Dentistry Today — August 2012

Inside this issue

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1. Page 10

   Semantics Undermines the Oral-Systemic Disease Message On April 18, 2012, the American Heart Association (AHA) presented a position paper which left the impression that optimally treating oral disease will not reduce a person's risk of systemic disease. Charles C. Whitney, MD Academy of Periodontology position papers take great pains to accurately discuss periodontal disease as being an associated link to various systemic disorders, including CVD. Unfortunately, this semantic nuance is lost on the average consumer, physician, and perhaps even some dental practitioners as well. The end result may be more patients and practitioners asking themselves, "What's a little blood in…

2. Page 12

   VIEWPOINT continued from page 10 many years are needed to complete these studies to establish definitive proof. This is a common problem in the field of medicine. Academic physicians insist on repeated large prospective studies before recommending an intervention as standard of care. This process can take many years to accomplish. While awaiting study findings and completion, many safe, effective treatments go underutilized. In an attempt to practice optimal care, physicians, on the front line in the battle to help our patients, strive to ate optimal health. We base our core recommendations on proven guidelines that have been established as…

3. Page 14

   Dentistry Today.com Providing you with news and information from the industry leader in clinical content. Visit Our Site Today! Be apart of our... LIVE ONLINE BLOG ADA live-blog Reach Your Target Audience San Francisco American Dental Association ANNUAL SESSION Showcase Your Products Beyond The Showroom Floor Interactive Coverage: •Live video product demonstrations •Product releases & Announcements •Insight from clinicians or products •Interviews with manufacturers •E-mailed to more than 85k dentists DENTISTRY TODAY Space is limited. Call your sales representative today for more details. advertise Technique of the Week Month Pain Evaluation Lee Ann Brady, DMD Lee Ann Brady, DMD, of…

4. Page 16

   From the April/May 2012 Issue RETRACTION CAPSULE 3M ESPE The Retraction Capsule is designed with an extrafine tip that can be inserted right into the sulcus. It is the first gingival retraction product that delivers atraumatic retraction paste using a revolutionary retraction system. The time saved by its use makes it a convenient alternative to traditional gingival retraction methods. For more information, call (800) 634-2249 or visit the Web site 3mespe.com. FREEinfo, GLASS IONOMER RESTORATIVE DENTSPLY Caulk ChemFil Rock Advanced Glass Ionomer Restorative, a breakthrough in self-adhesive glass ionomer restorative materials, features a proprietary zinc-reinforced formula that provides up to…

5. Page 17

   FOCUS ON: Implant Dentistry Ara Nazarian, DDS, discusses implant dentistry in today's practices. Q: Is there an increasing need presently for implant dentistry? A: Today, there is an even larger need for some type of tooth replacement due to the economic situation that has led patients to put off dental treatment. In fact, here in Michigan where I practice, patients have put off dental treatment until it starts to hurt. By that time, it is too late to salvage some, or all, of the teeth in question, and the necessity for implants and implant-supported restorations is needed. In addition, several…

6. Page 18

   NEW PRODUCTS INTERNAL CONNECTION IMPLANT Sterngold The Stern IC, an implant compatible with the Straumann ITI Dental Implant, can be placed in a single-stage procedure that allows for reduced chair time and patient trauma. It is offered in 3.3 and 4.1-mm diameters and is available in lengths of 8, 10, 12, and 14 mm. For more information, call (800) 243-9942 or visit sterngold.com. FREEinfo, LITHIUM DISILICATE POLISHERS Brasseler USA From the makers of Dialite comes a new, 2-step system for adjusting and polishing lithium disilicate. It allows you to quickly achieve maximum surface smoothness, enhancing your restoration's longevity and minimizing…

7. Page 20

   To assist practitioners in their selection of essential dental products, Dentistry Today presents items reviewed by THE DENTAL ADVISOR'S staff of editors and consultants. Established in 1984, THE DENTAL ADVISOR, based in Ann Arbor, Mich, has provided dental professionals worldwide with objective, accurate information using in vivo and in vitro results on the performance of materials and equipment based on clinical and laboratory research. For more information, visit dentaladvisor.com or call (800) 347-1330. Identafi ++++ DentalEZ | (866) DTE-INFO | dentalez.com Consultants' Comments • "Identafi made my patients very aware of my intraoral examination." • "The small size is great.…

8. Page 22

   Spotlight Next-Generation Autoclaves Offer Perfect Blend of Speed and Capacity CANONSBURG, Pa.-SciCan introduces its next generation of autoclaves, the Bravo Chamber Autoclave line, offering the perfect blend of speed and capacity, with SciCan's total cycle times, including drying, set at about half the time as other chamber autoclaves. The Bravo17V (shown), with a 17-L chamber, has a larger vacuum pump than its predecessor, the BRAVO17, and employs total cycle times, including drying, starting at just 17 minutes. One of the fastest chamber autoclaves on the market, it comes standard with 5 sterilization trays, increasing load capacity and office efficiency. The…

9. Page 24

   Complimentary iPad App Enhances Capabilities of Digital Pan/Ceph Imager CHARLOTTE, NC—MyRay, manufacturer of digital radiography equipment, now offers the Remote Panel iPad app for Hyperion, its digital pan/ceph unit that features supreme image quality proven ease of use. With the app, available as a free download from Apple's iTunes, dental practices can now connect Hyperion to their iPads via Wi-Fi. The app offers a pleasant graphic interface and lets Hyperion owners pilot their machine and enhance the acquired radiography on their iPad. It allows users to browse and select one of 28 diagnostic programs and then preview, enhance (brightness, contrast,…

10. Page 26

    Spotlight Software Delivers Improved Power and Performance to the Entire Restorative Process CHARLOTTE, NC-Sirona Dental Systems' inLab Software 4.0 is a major software upgrade that effortlessly handles everything from single-unit crowns to complete smile makeovers with the touch of a button. Among the many enhancements made possible with inLab Software 4.0 are the following: (1) Intuitive Graphical Interface—the software guides you confidently through the design process. See exactly what step you're working on, what's next, and what you've already accomplished. (2) Multiple Restoration Design—work on as many different restorations and indications as you want and at the same time. (3)…

11. Page 28

    Spotlight Composite Veneer System Provides Low-Cost Alternative to Custom Lab Veneers SOUTH JORDAN, Utah–Ultradent Products' Edelweiss, a uniquely engineered composite veneer system, provides a low-cost, custom lab alternative to a natural, elegant smile. Each composite veneer in the Edelweiss system is laser-sintered, combining a uniform high-gloss surface with a thermally tempered resin base, and Edelweiss's unique manufacturing technology makes the veneers harder than other composite veneers, resulting in greater resistance to scratch and wear. Ultradent developed Edelweiss as a solution for those seeking a low cost alternative to custom lab veneers. With no lab or separate appointment time for consultations,…

12. Page 30

    Nanohybrid Composite's Exceptional Surface and Physical Properties and Effortless Handling Cited WALNUT, Calif.–Offered by Pac-Dent International, OptiComp Nano Composite offers exceptional surface and physical properties, effortless handling, long working time, and short curing time. A tooth-colored composite, it is designed for direct restorative treatment and repair of composite and ceramic veneers, and its simple delivery makes application precise and easy to control. With its unique characteristics and increased filler load—including the ability to prevent caries due to fluoride release—this exceptional nanohybrid composite is the material of choice in many clinical situations, especially for both anterior and posterior aesthetic restorations. For…

13. Page 31

    New Protective Coating Offered ALSIP, ILL-GC America's new OPTIGLAZE, a nanofilled, light-cured protective coating, provides an aesthetic, glossy surface on indirect composite restorations, artificial teeth, removable dentures, temporary crowns, and individual acrylic trays. It can be used in difficult-to-polish areas such as posterior fissures or interproximal areas of indirect composite restorations. Instead of mechanical polishing, take the easier option and get a higher-quality final gloss with OPTIGLAZE. Included among OPTIGLAZE's characteristics and benefits are the following: easy handling; thin layering (≤ 50 μm), with no influence on restoration color; high resistance against wear and discoloration; and superior bond durability for…

14. Page 32

    Spotlight With Its Prismatic Nanofillers, Temporary Cement Has the Ability to Blend to Any Adjacent Surface OXNARD, Calif.–Introduced last month, DUX Dental's ZONEfree is the first translucent, noneugenol zinc oxide temporary cement in the dental market. Developed using proprietary prismatic nanofillers, it has the ability to blend to any adjacent surface, making it a terrific option for all your temporary cementing needs but especially for aesthetic cases. ZONEfree gives you effortless cleanup and unsurpassed ease of removal, and the 4 g automix syringe provides accurate placement and minimal waste. It has a working time of 1.5 minutes and self cures…

15. Page 34

    NEWS/TRENDS Industry News DEKA Laser Technologies Relocates DEKA Laser Technologies announced recently that it has relocated its North American dental headquarters to a new facility in Carlsbad, Calif. The move will allow DEKA to implement significant enhancements in communications technologies among its customers, its manufacturing headquarters in Italy, and its affiliated sales, marketing, and business development offices across the country. For more information about DEKA, call (760) 918-0297 or visit dekalasers.com. BIOMET 3i/ Marks 25th Anniversary Palm Beach Gardens, Fla-based BIOMET 3i, a world leader in oral reconstructive devices, is celebrating its 25th anniversary this year. Founded as Implant Innovations…

16. Page 35

    School of Dentistry Receives $5M Grant to Train Future Leaders in Oral Health Research The UCLA School of Dentistry has received a $5 million grant from the National Institutes of Health's National Institute of Dental and Craniofacial Research to create a comprehensive research training program to help cultivate the next generation of dentist-scientists and oral health researchers. The grant, now in its fourth cycle and third renewal since 1997, establishes a pipeline that transforms dentists into science and research leaders who will advance the oral health field and the dental profession. And while prior grant cycles allowed only US citizens…

17. Page 36

    American Dental Hygienists' Association Announces New Leadership Susan Savage, RDH, BSDH, of Ellensburg, Wash. was installed as the 2022-2023 president of the American Dental Hygienists' Association (ADHA) at the association's 60th annual session, held this past June in Phoenix. She succeeds Pamela Quinones, RDH, BS, of Rockville, Md, who remains an ADHA officer as immediate past president as well as the 2012-2013 chair of ADHA. Institute for Oral Health. "As the debate about accessing healthcare takes place across the country, oral health is becoming an instrumental part of the discussion," said Ms. Savage, who has practiced dental hygiene for 24…

18. Page 40

    Clostridium Difficile: Germ Poses Threat Across Medical Facilities Infections from Clostridium difficile, a bacteria that causes diarrhea and other health issues, are a patient safety concern in all types of medical facilities, not just hospitals as traditionally thought, according to a new Vital Signs report from the US Centers for Disease Control and Prevention (CDC). C difficile infection rates have climbed to historic highs. "C difficile bacteria patients list about everywhere medical care is given," said CDC Director Thomas R. Frieden, MD, MPH. "Illness and death linked to this deadly disease do not have to happen. Patient lives can be…

19. Page 42

    Potential Benefits of Sugar-Free Chewing Gum A study by Dr. M. Al-Haboubi et al. published in Community Dentistry and Oral Epidemiology, investigated the effects of prescribing sugar-free chewing gum on the oral health and quality of life of a dentate older people living in the community and attending for routine dental care. The randomized controlled trial involved 386 people, aged 60 years and older, who were not regular chewers of gum. Participants were randomly allocated to a gum-chewing group (chewing sugarless gum twice a day for 15 min; n = 95) or a control group (no gum; n = 291).…

20. Page 43

    Why Some Cancers Spread to Bones Researchers at the University of Michigan (U-M) School of Dentistry have found that administering a common chemotherapy drug helps bone tumors lock not actually fertilized the bone marrow, enabling cancer cells, once introduced, to seed and grow more easily. The findings provide valuable insight as to why some cancers metastasize to bone and could eventually result in metastasis-prevention drugs, said Dr. Laurie McCauley, professor in the department of periodontics and oral medicine and principal investigator on the study. The good news is that researchers reversed the tumor-friendly effect of the drug, called cyclophosphamide, by…

21. 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. BeautiSealant Shofu Dental Sealants are one of the mainstays of protecting children (and adults) from occlusal decay. The benefits of a fluoride-releasing sealant are evident; most sealants, having released their tooth-protecting ions, are simply physical barriers to decay. Unfortunately, sealants are underused; children, particularly young ones, are not particularly fond of the tooth-etching process. The acerbic taste of the etch makes the first quadrant difficult and subsequent quadrants positively challenging. Shofu Dental's innovative BeautiSealant has…

22. Page 46

    ADVERTISING SUPPLEMENT INTERVIEW: SCOTT ROOT, PRESIDENT, DENTSPLY Implants, North America 1 Can you tell us about the newly formed company, DENTSPLY Implants? DENTSPLY Implants is the union of Astra Tech Dental and DENTSPLY Friadent following the August 31, 2011, acquisition of Astra Tech AB by DENTSPLY International, a leading manufacturer and distributor of dental and other healthcare products. By bringing together DENTSPLY Friadent and Astra Tech Dental, the No. 4 and No. 3 dental implant companies worldwide, respectively, we are able to truly leverage the expertise, experience, and product and service solutions of both organizations under this one new company.…

23. Page 48

    buyers-guide BUYERS' GUIDE 16th Annual Dental Implant Systems The proportion of people older than 50 years old in the United States is increasing rapidly. Reliable estimates indicate that 20% of this demographic wears at least one removable prosthesis. Far more have one or more missing unreplaced tooth. From a practice perspective, at least 120 million people require tooth replacement therapy. These are individuals most likely to be interested in implant dentistry, and they represent a significant part of the population. For many practices, this signifies a large untapped resource. It is incumbent that successful practitioners must concern themselves with the…

24. Page 50

    DENTAL IMPLANT SYSTEMS continued from page 48 the permanent implants. These provisional implants are designed to protect the implants and grafts from any possible trauma during the healing process by providing vertical stops during patient function. IMPLANT PROSTHETICS Prosthetic Retention The prosthetic retention to the osseointegrated implant may be fixed, screw retained, removable, or cemented. The choice of retention depends upon the intended function: fixed, single, or multiple tooth restorations, or removable retention for partial and complete dentures. Copings Impression copings are used to transfer the exact 3-D intraoral implant position to a stone model. The open tray direct method…

25. Page 52

    continued from page 50 Biomet 3i The key to achieving long-term sustainable aesthetic outcomes is preservation of hard and soft tissues. The PREVAIL Implant System's unique features are designed for preservation. It has crestal bone preservation through integrated platform switching; it provides soft tissue protection through the Cortical Internal Connection design; and it has enhanced osseointegration, which includes implants designed for osseointegration, peri-implantitis risk mitigation, and increased primary stability. For more information, call (800) 342-5454 or visit biomet3i.com. FREEinfo, CAMLOG USA The CAMLOG Implant System was developed by internationally renowned experts in the fields of clinical implantology, research, and manufacturing.…

26. Page 58

    DENTAL IMPLANT SYSTEMS continued from page 52 together to help to maintain peri-implant bone and soft tissue health, even over the long term. The comprehensive line of implants includes OsseoSpeed TX 4.0 S, OsseoSpeed TX 3.0 S, and the patented OsseoSpeed TX Profile. For more information, call (800) 531-3481 or visit dentsplyimplants.com. FREEinfo, Glidewell Laboratories Inclusive Dental Implants combine proven, industry-compatible design features with state-of-the-art surface technology for clinicians of all experience levels. Used alone or with the revolutionary Inclusive Tooth Replacement Solution, Inclusive Tapered Implants emphasize efficient placement protocols and facilitate a natural, aesthetic restoration. For small diameter indications,…

27. Page 60

    DENTAL IMPLANT SYSTEMS continued from page 58 The Swish System profession-standard internal octagon implants are designed to provide compatibility with Straumann's tissue-level implants. Both the SwishPlant and new SwishPlus feature improvements such as progressively deeper threads and vertical cutting grooves. Varying transgingival surface roughness allows for compatibility between bone and tissue-level placement. A cover screw and 2-mm healing collar are included in the all-in-1 packaging for each Swish implant. Differing fixture mounts provide options to meet your economic and functional needs. For more information, call (888) 649-6425 or visit implantdirect.com. FREEinfo, Intra-Lock These intelligently engineered dental implant systems incorporate a…

28. Page 62

    DENTAL IMPLANT SYSTEMS continued from page 60 nection, accommodating a wide range of anatomical needs. Each of the implants is packaged with a sterile final drill guide to specifications for the length and diameter of each implant. Its surface has microgrooves and macrogloves for excellent osseointegration. Seven's dual, self-capping threads ensure excellent initial stability. For more information, call (860) 797-7333 or visit implantblake.com. FREEINFO, Neoss Neoss Implant System offers an innovative and scientifically based implant system. It provides a simple, easy-to-use means of anchorage for a single crown, bridge, or denture, thereby satisfying a wide range of aesthetic and functional…

29. Page 64

    DENTAL IMPLANT SYSTEMS continued from page 62 The Likhro is a one-piece small-diameter implant, precision-machined out of titanium alloy with OCO Biomedical's proprietary surface-treated threads. The implant is engineered with an aggressive thread pattern for initial stability. Compatible with many wrenches and drivers, it is the perfect small-diameter implant without the costly investment of new instrumentation. For more information, call (800) 228-0477. FREEinfo, Park Dental Research The Lew MDI Mini Dental Implant is designed for the stabilization of a full denture using a minimally invasive procedure. It's available in diameters 2 and 2.5 mm and lengths of 10, 11, 13,…

30. Page 65

    DENTAL IMPLANT SYSTEMS 65 Its metal-free properties are also perfect for people seeking metal-free dental implants. The FDA-approved, metal-free implant system is made from the performance TZPA BIO-HIP zirconium oxide (zirconia) ceramic. The special zirconia has a higher flexible strength than regular zirconia used for dental crowns and bridges. The major advantages are excellent biocompatibility, good osseo-integration, low plaque adhesion, and perfect soft-tissue behavior for some of the best pink aesthetic results. For more information, call (877) 874-9407, visit the Web site ztsystems.biz, or send e-mail to usa@ztsystems.biz. FREEinfo, Zimmer Dental The newest members of the renowned Tapered Screw Vent…

31. Page 66

    ce Test 152 dentalCEtoday.com IMPLANTS Intraoral Radiography and Dental Implant Restoration Chandur P. K. Wadhwani, BDS, MSD Ralf Schuler, DMD, MSD Stuart Taylor, BDS, MSD Curtis S. K. Chen, DDS, PhD The planning stages of implant dentistry often involve sophisticated imaging and technique which most dental offices do not presently possess. This is in contrast to the implant restorative phases where intraoral radiography (IOR) is commonly used as a diagnostic tool. The equipment necessary for IOR is readily available in most dental offices, and when used appropriately it can provide clinically relevant information in a minimally invasive, inexpensive, and immediate…

32. Page 68

    Intraoral Radiography... continued from page 66 these sites will be obscured by the implant itself. A study on the accuracy of radiographic diagnosis of peri-implant radiolucencies evaluated implants that were inserted into bone and radiographed under standardized conditions. An implant with intimate contact to bone was compared to others where an intentional gap was created between the implant and the socket. Ten experienced implant clinicians compared radiographs of these sites and were asked to judge the likelihood that a space was present. The interobserver agreement was low and the diagnostic accuracy was greatest only when a 0.175 mm gap existed.…

33. Page 70

    Intraoral Radiography... continued from page 68 implant has been previously restored, it may be more difficult to determine the orientation without first removing the restoration (Figure 6b). The angulation of the x-ray tube head relative to the implant long axis is critical. Under optimum conditions, gaps of 0.05 mm may be detectable but become obscured when deviations of the x-ray tube head are 5° or more to the long axis of the implant.13 Gaps of 0.1 mm or larger can also be detected with 10° to 15° x-ray beam incidence away from the long axis. However, when the incident beam…

34. Page 71

    IMPLANTS 71 into the implant body itself,21-23 that allow the film, so stay talks, and implant body axis to be related. However, once the implant restoration is placed, this becomes impractical, as removal of the restoration at frequent visits is both time consuming and may alter the soft tissues and bone level around the implant.24-31 It is known that the disruption caused by removal and replacement of the abutment may lead to loss of the implant supporting tissues. One means of standardizing IOR is to develop more practical devices that align the implant body to the x-ray beam precisely, but…

35. Page 72

    Test 152 Expiration date of this CE article is August 1, 2015. To submit Continuing Education (CE) answers, use the answer sheet on page 73. Circle the letter corresponding to the answer you believe is correct, detach the answer sheet from the magazine, and mail to Dentistry Today Department of Continuing Education. Or, use our easy online option at dentaltoday.com. This article is available for 2 hours of CE credit. The following 16 questions were derived from the article "Intraoral Radiography and Dental Implant Restoration" by Chandur P.K. Wadhwani, BDS, MSD, et al on pages 66 to 71. Learning Objectives…

36. Page 74

    The CT/CBCT-Based Team Approach to Care Part 1: Identifying the Implant Patient and Prosthetic Options This, and all future articles that are presented in multiple parts, are available to our readers at our Web site, . Michael Tischler, DDS Scott D. Ganz, DMD INTRODUCTION Replacement of missing teeth with dental implants involves a coordinated effort between surgical and prosthetics disciplines. A successful surgical and prosthetic result is directly related to proper planning and coordination among the dental surgeon, the dental laboratory team, and the restorative dentist. New digital workflow tools, online communication tools, and the integration of cone beam computed…

37. Page 76

    The CT/CBCT-Based Team... continued from page 72 outlined in this article are based on the key concept of CBCT 3-D imaging that can provide the necessary anatomical information to aid in guiding the team. First, a meeting venue, time, and agenda have to be determined. One person should be responsible for the agenda. Second, a treatment plan sequence has to be agreed upon by the parties involved. Third, the prosthetic steps need to be fully communicated to the dental laboratory to review necessary components and cost for the restorative phase. Once these 3 steps have occurred, the coordinated communication not…

38. Page 78

    The CT/CBCT-Based Team... continued from page 76 These third party service providers can also assist in the planning phase, template utilization, and more cD imaging). Diagnostic; 360 Imaging). Therefore, a clinician is no longer required to purchase a specific software application. Clinicians who have an in-office CBCT device have an advantage of immediate access to the DICOM data for diagnostic and planning purposes. All members of the team can visualize the 3-D data represented as a basic views regardless of the software. These are the: panoramic overview, axial view revealing the coronal/sagital perspective, cross sectional view from buccal to lingual…

39. Page 80

    Predictable Stabilization of a Lower Denture INTRODUCTION While ill-fitting dentures may not be considered by some as one of the most serious or health-threatening dental conditions, any dental professional who has spent time speaking with a patient living with a poorly fitting denture knows that the resultant discomfort, inconvenience, and embarrassment is often unbearable. Even after making a considerable investment in a full set of dentures, it is common for the patient to have difficulty eating or speaking. Many patients opt not to wear one or both dentures, even when they are new, often avoiding social gatherings or eating in…

40. Page 82

    Predictable Stabilization... continued from page 80 sive and relatively fast moving SDI procedure.10 Proper Treatment Protocol Once it has been determined that a patient is a good candidate for the SDI procedure, the practitioner must create a treatment plan outlining the number of implants to place and the ideal diameter and length needed to provide the greatest possible retention. This plan should be verified by a panoramic radiograph of the mandible superimposed by an implant length guide, which can be obtained by the manufacturer of the implants. The risk of mandibular nerve injury is largely avoided by performing the SDI…

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