

Similar to every diagnostic procedure, symptom-based COVID-19 screening has false positive and false negative determinations. Although the specificity of symptom-based screening is good (90.3% in the study by Nishiura et. al), there are likely to be more false positives than true positives in most populations due to the low prevalence of infection. In the dental setting, the treatment of these false positive individuals may be delayed pending determination of their true status. The high number of false negatives consisting of asymptomatic and presymptomatic individuals (estimated to be at least 50% by Gostic et al.) is more problematic.7 These individuals may inadvertently spread the infection to staff and other patients because the COVID-19 virus can be transmitted through aerosols produced by dental procedures. This conclusion highlights the continuing need for effective infection control practices and training of the dental workforce.

Although commonly conducted in dental facilities, using body temperature measurements and a person’s self-report of symptoms can fail to identify COVID-19–infected individuals. In areas where the rate of infection is increasing, the number of asymptomatic and infected individuals will increase, further eroding the effectiveness of symptom-based screening. We recommend that symptom-based screening continue and improve in dental facilities. The evidence does however indicate that symptom-based screening of patients and staff for COVID-19 should not be relied on to protect the dental environment from this virus.

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39th IDS defying the Corona crisis and treading new paths in 2021


The uncertainty caused by the ongoing Corona crisis is also noticeable within the dental industry. Over the past months, together with Koelnmesse, the partners of the 39th edition, IDS 2021, the GFDI mbH, a commercial company of the VDDI, the association and its bodies have intensely occupied themselves with the safety criteria, which makes the physical presence of an international trade fair like IDS possible. Ultimately, different solutions were developed jointly by all of the parties concerned and an alternative concept was drawn up for the trade fair format, IDS.

A current visitor and exhibitor survey by Koelnmesse shows that many exhibitors will definitely participate in March 2021. 1,276 companies have already confirmed their participation to-date. Beyond this, the conditions of a criteria and quality catalogue, which are among others governed by the current safety regulations in Germany, are fulfilled. The following concept-related measures will be implemented to ensure the successful conduction of the 39th edition of IDS in March 2021.
– The duration of the 39th IDS is being reduced from five down to four days (from Wednesday, 10.03. to Saturday, 13.03.2021).
– The design of the fair grounds and the hall allocation will be completely replanned in order to safely distribute more than 1,200 exhibitors in line with the Corona protection regulations and to organise the visitor traffic with several entrances and larger safety distances.
– A generous layout with wider aisles, additional circulation, food service and resting areas.
– Koelnmesse additionally offers hybrid tools on a digital platform, in order to expediently enhance the physical presence at the trade fair. This also enables guests or exhibitors from abroad to participate in IDS 2021.
VDDI Chairman, Mark Stephen Pace, commented in this connection: “Several working committees comprising of our members have in close coordination with the board and advisory board and with the association’s office, undertaken everything possible to make the 39th edition of IDS possible in spite of the current difficult framework conditions. It was not an easy task to come to an agreement regarding the new concept for IDS. During the session yesterday, we strove to find the best solution and many aspects were controversially debated. I am delighted that we now have the certainty and can all work jointly on offering the 39th IDS 2021 as a platform for the dental industry in spite of the restrictions brought about by the crisis. The VDDI Association has mastered many challenges in its meanwhile 104-year history and will proactively shape the current crisis.”

And Oliver Frese, Executive Director and COO of Koelnmesse added: "We are delighted about the positive commitment of the dental industry and are well-prepared for staging IDS. In compliance with the provisions of the Corona Protective Ordinance of the State of North Rhine-Westphalia and in close coordination with the authorities in Cologne, we have developed our extensive hygiene and safety concept #B-SAFE4business, which comprises of a host of measures that interlock seamlessly and govern the interaction among all people present at the trade fair. In close cooperation with our partners, we have additionally developed different stand construction concepts and event formats and perfectly aligned them to suit the changed framework conditions. These include for example the newly developed eGuard app for guiding the visitor flow, a streaming studio, a camera-based people-counting system or the “Human Security Radar”, which enables contact-free bag controls. In our #B-SAFE4businessVillage, exhibitors and media representatives can currently gain an impression of how it is possible to stage trade fairs also in times of Corona in compliance with the hygiene and safety distance regulations. We are looking forward to IDS in Cologne.”

The estimation of AUMA, the Exhibition and Trade Fair Committee of the German Economy e.V. also speaks in favour of a successful conduction of IDS in March 2021, according to which foreign trade fair participants are principally also allowed to enter the country. According to a resolution of the Federal Government passed on 15.09.2020, trade fair participants (exhibitors and visitors) are in principal allowed to travel to Germany even if they come from a nation that doesn’t belong to the EU/Schengen region or from a group of countries on the German positive list. The quarantine obligation for travellers from risk regions, who provide a negative Corona test that has been carried out no longer than 48 hours before entering the country, does not apply. The test can be carried out in Germany, however in this case the quarantine regulations have to observed until the test result has been received.

About IDS
IDS (International Dental Show) takes place in Cologne every two years and is organised by the GFDI Gesellschaft zur Förderung der Dental-Industrie mbH, the commercial enterprise of the Association of German Dental Manufacturers (VDDI) and is staged by Koelnmesse GmbH, Cologne.

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