Interview: Contemporary dentistry – striking an effective balance between esthetics, efficiency and quality

Interview with Dr med. dent. Martin von Sontagh, Hard/Austria

Dr med. dent. Martin von Sontagh, who hails from South Tyrol, has been running his own private practice in Hard (Vorarlberg, Austria) for more than ten years. His rooms are an extension of his philosophy, effectively combining modern interiors with personal ambience to create an overall sense of warmth and wellbeing. The practice is equipped with three state-of-the-art dental chairs. Dr von Sontagh, who is ably supported by eight dental assistants, practices contemporary dentistry – striking an effective balance between esthetics, efficiency and quality. He specializes in dental prosthetics, microscopic root canal treatment and periodontology.

Please describe the philosophy that guides your work?

In one sentence: I’m a human being first and then a dentist. In our practice, we focus on the needs and expectations of our patients. We cultivate an empathetic doctor-patient relationship. Furthermore, we try to keep our patients appropriately informed at all times. They should feel comfortable in our practice. We strive to create a welcoming atmosphere and put patients at their ease. Many patients present to the practice feeling very tense. Some of them are afraid of visiting the dentist. We can usually allay their fears and make them feel better by simply talking to them in a warm and open way. Moreover, we are committed to providing top quality. I don’t treat patients as numbers. Instead, I take time to know each one individually. That’s why I have a private practice. I work with a maximum of 15 patients per day. This allows me to meet my standards.

Why do the products from Ivoclar Vivadent suit your philosophy?

Because of their quality! Our success as dentists depends on our professional expertise and the quality of the products that we use.  I’m an advocate of composite resins and I like to use the materials from Ivoclar Vivadent. In my opinion, the bulk-fill technique has revolutionized dentistry. Ivoclar Vivadent offers a number of products for this technique. I wouldn’t want to be without their exceptional esthetic and physical properties ever again. In this context, I’d like to mention the 3s PowerCure product system in particular. This intelligent system is simply amazing for direct posterior restorations. I love its esthetics and quality. It allows me to accomplish my work more quickly and efficiently without having to compromise on quality. I have more time available to sculpt the functional characteristics of my restorations. Ultimately, it increases my profitability.

What percentage of your work is taken up by direct restorations as compared to indirect restorations?

I prefer to place direct restorations whenever this is possible. The procedure is minimally invasive and saves healthy tooth structure. Due to the continued improvement of composite resins, we now have access to materials with superb properties. Their clinical prognosis is excellent and their esthetics and biocompatibility are outstanding. Not only small and medium, but also large lesions can be treated with direct restorations. We use direct restorations in 95 per cent of our cases.

What is important to you in direct restorations?

First of all, my restorations have to last a long time. I like to offer my patients excellent solutions and this includes long-lasting clinical results. Many factors contribute to the outcome, for example, the wear properties and the resistance to discolouration of the materials. In addition, the restorations have to meet the esthetic requirements of the patient. This is not a problem these days because of the advanced materials which we have at our disposal. For my work, I make sure that the restorative materials I choose are all matched to each other and convenient to use.

In what way do the products of Ivoclar Vivadent fulfil your expectations?

First of all, the materials from Ivoclar Vivadent are all coordinated. They are easy to use and they are very durable.  For the past ten years, I have concentrated my work on direct restorative procedures. During this time, I have not had to replace a single restoration. I like the basic idea of minimal wastage behind the Adhese Universal VivaPen, even though it sometimes takes me several clicks before the adhesive dispenses properly. In general, the products are exceptionally convenient to use. The new restorative material Tetric PowerFill is very easy to sculpt. The products fulfil my expectations with regard to durability. The esthetic results I achieve with the materials from Ivoclar Vivadent leave nothing to be desired. I am happy and satisfied with the appearance of composite resin restorations.  The results are great and what my patients want: beautiful looking teeth.

Why do you like to use Ivoclar Vivadent products to create your direct restorations?

It’s quite simple: They have an excellent reputation! When I was a very young dentist, it was important for me to use highly dependable products. That’s when I decided to rely on Ivoclar Vivadent, a company with an excellent track record. My patients trust me and I trust Ivoclar Vivadent. I use all the company’s composite resin systems and curing lights. The products complement each other and are superbly matched. It’s easier and more reliable for me as a practitioner to use the products of only one manufacturer. It makes life much simpler. For example, all the products I use need to be exposed to light for the same amount of time. In addition, I appreciate the clear instructions for use, which explain the correct way of handling the products.

Allow me to give you a few examples to illustrate my point. The Adhese Universal light-curing single-component adhesive saves me several working steps. The pen delivery form is sensational. The VivaPen is an exceptional tool, which makes work much easier. Furthermore, some of the products from Ivoclar Vivadent are unique: for example, OptraGate. I’m also a great fan of the company’s curing lights, which I use on a daily basis: for example, the intelligent Bluephase PowerCure in combination with the new 4-mm composite Tetric PowerFill and Tetric PowerFlow, which take a very short time of only three seconds to cure. In short, I use products that enable me to produce esthetic, long-lasting results. I expect this same performance from Tetric PowerFill and Tetric PowerFlow in the future.

Are these products more convenient for you to use and more comfortable for your patients? Do you feel a difference?

Let’s take light curing as an example. From an objective point of view, there is not much difference between ten and three seconds. However, if one fully focuses on three or ten seconds, there is a big difference. It’s particularly noticeable on an extremely busy working day or when a patient is difficult. In that case, every second counts. Knowing that a material cures in three seconds makes me feel relaxed and confident and therefore allows me to work more efficiently. If you are under pressure, I’m sure that you too will feel that three seconds are much longer than ten seconds. I can place one to two restorations more per day. I can tell you with certainty that patients perceive ten seconds of light curing per working step as a very long time. Three seconds, however, are over in a flash.

What is the difference between treating anterior and posterior teeth?

I never use a bulk-fill material in anterior teeth. The lesions in these teeth are usually very small and do not require 4-mm fillings. As a result, I like to use Tetric EvoCeram and Tetric EvoFlow, or IPS Empress Direct to restore anterior teeth. These materials allow me to build up the teeth (or restoration) to look very natural with a lot of detail. I can recreate the natural beauty of a tooth by relying on my own creativity and my anatomical knowledge related to form, function and morphology.

How do you create a dry working field?

We all know that creating an absolutely dry working field is not always easy. Furthermore, a rubber dam is not necessary in every case. That’s why I like to work with OptraGate. It allows me to isolate the working field comfortably and effectively. It assists my patients in keeping their mouth open and it gives me a clear view of the working field. The assistant has a hand free to assist me in my work. OptraGate is a sensational auxiliary aid for creating a relatively dry working field. Moreover, it allows me to take photos of the working steps and my results more easily.

Thank you very much for this interview about contemporary dentistry and striking a balance between esthetics, efficiency and quality!