News Feature

Nature style: Observe. Understand. Copy.

Interview with Ghaith Alousi, DT

He inspires dental technicians with his passion and creativity as a course instructor, and with Nature Style, he has developed a well-conceived concept for the creation of lifelike anterior restorations. We are talking about Ghaith Alousi, a dental technician based in Wiesbaden, Germany. While course participants usually attend his training courses eager to learn from his experience and technical knowledge, they often return to their laboratories bursting with positive energy, truly inspired and deeply motivated to break new ground.

Ghaith Alousi, what is the dental technician’s primary mission?

In my eyes, dental technicians are not artists; rather, their primary mission is to replicate nature – both functionally and aesthetically. Every tooth, like every patient, is as unique as a fingerprint. To recreate a natural tooth as accurately as possible, we must listen, observe, and understand. To truly perceive the details that matter, however, we need to know where to focus our attention. In my opinion, the three golden keys to anterior aesthetics are paramount: balanced translucency and opacity, morphology, and surface texture.

What about colour?

While colour is undoubtedly a crucial aspect, I believe it is often overemphasized. Many dental technicians focused on aesthetic anterior restorations find themselves preoccupied solely with colour. However, natural teeth – the model we aim to replicate – embody far more than just a blend of hues.

First and foremost, we must understand how light interacts with teeth. They diffuse light in a unique manner, with different layers of enamel and dentin each possessing distinct optical properties. Additionally, the individual shape and surface texture of a tooth significantly affect the perceived attractiveness of a patient’s smile and overall facial appearance. Therefore, I have learned to prioritize these elements, observing nature closely and striving to comprehend what I see before embarking on the replication process.

Fig. 1. Light-optical properties of natural teeth imitated with KATANA™ Zirconia YML, Esthetic Colorant and CERABIEN™ ZR porcelain (Kuraray Noritake Dental Inc.).

Let’s take a brief look at each of the three golden keys, starting with the light-optical properties.

To truly grasp how light interacts with natural teeth, we must first examine their structure. Natural teeth consist of various layers, each displaying unique light-optical behaviours, with enamel and dentin being the most significant. Upon closely observing the dentin core of a tooth, we realize it is not only responsible for the tooth’s fundamental colour but also exhibits distinct opacity – it does not transmit light; instead, it reflects and absorbs it. In contrast, enamel presents a different scenario: its thickness varies with factors such as the patient’s age, but it is consistently highly translucent. This translucency allows a portion of light to pass through, with only a minimal amount reflected or absorbed.

Once we have a solid understanding of the natural light dynamics inherent in a patient’s teeth, the next step is to replicate these characteristics using selected materials. Thus, comprehending the light-optical properties of available materials, choosing them wisely, and applying them effectively are crucial milestones on the path to success.

What about morphology?

I firmly believe that mastering morphology – the replication of natural tooth shapes – can significantly impact a dental technician’s work. The growing popularity of carving workshops in Japan and other parts of the world reinforces this idea. Aspiring technicians avoid using standard dental libraries that produce generic smiles for their patients. Rather than traveling long distances to attend workshops and build our own mental library of tooth shapes, we can explore the intricacies of form and shape right in our dental laboratories through careful observation and consistent practice. Some technicians capture images of the teeth they encounter, while others concentrate on their own teeth or those of colleagues and patients. This approach allows for the replication of shapes using materials like wax or ceramics. By honing our observation and replication skills, we expand our personal knowledge base. This commitment to detail fosters true mastery – a continuous journey toward perfection.

Fig. 2. Example of a natural surface texture reproduced with CERABIEN™ MiLai and different diamond burs, stones and rubber polishers.

Is surface texture similarly important?

Absolutely. The surface texture of a restoration, even more than its hue, must precisely match that of surrounding or opposing teeth to achieve a natural appearance. To accomplish this, we must understand and replicate the intricate interplay of micro- and macrotextures that create a tooth’s natural look. Macrotexture encompasses the tooth’s overall surface characteristics, including varying concavities, convexities, line angles, and vertical V-shaped grooves. In contrast, microtexture focuses on finer details, such as growth lines (striae of Retzius), perikymata, small grooves, and the degree of surface gloss. A keen eye is essential to replicate every surface detail harmoniously so that light interacts optimally, creating reflections, shadows, and highlights exactly where they are needed.

Fig. 3. Large tooth created with CERABIEN™ ZR.

How do you practice?

To practice replicating surface texture and morphology, I typically start with enlarged model teeth, first using wax and later transitioning to my preferred dental materials and instruments. The increased size of the working base allows for easier detection, reproduction, and assessment of relevant morphology and surface details compared to original-sized tooth forms. This enlargement also facilitates the evaluation of light-optical properties. For the final assessment, I often apply silver or gold powder to the surface of the model tooth, which highlights even the finest surface nuances. This method makes it easy to identify areas that are well-executed and those that may need improvement.

Fig. 4. Gold powder applied to anterior restorations …

Once I achieve a high level of quality with the enlarged model teeth, I transfer the acquired skills to real-life applications by working with actual-sized teeth. This practice framework allows me to continuously enhance my basic skills. Moreover, each time I start working with a new instrument or material, this approach streamlines the initial learning curve, quickly elevating my performance to a high standard.

Fig. 5. … to evaluate their shape and surface texture.

What are your preferred material combinations for different indications / needs?

For cases with highest aesthetic demands, CERABIEN™ ZR (Kuraray Noritake Dental Inc.) is my favourite porcelain system. I This system can be utilized either as a standalone solution for producing veneers using the refractory die technique or in conjunction with a zirconia framework – typically crafted from KATANA™ Zirconia variants such as KATANA™ Zirconia UTML, STML, HTML Plus, or YML (also from Kuraray Noritake Dental Inc.) – in a full layering approach.

I frequently employ this combination to produce single crowns in the anterior region, selecting the framework material based on the colour of the underlying tooth structure and the appearance of adjacent teeth. An alternative approach is layering with CERABIEN™ MiLai, which consists of internal stains and porcelains compatible with zirconia and lithium disilicate. I prefer to combine this system with the previously mentioned zirconia variants or with lithium disilicate, predominantly using the porcelain to replicate enamel. Sometimes, I employ the system’s internal stains to enhance the result with natural colour effects.

Apart from observing closely, selecting appropriate materials and copying carefully, are there any additional factors decisive for great treatment outcomes from the technician’s point of view?

To my mind, there are two additional essential factors: Proper interaction and communication within the restorative team and personal interaction with the patient. Especially in the highest aesthetic demand cases, meeting a patient in person is very important. They are usually invited to visit the dental laboratory twice, prior to treatment planning and for try-in. Nothing can replace personal interaction with them and a genuine impression of the initial situation. After all, we need to give them a sense of security and build trust, while analysing their character, facial characteristics, skin colour and more allows us to produce perfectly matching restorations.

Fig. 6. Full layering approach with CERABIEN™ ZR on a KATANA™ Zirconia YML framework.

And the restorative team?

We share a common goal: to fulfil the desires of our patients. I firmly believe that achieving this requires a united effort from the entire team. Collaboration hinges on appreciative and open communication at all levels and demands absolute honesty. Furthermore, everyone involved must be committed to continuously developing their skills.

I hold high expectations not only for my own work but also for the contributions of each dentist in our team. After all, their work forms the foundation of what I do. For example, when a dentist invests in an intraoral scanner and starts providing digital records, it is my responsibility to verify whether the quality of those scans meets our high standards. If I notice that the quality could be improved, I approach the situation with respect, offering constructive feedback and guidance to help them deliver quality scans consistently. This is crucial, as high-quality scans are the prerequisite for creating outstanding restorations.

In my experience, most dental practitioners appreciate this kind of honest and supportive communication. It creates an environment where we can all grow and evolve together.

Do you have any additional comments?

Be authentic, strive for excellence, and approach each day as an exhilarating opportunity. Courage plays a vital role, too – the readiness to venture beyond your usual routines, such as experimenting with different shades to discover new possibilities, fosters growth. Even if the outcome does not meet your expectations, there is valuable insight to gain from the experience that can guide you in the future. To reach new horizons, be open to exploring uncharted paths.

Dentist:

GHAITH ALOUSI

Ghaith Alousi, born in 1994, successfully completed his training as a master dental technician in 2013 in Damascus, Syria, where he gained initial experience in a dental laboratory. From 2014 to 2016, he worked independently in Damascus, using his craftsmanship to produce ceramic work such as frameworks, veneers, crowns and bridges, and implant-based restorations. He also engaged in shade determination, photography, and CAD/CAM technology.

He came to Germany in 2016 and quickly felt at home. Through further education, he has continuously expanded his knowledge and skills and is currently working as a dental technician in Wiesbaden. To achieve the best possible results, Ghaith Alousi places great value on collaboration with dentists and personal contact with patients.