Dentistry Today — April 2018

Inside this issue

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

1. Page 6

   April is Oral Cancer Awareness Month It's time, once again, for our profession to be reminded of the importance of focusing awareness, training, and action on the prevention, diagnosis, and treatment of oral cancer. An informative Viewpoint article by Jo-Anne Jones has been selected for Oral Cancer Awareness month. Jones is a dental hygienist and frequent contributor on the topic of oral cancer. On a sober note, Jones was informed recently that one of her family members was diagnosed with late stage HPV positive tonsillar cancer while preparing to present her extensive research on HPV-related oropharyngeal cancer. Oral cancer and…

2. Page 8

   Have We Become Disconnected? April is Oral Cancer Awareness Month. The objective in sharing my thoughts here is not just to write another article on the horrors of oral cancer, but to incite a much deeper response. The employment of opportunistic oral cancer screenings is an effective means of finding cancer at its early and highly curable stage. Of course, there are shortcomings experienced, particularly when we consider the difficulty in visually accessing the high-risk anatomical areas associated Jo-Anne Jones [IMAGE: Professional headshot photo of Jo-Anne Jones] [IMAGE: Young girl with long blonde hair smiling] with Human papillomavirus (HPV)-related oropharyngeal…

3. Page 10

   VIEWPOINT continued from page 8 ones who survive live in daily fear of recurrence; gross disfigurement; severe xerostomic conditions impeding the ability to enjoy life's simple pleasures; and the scar of a disease that has one of the most brutal treatment regimens, affecting quality of life for the remainder of life. We know this, and we screen for this, and, yet, are we remotely disconnected until it affects our life personally or that of a loved one, friend, or colleague. Then we are connected. I'll Never See This in My Practice A common perception about oral cancer is that it…

4. Page 16

   FOCUS ON: Marketing in the Modern Dental Era Roger P. Levin, DDS, discusses what it takes to build an effective marketing campaign for your practice. Q: What do you do if your marketing plan is still one from the Stone Age? A: If so, it's time for it to enter the modern dental era! Marketing in dentistry is now as fast paced and ever changing as most businesses are, and the days of simply relying on postcards, newspaper ads, or worse, tooth markers are over. Today's effective dental marketing campaign requires a variety of traditional (eg, print, radio, etc) and…

5. Page 18

   Tornado LK ★★★★★ ½ (91%) Bien-Air USA | (800) 433-2436 | bienair.com Consultants' Comments • "Really good power and torque." • "Quieter than my usual handpieces." • "Performed well during the 2-year test period." • "The Tornado LK is a workhorse." Evaluation Highlights • Easy to use. • Very efficient cutting. • Chuck firmly grips the bur. • Good illumination and a wide field of view. • Quiet when running. • Minimal vibration. Description The Tornado LK is an air-driven, high-speed handpiece with a built-in LED light. The turbine contains ceramic bearings to reduce the life of the turbine and…

6. Page 20

   Papa's Got a Brand New Bag Paul Fuerstein, DMD Moving around the meeting floors, I found that Glidewell Laboratories was making noise in one-visit dentistry systems with its new product, glidewell.io. Since the beginning of this year, we once again have a number of new products that were shown at the Greater New York Dental Meeting, Yankee Dental Congress, Chicago Dental Society Midwinter Meeting, and the Hinman Dental Meeting. I will defer right now on talking about 3-D printers and materials, as that is a huge topic. Let's just say that 3-D printing is exploding, and we will address it…

7. Page 21

   teria and viruses almost instantly, but it's certainly not safe to be shooting this gas all over the room. Using a clever electronic system in a simple-looking spray bottle, the user just fills the OZ with tap water and sprays it on any surface. The only byproduct is water, with no odor or chemical residue. According to Toppen, "The OZ incorporates a proprietary electrolytic process technology into the spray head to generate on-demand ozone in aqueous form (dissolved in water). While ozone in solution nat on-demand generation assures that concentrations are consistent at the time of use." Wow. For more…

8. Page 22

   Spotlight Milling System Provides Intuitive Interface and One-Step Material Selection YORBA LINDA, Calif.–To meet the special needs of chairside milling dentists, VITA North America has introduced the VITA SMARTFIRE, a fast, efficient, and compact firing unit for chairside restorations, including the crystallization, glaze, stain, and corrective firing of all common chairside materials. Featuring an intuitive user interface, materials may be selected in one simple step. In addition, customizable, material-specific programs are already preinstalled for simple firing. The VITA SMARTFIRE system includes a durable firing unit for robust firing technology and reliable function, an intuitive touch control unit with a high-resolution,…

9. Page 23

   TECHNOLOGY 23 System's Features Produce Stunning Images for Evaluation IRVINE, Calif.-J. MORITA USA has unveiled the Veraview X800, a new multifunctional x-ray unit with 3-D, panoramic, and cephalometric capabilities. Completely redesigned, it is loaded with practical, unique, and refined features that produce stunning images for a thorough evaluation. It offers progressive technology that automatically sets the optimal x-ray beam angle horizontally for 3-D or raised 2-D panoramic images. This slight upward projection for panoramic imaging enhances image quality by eliminating potential superimposition of anatomical structures, including the shadow from the base of the skull and hard palate over the maxillary…

10. Page 24

    Polishing Cap Fully Protects Inside and Outside of Metal Coping GROVER BEACH, Calif.-PREAT Corporation introduces yet another new and innovative tool for all implant professionals: the Bidra Conversion Smart Polishing Cap. It's a must-have for your next conversion from removable to a fixed prosthesis. Existing polishing caps only protect the inside of the coping, not the outside. After seeing the poor results with existing products, Avinash S. Bidra, DDS, Director, University of Connecticut Post-Graduate Prosthodontics, designed this innovation with the dental professional in mind. With an extended metal rim, the Bidra Conversion Smart Polishing Cap fully protects the inside and…

11. Page 25

    TECHNOLOGY 25 Handpiece's Torque Ensures Accurate and Powerful Cutting TORONTO—Beyes Dental Canada's AirLight M800x handpiece enables clinicians to have a clearer illuminated operative field. The direct LED is also brighter and has a larger light pattern than traditional power optic systems. The well-designed and precisely manufactured handpiece provides extraordinary torque to ensure the accurate and powerful cutting dentists need. Its new features include (1) IS technology, which provides instant stop capability while eliminating backflow and noise when ceasing operation; (2) X ball bearings that last up to 4 times longer than traditional ball bearings thanks to Beyes' newly engineered ball…

12. Page 26

    Spotlight Bundle Makes Impression Taking Easy ST. PETERSBURG, Fla.–Sun Dental Labs' SunDigital Solutions Business Bundle makes taking an impression and ordering your restorations easy. Say hello to an affordable solution that increases efficiency and patient satisfaction. The bundle includes the CS 3500 intraoral scanner and a free laptop, as well as free cloud storage, data transfer, and shipping. Simply plug the scanner into your laptop, take a scan, upload the digital file to your laptop through Sun Dental's user-friendly Sun Cloud app, enter the patient's information, and click send. For more information, call Sun Dental Labs at (888) 303-1226. FREEinfo,…

13. Page 27

    Resin-Modified Glass Ionomer Shines with Unique Formulation and Exceptional Biocompatibility Paresh Patel, DDS, and Apolinar Madrigal, DDS Geristore by DenMat (Figure 1) is a time-tested material that has received numerous accolades from the dentists who use it. Some have even called Geristore a staple in their practices, thanks to the material's high degree of biocompatibility and abundant indications for use. That's because Geristore is a self-adhesive, fluoride-releasing, resin-modified glass ionomer that offers ideal strength, a modulus of elasticity, self-adhesion, and low water sorption. This translates to a material that not only adapts in any clinical situation but will also stand…

14. Page 28

    Spotlight System Tackles Key Challenges Present During Final Impression-Taking Procedure MILFORD, Del—Dentsply Sirona Restorative is excited to push delivery performance to the next level and reset the expectations of what clinicians should expect from their delivery systems with a powerful and radically new way to deliver two viscosity materials with the introduction of the digit Power Dispenser. It is a battery-powered, precision delivery system for Aquasil Ultra+ material's low viscosity products available in digit power cartridges and is available for purchase through approved Dentsply Sirona distributors. Developed with input from clinicians around the world, digit Power Dispenser tackles the key…

15. Page 32

    Placement Into the Osteotomy Comes Quickly and Easily With Implant System SAN ANTONIO–Implant placement into the osteotomy has never been easier or faster than with the Ritter SBLA Spiral Implant System. The stopper on the inner vial holds the implant by the apex for quick access to insertion of an implant driver into the internal hex connection. Ritter offers superior quality and thoughtful design, manufactured in Germany. For more information, call Ritter Implants at (855) 807-8111 or visit ritterimplants.com. FREEinfo, DrQuickLook LEARN MORE AT drquicklook.com 1-888-346-6153 Need a portable low-tech imaging solution? The PDA TABLET is your low-tech solution with…

16. Page 34

    Spotlight Enzymatic Cleaner Provides Multiple Dispensing Options for Ease of Use HEATH, Ohio—Earning THE DENTAL ADVISOR's Preferred Product Awards in 2016 and 2017, Enzyme Industries' Sani-Soak Ultra is a dual-purpose, anticorrosive enzymatic cleaner that can be used in an ultrasonic and as a wet-evacuation cleaner. Offered in 2 scents, Lemongrass Lavender and Cool Mint, it is highly concentrated, nontoxic, biodegradable, safe for the environment, and effective in removing organic debris while improving the life of instruments and burs. Multiple dispensing options are offered for ease of use and added convenience. For more information, call Enzyme Industries at (888) 236-9963 or…

17. Page 37

    Oral-Adhering Discs Provide Dry Mouth Remedy to be Used While Sleeping SEATTLE–OraCoat's XyliMelts for dry mouth are an all-natural, great-tasting, oral-adhering disc that slowly release 550 mg of xylitol and oral lubricant to coat, moisturize, and lubricate a dry mouth day and night while reducing the risk of tooth decay. It is the only dry mouth remedy for use while sleeping, the time when dry mouth is worst and saliva flow is lowest. When used while sleeping, XyliMelts slowly releases an effective level of xylitol to reduce caries. Additional benefits of XyliMelts include (1) a nonacidic pH of 8.1, which…

18. Page 38

    NEWS/TRENDS Industry News Ivoclar Digital Debuts at Chicago Midwinter Meeting With over 1,500 people attending its programs, Ivoclar Vivadent launched Ivoclar Digital at the Chicago Midwinter Meeting (CMW) in February. The new brand includes milling machines, CAD/CAM materials, patient communication tools, and training for dental laboratory technicians and dentists. "We are focused on creating new opportunities for dental professionals that include improved workflows for efficiency, better predictability, and outstanding aesthetics. At the end of the day, it's all about the patient. They deserve these outcomes, and we intend on delivering. Ivoclar Digital is our promise to the profession and the…

19. Page 40

    Best Dental School... continued from page 38 "Maintaining our position as the top school in Europe but also rising to see a role in detecting eating disorders and other gastrointestinal issues, why some people suffer from tooth erosion while others don't; how a tiny population of cells can provide new stem cells during rapid tooth growth, and how tooth loss contributes to musculoskeletal frailty in those over the age of 50. "Rankings like the annual QS report help us confirm our tradition of excellence at the [University of Michigan] School of Dentistry," said Laurie McCauley, DDS, MS, PhD, dean of…

20. Page 41

    NEWS/TRENDS Book Tackles Aesthetics for Dentists and Patients Alike Written for both patients and dentists, Open Wide: A Guide to Smile and Facial Aesthetics to Enhance Your Confidence, Appearance, and Overall Health by Larry Rosenthal, DDS, describes the possibilities and approaches that people can take to boost their self-image, improve their general health, enhance their beauty, and enrich the fulfillment they derive from life itself. "This is a book about the possibilities. It is a book of optimism and passion. It is a renaissance..." "This is a book about the possibilities. It is a book of optimism and passion. It…

21. Page 43

    MEETINGS/SEMINARS 43 Women's Event Ultradent is hosting a 2-day event celebrating women in dentistry, called "Icons of Dentistry: A Workshop for Women," which will take place from June 22 to June 23 at Ultradent's headquarters in South Jordan, Utah. The theme of the workshop is "Compassion and the event features iconic women in the profession leading CE courses on practice management, lasers, aesthetic dentistry, work/life balance, and more. Other highlights include a keynote speech and dinner at the home of Ultradent founder and CEO Dr. Dan Fischer. Earn 16 CE credits. For more information, call (800) 530-6640 or visit icons@dentistry.com.…

22. Page 44

    Digital and Conventional Implant Impression Techniques Compared A study that was published recently in the Journal of Prosthodontics evaluated the accuracy of a digital implant impression technique using a TRIOS 3Shape intraoral scanner (IOS) compared to the conventional pickup and transfer implant impression techniques in all clinical situations. The study involved 36 patients who had a pair of implants (Implantium, internal connection) ranging in diameter between 3.8 and 4.8 mm in posterior regions of the mouth. Thirty-six reference models (RMs) were fabricated by attaching 2 impression copings intraorally, splinted with an autopolymerizing acrylic resin, verified by sectioning through the middle…

23. Page 45

    Dental Implants See High Success Rates Even After Radiation Therapy A study that was published in the Journal of Oral and Maxillofacial Surgery analyzed the long-term success of dental implants placed in patients with head and neck cancer who underwent radiation therapy with a minimum total dose of 50 Gy between 1995 and 2010. The factors potentially influencing the success of dental implants in these patients were also analyzed. The study involved 35 patients who had 96 dental implants. Data on the patients' demographic characteristics, tumor type, radiation therapy, implant sites, implant dimensions, and hyperbaric oxygen therapy (HBOT) were obtained…

24. Page 46

    Revolutionary Protocol for Endodontic Access Dentistry Today's Editor-in-Chief, Damon Adams, DDS, conducts an interview with L. Stephen Buchanan, DDS; Charles Maupin, DDS; and John Khademi, DDS, about dynamic guidance, a revolutionary new technology in endodontics. Let's start out with defining this technology. Steve, what is dynamic guidance and how does it apply to your daily practice? Dr. Buchanan: Dynamic guidance (DG) has recently been introduced as an alternative to the printed or milled (static) drill guides that implant surgeons have used for more than a decade. While static drill guides must be planned and fabricated some time before the surgical…

25. Page 48

    A Revolutionary Protocol for... continued from page 46 JOHN, I know that you and Dr. David Clark have written about MIE objectives for our readers in Dentistry Today. How helpful is DG in achieving MIE outcomes? DR. KHADEMI: The dentin preservation shift really started with Steve and his GT files, designed to have maximum flute diameter limitations to control coronal canal enlargement. David and I extended this basic idea of dentin preservation to the coronal portions of the tooth with endodontic access cavities. Before we had dynamically guided access (DGA), cutting dentin-preserving access cavities required a lot of skill, experience,…

26. Page 49

    INTERVIEW 49 Figure 5. (a) A pre-radiograph shows a maxillary lateral incisor (b) broken at the gum line secondary to a traumatic event. (c) A working radiograph shows the drill positioned to midroot. (d) Working radiographs and (e) A postoperative image show the completed RCT with post space. Our initial look at the data tells us that we can achieve accuracy within 0.5 to 0.25 mm of the planned target at full planned depth. they have learned to use successfully. Endodontists have no guidance but dynamic guidance. Regarding our teaching efforts, Steve and I are doing a live demonstration of…

27. Page 50

    READERS' CHOICE 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 clinicians the safety of reciprocation movement and the efficiency of rotary movement. It is designed for reciprocating and rotary files, and easy-to-use handpiece. It is perfect for any endodontic procedure since it provides the safety of reciprocation and the efficiency of rotary movement. The Genius motor has various torque settings and…

28. Page 52

    Top 25 Endodontic Products 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 obtruators. For more information, call (800) 662-1202 or visit dentsplysirona.com. FREEinfo, Essential Dental Systems Tango-Endo is a 2-instrument, safe, economical, and efficient endodontic instrumentation system. It is unlike other reciprocating systems…

29. Page 54

    Top 25 Endodontic Products Brasseler USA The XP-3D Shaper addresses the shortcomings of traditional NiTi instrumentation and ushers in a new biologic standard of care in endodontic instrumentation. It features MaxWire NiTi technology, which allows the instrument to expand once introduced to body temperature. As it rotates, the instrument's orbit expands and contracts to absorb the broad and narrow aspects of the canal. This intuitive, micro-mechanical debridement allows the practitioner to utilize a single instrument to safely clean and enlarge the canal while respecting the original canal morphology. For more information, call (800) 841-4522 or visit brasselerusa.com. FREEinfo, Video Dental…

30. Page 56

    TOP 25 Endodontic Products READERS' CHOICE Parkell C1 White Posts feature significantly increased radiopacity. The posts comprise fiberglass/epoxy materials and are available in 2 sizes. They are tapered, reducing the chance of sidewall perforation in narrow root spaces and for venting excess cement safely. The posts are strong due to the braided reinforcing fibers, having a large retentive head that increases the reinforcement of the post, and aiding in resisting marginal openings. Ultimately, the construction allows excellent bonding with all adhesive systems. The C1 post system also has Plastic Pattern posts available for casting and Surgical Stainless Steel posts for…

31. Page 57

    Endodontic Products READERS' CHOICE Top 25 DiaDent The Dia-X Rotary File System offers heat-treated, premium NiTi construction with extreme flexibility and durability. The resistance to cyclic fatigue is at least 143% greater compared to other nontreated rotary files. With its progressive taper design and superior cutting efficiency, these files offer precision, safety, and reliable clinical results. The Dia-X Rotary File has a convex triangular cross section while reducing rotational friction and contact with canal walls. The heat-treated surface is also coated, providing high corrosion resistance. Dia-X Rotary File's handle has a length of 11 mm, offering improved accessibility to teeth.…

32. Page 59

    Endodontic Products READERS' CHOICE Top 25 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 dental coolants 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 cusp or other suspected areas to help detect fractures. For more information, call (800) 752-2812 or visit jordco.com. FREEinfo, Kerr Endodontics The TF…

33. Page 61

    Endodontic Products Top 25 READERS' CHOICE Aceptico A product with 30 years of motor manufacturing experience, the 7000 Series Motor is one of the most powerful and comprehensive dental motors on the market today. It features adjustable torque and can be used for implant, surgical, and endodontic applications. Aceptico's worldwide reputation for building strong, dependable dental equipment ensures reliability and performance for years. Many other features set the 7000 Series Motor apart from the rest, including a dynamometer calibration system that ensures that the motor's torque output is always accurate. Six programmable preset buttons allow for complete personalization. The motor's…

34. Page 62

    Top 25 Endodontic Products B&L Biotech The Superioryo Beta Mini Cordless obturation device is designed for warm gutta-percha techniques. Perfectly complementing B&L's Alpha heat source, it provides simplicity, durability, ease of use, and comfort in a cordless injectable obturation gun. Compact in size, the Beta Mini is designed for an effortless squeeze of gutta-percha while being lightweight and ergonomic for all users. With the use of the patented 360° swivel needle, users can change the angle of entry to any canal. It also has a faster heating rate and a 90° angled trigger set for an easier grip. You may…

35. Page 63

    Endodontic Products Top 25 BISCO Dental Products D.T. LIGHT®FUSION 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, prefabricated quartz fibers bound in a resin matrix. The posts are available in 4 sizes, with each one being color-coded. The post…

36. Page 64

    Endodontic Treatment Advances Apical Cleaning and Apical Shaping Limits Carlos A. Spiromelli Ramos, DDS, MS, PhD INTRODUCTION A reasonable and prudent general practitioner (GP) must keep up to date with the available advances accepted and embraced by endodontists through research, evidence, and experience (Figure 1). The overwhelming majority of endodontists respect their GP dental colleagues and, although it may seem contradictory at first, wish to see the standard of endodontics performed at as high a level as possible by both sets of clinicians. A survey¹ about the major factors concerning the GP's decision to perform endodontics showed that 9 in…

37. Page 66

    Figure 2. The clinical sequence in the right mandibular first molar. (a) A preoperative radiographic image for diagnosis and treatment planning. (b) A radiographic image immediately after filling with extrusion of sealer, indicating a lateral foramen exit of the distal canal, away from the anatomic root apex. (c) A radiographic image 30 days posttreatment, showing resorption of the extruded sealer. An analysis of the follow-up radiograph might lead one to criticize the filling as being "short." Figure 3. Apical shaping and cleaning limits (SEM, 40X [JEOL Electron Microscope]). Figure 4. A representation of the file tip outside the canal and…

38. Page 67

    ENDODONTICS 67 apex locators have found a prominent place in endodontic research. The early devices showed success rates that were lower than or comparable to radiographic techniques. However, impedance-frequency-dependent, third generation electronic apex locators are now able to establish the foramen position with an accuracy of ±0.5 mm under different clinical conditions in more than 92% of the cases. In addition to being more precise, the electronic method is safer for the patient and more Precautions During Electronic Measurements to Overcome False or Absent Readings Some points to be observed during electronic measuring, irrespective of the model used: • It…

39. Page 68

    ENDODONTICS easier when measuring a root canal with necrotic pulp contents or even in retreatment cases. Therefore, a partial pulpectomy is recommended, followed by abundant irrigation with sodium hypochlorite solution, to allow the canal to be measured without interference from the inflamed pulp in the root canal. • The endodontic instrument selected to explore the underbridged apical portion of the canal and the associated electronic working length must be 5 mm longer than the temporary working length, which was measured on the initial radiograph. This is due to the need for available space to place the file clip between the…

40. Page 69

    Studies have shown that electronic apex locators are a reliable tool to accurately locate the apical foramen. True. There is no conclusive evidence showing that using an apex locator in patients with a pacemaker will affect the pacemaker. Taking a Radiograph to Check the Electronic Measurement Although electronic measurements are more accurate than radiographs, it is still important to take a radiograph to verify the accuracy of the method. In this regard, there may be a conflict of objective, but not of procedure. A radiograph must be performed after the electronic working length measurement, even if the basic purpose is…

And 20 more pages — read the whole issue.