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New perspectives in restorative dentistry - zm

Dental communications May 16, 2016 No. 10 New aspects of restorative dentistry ZFA: Monetary extras on the fixed salary Barmer Zahnreport: Regional differences in the ZE supply DP AG Postvertriebsstück - Fee paid - 7443 - Issue 10/2016 Deutscher Ärzteverlag Ärzte-Verlag GmbH GmbH– - Postfach Postfach 40 02 406502 -6550832 - 50832 Cologne Cologne on May 16, 2016, No. 10 www.zm-online.de Paronormal Activity. SF10, a new kind of sonic tip. The SF10: A rounded tip that ablates with the inside. of course, a new feeling of work in the periodic treatment. Precise, the working part nestles perfectly to every root shape and is minimally invasive and at the same time with extensive removal minimizes the risk of injury. The new SF10. Make yourself and excellent result. The secret lies in the loop shape ready for a paronormal experience. © 02/2016 · 413970V6 The new SF10 sonic tip from Komet ensures an almost over- www.kometdental.de zm 106, No. 10 A, May 16, 2016, (2) Editorial 3 Does dentistry have any evidence? The obligation to justify, especially with regard to the risks, increases. To stay in the picture: The closer you get to the cellar on the evidence staircase, the louder the calls of the “cellar ghosts” (sparkling wine-containing drink with headache guarantee) from the Institute for Quality and Efficiency in Health Care, IQWiG for short, which the “observational bias “Or complain about the bias of the examiner, in other words the too high eminence factor. Dr. Rainer Hess, the former impartial chairman of the G-BA, on the other hand, put it in a nutshell: “We decide not according to the highest, but according to the highest available evidence class.” From a dental point of view, this may sound reassuring, but it is not really. Because the weakened requirements for rare diseases will only seldom be used. It is therefore increasingly important that studies in dentistry are carried out in accordance with the given quality criteria. So that no wrong impression arises: There are also level 1b studies in dentistry. For the IQWiG report expected in autumn on the subject of “Systematic treatment of periodontal disease”, the institute announced that “only RCTs as relevant scientific literature will be included in the benefit assessment”. But that is more likely because periodontal diseases are systemic in nature ... If you consider how the current concept of evidence-based medicine came about in the USA in the 1980s due to the explosion of pharmaceutical studies with questionable results, you can In dentistry, you may well ask yourself why the G-BA requires level 1b studies for the results of dental work that are intrinsic to the subject. It feels like it makes a big difference whether a new drug is used systemically and therefore double-blind studies are required, or whether a new material is used in or on a tooth where anyone who wants to see can see everything. Unfortunately, with every invasive measure there is the problem of having to explain and evaluate the benefits and risks. And that is why EBMisation will not stop at dentistry either. Or should I say better: IQWiGization? Because the institute focuses on external evidence. The internal evidence, the individual clinical expertise of the dentist as well as the patient preference falls through the rust with this view. The IQWiG thus determines the "league". Unfortunately! Photo: zm-Axentis.de Of course it has. The only question is which class, is it a Bundesliga or a regional league? The highest available evidence is class 1. In order to be able to play in this league, methodologically high-quality studies, so-called RCTs - Randomized Controlled Trials - are required, which in addition to controlled clinical conditions also require a randomized distribution of the patients to the respective study groups. If one uses the yardstick for the large pharmaceutical intervention studies, double blinding is also required. The latter is difficult in dentistry, since even a dentist who is blind in both senses of the word does not help (irony off). But that's not the point. Even the Federal Joint Committee (G-BA) does not require studies with double blinding in its guidelines (both the practitioner and the patient know neither verum nor placebo), but randomized clinical studies that correspond to level 1b. If these are not available, one practically descends the stairs of evidence to make a decision. Down to the basement at level 5 - here there are only case series or expert opinions - the "descent" only goes in individual cases, e.g. B. in rare diseases. The rule is that the more you deviate from level 1, the more Dr. Uwe Axel Richter Editor-in-Chief zm 106, No. 10 A, May 16, 2016, (1081) Photo: robuart - iStockphoto.com How does the placement of medical tourists who come to Germany actually work? Photo / Cover photo: Koelnmesse 14 40 The advanced training part deals with new and old ways of taking impressions, restoring the bite position with composite, new hybrid materials and implant scenarios in different dentition situations. F ORT EDUCATION PART 1/2016 OPINION Editorial 3 Leading article 8 Readers' forum New aspects in restorative dentistry 10 P OLITICS Business model Patient referral Always with no commission 14 The impression - in old and new ways 41 Restoration of advanced tooth loss with composite 48 Hybrid materials - indication and probation 56 indications for prosthetics - how many implants are necessary? 64 ZÄKWL Congress for Young Dentists The future begins today 18 Interview with Dr. Wolfgang Eßer / Bernd Meurer “Cooperation leads to success” 20 Spring Festival KZBV / BZÄK The new licensing regulations are coming 22 zm Visit us on the Internet at www.zm-online.de zm 106, No. 10 A, May 16, 2016, (1082 ) Photo: P. Kämmerer Photo: vario images 38 92 The nationwide medication plan will come in October. The first real benefit of the eHC is finally in sight. Oral health for those in need of care Closing prevention gaps 26 Zahnreport 2016 Barmer enthusiastic about standard care 28 New maternity protection law New requirements for employers 32 Health monitor Barmer / Bertelsmann 72 percent trust the second opinion 34 The nationwide medication plan The first real benefit 38 M EDIZIN revision course: Head and neck tumors is crucial early diagnosis 92 Photo: stockWERK - Fotolia.com 5 Head and neck tumors are a challenge for dentists when it comes to initial diagnosis. And radiation requires special dental treatment. G ESELLSCHAFT Do you really still need the guarantee 104 that you took out when you founded the practice? R UBRIKEN Aid project in Cambodia “Making the world a little better” 98 P RAXIS Volker Looman Homes cost a fortune 100 Additional forms of remuneration (1) How to reward your ZFA 102 Loan collateral Do you still need the guarantee? Test for loan collateral 104 106 Judgments 108 The best at www.zm-online.de 12 Dates 72 Form reporting incidents with medical devices 90 Imprint 112 Last but not least 138 M ARKT innovations 114 zm 106, No. 10 A, May 16, 2016, ( 1083) Security on every floor. The W&H prophylaxis program. The new kind of irritation-free prophylaxis. Now at your dental depot or at wh.com zm 106, No. 10 A, May 16, 2016, (1084) Jana Pallaske photographed by Lars Kroupa for W&H zm 106, No. 10 A, May 16, 2016, (1085) Editorial photo: KZBV-Baumann 8 We need safe framework conditions Dear Sir or Madam, so that the new services arrive quickly at the joint KZBV spring festival. and BZÄK in the British Embassy in Berlin When ensuring the dental care was once again successful, the demographic platform for exchange with politicians presents us with great challenges. Association representatives, science and the Here we have to meet the needs of the vulnerable specialist public. Last but not least, groups of the population can take network events like this into account. Our contacts with politics have done a lot here recently: they have been stabilized in the last few years. The successes two years over 2,700 of our professional cooperation agreements We are not allowed to show a functional work in the past year between dentists and renal system of dental care that we have concluded that we have relied on care institutions through unnecessary experiments. Which of us endanger. Forced regulation, characterized by professionalism, on the relationship between the KZBV and the responsible health policymakers to be able to find care in care facilities and in the building. The prevention mana home environment helps ensure that we gement for those in need of care and dentists the barriers to the care of old, needy people and people with disabilities in the statutory health insurance supply strength with disabilities, a large gap in the service catalog of the statutory health insurance was closed. Actively overcome this on our part. We will need a considerable amount for millions of insured persons for the necessary remodeling to improve their oral health and measures in our practices, but also to enable them to improve their quality of life. This has financial resources, not loans, without which the dental profession has worked for a long time. the measures will not be feasible. The provision of funding Likewise, the legislature has followed our advance the funding programs of the credit stroke for the additional dental early diagnosis examinations within the framework of the institute for reconstruction (KfW) through the prevention law. In the GeNational Action Plan 2.0, a joint federal committee would be an important component. This is what we have recently demanded and confirmed with the public at a press event ”zm 106, No. 10 A, May 16, 2016, (1086) together with the National Association of Statutory Health Insurance Physicians. Now, at the end of the legislative period, two further measures are important to us in order to be able to continue to guarantee the security of supply: First: In order to avoid undersupply scenarios, the legislature must no longer demotivate dentists in rural areas through degression. Otherwise, the consequence would be a decrease in the commitment of colleagues in the regions where they are most needed. Preventive services, outreach care and services in undersupplied areas must therefore not be taken into account when calculating the degression quantities. At least here, degression must be abolished. Second: With the GKV-VSG, the legislature has created a form of establishment for the contract dentist sector with the medical group-like MVZ, which is not only completely superfluous in the contract dentistry sector, but also endangers an absolutely stable supply system. With the MVZ, an already existing oversupply in structurally strong regions is reinforced and a tendency towards undersupply in structurally weak regions is generated. The model that was intended for general practitioners is not suitable for dentists. We therefore demand that employment limits for private practices must also apply to dental MVZ. We need uniform framework conditions. Hence our urgent appeal to politicians: We must not jeopardize a functioning system of dental care through unnecessary experiments. Because developments that go wrong today can only be corrected later with great effort. Sincerely, Dr. Wolfgang Eßer Chairman of the Executive Board of KZBV The art of shining BRILLIANT EverGlow TM Universal Submicron Hybrid Composite  Excellent polishability and gloss retention  Brilliant single-color restorations  Ideal handling thanks to smooth consistency  Good wettability on the tooth substance 002509 everglow.coltene.com | www.coltene.com zm 106, No. 10 A, May 16, 2016, (1087) Readers' forum 10 Geneva vows instead of Hippocrates Hand file is irreplaceable u 䡲 To the editorial “The ethical 䡲 To the article:“ Fractured trap ”, zm 7/2016 , P. 3 Instruments - recovery techniques in the root canal ”, zm 7/2016, p. 34ff. Even if it appears again and again in connection with ethical questions, the "Oath of Hippocrates" is no longer spoken. For good reason, if you know the wording, but who already knows it! It has been replaced by the “Geneva Vow” (or “Declaration of Geneva”), everything else is regulated by professional law. Name is known to the editors. Source: http://www.bundesaerztekammer.de/filef df admin / user_upload / downloads / Genf.pdf The correct cleaning From HR manager to practice manager competence ", zm 8/2016, p. 28 Here a caption is published incorrectly. The correct caption reads: "An employee explains to the student how to clean and disinfect the instruments in the thermal disinfector." Thomas Hoffmann, Dresden 䡲 The zm editorial team is free to accept letters to the editor and reserves the right to make meaningful abbreviations. We also reserve the right to publish letters to the editor in the digital edition of zm and at www.zm-online.de. Please always give your full name and address. zm 106, No. 10 A, May 16, 2016, (1088) 䡲 On the article: "Team management: Leadership in a way that is fair to the generations - does that bring what?", zm 9/2016, p. 32f. The use of a specific vocabulary is characteristic of specialist media. So far so normal, but sometimes it also leads to misuse of names when words sound similar and therefore familiar. Practice manager instead of HR manager is such a case and unfortunately happened to us in the last issue of zm. Whereby the word personnel manager would have been the only correct one. We apologize for this misnomer and expressly state that our conversation partner Bianca Dedolf ​​from Health AG in Hamburg is the company's HR manager. Ri Photo: Health AG 䡲 To the article “Observation with Bianca Dedolf ​​is HR manager at Hamburger Health AG. Among other things, she is responsible for organizational development and personnel development for all employees and managers. In the eighties and nineties of the last century, machine root canal preparation was increasingly propagated. Inadequate materials and incorrect techniques resulted in a flood of fractured root canal instruments. The topic of "rescue techniques" was then again and again a topic at congresses and training courses. The zm is now presenting a whole series on the subject of “rescue techniques”. The authors are two employees of the tooth preservation department at the University of Greifswald, whose position as director is no longer to be filled! However, the "old" hand file is still irreplaceable in difficult cases and is now used successfully in combination with a wide variety of rotating techniques and leaves very few fractures. In the first two contributions, the young authors skilfully deal with the old lentulo and the difficulties with curved root canals. Unfortunately, the quality of the X-ray images is not acceptable. They are consistently "warped" and seldom show reference and root tip together. X-raying under a cofferdam in the OK is not for everyone and requires good training and experience. Dr. Fritz Haun, 53117 Bonn Lentulo - there are better alternatives 䡲 To the article: "Fractured instruments - recovery techniques in the root canal", zm 7/2016, p. 34ff. Matthias Schwaabe, Elmshorn Bullish advanced training?䡲 On further training: “Bullous autoimmune dermatoses”, zm 8/2016, p. 72ff. In 1976 I passed my state examination in dentistry in Bonn. During the course of my studies, I had a lecture for one semester, three hours a week, in the area of ​​"skin". Prof. Feldmann took the 13 points advanced training into account with the help of in itl Le r de ZMK BZÄK / DG Flemming Congress & MORE am Meer Wissen.Scha ff t. Emotions. September 9th + 10th, 2016 in the yacht harbor residence Hohe Düne, Rostock-Warnemünde Among others with: Univ.-Prof. Dr. med. dent. Daniel Edelho ff Aesthetic and functional rehabilitation of the abrasion teeth Photo: Lima Hats off to the colleagues, whether endospecialists or committed generalists, who painstakingly, patiently and meticulously “recover” broken root canal instruments. One thing must be noted, however: fracturing a lentulos should be a thing of the past by means of a very simple measure, namely by consistently not using the above-mentioned instrument. Because of its geometry and material properties, it almost screams to break off and can bring each of us into unpleasant situations. My suggestion on this: Dear colleagues, instead of this “risk instrument”, for example, use a so-called past-inject instrument.Like the Lentulo, it is a spiral conveyor, but due to its material properties it cannot break because the material is made of a very soft alloy. This instrument has extremely plastic physical properties, it only bends under strong mechanical stress without breaking. I have been using this instrument since I was an assistant over 20 years ago without ever experiencing a fracture. I do not intend to make the endospecialists I hold dear (I was a patient of one myself the other day and I am extremely satisfied) out of work, but if I can help, I would give just one colleague the embarrassing confession for each of us, the one instrument is fractured to spare the patient, then this modest contribution has already paid off. So dear colleagues: In your own interest, "never never not" use a Lentulo !. Univ.-Prof. Dr. med. dent. Matthias Kern is of the opinion that as a dentist, bullous changes in the mucous membranes should have a broad differential diagnosis in mind. Prof. Krüger (ZMK) was of the opinion that one should only take a trial excision or the like if one has also mastered the further treatment, otherwise one should refer to a specialist. In this sense, I consider the new training to be excessive and more for dermatologists suitable. Minimally invasive aesthetic anterior tooth replacement: The single-wing adhesive bridge as an alternative to the single-tooth implant Priv.-Doz. Dr. Dr. Ste ff en Koehler Immediate Implantation - A Contribution to Bone Preservation Be there! [email protected] Tel .: 040 - 32 102 408 www.flemming-dental.de Dr. W Fiekens, Lauterbach / Hessen zm 106, No. 10 A, May 16, 2016, (1089) zm 106, No. 10 A, May 16, 2016, (1089) online The best at www.zm-online.de Even more exciting There are topics on the net. Get to know us: Don't just read the printed booklet, go to zm-online.de. Here we present you with online articles selected by the editors. Caries therapy today When it comes to caries treatment, scientists today are unanimous: It is best to make only the periphery of the cavity free of caries, while the caries near the pulp is restrictively excavated in order to reduce the risk of pulp exposure. The use of certain instruments is a lively discussion. zm-Code: 36270 Many patients leave without a word The portalkosten-beim-zahn arzt.de evaluated over 1,320 individual data sets for its study "Zahnarztwechsel 2016". The result: According to a study, almost three quarters of all patients have already changed dentists, 83 percent of them without a word. You can find out the reasons here. zm-Code: 19755 Founder of the practice: Dream practice in the new building zm zm-Code: 74653 Photo: Henry Schein 12 Splint therapy at CMD MORE ON ZM-ONLINE Explanations zm-codes Here you will find the direct links to the articles described on zm-online. To do this, simply scan the QR code with a smartphone or tablet app or enter the numeric code in the search mask at the top right of the website. zm 106, No. 10 A, May 16, 2016, (1090) In the treatment of functional diseases of the craniomandibular system, reversible treatment using constructed occlusion splints can also be considered as a dental measure. Physiotherapeutic measures are also an option. The photo series shows examples. zm-Code: 62841 Retro becomes modern Practice founder Dr. Alexandra Thies took over the premises in an ideal location in Bochum. Your predecessor worked in the practice for over 30 years, which was originally set up in the style of the 1970s. Thies has rebuilt and renovated. The photo series shows the before and after comparison. zm-Code: 61590 My practice advisor and I Dorothee Schwarz is now her own boss. In zmPraxisgründer we accompany the dentist on the exciting journey to her own practice. In this phase, Kjell Ole Kröger is one of the most important people in Dorothee's life. Here she explains how the practice advisor supports her. zm code: 59188 Opioids from the dentist Opioid abuse has reached epidemic proportions in the USA and often begins with a prescription for a pain reliever. Dentists are among the leading prescribers of opioid analgesics and tooth extractions are one of the most commonly performed dental procedures, the study shows. zm-Code: 9933 Therapy of a radicular cyst A 35-year-old patient presented to a day clinic with an unclear mass in the left upper jaw after a referral from the family dentist. The patient himself was bothered by an increasing mass below the left eye. Is the suspicion of a cyst confirmed? zm-Code: 6863 zm 106, No. 10 A, 16.5.2016, (1091) zm 106, No. 10 A, 16.5.2016, (1091) 14 Policy Business model patient referral Always with no commission zm 106, No. 10 A , May 16, 2016, (1092) And that's not all: The HRC offers German clinics a comprehensive basic concept for the business field of foreign patients, a package as a workshop in the clinic itself and support in setting up an in-house “International Office”. Regardless of which Internet button visitors to the site click, the same contact number always appears - that of Pepler. The man who doesn't want to give any information. Why not? Non-transparent one-man shows According to Jens Jusczak, an expert on foreign patients at the Bonn-Rhein-Sieg University of Applied Sciences, there are now thousands of patient referrals in Germany. Most of them are "one-man shows with a migration background and non-transparent organizational structures". Even more fatal: Medical laypeople often felt called upon to look for a suitable clinic in Germany for foreign patients - “that can't go well,” Jusczak is convinced. Nevertheless, patient referrals are more in demand than ever. After all, the German business with foreign patients is booming, as the latest survey by the Bonn-Rhein-Sieg University of Applied Sciences showed. 251,000 international medical tourists from 176 countries came to Germany in 2014 for inpatient and outpatient treatment. Compared to 2013, this is an increase of around 4.5 percent. Most of them come from the United Arab Emirates (up 30 percent), still followed by Russian patients. Above all, the demand in the capital is rising and rising, compared to 2004 it has even quintupled, according to Juszczak: "An estimated 150 million euros are poured into the capital's coffers’ annually through revenues from medical facilities, hotel accommodation and purchases. Indirect effects such as expenses for transport (airplane, taxi, etc.), interpreters, tourist expenses such as visiting cultural and leisure facilities as well as investments in real estate, company holdings or the maintenance of private aircraft are not included. ”The turnover that the business with the Experts estimate that the German health care system has brought foreign patients to around 1.2 billion euros. The price does not play the role Medicine “made in Germany” seems popular and in demand, the quality in the field of dentistry is also attracting more and more foreign patients, reports Fabian Jain from Ku64 in Berlin. According to the PR manager of what it claims to be the "largest dental practice in one location in Germany", patients abroad are looking for precisely this quality. Some patients in the dental practice have this quality cost 30,000 euros per treatment. Illustration: Seraphim Vector - Fotolia.com After ringing the doorbell several times, someone finally answers. At the other end of the phone line you can hear a dark male voice, Vadim Pepler's. When asked whether he would be ready to talk about his patient referral in a timely manner, the managing director of HRC International replied in broken German that he was currently in another conversation. He will contact you - "in an hour". But Pepler doesn't answer in an hour. The native Russian casts off further telephone inquiries. He does not answer written questions at all. The website of HRC International - Patient Placement & Service, it says there - is extremely professional. In perfect German she suggests that she can offer a solution for everyone - be it the foreign patient looking for a clinic, be it the German hospital that wants to open up a new market with foreign patients. The list of services that the agency praises is almost endless: The HRC takes on the planning and implementation of hospital stays, including the patient's arrival and departure, including official services such as visa applications, but also organizing on-site concert visits, private nursing services, from security services, from wellness offers and ... from "special requests". Illustration: lightgirl - Fotolia.com Illustration: macrovector - Fotolia.com One direction of medical tourism is the way to Germany - dentistry / medicine made in Germany is valued. The trip is managed on a grand scale by self-appointed patient placement agencies. It often becomes dubious, intransparent and unprofessional, say the critics. We investigated who pays whom how much and what structures are behind the portals. On request, Ku64 offers foreign patients the entire program - hotel booking, transport, pick-up service including the supporting program. It is not uncommon for all of this to be organized by one of the “two to three” agencies with which the dental clinic works, says Jain. These agencies are based in Berlin and have a good network of patients in Russia. However, the names of these agencies are not given. But Jain quickly makes one thing clear: “We no longer pay commissions to the referrals!” The reason: In the past, quite a few brokers opened and demanded a certain percentage of the total treatment costs as a commission. However, their poor service prompted the dental practice to no longer pay any commissions for referrals. Now it is said that prepayment is required from the patient. Immoral commissions, illegal business practices Continuous training, clear responsibilities, strict intermediate and final controls in production and working according to well-founded quality goals guarantee the best results in every individual patient case. Still without a QA laboratory? Go the right way! You can find your QS-Dental certified master laboratory on site at: WWW.QS-DENTAL.DE ntal tested -De ft QS herh ei t ® nt or w zm 106, No. 10 A, May 16, 2016, (1093) Do you know QS -Dental? With QS-Dental the certified dental technicians document their high demands on quality and safety, perfect function and the highest aesthetics of the dental prosthesis. You are the ideal partner for your practice! From Vera However, there are not only black sheep among the placements. There are also those who provide information that is open. The Orient Academy sees itself as a service agency. It offers everything from company training, intercultural seminars, Arabic courses, political advice to services in the health sector. According to the managing director Mohammed Khalil, customers, i.e. patients, often come from ministries in Jordan, Kuwait and Iraq. The Orient Academy plans their trip from A to Z. It suggests private clinics in Germany, which it claims to have checked beforehand. The patients also received a cost estimate before they started. With us, you are on the right track. S ic mediation is also reliable DENTAL RESTORATION WITH QUALITY PROMISE & The reason for this decision is certainly another one: Commissions for referring patients to clinics are immoral, the Kiel Regional Court ruled in a judgment on October 28, 2011; corresponding agreements under applicable law are null and void. There are no controls over the pricing of mediation in Germany, explains Leonore Boscher, Head of German Health Management & Consulting. The joint attempt with Juszczak to introduce criteria for the approval of patient referrals in Germany has so far failed. Neither the Federal Ministry of Health nor the German Hospital Association and certainly not the intermediaries themselves are interested in seals or certificates as proof of quality. In response to a request from the Green MP Maria KleinSchmeink as to whether the federal government was planning legal regulations to prevent dubious business practices, the parliamentary state secretary in the Federal Ministry of Health, Annette Widmann-Mauz (CDU), only said in 2012: “The introduction of an approval procedure for placement companies In the view of the Federal Government, illegal business practices cannot be considered as a suitable measure to prevent such practices ”. Point. g f ü r Q u a li zm 106, No. 10 A, May 16, 2016, (1093) Politics “Basically the demand is positive” The Vice President of the Berlin Dental Association, Dr. Michael Dreyer, warns against cooperation with unknown agencies. zm 106, No. 10 A, May 16, 2016, (1094) "After all, the patients usually do not know whether the doctor they have referred is really qualified," emphasizes Dreyer. Dreyer basically considers medical tourism to be a good development. It is positive that foreign patients are interested in German medicine. “That speaks for our good quality.” Whether referrals with your patients ultimately “make the big difference” depends on the individual doctors and clinics. In the dental field, foreign patients are billed in accordance with the fee schedule for dentists (GOZ), as is the case with domestic patients. However, a "different agreement" is possible (Section 2, Paragraphs 1 and 2 of the GOZ). It says: By agreement between the dentist and the debtor, a fee amount that deviates from this ordinance can be determined. For his foreign patients, the normal GOZ price is exceeded by a lot, says Heybach of the dental suite quite openly. And that's right. "With foreign patients, a completely different dynamic is required of the doctor, there is a completely different effort," is his explanation. As a doctor, for example, he has to take more time to treat the patient due to the language used and to deal with the translator. In addition, the dental assistants are more involved in the care than with German patients. In addition, his clientele is almost always required to get appointments immediately and to carry out complex treatments quickly. So much openness is rather rare in the clinical area. According to the Hospital Remuneration Act, there is officially no incentive for German clinics to treat foreign patients. The hospitals that are subject to the flat rate system and for which a base case value is accordingly agreed are also bound to the remuneration for the treatment of foreign patients. The principle of uniformity of care rates applies in accordance with Section 8, Paragraph 1, Clause 1 of the Hospital Remuneration Act. “For a clinic, the treatment of a foreign patient is so complex because of the necessary organization that it is theoretically not worthwhile even with private payers,” says expert Jusczak. Discreet, welcome guests However, no one is currently checking whether clinics really adhere to this requirement. The fact that surveys the Photo: sabelskaya - Fotolia.com of their trip, this includes the cost of the service of the Orient Academy. Dr. Jochem Heibach sees the cooperation with mediation calmly. Heibach has been running a chic practice right at Cologne / Bonn Airport for a number of years; an offshoot of the “dental suite”, which is geared towards financially well-off business people, is still in Rösrath. When asked, Heibach says he likes to work with agencies, he doesn't control them either. It is important to him that everything runs smoothly and that the agencies relieve him of a lot - in other words: translator, travel, accommodation, possible catering for the patients according to their cultures. Marina Schermer from the Berlin Clinic sees it similarly - “if you go to the dentist, then first class!” Is the motto of the luxury dental practice on Leipziger Platz in Berlin. Schermer, also Russian, is easier to reach than her compatriot Pepler. Even though the PraxisManager, as the sole organizer of the entire international business, seems to have her hands full. She makes phone calls while walking. The patients at the Berlin Clinic come from all over the world. Some of them have a treatment costing 60,000 euros, says Schermer. The supporting program is not included. The Berlin-Klinik is happy to use mediation to organize this supporting program. They receive one percent of the doctor's fee from the clinic. The experiences with mediation are different: some only want money, others work professionally. Basically, adds Schermer, the BerlinKlinik is happy to gain new patients through agencies and values ​​professional cooperation.Illustration: macrovector - Fotolia.com Illustration: djvstock - Fotolia.com 16 According to the Bonn-Rhein-Sieg University of Applied Sciences, patients from abroad are welcome guests at almost every major German clinic, suggests otherwise. However, it is not discussed. The head of the international patients department at Charité International, Henri Ritschel, only says: The turnover from foreign patients is growing. One does not like to work with mediations. However, it does happen in a few cases - but without commissions. Vivantes International Medicine does not want to give any information about the business with foreign patients. The PR lady in charge simply said that there was no interest in being open to German media. That is a strategic decision. Martina Merten Specialist journalist 1 3M ™ ESPE ™ astringent retraction paste 3M ™ impression solutions. 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In short: the simply better way to get better impressions. 2 Mixing 3M ™ ESPE ™ Pentamix ™ 3 Automatic mixing device 3 Impression 3M ™ ESPE ™ Impregum ™ Polyether impression material 3M ™ ESPE ™ Impression Tray Disposable impression tray www.3MESPE.de zm 106, No. 10 A, 16.5.2016, (1095) Politics ZÄKWL congress for young dentists The future begins today More than 100 young dentists came to the 2nd future congress of the Dental Association Westphalia-Lippe (ZÄKWL) in Münster and spent a whole day learning about marketing, MVZ, online consultation hours - and yourself: As Ypsilonians, they were told, they evaluate their environment ... well ... pragmatically. company: On a company's own platform, patients can speak to their doctor "face to face" and, for example, exchange surgical reports or X-rays in video consultation hours via a web browser. "We guarantee high safety standards," assured Schulwitz. At the end of 2015, Patientus was awarded the “Health Economy Future Prize”. Thinking in terms of sense and nonsense Photo: ZÄKWL - W. Hilgert 18 The congress of the Dental Association Westphalia-Lippe did not only interest young dentists. Dr. Ralf Ueding, lecturer in marketing and sales at the University of Applied Sciences in Bielefeld, in the opening lecture: There are currently 87 dentists for every 100,000 inhabitants. We all do marketing In order to firstly react to this increased competition and secondly to meet the demands of the patients, every practice needs a modern marketing concept. "We all do marketing, the important thing for success is: You have to know your target group," Ueding clarified. Dr. Stefan Droste, specialist lawyer for medical law. Basically, at least two dentists must work in a (dental) medically managed MVZ - zm 106, No. 10 A, May 16, 2016, (1096) regardless of whether they are partners or employees. According to him, two half approvals are also sufficient. According to the latest figures from the KZV Westfalen-Lippe, there are currently ten dental MVZs in the chamber area, with over 15 dentists working in the largest. "On average, there are currently four to five dentists working in MVZ," reported Droste. While, according to BMV-Z / EKV-Z, contract dentists can employ up to two full-time or up to four half-time dentists at the contract dentist's office, the legislature does not provide for any limit for the MVZ. (Editor's note: This advantage over resident dentists is heavily criticized by professional politics and is therefore now being reviewed by the BMG.) Nicolas Schulwitz, managing director of the award-winning start-up Patientus, then presented the business idea of ​​his company continue with the "Ypsiloners". According to Dr. Bernhard Marschall, Dean of Studies at the Westphalian Wilhelms University in Münster, Generation Y has learned to evaluate the environment according to sense and nonsense. She puts personal needs in the foreground, in particular ... ... mastering challenges and achieving a high standard of performance. ... influencing others ... impressing others, taking responsibility ... and maintaining positive relationships with other people. Marschall described the strict selection process that applicants have to go through in order to be admitted to the second largest dental faculty in Germany - the application letter alone is checked by five experts. Not only does the NC apply - the Abitur grade only counts 50 percent - rather, in Münster you test your understanding of the natural sciences and design a so-called multiple mini-action setting: Among other things, a 90-second “read-in process” gives the applicant a situation from the everyday dental work is outlined, for which he should give recommendations for action. Ass. Jur. Sarah Potthast from the Westphalian Lippish Pension Fund (VZWL) presented her employer in a short lecture: The structural principles of the institution are therefore self-organization and self-responsibility with full self-financing by the members. Founded in 1957, the VZWL now has more than 7,400 dentists as members. "Pension funds are fully self-financed," said Potthast. In Westphalia-Lippe, the assets amount to around three billion euros. Investment focus: the real estate business. The primary purpose of a pension fund is to guarantee that all dentists and their family members are financially secure in old age and in the event of premature occupational disability or death. The advantages over the German Ren- Photo: ZÄKWL - W. Hilgert 19 "I was wondering how I can define’ my ’target group!" Björn Kuhles tells what he will take away from the congress. Thomas Beier, Product Manager at Dreve Dentamid GmbH, reported what role 3-D printing is now playing in dentistry. "Dentistry is one of the medical fields that can experience far-reaching changes with growing technological progress," said Beier. So far, the 3-D printer has mainly been used in dental technology because it cannot yet process ceramics. Crowns and inlays are then milled out of a block. Beier: “But 3-D printing will be much more widespread because the process achieves a particularly high level of precision.” Christina Conradi-Starr Public Relations Office at the Westphalia-Lippe Dental Association? “With us, you can shape things thanks to self-administration. Take advantage of this opportunity! ”䡲 The 2nd ZÄKWL Future Congress took place on April 23rd in the Münster Landscape Museum. The fastest universal drill in the world? 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