Editorial. Contents. An Innovative Magazine for Dentists from 3M ESPE MAGAZINE

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1 MAGAZINE July 2003 No. 2 Year 1 An Innovative Magazine for Dentists from 3M ESPE Editorial Dear Readers, It is now ten years since we started a revolution in the field of precision impressions with the Pentamix unit. Happy birthday, Pentamix! Today, automatic mixing is the gold standard for quality for precision impressions, and more and more companies are joining in by offering their impression materials in foil bags as could be seen during the International Dental Show IDS which recently took place in Cologne, Germany. Further trends in dentistry could be identified during the IDS, the worlds biggest exhibition in the dental field: As with the Pentamix system, easy handling by reducing the number of necessary treatment steps also seems to be a trend in adhesive dentistry: with Adper Prompt L-Pop Self-Etch Adhesive 3M ESPE was a trendsetter in this field as well as with RelyX Unicem Self-Adhesive Universal Resin Cement. Another trend is aesthetic dentistry with materials for tooth colored restorations such as Filtek Supreme Universal Restorative, which can make you a winner in our photo contest described later on in this magazine. I hope you enjoy reading the second edition of our new 3M ESPE Espertise Magazine Gerhard Kultermann, Editor 3M ESPE, Seefeld, Germany Contents Editorial & Contents 1 Prompt L-Pop All-In-One Adhesive: 2 Scientific Facts Support the Efficacy of Self-Etch Adhesive Systems Product Information: Pentamix Automatic Mixing Unit: 4 Pentamix Devices Serve Dental Care for 10 Years User Report : Ten Years Anniversary of Pentamix : 5 What about your Experiences? Clinical Case Report: High Quality for All Indications and 6 Requirements in the Dental Practice User Report: Impregum Penta Soft: 8 Perfect Impressions for Fixed Restorations The Dental Practice Forum: Filtek Supreme Photo Contest 10 Professional Communication in Dental Practice 11 Calendar of Events 12 Editorial Information 12

2 Clinical Results Results of Clinical Trials with Prompt L-Pop All-In-One Adhesive Scientific Facts Support the Efficiacy of Self-Etch Adhesive Systems Roland Richter, Andreas Syrek; 3M ESPE, Germany Clinical trials rank very high in the hierarchy of evidence, especially if they follow a controlled and randomised design. While in vitro-studies allow data to be obtained in a relative short amount of time, they can never perfectly simulate the clinical situation and thus sometimes lack clinical significance. Therefore powerful clinical studies are a necessity. Power in this respect means the probability of detecting a certain level of treatment effect when such a treatment effect truly exists. The power of a clinical study increases not only with the number of patients involved, but also with the duration of a study. Consequently we report in this magazine the longer-term clinical data on Prompt L-Pop and it s performance in various types of cavities, in combination with either a composite or a compomer. In the quoted studies of this publication Prompt L-Pop was used as the adhesive. Since September 2002 Prompt L-Pop was substituted by Adper Prompt L-Pop Self-Etch Adhesive. 2 Two Year Clinical Evaluation of a Self-Etching Primer in Posterior Composites G.E. DENEH, D.S. COBB, M.R. BOUSCHLICHER and M.A. VAR- GAS, The University of Iowa, Iowa City, IA 52242, USA; source: IADR 2002, # 434 Objectives of the study: This longitudinal, double-blind, controlled clinical study evaluated the clinical performance of Prompt L-Pop in 82 Class I composite restorations. Materials and methods Eighty-two teeth were prepared for Class I posterior composites and restored under rubber dam, using a split mouth design (n=42 each), with either Prompt L-Pop self-etching primer/adhesive and a reference composite resin (3M ESPE) or Prime & Bond NT (P&B) one bottle primer/ adhesive and TPH resin composite (Caulk/Dentsply). Clinical Evaluation of a Self-etching Adhesive: 1 Year Results A. BOGHOSIAN, Northwestern University Medical School, USA; source: IADR 2002, # 192 Objectives of the study: The aim of this study was to clarify whether Prompt L-Pop can be used successfully in the clinical situation as an adhesive for class V composite restorations. Materials and methods: 47 Class V abfraction/abrasion restorations in 14 patients were restored with Prompt L-Pop (26 restorations) with Scotchbond 1 (3M ESPE) as a control (21 restorations). Filtek Z250 (3M ESPE) was incrementally placed and polymerised. Restorations were evaluated using The restorations were evaluated at baseline, 6 month, 1 and 2 years using the USPHS criteria with Alfa representing clinically ideal, Bravo, clinically acceptable, and Charlie, clinically unacceptable. Results After the two-year re-examination no clinically significant differences between Prompt L-Pop and Prime&Bond NT were observed. 100% of re-examined fillings were classified excellent (Alpha) or clinically acceptable (Bravo). No loss of fillings was reported year Recall 2 year Recall Alpha Bravo Alpha Bravo Prompt L-Pop P&B NT Marginal Discolouration in % modified USPHS rating criteria at baseline and 1 year. Results: With regards to the re-examination criteria, no statistically relevant differences between Prompt L-Pop and Scotchbond 1 were recorded after a 12- month observation period. The retention rate of Prompt L-Pop was of 96%. Adhesive Prompt L-Pop Scotchbond 1 n Retention Post-op sensitivity Marginal adaptation tactile Marginal adaptation visual Table results after 12 months are expressed as Percent (%) Alpha according to USPHS criteria

3 MAGAZINE July 2003 No. 2 Year 1 Prompt -L-Pop and Two Compomers in Primary Molars: Clinical Results after Two Years F.J.M. ROETERS, F.W. FRANKEN- MOLEN, E. BRONKHORST, N.J. OPDAM, and R.C.W. BURGERS- DIJK, University of Nijmegen, Netherlands; source: IADR 2002, # 447 Objectives of the study: The aim of this clinical study was to evaluate the efficacy and safety of Prompt L-Pop when combined with the compomers Hytac (3M ESPE) and Dyract (Caulk/Dentsply) in class II primary molar restorations. Materials and methods: A group of 41 children (average age 7.5 years) with two class II cavities in primary molars participated in the study. One cavity was restored with Prompt L-Pop / Hytac, the other with Prompt L-Pop / Dyract. The restorative material was randomly assigned to the cavity. Restorations were evaluated during a two-year period using modified Ryge (USPHS) criteria. Results: During the two-year period, 69 of the 82 restorations (84%) were available for evaluation. From the remaining 69 teeth, 61 were clinically acceptable (survival rate 88%). No statistically significant differences were found between Hytac and Dyract AP. Compomer restorations bonded with Prompt-L-Pop performed well in deciduous molars over a 2-year period. Clinical Evaluation of a Self-Etching Adhesive at 3 Years J. MANHART, K. HUTH, C. GLOMB, D. STUECKGEN, P. NEUERER, H.P. FLESSA, R. HICKEL, University of Munich, Germany Objectives of the study: This study reports the 3-year clinical performance of Prompt L-Pop combined with the compomer Hytac (3M ESPE) in class I restorations. Materials and methods: 40 class I cavities were cut in 11 premolars and 29 molars of 25 adults. All cavity surfaces were treated with the self-etching primer Prompt L-Pop. Baseline assessment was made with photographic slides, polyether impressions, response to cold stimulation and modified USPHS criteria. At 3- year recall 40 restorations (100%) were evaluated by 2 calibrated dentists, who had not been involved in the placement of the restorations. Results: Significant differences between baseline and 3-year recall could be detected for marginal integrity and integrity of the tooth (p<0.05). However, this was mainly the result of Alpha-Bravoshifts. Apart from 1 failed restoration, all other restorations bonded with Prompt L-Pop demonstrated a good clinical performance (Alpha and Bravo scores) up to 3 years. Baseline 6 Months 12 Months 24 Months 36 Months (n = 40) (n = 40) (n = 40) (n = 34) (n = 40) USPHS-rating [%] Alpha Alpha Bravo Alpha Bravo Charlie Delta Alpha Bravo Charlie Delta Alpha Bravo Charlie Delta Marginal integrity , ,5 88,2 8,8 0 2,9 80,0 17,5 0 2,5 Marginal discolouration ,5 2,5 97,5 2, Integrity of the tooth ,5 2,5 82,5 17, ,4 17, ,0 15,0 0 0 Sensitivity testing ,0 2,5 2,5 0 97,1 0 2,9 0 97,5 0 2,5 0 Patients compliance ,5 2, ,1 2, ,0 5,0 0 0 Summary Since its market introduction in the year 1999 several clinical trials have been performed with Prompt L-Pop. The clinical results summarised above display the longevity and the very low incidence of postoperative sensitivities of restorations adhesively bonded with Prompt L-Pop, and this was before we improved it. Adper Prompt L-Pop Self-Etch Adhesive is a further development of Prompt L-Pop. It shows excellent adhesion to enamel and in comparison with Prompt L-Pop improved dentine bond strength. Due to its simple application Adper Prompt L-Pop is still the pioneer of innovative functionality but now with even more advantages than ever before. For more information please request our Technical Product Profile for Adper Prompt L-Pop. 3

4 Product Information Pentamix Automatic Mixing Unit a Story of Success Pentamix Devices Serve Dental Care for 10 Years Laslo Faith, 3M ESPE, Germany 10 Years Pentamix In 1993 ESPE introduced the Pentamix in Switzerland. Germany, Austria, Italy and many other countries soon followed. Now 120,000 Pentamix machines dispense 3M ESPE impression materials for dentists everywhere in the world. The homogeneous, void free, perfectly mixed materials give the base for perfect team work, re-makes become a thing of the past. The significant benefits of Pentamix are shown in the number of units in Dental practices and this number is still growing rapidly. Pentmix Market introduction in 1993: Starting with a push on a button into a new era of perfect impressions Taking an impression has been a challenge since the early days of dentistry. After gypsum and waxes more and more precise and easierto-handle materials were used. Nevertheless the hand-mixing of the impression material was still a major factor in the process because of all the inconsistencies of such work. If we also consider how different patients and other environmental factors as room temperature, storage temperature etc. are, we can consider impression taking as a non-repeatable experiment. The automatic hand dispenser for low and medium body materials introduced by 3M in the early 80s was a help, but not the total solution for the problem, because putty materials were still mixed manually. Additionally, the force needed to operate the system especially for medium body materials, was still significant. The powerful Pentamix unit combined with Impregum Penta, Express Penta, Permadyne Penta and other 3M ESPE impression materials significantly improved the quality of mixed impression materials. With this system hundreds of thousands of working hours were saved, hours used previously for cleaning surfaces, tools, clothing and equipment. With Pentamix the reliability of impression taking was significantly increased. It helps assistants, doctors and technicians to generate excellent results and reduces patient chair time. For 3M ESPE researchers, a device is never finally completed. Development work is ongoing, to bring new generations of the Pentamix device with additional useful features and benefits to users. Close collaboration with dentists is the way to further improve the Pentamix system. The Pentamix system and 3M ESPE impression material are on the way to becoming the technology standard in impressioning, helping to create better, faster, easier and more economic dental care. 4

5 User Report MAGAZINE July 2003 No. 2 Year 1 Ten Years Anniversary of Pentamix Automatic Mixing Unit What about your experiences? An interview with Nitzan Bichacho; Israel Q. What do your assistants say concerning the fact that hand-mixing is disappearing? A. Our assistants don't mind, and obtaining a homogenous consistency of the material with no entrapped air voids, and reducing contamination danger, conclusively diminishes the need for impression remaking,. From that aspect the patients, I myself and our assistants are very happy. Q. Which clinical areas are your fields of activity? A. In our clinic the emphasis is on all areas of restorative dentistry. About 30% of our treatments are implant supported restorations. We also invest a lot of energy into the aesthetic aspect of the entire treatment process: from treatment planning through 3-dimensional as well as computerized previews to the provisional restorations, and then we copy them into the definitive materials we term it: 'Aesthodontics'. Our credo is teamwork, and we cooperate closely with multifaceted specialists from the diverse fields of dentistry, and the majority of our treatments can be defined as multi disciplinary. Q. What kind of patients do you have? A. Most of our patients can be classed as dental 'connoisseurs'. Mainly over 20 years of age, 60% are women. They participate very actively in all phases of their treatment. As can be expected in this patient type, most have a high degree of self-awareness concerning their appearance, and are confident of the role played by oral health in the overall picture. Q. In your work in science and education you also work in the field of impressioning. What is the importance of impressioning for you? A. Without a doubt, impression making is one of the most critical phases in indirect restorative dentistry, and the easy production of consistent, super high precision, predictable impressions is still a 'must' in today's high-tech dentistry Q.You are a Pentamix user. When did you start working with Pentamix? A. We've been working solely with polyethers and Pentamix 2 for the past two years. This last year we've been using mainly Impregum Penta DuoSoft, and in the majority of cases we block out existing undercuts of the non-treated teeth with putty material. Q. How do you judge the quality of mixing with Pentamix 2? A. Compared to other irreversible plastic impression material systems, it is unbeatable. Q.Are there clinical cases for which the use of Pentamix 2 is especially important? A. Whenever there are multi-units, especially in cross arch restorations, but also in long-span restorations, it has a major advantage over silicones. The same goes for impression making of implant restorations with the closed tray technique, where the implant transfer copings are not rigidly splinted prior to the impression making. The advantageous combination of having a heavy body in the tray and a light flowable material injected intraorally guarantees excellent reproducibility of all the details of the hard and soft tissues, with practically no distortion. Q. Why do you use a polyether (or VPS)? A. In the past two years we have only used polyethers due to their superior accuracy, ease of use (with Pentamix 2), initial hydrophilicity, their thixotropic characteristic, their snap setting (the short time it takes to transfer from plastic to elastic properties), and their good resistance to tearing. The main advantage for me is their excellent accuracy in all magnitudes of abutment (numbers and locations) in the arch. Q. Which other impression materials have you tried? A. We used to work with condensation-type silicones, and mainly with addition type silicones, for more than 15 years. But for the past 2 years we use polyethers exclusively with Pentamix 2. Thank you very much for the time you gave us. Nitzan Bichacho, D.M.D., is a professor of prosthodontics and the head of the Ronald E. Goldstein Center for Aesthetic Dentistry and Dental Materials Research, Hadassah Faculty of Dental Medicine, at the Hebrew University of Jerusalem. 5

6 Clinical Case Report The wide product range from 3M ESPE High Quality for All Indications and Requirements in the Dental Practice Martin Groten; Germany Fig. 1: Base line Baseline 12 to be extracted, new bridge from 11 to 13 necessary. (figure 1) Preparation of the temporary After extraction of 12 and removal of existing full ceramic crowns on 11 and 13 the preparations were adapted to the new situation. Using the vacuum foil technique a temporary resin bridge was built with an extended pontic design to form the gingiva for the new bridge (figures 2-5). Complications Complications in the healing process meant that a revision of the alveolus was required, this to an advanced gingival retraction. Therefore the temporary resin bridge had to be modified by the addition of resin (Sinfony Light-Curing Composite from 3M ESPE) to the bridge span to form a new pontic. Fig. 2: Filling vacuum foil with Protemp 3 Garant from 3M ESPE Fig. 4: Preparation of temporary resin bridge Fig. 3: Protemp 3 Garant after setting featuring all details Fig. 6: Clinical situation after 2 weeks 6 Fig. 5:Finished temporary resin bridge

7 MAGAZINE July 2003 No. 2 Year 1 Taking the precision impression Two weeks later (figure 6) a precision impression of the prepared teeth (figures 7 and 8) and an impression of the opposing jaw (figure 9) as well as bite registration (figure 10) could be taken. The stone cast shows the perfect quality of the impression (figure 11). Eight weeks later, the final full ceramic bridge could be temporary cemented for the adaptation phase. Figure 12 shows the final situation after 2 months. Fig. 9: Impression of opposite jaw using Position Penta VPS Preliminary Impression Material Fig. 10: Bite registration using Imprint Bite VPS Bite Registration Material Fig. 7: Precision impression of upper jaw using Impregum Penta DuoSoft Polyether Impression Material from 3M ESPE Fig. 11: Exact stone cast Fig. 12: Final situation after 2 months Fig. 8: Perfect precision impression 7

8 User Report Impregum Penta Soft Polyether Impression Material in the Daily Practice Perfect impressions for fixed restorations using a predictable impression technique Henrik Holm; Denmark At the dental clinic we currently devote our time mainly to treatments with fixed restorations and implants. Consequently, it is essential for us to use a predictable impression technique, relieving stress while the impression is taken. After many years of using vinyl polysiloxanes as impression materials, my preferred choices today are a monophase technique using Impregum Penta Soft and a heavy/light body technique using Impregum Penta Duo Soft from 3M ESPE. Polyethers versus VPS Many vinyl polysiloxanes (VPS) have become more hydrophilic over time, but in this respect they still do not measure up to the polyether family of materials. Vinyl polysiloxanes require a dry and blood-free prepared area which may be difficult to obtain if the impression is being taken on the same day as the preparation was performed. The use of two or maybe three different viscosities (light, medium and putty) are required in order to make a sufficiently sharp impression and to ensure that the pressure of the tray material distributes the corrective material over all of the preparation. Properties of the new generation polyether In contrast, both Impregum Penta Soft and Duo-Soft are syringeable, but also provide sufficient pressure as tray materials. Polyether materials are substantially more hydrophilic than the vinyl siloxanes and thus tolerate small gingival bleedings better. The soft versions also have better taste and as indicated by the name reduced rigidity, allowing for easier removal of the impression from the mouth and after pouring of the stone model Aquasil 116,8 73,4 Impregum Soft Time [s] Polyethers show high initial hydrophillic properties Clinical experiences We often work with all-ceramic crowns, veneer crowns, inlays and onlays, so our preparation margins are frequently at level with or just under the gingiva. In these situations we use the monophase technique with Impregum Penta Soft. If the preparation margins are placed subgingivally, as for instance when preparing for ceramic-metal crowns or bridges, as a routine measure we use Impregum Garant L Duo Soft as a light body because, with its lower viscosity, it flows better into the pocket. Impregum Penta H Duo Soft is used in the tray as the as heavy body. I have used these materials in all clinical situations within conventional crown/bridge work for about 2 years. My laboratory technicians and I are all very excited about the sharpness of detail. Tips on preparation and impression techniques Working atraumatically is essential in order to save both hard and soft dental tissues. The preparation should initially be supragingival along the total periphery of the tooth (Komet 845/016). Cosmetic requirements or the gingival extent of previous cavities may require a subsequent lowering of the preparation margin to a level below the gingiva. For this purpose a thin flame or needle shaped diamond (Horico FG ) is used. The marginal gingiva is retracted using a retractor and a plastic instrument, this prevents preparation trauma. A gentle preparation technique results in minimal gingival trauma. Subsequent to preparation, the patient initially rinses with water to remove any debris after the preparation. This is followed by a 1 min rinse using 3% H2O2. This usually ensures a fine primary haemostasis. If there is continued capillary bleeding then the above procedure is repeated. The patient must not rinse again with water. Impregum Penta DuoSoft Intro Kit 8

9 MAGAZINE July 2003 No. 2 Year 1 Double Cord technique The first cord is cut to shape to allow it to be placed precisely once around the periphery of the tooth. I use size 0, 1 or 2 Ultrapak cord from Ultradent. Prior to use the the second cotton thread cord is wetted. The next step in my double cord technique is the application of a simple cotton fibre (Mayflower cotton thread) that has been soaked in Kutan fluid for at least 24 hours. The cotton thread is so saturated that both vertical and horizontal retraction of gingiva occur when it is "rotated" down into the pocket on top of the Ultrapak cord. Since the two fibres are substantially different in structure the Ultrapak cord will not be pulled out when the cotton fibre is removed 1-2 min after application. Please note however, that it is important to rinse the cord with a firm air/water spray to remove any coagulated matter, and to ensure that the gingiva does not adhere to the cord. Otherwise bleeding may occur. Now that we have a perfect pocket opening, Impregum Penta Soft can easily be syringed into the pocket without the risk of major gingival bleeding. In principle the same pocket cord technique using double cord is used for ceramic-metal crown/bridge preparations. However, where the preparation has a final bevel, or if a slanting fracture in the bottom of the pocket forms the preparation margin, both cords are removed before the impression is taken. The tray previously filled with Impregum Penta Soft directly from the Pentamix, is then placed, and 3-5 min later you have a perfect impression! A gentle preparation technique results in minimal gingival trauma. Precise impression Conclusion In Impregum Penta Soft and Duo Soft, 3M ESPE have in my opinion created an outstanding impression system. The combination of a predictable impression technique and an easy to manage impression system relieves some of the stress in everyday work in the clinic. Double cord technique: The thinner Ultrapak cord is packed once in the pocket. The cotton thread is packed on top of the Ultrapak cord. 9

10 Dental Practice Forum Filtek Supreme Universal Restorative: European Photo Contest One Smile could make you a Winner The background is the material s innovative filler particle concept. Filtek Supreme is based on the latest findings in nanotechnology. Moreover, four different opacities and 30 shades allow that Filtek Supreme can be accurately adapted to any clinical situation. The material also takes an outstandingly durable polish with mechanical stability equal to hybrid composites. All of this makes Filtek Supreme a universal restorative for both anterior and posterior restoration. Any dentist who documents these qualities with convincing clinical photography has a chance to win a digital camera with a total value of 1,300. Winners wanted! Any dentist with a business in this country is eligible to take part. For more information or contest documentation, contact your local 3M ESPE Office by phone. As a token of our appreciation, all participants will also receive a decorative certificate for their office. 3M ESPE is looking for the best aesthetic restoration using Filtek Supreme Create a Winning Smile: With this slogan and the chance to win fabulous prizes - dental industry specialist 3M ESPE is inviting European dentists to take part in a photo contest for Filtek Supreme. The goal is to convince the last remaining sceptics of the extraordinary qualities of this restorative material. Until now, the creation of visually flawless restorations took a lot of time; thus, for most dental practices, it was impractical for financial reasons. Filtek Supreme, however, offers the best of both worlds: aesthetic perfection on one hand, simplicity and efficiency on the other. No longer must dentists choose between picture-perfect teeth for their patients and a healthy financial position for themselves - and that, in a nutshell, is the product message, backed up by easy handling, high quality and aesthetic excellence. 10

11 Dental Practice Forum MAGAZINE July 2003 No. 2 Year 1 The Dental Practice Forum Professional Communication in Dental Practices Researchers in the field of communication have ascertained that a large proportion of all interpersonal problems are in fact communication problems. For example if the words used are interpreted by the person addressed quite differently from how they were intended. Conscious ill-will is seldom the cause. The decisive reaction of my opposite number after an unsuccessful, unprofessional communication is the famous no-decision, e.g. No, I don t want to do that. No, I must ask my wife first. No, I can t afford it, or in another form the equally disturbing Yes, but. Professional communicators consciously avoid the no-decision and succeed in achieving the aim of their conversation by bringing their customers or patients round to the attitude of saying yes. Their successful method starts off with the use of socalled keywords or by adopting behavioural strategies. 1. Verbal keywords People use their sensory (representation) systems to perceive their environment: visual, auditory, kinaesthetic, olfactory and gustatory systems (seeing, hearing, feeling, smelling, tasting). While all five systems are constantly processing information, we only become aware of, and express in speech, a part of it. The most active system at a given moment is described as the primary representation system. A patient who says, It seems to me that you should show me what you have in mind again, is using a different system to the patient who says I say to myself, we should talk again about the opinion Knowledge and experience of older colleagues coupled with the carefree enthusiasm of younger members creates innovative potential, image gains and a strong team. you expressed with regard to the preventive treatment, or one who says I get the feeling that you take a different point of view in your attitude to the prophylaxis. While in the first case the visual system was the primary system, in the second and third cases the auditory and kinaesthetic systems played the decisive role. A doctor who communicates professionally adopts the relevant system and adapts it optimally to the customer. Untrained staff always respond with their own system regardless of what a customer sayes, e.g. Customer: I said to myself, you must ask about that (auditory). Member of staff: Please sit down first (kinaesthetic). This unconsciously generates resistance, which is expressed at the crucial moment. 2. Adopting behavioural strategies An even more subtle form of adapting to a customer or patient is the use of a suitable reaction to behavioural strategies. A behavioural strategy is a structure containing a specific sequence of perception representations. Customer: Before I agree, I must first consider your offer from all angles. I will then say yes if the benefits have become clear to me. The order of the words agree (A- auditory) consider (V - visual) say yes (A) become clear (V) contains the behavioural strategy A-V-A-V. 11

12 General Information MAGAZINE A professional response would now be: I think that I will show you the benefits again. Then you tell me, whether you understand. An identical strategy is contained in the response, which brings customers round to the attitude of saying yes. The customer unconsciously feels that he is understood exactly. Of course it requires practice and training to learn these kinds of skills, and research has shown that in the case of particularly pleasant people, adopting these kinds of keywords and behavioural strategies often takes place unconsciously. The neurologist Roger Sperry (Nobel prize 1982) has proven that the emotional right-hand side of the brain only reacts to the keywords, the so-called perception associations, and motivates the customer to accept a decision desired by the doctor. 3. The importance of questions in conducting professional conversations. The ruling school of thought with regard to successful communication has long been summed up in the sentence: The person asking the questions leads the conversation. The most recent findings suggests a particular form of customer-friendly questioning. I like to call these questions US Open, firstly because this type of questioning was discovered in the USA and secondly, because they are basically open questions. This means that the customer/patient is encouraged to speak with the aim of identifying their keywords or their behavioural strategies, in order to be able to pick up on them again. In the case of the conventional questioning technique, which applies especially in medicine, it is a matter of obtaining information from the patient. The interest is therefore focused on the questioner, the conversation is less important. In US Open questioning, what the patient has said before is incorporated into the questioning as much as possible, which will make the patient realise that he (the customer) is the centre of attention.customer: I know for sure that that s not for me. (no keyword) Calendar of Events June to September 2003 Copenhagen September 05 06, 2003 Dental Expo, Moscow September 09 12, 2003 CEDE, Lodz September 11 13, 2003 NordDental, Hamburg September 13, 2003 Fachdental, Leipzig September 19 20, 2003 BALTDENT, Vilnius September 24 27, 2003 Dental Fair 2003, Vejle September 26 27, 2003 Fachdental, Munich September 27, 2003 EDAD 2003, Istanbul September 27-29, M ESPE AG ESPE Platz, Seefeld Telephone: +49 (0) / Telefax: +49 (0) / info3mespe@mmm.com Internet: Doctor: How did you find out (or do you know or have you established ) that it s not for you? Customer: My instinct tells me when I should take up an offer like that. (auditory-kinaesthetic) Now the doctor has the so-called access information and he/she can approach the customer on a more personal level. The customer-orientated questions therefore do not gather any information for the questioner, but reach the thought and perception processes of the patient. EDITORIAL INFORMATIONS Published by: 3M ESPE AG ESPE Platz Seefeld Germany Telephone: +49 (0) 8152 / Telefax: +49 (0) 8152 / info3mespe@mmm.com Internet: Editor: Gerhard Kultermann Editorial team: Keith R. Haig, Dieter Klasmeier, Roland Richter, Markus Roepke, Laurence Settekorn, Al Waning Coordination: Laurence Settekorn Final editing and production: Markus Roepke Circulation: We accept no liability for unsolicited manuscripts or photographs. Court of Jurisdiction: Munich 3M ESPE AG, Seefeld, M, ESPE, Scotchbond, Pentamix, Adper, Clinpro, L-Pop, Espertise, Express, Filtek, Prompt, Garant, Hytac, Impregum, Imprint Bite, Permadyne, Position, Protemp and Sinfony are trademarks of 3M or 3M ESPE. Dyract, Prime&Bond and Spectrum TPH are trademarks of Caulk/Dentsply. Tetric Ceram is a trademark of Ivoclar-Vivadent Ultrapak is a trademark of Ultradent All rights reserved. 3M ESPE 2003.