Dentsply Sirona is the world's largest global company in dentistry. Dentsply was founded in 1899 in New York, USA originated from an inventor Erwin Moritz Reiniger, a mechanical engineer at the Uni- versity of Erlangen, Germany and grew continuously through multiple Mergers and Acquisitions. Si- rona developed out of the Siemens AG dental division, which was divested in 1997. In 2016, Dentsply which became a leading player in dental consumables combined with the dental equipment company Sirona.1 As an equipment maker and consumable producer the company has hundreds of brands coming in 120 foreign countries from 76 subsidiaries and 106 branches.2 They design and manufac- tures laboratory and specialty products relating to dental supplies. With regards to consumable prod- ucts, DS specializes in anesthetics, plaque, and gum disease prophylaxis. They also design and con- struct artificial teeth, implants, etc.. They offer a huge variety of products and services with different positioning in most regions around the world. The "merger of equals" created the largest manufac- turer of professional dental products. In 2020, DS reported revenues of $3.3B, a decline of 17% from 2019 $4.0B, due to the Corona Virus pandemic (see Figure 1).

Figure 1: Dentsply Sirona Revenue Development 2006-20203

The merged Dentsply Sirona (DS) company rapidly faced major economic crisis as investors' expectations were not met according to plan and in addition, due to the aggressiveness of major competitors, such as Strauman Group and Nobel Biocare on the marketplace that reduced DS' market share. In addition, dental companies positioned themselves as Premium Brand companies to which a few global players including DS belong and a large number of about 400 smaller companies thrive for. They positioned themselves as so called Value brands. As relatively little technical innovation has been achieved since several decades depending on the product and service segment Value brand companies

1 Historical development of Dentsply and Sirona https://www.dentsplysirona.com/en/about-dentsply-sirona/history.html 2 SEC reporting https://www.sec.gov/Archives/edgar/data/818479/000081847917000007/exhibit211q42016.htm and Dun & Bradstreet https://www.dnb.com/business-directory/company-profiles.dentsply_sirona_inc.5a9be1a895884b3ca8bd79877a780fec.html

3 See Annual Reports https://investor.dentsplysirona.com/financial-information/annual-reports and https://www.macrotrends.net/stocks/charts/XRAY/dentsply-sirona/revenue

have increasingly put Premium companies under pressure, also amplifying DS' crisis between 2016- 2018 (see Selected Financial Data in Appendix 1). As a result, DS went through several dramatic transformations since 2018, having renewed major part of the management team at corporate and Business Unit level and re-orienting its Business Model to the Dental Solutions CompanyTM, providing "dental professionals comprehensive end-to-end solution offerings".4 This process is still ongoing, and several aspects will be depicted in the following and particularly regarding the Dentsply Sirona Implants (DSI) Business Unit.5

Evolution towards a H2H Marketing Model

DSI serves dentists, dental surgeons and dental laboratories and provide all products and services allowing for a replacement of one or several teeth by a dental implant. The division was created out of the acquisition of various companies, such as MIS Implants Technologies Ltd. (2011), Astra Tech AB, a leading provider of dental implants, customized implant abutments from AstraZeneca (2016), Datum Dental, Ltd. (2021) and many more. Traditionally, innovation was mainly driven by R&D and Clinical Departments determining portfolio improvements. The value chain creation thus typically flew from R&D/Clinical through Product Management, Product development, Operations and Marketing/Sales, the letter being considered as an organization with the task to push new products and services on the market. Therefore, the logic followed the classical 4Ps based Marketing Mix. Growth depended on the ability to design new product and services that were believed to meet customer needs and wishes. A price strategy was very much based on product and service bundling and often taking advantage of the company's scale.

DS was thus regarded as a premium company virtually satisfying all needs a customer may had, resembling to an Amazon-like warehouse containing several ten thousand of products and services. Customer access and marketing communication were very country specific. There was very little alignment between product design and development on one hand and pricing, distribution, and sales promotion of these offerings on the other hand. Little alignment further existed between the 10 different Business Units of DS and operational processes suffered from lack of transparency and sometimes, control. In a first transformation the global organization was restructured in a way to re-group the 10 Business Units into only 4 segments and a global Executive Leadership Team elaborated the following 5 top priorities (see figure 1 and Appendix 2 Business Units).

Figure 1: Top 5 priorities, 2017

4 See https://www.dentsplysirona.com/en-hk/about-dentsply-sirona.html 5 Video introduction under https://www.youtube.com/c/dentsplyimplants

These priorities showed the intention to reduce the complexity of the organization, to simplify and align the Management of the legacy Business Units as well as the operational processes, thus aiming at the optimization of the existing organization however, still largely proceeding with the classical 4Ps Marketing

Figure 2: Realizing Top Priority

Digitalization and Customized Offerings

For the last 50 years, dentists and dental technicians in small and medium size laboratories have been performing treatment by mainly relying on mechanical, analog tools and manual working processes. Since 1980, digital CAD/CAM systems were introduced and were quickly adopted by larger laboratories High volumes and standardized processes accelerated the introduction. In 2018, less than 20% of dental clinics were using CAD/CAM systems across the US and Europe. In addition, the exchange of information and workflows between dentists and laboratories were largely analog and AI-supported imaging solutions common in medical fields such as radiology or fertility have not yet seen their breakthrough in dentistry.6

Today, the structural reasons for the adaptation of digital innovations are disappearing and dentistry is also going through a strong digitalization process. The availability of technological miniaturization, connectivity of instruments, digital medical imaging, and digital planning tools is speeding up the process. Digitalization not only bears the opportunity to facilitate the customer experience through

6 More information under Roland Berger (2020) The future of Dentistry is Digital - How digital innovation is

reshaping administrative and clinical processes https://www.rolandberger.com/en/Insights/Publications/The-Future-of- Dentistry-is-Digital.html

concept.

A first step towards a customer centered mindset can still be recognized in the priority 4, which is the commitment to become a Dental Solutions Company instead of remaining a company offering single products and services.

Figure 2 shows the chosen approach taken to realize this goal. As easily seen, the idea is to offer complete solutions in order to help customers in their entire workflow to treat a particular clinical indication. This approach requires the combination of products and services from different Business Units to one single system and therefore, a very much customer-oriented mindset and understanding of the targeted customer experience that DS would offer as a whole. One can thus conclude that this change followed a Goods-Dominant Logic to a Service-Dominant Logic, an important step towards a H2H Marketing concept.

the integration of major systems, but also provides the opportunity to take advantage of economy of scale effects by combining various existing offerings. In addition, it is a powerful instrument to get customer information through the usage of connected instruments. Customized offerings thus become possible.

Dentsply Sirona Implants (DSI) Business Unit innovation initiative is following these principles with various new products and solution offerings. A typical example of a product launched recently following this approach was Azento (see Figure 3).

Azento is a system embracing all steps needed for a dentist to replace a tooth by a dental implant. This is including medical imaging to scan the dental defect, in silico design of the surgical intervention, the selection of the most appropriate implant system and also the prosthetics, i.e. the crown, which is a customized product. As a result, the dentists are using only one system containing all instruments and tools, which are all compatible and work perfectly together. He gets a box containing all necessary instruments and guided surgery tools to perform the surgery, place the implant and ultimately, place also the crown. Appendix 4 shows the box and its content in more details. The offering of the Azento systems also required to setup dedicated teams receiving the customer data in order to design a custom-made solution.

Figure 3: The Azento system and its workflow to place a single dental implant

Don Casey, CEO of Dentsply Sirona stressed this in an interview: "It is the solution for single-tooth replacement that provides dentists everything they need for an implant treatment, including a proposed surgical and prosthetic plan, as well as all the components and instruments needed for the case, a DS implant and a custom healing abutment. It could not be simpler. It's one company, one set of questions for the dentist and it works seamlessly. We are the best company to provide a single tooth replacement in a seamless and easy workflow."7

Design Thinking

After the Dentsply Sirona Implants (DSI) Business Unit took the first steps towards a customer centered elaboration of offerings, the need to harmonize the internal approaches for better understanding customer needs was identified. In addition, there was a need to drive innovation, define a portfolio strategy, develop products and services and to elaborate a consistent branding and market

7 Quintessence Publishing Deutschland Wirtschft 2019, May 24 For us, 'Inspired by your needs' is much more than a slogan" Don Casey, CEO of Dentsply Sirona, talks about expectations, added value, trends and the

company three years after the merger https://www.quintessence-publishing.com/deu/de/news/nachrichten/wirtschaft/for-us- inspired-by-your-needs-is-much-more-than-a-slogan

communication. A significant change was thus conducted to re-define the role of the Business Units so that they would be mainly responsible in the elaboration of a portfolio strategy and especially in alignment with the other Business Units. Departments such as Supply Chain, Operations, Sales, Clinical, Quality, Regulatory and Finance were re-grouped in global pillars of their respective domains outside their original Business Units.

Consequently, the Leadership teams of all Business Unit which were renamed to Product Groups instead kept their R&D and Product Management functions and in addition, new functions were created including Business Development and Strategic Development. Most strikingly, a Strategic Marketing function was created as well as a Product Marketing function, the latter would work together with the Sales Organization. The new role of the former Business Units and the composition of their respective Leadership teams was a complete paradigm change in the way DSI and DS is now elaborating new offering and seeks to be perceived in the marketplace. Many Design Thinking workshops were conducted and through hiring experience experts the Design Thinking became ingrained in the organization.

This was a strong commitment toward a truly Human centered mindset and a customer insight-based Marketing approach. The value chain changes to a path going from the Global Company Strategy to a Strategic Marketing process which was entirely non existing in the past ensuring a customer centered approach and subsequently, reaching the R&D and Product Management Teams translating the targeted Business Model into a Product and Service Portfolio and a R&D Strategy. To ensure optimal alignment and cooperation between these new roles care was taken to fill the new Leadership team position as well as mid and lower Management and Project Management positions with employees with personal affinities and interests for the other disciplines, that is, showing a natural out-of-the box thinking mindset. This allows overcoming the typical former silo thinking and ensured that employees understand the language and role of colleagues from other functions. As an example, many R&D leaders and Project Managers received further education in managing businesses and entrepreneurship, and Marketing and Product Management employees were hired with an originally scientific or engineering background. The result is the feeling to work in a strong team with employees who understand and respect each other and show interest in their mutual disciplines. A high level of mutual trust in these teams can be observed as well as an excellent motivation to work together.

Questions for discussion

1. Win your opinion, were most employees able to understand the new roles of the Product Groups and capable to work together and adhere to the H2H transformation?

2. What are the opportunities to push further to digital transformation process towards the offering of digital services?

3. For the coming years, is it possible to conceive e-Commerce like Business Models in dentistry?

4. What are the opportunities to utilize digital data to understand better customer needs while ensuring full data protection?

5. How to offer customized Premium products and services at a large scale in a global world and how to deliver them on time?

6. How global Premium companies can take further advantage from Digitalization and Design Thinking to innovate on their Business Model and ensure long-term growth despite the pressure generated from Value companies?