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DENTALTRIBUNE Middle East & Africa Edition Meeting & More 9 It all started with a nerve broach in 1907. MICRO-MEGA, whose headquarters are lo- cated in Besançon (France), has been manufacturing en- dodontic tools for over a hun- dred years and played a deci- sive role in endodontics through new developments. Internationally, the innovative company has a recognised rep- utation of being a specialist in dental instruments. At this year’s Adviser Group for En- dodontics (AGE) meeting, Dental Tribune met with Au- drey Stefani, MICRO-MEGA Marketing Manager; Dr StephanGruner,CountryMan- ager MICRO-MEGA Germany; and Dr Khaled A. Balto (Saudi Arabia), Associate Professor and moderator of the AGE meeting. Dental Tribune: Mrs Ste- fani,foroveracenturyMICRO- MEGA has been operating suc- cessfully in the dental market. Could you tell us anything in particular that stands out for you in the company’s history? Audrey Stefani: MICRO- MEGA is proud of having set in- ternational milestones with handpieces and contra-angle handpieces, micro-motors, en- dodontic files and NiTi files. A fact that perhaps only a few people know is that MICRO- MEGA used to be the sole manu- facturer of handpieces and con- tra-angle handpieces for the large brands in Germany and other countries. The Citoject, for example, was a MICRO-MEGA product, manufactured under Heraeus’ own brand for Heraeus. Today, it is still available as LigaJect from MICRO-MEGA, even after it was phased out of production. To a considerable degree, the com- pany was characterised by being able to launch world-first inno- vations on the market regularly, and we are able to build on this expertise today. Which MICRO-MEGA products have set standards on the international dental mar- kets? MICRO-MEGA inventions have set world standards; for ex- ample, in 1957 with the first dis- mountable handpieces with tungsten-carbide bearings; in 1963, Giromatic, the first contra- angle handpiece able to produce an alternating 90° rotation and specially made root-canal tools; in 1964, micro-motors with 40,000 rotations per minute, on the basis of which micro-motors arebuilttodaybyallmanufactur- ers; in 1974, the Masserann Kit for the removal of fractured en- dodontic tools from root canals; in 1996, HERO 642, a clear and simplesystemofrotaryNiTifiles; in 2002, HERO Shaper, a rotary NiTi file system. I could go on with this list indefinitely. All these experiences led to the development of the Revo-S file system, which was launched in 2009. This system enables a root-canal preparation with only three files. Revo-S is currently state-of-the-art technology; however, development is ongo- ing, which is why we hold the AGE symposium every year. In autumn 2009, MICRO- MEGA joined a group of com- panies under the management of SycoTec. In March of this year, the Canadian SciCan joined the European duo. The group is now amongst the top ten manufacturers of dental equipment worldwide. What opportunities does such a strong group offer? One great asset is that we are able to join forces and learn from one another. Our focus here in Europe naturally lies in Ger- manyandFrance,butwearealso going to enter new markets. If possible, we will use joint mar- keting, and joint research and development in order to consoli- date our position on the market. An important part of the strategy istomaintainandfurthertheSci- Can and MICRO-MEGA brands. Isthenameofthegroupstill under debate? Indeed, we have debated this for a while but have finally agreed on a name. I am proud to announce that MICRO-MEGA, SciCan and SycoTec are mem- bers of the Sanavis Group. MICRO-MEGA sells its products worldwide. Which countries are the most impor- tant in terms of turnover? And which regions hold the most potential in your opinion? Europe has always played an important role in our corporate development. The most impor- tantimportingcountriesareGer- many and, in our domestic mar- ket, France. North and South America are in the process of de- velopment, particularly with the introduction of our rotary NiTi systems. We have also recorded good growth figures in the Asia- Pacific region. Moreover, we are keenly observing the Middle Eastern region. As you can see, MICRO-MEGAasaninternation- ally known brand is in the process of exploiting current po- tential markets. There is every chance of suc- cess, particularly since research and development in the group have now reached global player magnitude and we know how to take advantage of this. Dr Gruner, are you cur- rently working on the develop- ment of new products? Dr Stephan Gruner: Thanks to the abovementioned syner- gies, our newly created group is going to get things moving in the dental world. We are constantly tryingtomaintainourtechnolog- ical lead and thus work hard and intensively. An event like the AGE helps keep MICRO-MEGA’s finger on the pulse of world trends. Have your expectations of this year’s AGE meeting been met? The AGE meeting has once again helped us progress scien- tifically thanks to top-notch re- search results presented by the speakers. During our internal MICRO-MEGA sessions, we were able to discuss interna- tional market demands further, which were then tested for feasi- bility and formed into projects. Prof Shimon Friedman lec- tured on The endodontic treat- ment outcome: The impact of the new technologies. Would youpleasesummarisethemost important points for us? Prof Friedman is world- renowned in the field of en- dodontics. Together with co-au- thors Dr Thuan Dao et al., he au- thoredtheworldfamousToronto Study, a series of articles in the Journal of Endodontics. This is anextensivepieceofworkthatil- lustrates and analyses the status of endodontics, starting with the publication of the first results in the year 2000 up to and including 2010. In his excellent lecture, Prof Friedman made clear that differ- ences in the evaluation and suc- cess or failure of an endodontic treatment greatly depend on the methods and structure of the evaluating studies themselves. If the correct evaluation criteria are applied, the success rate of endodontic treatments over the lasttenyearsisaround88to95%. Amongst the various authors, a high consistency of results is no- ticeable. These studies are en- couraging. The new product Revo-S was a part of further presenta- tions. Dr Balto, in connection with the innovative Revo-S concept you also spoke about the ‘third dimension’ of en- dodontic treatment. Would you please illustrate the main points of the system? Dr Khaled A. Balto: In gen- eral, endodontic rotary systems are evaluated with regard to the parameters of geometric fea- tures, taper, tip size, etc. There- fore, the equation for efficiency of a given file has long been con- sidered to be inner core size and symmetric design (which means perfect geometry), which results in stronger files. After 17 years of using Rotary NiTi files, we have learned that the equation for effi- ciency is rather the asymmetric design and efficient clearing of dentinal debris. This under- standing was applied in the con- ception of the Revo-S system. Revo-Sistheresultof17years of critical performance analysis, whichforthefirsttimeaddressed the concept of dynamic asymme- try. As a result, we now have files withbetterpenetrationandabet- ter clearing effect. Moreover, it is efficient, with only three files for initial treatment and much less likelihood of separation. To per- ceive the bio-mechanics of the file in the ‘third dimension’, the canal depth, the kinetics of Revo- S—the way it rotates inside the root canal—are analysed. What is your view of en- dodontics in the Arabic region compared to the Western world? Endodontics is a rapidly growing speciality in the Arab world in general, particularly in Saudi Arabia. Rotary endodon- tics, micro-training, warm obtu- rationtechniquesaswellasmod- ern retreto-dontics are all an in- tegral part of teaching curricula at many universities. However, as in many other countries in the world, there is a wide range of performance results depending on the experience of the dentists and the difficulty of the cases. In- dividual variation plays a signifi- cant role in the treatment stan- dards. For example, being an as- sociate in a practice limited to micro-endodontics in Jeddah, I treat patients from all over the world as well as locals. I have managed failures for treatments rendered domestically and from other countries. All in all, I do not see substantial differences be- tween the different countries in regards to the standard of treat- ment however, there might be a difference in the number of well qualified individuals. Your comprehensive publi- cations illustrate the wide range of your work. What are youworkingonatthemoment? Being an academic, clinician and researcher at the same time isratherdifficultbutnotimpossi- ble. As Deputy Director of the Center of Excellence for Osteo- porosis Research in Jeddah, my current research focuses on os- teoporosis as it relates to oral health. Since I returned from Har- vard Dental School, where I re- ceivedmyD.M.Sc.,theessenceof my research interest has re- mained the same, which is in brief:cellularandmolecularme- diators of infection-induced bone destruction, evidence- baseddentistryandotherclinical endodontic research. Apart from publishing, how do you exchange information with international colleagues? The world has become a small village thanks to the recent developments in information and communication technology. The Internet is the driving force for today’s information ex- change. Online publishing, dis- cussion forums, YouTube, etc. make it easy to stay in touch and remain updated on new develop- ments.Inmyopinion,postgradu- ate training programmes in en- dodonticsconstitutethemostim- portant cornerstone. AsDirectoroftheSaudiBoard of Endodontics, I have the privi- lege of reviewing articles and thus am constantly kept up to date on what’s new. Additionally, I value the international interac- tion that is possible through con- ferences and meetings like the AGE meeting. Wewouldliketothankyoufor this interview and wish you con- tinuing success. Editorial note: The interview was led by Jeannette Enders and Steffi Goldmann. “Endodontics is a rapidly growing speciality in the Arab world” An interview with Audrey Stefani, Dr Stephan Gruner & Dr Khaled A. Balto Audrey Stefani Dr Khaled A. Balto & Dr Stephan Gruner