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Published: Monday, 07 June 2010 23:11

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The tone of event was not maudlin, instead it was nostalgic, reflective and uplifting – all the speakers were proud of their association with John McLean, reverential of his tremendous contribution to dentistry but amused by his foibles. We learned that not only was he a pioneering scientist, he was a bon viveur, competitive gardener and proud family man. Testimony to the profound effect he had on his colleagues was the fact that every one of the 23 speakers not only travelled from all over the world but paid their own travel and accommodation expenses to have the honour of addressing the Symposium and received no honorarium for speaking.

Dr David Winkler who organised the event commented “John’s pioneering work contributed to changes in many aspects of dentistry, to the benefit of generations to come. His work was underpinned by his passion for science, astute insight into trends in dentistry and meticulous attention to detail. During his lifetime John studied and worked with many of us and become not only a good friend but achieved international renown as a highly regarded dental practitioner, scientist, author and keynote lecturer, making an important contribution to the advancement of dentistry”

The delegates were greeted by a filmed oration by Graham Mount from Adelaide , Australia , who outlined some of the honours conferred on John McLean during his lifetime. He listed that John served on both the General Dental Council and the British Dental Association. He was awarded a Fellowship in Dental Surgery from the Royal College of Surgeons of England as well as many other honours, including two distinguished science awards from the International Association for Dental Research, the OBE in 1988 and last year the coveted Golden Medallion of the American Prosthodontic Society

Edwina Kidd, took to the podium to talk about Caries and John. She is Emerita Professor of Cariology at King’s College, London and has published extensively in research journals and lectured worldwide. Her principal aim in teaching and writing has been to base the practice of Conservative Dentistry on the science of Cariology. Eponymous lectures on caries mark the beginning and end of Edwina’s 35 year friendship with John McLean and in her talk she looked at how the carries process – the metabolism in the bacterial biofilm – can be controlled so that lesions never form, or, one formed, arrest. She also discussed the role of fillings in caries control and how adhesive materials have revolutionised this restorative care. She concluded that the current challenge is to deliver caries control strategies cost-effectively to the whole population.

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Next to the stage was Avijit Banerjee, whose talk covered Modern Caries Management. Dr Banerjee is Senior Lecturer and Honorary Consultant in Restorative Dentistry and Head of Pre-clinical Conservative Dentistry at King’s College, London. He talked about the benefits of Minimal Intervention Dentistry – appropriate control measures to prevent new lesions and about the operative management of cavitated lesions, minimal caries excavation and restoration. His exploration of restoration covered adhesives and bio-active materials to seal off the process within the tooth and enable the patient to disrupt the relocated biofilm at the tooth surface, so preventing progression. He finished with recent developments in operative technologies and dental materials which are making these principles a reality.

The third speaker wasIvar Mjorwho during his career has beenPresident of the Norwegian Dental Association and President of the International Association of Dental Research and has been awarded seven honorary memberships from national dental associations. Since 1993 he has held the position as Academy 100 Eminent Scholar and Professor of Operative Dentistry at the University of Florida until he retired in May 2008. In his talk about Practice-based Dental Research he gave a brief overview of practice-based research related to restorative dentistry, because about two thirds of general dental practice involves diagnosis and prevention of caries, and the restoration of carious defects. He discussed the aims of practice-based research networks to identify clinical problems and establish criteria for prevention and treatment as needed.

This was followed by a reflective talk by Alan Wilson about The Early Days with John McLean. Dr Alan Wilson’s principal research interests were the Dental Silicate Cement and other dental cements, the invention and development of the Glass Iometer, the devising of test methods for dental materials and sustained delivery devices. Now retired, he was Senior Research Fellow at the Eastman Dental Hospital and then at King’s College, London . In his talk he gave an account of the early days of John McLean’s collaboration with the Laboratory of the Government Chemist on the glass ionomer project, work that lead to the acceptance of the glass ionomer by the profession.

Concluding the first session, Denis Smith took as the topic of his talk The Genesis of Adhesives for Enamel and Dentin. Though he formally retired in 1993, Dr Smith remains active as Professor Emeritus of Biomaterials. As Head of Dental Materials Science at the University of Manchester he developed acrylic bone cement for the fixation of hip and knee implants and invented the adhesive dental cements which are widely used by almost every dentist in the world for restoring teeth. In 2006 he was appointed and Officer of the Order of Canada . His talk outlined the problems in clinical usage and complexity of manipulation – especially with the enamel/dentin bonding agents - of self-polymerizing acrylic resin. He gave an overview of the research and development of a number of pioneering individuals – including John McLean – over 60 years who contributed to the composite systems of today.

After a reviving break for coffee Oswald Gasser was first to the lectern with a presentation he called In Every Cloud there is a Ketac-Silver Lining: Developing Dental Cermets with John McLean. Dr Gasser is the co-inventor of 350 international patents and patent applications in dental materials. He was Global Technical Director of 3M ESPE before retiring in 2007. He reported on his personal experience of innovative, inventive and inspiring collaboration with John McLean – in the creation of a self-adhesive, monomer-free dental material overcoming drawbacks of then existing self-adhesive solutions.

He was followed by Rainer Guggenberger who tackled the subject of Glass Ionomers: Leading the Way to Self-Adhesive Materials. Dr Guggenberger is Corporate Scientist at 3M ESPE and member of the Executive Board of 3M ESPE in Seefeld , Germany , where he is responsible for Research and Development. He has gained 25 years of experience in the development of dental products and a broad range of technologies such as glass ionomer cements, adhesive systems, composites and ceramics. He argued that without glass ionomers – pioneered by John McLean and Alan Wilson – self-adhesive composites would never have been developed. What is remarkable about glass ionomers is that they create a permanent bond to enamel and dentin. The ability of self-adhesion remained a key feature in the next development towards Resin Modified Glass Ionomers (RMGI) and to self-adhesive composite cements used today.

Dr Raymond L Bertolotti is currently Clinical Professor in Biomaterials Science at the University of California . He is perhaps best known for introducing “total etch” outside Japan . In his talk The Quest for the Perfect Bond he showed that judging bonds by shear bond strength tests on flat, 600 grit ground surfaces could be considered “shear nonsense”. And argued that other criteria are clearly more important predictors of clinical success.

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The next contributor was Harold Preiskel who is Professor of Prosthodontics at King’s College, London where he founded the dental implant programme. He has served as President of numerous societies and notably is the only non-American President of the American Prosthodontic Society. He was also the founding co-editor of the International Journal of Prosthodontics. His talk focussed on Clinical Science Meets Practice: Interface or Interference and in it he gave a synthesis of John McLean’s contribution to clinical dental science viewed through the eyes of an observer whose relationship matured from student to colleague and eventually close friend.

Commerce vs. Care: The Ethics of Esthetic and Restorative Dentistry was the subject covered byDr Richard Simonsen who is the Founding Dean of Midwestern University, College of Dental Medicine, in Glendale, Arizona, the newest dental school in the U.S. He is the developer of the Preventive Resin Restoration procedure and the etching of porcelain for aesthetic and restorative procedures. He has been awarded a Lifetime Achievement Award from the World Congress of Minimally Invasive Dentistry and he received the 1999 Distinguished Service Award form the American Society of Dentistry for Children. In his talk which was interspersed with stunning photography, he discussed the recent trend towards creating the perfect “smile”, sometimes with full mouth reconstruction based on shaky science. He looked at the ethical responsibility of the profession towards patient treatment and how practices choose to maximise income at the expense of the patient.

In the last session before lunch Galip Gurel focussed on Interdisciplinary Team Approach for Minimum Invasive Aesthetic Prepless Veneer. He stressed that clinicians must be highly ethical in their patient care ensuring treatment is minimally invasive to the healthy dental tissues. Dr Gurel is the founder and Honorary President of EDAD (Turkish Academy of Aesthetic Dentistry), President Elect of the European Academy of Esthetic Dentistry for 2011 and 2012, and Editor-In-Chief of Quintessence Magazine in Turkey. He has been practicing in his own clinic in Istanbul , specialising in aesthetic dentistry, since 1984.

After a chance to catch up with their colleagues, the 268 delegates returned for the afternoon session where they were first addressed by Ken Malament on the Integration of Esthetic Dentistry in Routine and Complex Prosthodontics. Dr Malament has a full time prosthodontic practice, is a Clinical Professor at Tufts University in Boston and a Course Director in the postgraduate department of Prosthodontics. His talk gave a comprehensive look at failure modes and effects in bilayer all-ceramic crown-cement-tooth systems. He explained that present bi-layered all-ceramic crowns on molars still fail because of breakage at relatively high rates and advocates for the Lithium Disilicate E Max mono-layered all-ceramic material which, he argued, is likely to change dentistry and improve long-term ceramic survival.

Hot on his heels came Dr Stefano Gracis who works in private practice in Milan, Italy, limiting his activity to prosthodontics and restorative dentistry. He is on the Editorial Board of the International Journal of Prosthodontics, European Journal of Esthetic Dentistry and European Journal of Oral Implantology. He took as his subject Metal-Ceramics: A standard on the road to extinction? in which he looked at the advent of new metal free prosthesis, which challenge metal-ceramics, up to now the standard for fabricating fixed prosthesis. The lecture analysed the indications and requirements for a metal-ceramic prosthesis vs. a zirconia device and addressed relative potential risks for failure.

Ceramics in Fixed and Removable Prosthodontics was the topic covered by Dr. Carlo Marinello who is Professor and Chairman of the Department of Reconstructive Dentistry and Temporomandibular Disorders at the Dental School of the University of Basel . He is the author of over 130 referred papers and, in 2003, received the Distinguished Lecturer Award from the American College of Prosthodontics. He showed the step-by-step clinical and technical fabrication of zirconia bar on implants and of a corresponding zirconia complete denture. During the talk he discussed the advantages and disadvantages of Zirkonzahn’s copy-milling unit.

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Dr Aris Tripodakis is past President of the European Section of the International College of Dentists and is Associate Professor of the Department of Prosthodontics at the National and Kapodistrian University of Athens. His talk Evaluation of Two Alternative Approaches in Designing CAD/CAM Frameworks for Fixed Veneered Restorations outlined his clinical-laboratory research, evaluating the different approaches in designing CAD/CAM frameworks for fixed partial dentures as to their efficacy in providing adequate support to the veneer porcelain. The conclusions of the research demonstrated that conventional wax modelling prior to scanning of CAD/CAM frameworks appears to provide the best control on the produced design.

He was followed by Dr Tidu Mankoo who runs a private and referral practice in Windsor, UK, treating complex implant, restorative and aesthetic cases and carries out both the surgical and prosthetic aspects of the treatment. He is the current President of the European Academy of Esthetic Dentistry, a founder and Past President of the British Academy of Aesthetic Dentistry and serves on the Editorial Board of a number of dental journals. He took as his subject Anterior Implant Aesthetics: The Key to Success and outlinedthe contemporary surgical and prosthetic concepts in the management of implants in the aesthetic zone with a view to achieving optimum long-term aesthetics and stability. He emphasised the importance of clinical management of bone, soft tissue and components for soft tissue aesthetics.

The final session was started with a talk entitled A Window of Opportunity – Strength and Beauty given by John Hubbard who is founder of the John Hubbard International Dental Studios, a technology centre specialising in crown and bridge and aesthetic dentistry. He began his teaching career in the early 1970s and in 1985 founded John Hubbard International Dental Seminars Postgraduate Learning Centre which was the first privately owned centre of its kind to be established in the United Kingdom . He is Past Editor-In-Chief of Quintessence Journal of Dental Technology UK and Past President of the British Academy of Aesthetic Dentistry. The talk was a personal account of Mr Hubbard’s working relationship with John McLean, commencing in the early 70s, discussing the laboratory techniques used during this period to develop Alumina reinforced porcelain, in order to optimise strength and beauty in definitive restorations.

Next on the podium was Andrew Dawood who is a Registered Specialist in Periondontology and Prosthodontics, working in Private Practice in London , and also in the Department of Maxillofacial Surgery, St Bart’s, the Royal London Hospital Trust and University College Hospital, London. He has 20-years experience in Implant Dentistry, and is particularly interested in implant reconstruction in maxillofacial surgery and in the severely atrophic jaw. He shares a passion for imaging and manufacturing technologies with a team of scientists and 3D technologists based at the London practice. His talk Digital Fabrication Processes discussed the use of computer guided surgery for precise and minimally invasive implant placement and examined some of the factors which may introduce error into the workflow.

8 Years of Zironia: A Clinician’s Retrospective Perspective was presented by Dr Balwin Marchack who serves on the Board of Councillors and is Adjunct Professor of Clinical Dentistry at the University Of Southern California School Of Dentistry and is the Chair-elect of the Editorial Council for the Journal of Prosthetic Dentistry. He maintains a private practice with a focus on aesthetic, restorative and implant dentistry in Pasadena, California . The presentation discussed the clinical performance of CADCAM zirconia restorations for natural teeth and impants in one private practice over an eight year period and looked at current design trends and future perspectives of this technology.

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Naoki Aiba is a ceramist and professional photographer who has published and exhibited his photographs around the world. He maintains his laboratory, Science Art, Inc. in Monterey , California and offers hands-on seminars at his teaching facility, Oral Design Center Monterey. In his talk Dentscape: Dental Photography for Dentist-Laboratory Communication he presented the three major aesthetic challenges faced by the dental technician when using dental photography – shade matching, midline orientation and incisal edge position. Naoki demonstrated the concept of “Shade View” to read, map, and analyse cases and how to photograph them, and showed the camera and flash set-up of Nikon and Canon systems for optimum exposure.

Dr Stefan Paul’s clinical work includes implantology, all ceramic restorations and complex aesthetic dentistry. He maintains a private practice in the heart of Zurich , Switzerland dedicated to implantology, aesthetic fixed and removable prosthodontics, paediatric dentistry, oral surgery and orthodontics. He also teaches at the University of Freiburg, Germany. In his talk Tissue Integration of Implants: Biodynamics of External vs. Internal Designs he exploredthe latest literature and clinical cases to test the hypothesis if delayed implant placement can still be considered the standard of care in the maxillary anterior zone. He took into account recent developments in the design of implant parts and implant micro-surface, which seem to have an impact on the guidelines for the 3-dimensional placement of implants.

In the final talk Nicolas Pietrobon discussed the Team Approach Between Prosthodontics and Dental Technology and looked at the rapidly changing face of restorative dentistry in relation to dental laboratories. He reviewed aspects in shade and material selection and the necessity of a close dentist-technician relationship. Mr Pietrobon has his own private dental laboratory in the centre of Zurich , Switzerland . He specialises in advanced dental technology and, from 1993 to 2001, was the Head of the Dental Technology Laboratory, Department of Removable Prosthodontics and Dental Materials at the University of Zurich .

Dr David Winkler concluded the event by commenting “If you, like us have been touched by John’s work and wish to honour his memory, we invite you to join us in making a gift to the John McLean Fellowship Fund. Your donation will help promote and nurture student research and dental materials, thereby enhancing the opportunities available to those beginning their careers in this important aspect of dentistry”.

The production of this article was supported by Philips Oral Healthcare. For more information about the John McLean Fellowship Fund please email This email address is being protected from spambots. You need JavaScript enabled to view it.

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