Dentistry Today — April 2017

Inside this issue

Excerpts from the issue. Open the digital edition to read any page in full.

1. Page 2

   Brasseler USA's XP-3D Shaper and XP-3D Finisher: Minimally Invasive Anatomical Cleaning The Challenge NiTi instrumentation has made a significant impact on the field of endodontics. However, despite the benefit of improved efficiency, all traditional NiTi file systems have the same universal disadvantages: (1) non-anatomical shaping—the root canal system is highly complex, and the majority of canals have an irregular anatomic shape (Figure 1); (2) excessive torque/fatigue—traditional NiTi files are prone to file deformation and potential separation, and they apply unwanted stress to the tooth; and (3) the use of multiple NiTi files—in order to reduce cyclic and torsional fatigue, multiple…

2. Page 8

   Oral Cancer Awareness Month April, Oral Cancer Awareness Month, presents us with the opportunity to reflect on profound responsibilities as dental professionals. Are you doing everything possible to reduce the deaths and the lifetime effects that this disease has on its survivors and loved ones? Do you perform regular and thorough oral cancer screenings? Do you regularly use adjunctive technologies to maximize the effectiveness and accuracy of oral cancer screenings; eg, (1) devices that help identify and better visualize oral mucosal abnormalities, and/or (2) the latest risk stratification testing using discriminatory salivary biomarkers? Hopefully, all our readers can answer "Yes"…

3. Page 10

   Periodontal Treatment Versus Antibiotics The systemic use of antibiotics to adjunctively treat periodontal disease has the endorsement of dentists utilizing principles of oral systemic medicine in their practices—all the while being discouraged by mainstream organized dentistry. Antibiotic stewardship is being framed from 2 very different perspectives of well-intended research and scientific evidence. Some practitioners are using systemic antibiotics to treat high-risk patients with high-risk pathogens on a regular basis. On the other hand, a majority of dentists are electing to talk about the connection between periodontal health and systemic disease but remain reluctant to engage in clinical practices that will…

4. Page 12

   VIEWPOINT continued from page 10 The focus of organizational recommendations rally around some select studies that show that local resolution of the disease does not appear to be significantly different when antibiotics are adjunctively used, versus the use of traditional scaling and root planing. None of the research cited, nor most of classic periodontal research evidence available, refers to oral pathogen markers before and after therapy. They all simply cite the degree of stabilization or restoration of tissue architecture as the analytic for determining the conclusion. There is also a concern relative to the death rate from antibiotic resistance, specifically,…

5. Page 14

   Technique of The Week www. totw E-PRESCRIBING WITH XLDENT Drs. David Andersen and Lora Nelson explain how easy e-Prescribing is with XLDent. Transitioning from front desk staff calling in, or sending prescriptions with the patient, to sending prescriptions straight to the pharmacy has saved them time. Electronic prescribing has offered a greater sense of security. The doctors share patient feedback from this prescribing technique, how this compliant with state laws played a role, and more. SONENDO: GENTLEWAVE SYSTEM A recent Technique of the Week video, sponsored by Sonendo, is still available for viewing on our website. Learn more about the…

6. Page 16

   FOCUS ON: Oral Cancer Screening Devices Camile S. Farah, BDSc, MDSc, PhD, discusses the role of optical adjunctive devices for the early detection of oral cancer and potentially malignant lesions. Q: What are optical adjunctive devices (OADs), and what are they used for? A: OADs are handheld tools designed to improve detection and visualization of oral mucosal pathology. They emit light at a particular wavelength that does one of the following (1) illuminates oral mucosal tissues and is reflected (reflectance and spectroscopy in the case of NBI (endoscopic device). In such cases, the clinician should follow the manufacturer's operating instructions…

7. Page 18

   From the January 2017 Issue CARBIDE BUR Dentsply Sirona Endodontics The appropriately sized, surgical-length Endo Access Round Carbide Bur provides extended reach and improved vision for progressively moving the access preparation deeper and into the pulp chamber. When there is a narrow interocclusal space, the round bur may be used as a side-cutting instrument for improved visualization. For more information, call (800) 662-1202 or visit the website dentsplysirona.com. FREEinfo, LED LIGHT DentLight The Nano Freedom LED Light is engineered to be superllightweight, with only 3 g of weight on the nose bridge, and its unique, touch-free battery design disperses weight…

8. Page 20

   Back to Chicago Paul Feuerstein, DMD The Chicago Midwinter Meeting is one of the year's premier dental events. New products are showcased, and there is always a corporate "who's who" in attendance. The Chicago Midwinter Meeting is one of the premier dental events of the year. Historically, manufacturers introduce many of their new products at the meeting, and there is always a corporate "who's who" in attendance. Additionally, many well-known clinicians are lecturing, consulting, or just "working the floor" to see the latest products and services. This year, the meeting's biggest surprise was the weather—mid 60° temps at a time…

9. Page 22

   CLINICAL REVIEWS THE DENTAL ADVISOR Tornado LK ++++1/2 Bien-Air | (800) 433-2436 | bienair.com Consultants' Comments • "Really good power and torque; the Tornado LK is a workhorse." • "Quieter than my usual handpieces; performed well during the test period." Description Tornado LK is an air-driven, high-speed handpiece with a built-in LED light. Its turbine contains ceramic bearings, extending the life of the turbine and reducing noise level during use. Its small head results in improved access, and it is sealed to help prevent contamination and increase hearing durability. The handpiece has a 4-port symmetrical water spray, a nonslip scratch-resistant…

10. Page 24

    Spotlight All-New Sectional Matrix System Designed for More Than Just Tight Contacts NEW MILFORD, Conn—CLINICIAN'S CHOICE's all-new DUAL-FORCE Sectional Matrix System is designed for more than just tight contacts. Its DUAL-FORCE Rings utilize dual NiTi wires that provide strong, balanced separation force on both mesial and distal surfaces, and they render the rings resistant to fatigue to provide consistent separation force throughout the rings' life. Available in molar and premolar sizes, the rings feature a independent thickness that adapt to the tooth morphology and exhibit the ideal engagement angle to ensure that seat firmly and securely, resisting dislodgement. DUAL-FORCE Matrix…

11. Page 25

    Spotlight Open CAD/CAM System Enhanced to Facilitate Creation of Natural-Looking Restorations DALLAS–Enhanced to facilitate the creation of natural looking restorations, Planmeca's PlanmecaFIT open CAD/CAM system comprises 3 distinct components: Planmeca PlanScan Intraoral Scanner, Planmeca PlanCAD, and Planmeca PlanMill 40 S. Planmeca PlanCAD offers dentists vibrant new color in an "I can see everything" view that provides images with true, realistic color. Color optimization is easily achieved during the scanning process, and color is directly correlated with time; the longer you scan an area, the deeper the color. Planmeca PlanMill 40 S streamlines the user experience via a self-contained onboard computer…

12. Page 26

    Tablet-Based Mobile Intraoral Scanner Facilitates Patient Interaction ST. PAUL, Minn. The 3M Mobile True Definition Scanner, a one-of-a-kind, tablet-based, battery-operated intraoral scanner that fits in your hand, allows clinicians to move freely between operatories without power cords or carts, and its flexible mounting options will help to minimize workspace clutter. Utilizing the scanner facilitates in-formed discussion and visual patient communication; place it directly into patients' hands or laps so they can experience a cutting-edge digital visualization of their oral anatomy and ultimately a better understanding of proposed treatments. For more information, visit 3m.com/truedef. FREEinfo, Oral Exam Light's Filters Improve Contrast…

13. Page 27

    Treatment Centers to Feature Integrated Ultrasonic Scaler CHARLOTTE, NC-Dentsply Sirona's Intego Treatment Centers, which this summer will feature Dentsply Sirona's Cavitron ultrasonic scaler integrated into them, offer everything necessary for professional dental hygiene, dental aesthetics, and dental care. Two models are offered: Intego TS, a traditional, over-the-patient delivery with hanging hoses, and Intego CS, a continental delivery system with whip arms. Thanks to their digital interfaces, the centers have been created as high-quality, reliable units designed for the technical requirements of the future. A network interface in the patient chair and USB connections in the doctor's element enable digital updates…

14. Page 28

    Spotlight Autologous Material Accelerates Body's Own Healing Processes BOCA RATON, Fla - IntraSpin LPRF has opened a new world of enhanced healing possibilities for today's dental patients. An autologous material, it accelerates the body's own healing processes. It is strong, pliable, and suitable for suturing, making it an excellent choice for grafting, extraction sites, and implant applications. Its natural fibrin network—rich in platelets, growth factors, and cytokines—promotes efficient cell migration and proliferation without chemical or bovine thrombin additives. When graft material is suspended in the fibrin matrix, handling characteristics are dramatically improved. An added benefit is the material's ease of…

15. Page 29

    Spectra Universal Composite Restorative Leveraging the Blending Effect of Dentsply Sirona's TPH Spectra Universal Composite Restorative for Clinical Excellence Jason H. Goodchild, DMD An important element impacting acceptance of aesthetic composite restorations is color matching. Also referred to as "chameleon effect," composite blending with adjacent tooth structure is dependent on material translucency and shade and is most pronounced in smallto moderate-sized restorations. Most current composites comprise methacrylate resins with inorganic fillers that have a refractive index close to that of enamel and dentin. The refractive index describes the angle at which light bends when passing from one medium to another;…

16. Page 30

    Spotlight Uniquely Formulated Diamond Disc Burs Are Ideal for Cutting and Polishing All-Ceramic Restorations TORRANCE, Calif–Continental Dental Labs' uniquely formulated Diamond Disc Burs are designed to cut faster and last longer than other diamond instruments. They are ideal for cutting and polishing all ceramic restorations, especially zirconia and IPS e.max. Now you can adjust and polish your restorations chairside. Receive Diamond Duck disc burs (a $52 value) free when you send in any 3-unit Luxer full zirconia case using code ducky14 on your RX. (Certain limitations may apply; while supplies last.) For more information, call Continental Dental Labs at (800)…

17. Page 32

    GINGI-PAK www.gingi-pak.com CONQUERING SOFT TISSUES SINCE 1955 Celebrating 60 years BUY 4 Get 2 FREE! Promo code: 17012 • Offer available for Gingi@pk® expires 6/30/17 Stock up and save to keep your practice running smooth. FREEinfo, on card Call for more promotions: 1-800-437-1514 Promo Restrictions apply. See local print & valid promo for Gingi-Pak via Email at info@gingi-pak.com. Valid until Jan 30, 2017. Cannot be combined with any other offer, no cash value. Same or lesser items applied. GINGI-PLAIN® RETRACTION GINGICAINE® TOPICAL GINGI-AID® HEMOSTATIC INNOVATIONS Spotlight New Hybrid Blocks/Discs for CEREC Restorations Introduced SAN MARCOS, Calif.—Shofu Dental introduces HC Blocks/Discs,…

18. Page 34

    Spotlight Universal Composite Balances Beauty and Performance to Yield Lasting, Lifelike Restorations SOUTH JORDAN, Utah--Ultradent Products' Mosaic Universal Composite balances beauty and performance to yield lasting, lifelike restorations. It can be used for all restorative purposes, whether basic or complex, and its well-balanced nanohybrid formula produces restorations of the highest quality. Combining the strength required for posterior use with the aesthetic characteristics desired for anterior use, Mosaic ensures superior results, both visually and functionally. Its smooth, polishable consistency allows for total control during manipulation, and once-shaped, it won't flow or slump. Offered in 20 intuitive dentin and enamel shades, Mosaic…

19. Page 36

    Spotlight New 3-D Pan/Ceph Imaging Device Introduced Self-Etch, Self-Adhesive Provides New Advancement in Adhesive Technology SOUTH HACKENSACK, NJ— Essential Dental Systems introduces Envy, a self-etch, self-adhesive cement that provides a new advancement in adhesive technology. A truly multisurface cement, it even solves the problem of adhesion to zirconia, and its unique chemistry provides tack curing for easy cleanup. Light-cure for a few seconds to allow it to become a gel-like material that flakes right off in one clean piece. As the first of its kind, Envy's multiple adhesion promoter technology allows you to depend on one single cement for all…

20. Page 38

    NEWS/TRENDS Industry News BIOLASE Names James D. Surek VP of Sales, Americas Irvine, California-based BIOLASE, a global leader in dental lasers, announced recently that it has appointed James D. Surek as its vice president of sales for the Americas. He will report to Harold C. Flynn, Jr, BIOLASE's president and CEO. Mr. Surek brings to BIOLASE more than 24 years of experience in medical device sales and sales leadership in startup, turnaround, and high-growth environments. Most recently, he served as the vice president of sales for Entelus Medical, a venture-backed startup. Since joining this company in 2010, he assembled a…

21. Page 40

    NEWS/TRENDS ADA Board... continued from page 38 for DLOSCE administration, and identify first state(s)/re gion(s) for the DLOSCE field test. The DLOSCE will be a national exam based on an analysis of US dental practice. It will remain the same regardless of the region of the country where it is administered, and it will become a third-party assessment of competencies repar larly evaluated at accredited dental schools. Both the ADA Council on Dental Education and Licensure and the ADA/ American Dental Education Association (ADEA) Joint Licensure Task Force have endorsed the initiative. "A key element of our efforts together has…

22. Page 44

    In First Impressions, George Freedman, DDS, gives readers a brief summary of products that have recently been introduced to dentistry, based on his clinical experience. Bio/Screen AdDent Oral screening is a responsibility that dentists have to their patients. The dental practice is, in fact, the only entity that can provide this service; most physicians and medical personnel are out of their area of expertise when it comes to oral abnormalities. Oral screening must be effective, rapid, convenient, and comfortable. For patients, otherwise wise, they will try to avoid this important procedure. The most advanced method for detecting oral mucosal abnormalities…

23. Page 45

    Minnow Polishers Microcopy Polishing composites is a time-consuming process that is typically required toward the end of the appointment, when time is short, the dentist is running late, and the next patient is waiting. Unpolishing is a step that is often skipped or hurried due to these scheduling constraints. The longevity of the restoration inevitably suffers. Particularly frustrating for the practitioner are the hard-to-access interproximal areas, the deeper reaches of carefully crafted occlusal anatomy, and the gingival margins of Class V buccal and lingual restorations. Sterilization is also a major issue; the porous nature of most composite polishing instruments does…

24. Page 46

    Top 25 ENDODONTIC PRODUCTS Dentistry Today's Readers' Choice Top 25 Endodontic Products, selected on the basis of lead generation, represent some of the profession's most innovative endodontic products. The products appear in no particular order. Ultradent Products The Endo-Eze Genius system is an endodontic system that gives you the safety of reciprocation movement and the efficiency of rotary movement. The Genius endodontic motor, contra-angle, and files are designed to work together as a complete system. The motor is designed for reciprocating and rotary files. An adaptable, easy-to-use motor, it is perfect for any endodontic procedure as it provides the safety…

25. Page 50

    Top 25 Endodontic Products . 1 Dentsply Sirona Endodontics WaveOne Gold Reciprocating Files allow most cases to be shaped safely and efficiently with a single file. The metallurgy is visibly enhanced with a gold thermal treatment that delivers greater flexibility, increased resistance to cyclic fatigue and improved cutting efficiency, and the 4 file sizes cover a wider range of canal morphologies. The files are complemented by corresponding absorbent points, gutta-percha, and obtutators. For more information, call (800) 662-1202 or visit dentslysirona.com. FREEinfo, Sonendo Complementing its mission to "save teeth through sound science," the GentleWave System offers an alternative to standard…

26. Page 52

    Top 25 Endodontic Products READERS' CHOICE EdgeEndo The EdgeTaper Platinum is an assortment of shaping and finishing files that set a new standard in safety and canal centering by significantly improving the resistance to cyclic fatigue and flexibility. The proprietary FireWire heat treatment vastly improves the NiTi metallurgy, delivering unmatched strength and flexibility. EdgeEndo was founded on a revolutionary idea of creating superior endodontic products for less and passing the cost savings on to the customers. Staying true to that promise not only defies industry wisdom but has made EdgeEndo one of the world's largest edgy NiTi suppliers in 4…

27. Page 54

    Top 25 Endodontic Products Video Dental Concepts QuickRay Direct USB dental sensors have been rated as a Readers' Choice Top 25 Endodontic Product due to the picture, high-resolution radiographs it produces as well as patient comfort. Available in sizes and 2, the sensor comes with a free 7-year replacement plan against accidental damage, which is a first in the profession. QuickRay is Mac and Windows-compatible and integrates with various software. For more information, call (800) 323-2690 or email sales@videodental.com. FREEinfo, A More Effective Imaging Solution at the best dealer pricing. XRAY2GO HANDHELD GENERATOR 70kV for great image quality with one-half…

28. Page 58

    Top 25 Endodontic Products . 1 Medidenta RootBuddy is the only endodontic obturation device that can heat, vibrate, or do both simultaneously, and this combination of heat and vibration provides a higher density of fill to both primary and lateral root canals than systems that use only heat. Therefore, the RootBuddy is perfect for (1) quickly heating the thermoplastic filling material, (2) distributing it laterally or vertically, and (3) condensing it in the root canal. The result is an extremely effective 3D apical and coronal filling of the root canal. For more information, call (800) 221-0750 or visit medidenta.com. FREEinfo,…

29. Page 59

    Jordco The e-Dx is the next generation in endodontic diagnostic instruments. This unique instrument can easily coldand fracture-test teeth. Using a special open-cell foam insert, the e-Dx stores instruments longer, enabling a doctor to easily cold-test multiple teeth. The detachable, contra-angled pliers are designed to securely hold the foam insert and reach posterior teeth to provide improved visibility during cold testing. The built-in FracTester can be placed onto a tooth cup or other suspected areas to help detect fractures. For more information, call (800) 752-2812 or visit jordco.com. FREEinfo, 3M With the RelyX Fiber Post 3D, 3M offers an integral…

30. Page 60

    Top 25 Endodontic Products BISCO Dental Products D.T. LIGHT POST ILLUSION X RO is one of the most advanced and aesthetically pleasing quartz fiber posts on the market, with the added benefit of color-on-command technology. When the post is placed, the intrinsic color of the post disappears, allowing it to blend into the natural dentition. If retreatment or removal is ever required, the color of the post will reappear on command by simply using cold water. The posts are constructed from unidirectional, pretensed quartz fibers bound in a resin matrix. This design produces a post with flexural strength exceeding that…

31. Page 61

    Endodontic Products READERS' CHOICE Top 25 Charles B. Schwed NanoFlow gutta-percha points are made with a new, advanced synthetic nanoformulation. As a result, numerous improved material and working characteristics have been made possible. During manufacturing, the cone material is injectionmolded to precision tolerances, eliminating any concern about point size variations. The nanochemistry employed provides a material that is denser, less sticky, and has significantly fewer voids. Coupled with a lower working temperature change during obturation, a lower working temperature can be utilized. The softness, hardness, and flow characteristics can also be carefully controlled, making NanoFlow suitable for use with a…

32. Page 62

    Top 25 Endodontic Products Angelus Dental MTA Angelus is a bioceramic endodontic reparative cement containing mineral trioxide aggregate. With more than 15 years of research, it is indicated for complications such as treatment of pulpotomy, pulp capping, perforations, apical surgeries, and more. It is the only cement capable of stimulating cells to the point of fully regenerating infection-compromise sites. Unlike other substances with identical indications, MTA can be inserted in moist areas, facilitating its application. Its calcium ion-release promotes the formation of a dentin bridge when used for pulp capping and it promotes biological healing and unbeatable sealing in cases…

33. Page 63

    Endodontic Products READERS' CHOICE Top 25 Filhol For root post-and-core buildup, FILPOST is engineered to be easier, faster, and safer to place. There is more preservation of healthy tooth structure and it is stronger in use. It is 99.8% pure titanium, biocompatible, and compatible with all dental materials that won't corrode. It can be customized to suit the canal without risk of fracture, enabling easy insertion of multiple posts into converging canals. No drilling is required, avoiding the risk of perforation. Its anatomical shape minimizes dentin removal. Retention grooves along the post, working together with retention grooves formed within the…

34. Page 64

    New Trends in Endodontics and Treatment Planning In an interview conducted by Dr. Damon Adams, Dentistry Today's editor-in-chief, endodontist John West, DDS, MSD, candidly expresses his thoughts on current topics and trends affecting endodontics. Dr. West is founder and director of The Center for Endodontics in Tacoma, Wash, and director of endodontics at the Interdisciplinary Dental Education Academy (IDEA) in San Francisco. Let's talk about some of the current trends and future issues in endodontics. John, would you like to make some opening comments to set the stage for this interview? Dr. West: That would be great, Damon. In endodontics,…

35. Page 66

    New Trends in Endodontics... continued from page 64 2. Tooth Atlas (chuman.com) offers interactive 3-D visualizations of teeth root canal systems, and we can literally practice virtual endodontics before even treating a patient. 3. Digital imaging helps us read images more clearly and in more detail. 4. Apex locators precisely identify the physiologic terminus. 5. Nickel-titanium (NiTi) endodontic shaping instruments have made mechanical shaping more predictable, safer, more efficient, and safer than ever before. With improved designs and metallurgy, almost all endodontic companies produce a satisfactory NiTi file, although some are higher quality and higher taper than others. 6. 3-D…

36. Page 68

    New Trends in Endodontics... continued from page 66 Dr. West: Dentists by nature are gadget people. For endodontics, the microscope was a breakthrough technology. It gave us a head start on digital technology before the word technology ever became popular. The new dentist and the dentist of the future are especially tuned into change. In fact, millennial dentists only know change, and that change is changing exponentially. Think about it. Humans and machines are evolving together. It is not humans versus machines; it is humans and machines. Could you describe how you envision the evolving role of endodontics in interdisciplinary…

37. Page 69

    University Henry M. Goldman School of Dental Medicine and the American Association for Esthetic Dentistry. He has been awarded the Distinguished Alumni Award. He serves on the editorial boards for The Journal of Esthetic and Restorative Dentistry, The Journal of Microscope Enhanced Dentistry, Dentistry Today, and is associate editor of Endodontic Practice. He is a clinical visionary, and welcomes the opportunity to consult for any dentist who wants to experience the successful possibilities of endodontics in his or her practice. He can be reached at (800) 900-7668, via email at the address johnwest@centerforendodontics.com, or by visiting centerforendodontics.com. Disclosure: Dr. West…

38. Page 70

    dentalCEtoday.com Go online to earn credit for reading this CE article. ENDODONTICS Excellent Canal Cleansing, Minimal Root Weakening Barry L. Masikant, DMD INTRODUCTION The title may sound too good to be true, but in the past, the split-shanked Flexi Posts (Essential Dental Systems) were developed with a design that combined the conflicting properties of maximal retention with minimal internal stresses. In like manner, the twin goals of full debridement of tissue with minimal removal of tooth structure were accomplished—2 goals that were generally considered an impossibility to attain together. Most dentists today have been sold on the concept of greater…

39. Page 72

    ENDODONTICS FIGURE 2. (Case 1) Note the dilacerated MB root in the maxillary right first molar. This case was included to demonstrate the adaptability of the SafeSiders to whatever situation exists. To negotiate this canal, the instruments were bent and manually negotiated around the curve. Once around, the instrument was attached directly to the handpiece to more readily clean and shape the canal. The SafeSider instruments worked buccally and lingually to remove tissue ensconced in there. Despite the abruptness of the curve, 30° oscillation virtually prevents instrument separation during the shaping process. FIGURE 3. (Case 2) This mandibular right second…

40. Page 73

    ENDODONTICS 73 • No. 20 SafeSider in the Endo-Express handpiece • No. 25 SafeSider in the Endo-Express handpiece • No. 30 SafeSider in the Endo-Express handpiece • No. 35 SafeSider in the Endo-Express handpiece. If desired, the dentist can open the canal further with No. 40 or one of the included SafeSider NiTi instruments. CASE EXAMPLES The best proof of concept is provided by examining several cases (Figures 2 to 7), noting what they have in common compared to the traditional view of cases completed with greater taper rotary systems. What one notices in these cases are the following characteristics:…

And 28 more pages — read the whole issue.