Dentistry Today — August 2015

Inside this issue

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   It's coming...are you READY? What happens in Vegas will not necessarily stay in Vegas CEREC September 17-19, 2015 - The Venetian & The Palazzo Hotel, Las Vegas LARGEST DENTAL EDUCATIONAL FESTIVAL OF THE LAST 3 DECADES This milestone event features three days of world-class educational sessions, abundant networking opportunities, unsurpassed entertainment and access to leading dental industry vendors showcasing their products and services. Program tracks include CEREC, Schick IntraRal Imaging, GALILEOS ExtraRal Imaging, inLab and Orthodontics. Join us, and discover for yourself why an event this amazing cannot be missed! ROCKING DENTISTRY FOR THREE DECADES est. 1985 WHY ATTEND? The…

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   Fired Up on Implants Implants continue to be one of the fastest growing treatment options in dentistry. This is reflected in our readership surveys as implant topics have now moved into the No. 1 position for the most read category. As a result, I am very excited to announce the introduction of a brand new section in the magazine, Implants Today, which will be making its debut in the September issue. With a special focus on quality, evidence-based clinical case report articles, and the GP in mind, we will publish timely information that is guaranteed to increase technical and clinical…

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   Dentists As Bartenders It's show time! I know this is a stretch, and like all analogies, this one has its limits. However, many of the practice management consultants in our profession advise their clients to start each day with the exhortation, "It's show time." Among others, bartenders say that to themselves every night when they report to work. Certainly, this is true of the successful ones. Let's learn from them, and explore what it means in a dental context. So really, how do bartenders and dentists relate to the notion of "it's show time"? Or, as they'd state it all?…

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   This month on CEREC 30th Celebration Coverage From Las Vegas The Dentistry Today film crew is heading to Sirona Dental's CEREC 30th Anniversary Celebration, taking place next month in Las Vegas and The Palazzo hotels in Las Vegas. This 3-day educational extravaganza will feature an extensive exhibit hall featuring educational opportunities aimed at all dental and laboratory professionals. With more than 5,000 expected to attend, there will be much to see and do. Watch our website after the event for highlights, dentist interviews, and more. CE Promotion Buy Two, Get One FREE Do you need continuing education (CE) credits? Dentistry…

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   FOCUS ON: Oral-Systemic Links Charles C. Whitney, MD, explores the emerging oral-systemic links and the possibilities of dentists and physicians working together to improve patient care. Q: What is meant by the term oral-systemic links? A: Historically, dentists have termed oral medicine as the dental specialty that treats complicated medical patients. Physicians have only looked in the mouth for signs that reflect systemic diseases like lupus or AIDS. For decades, we have known that oral bacteria can enter the bloodstream (oral bacteremia) and infect diseased heart valves. Increasingly, evidence is revealing that when pathogenic bacteria that cause periodontal and endodontic…

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   NEW PRODUCTS UNIT-DOSE BONDING MATERIAL BISCO BISCO's ALL-BOND UNIVERSAL is now offered in unit-dose packaging. Available in 50- and 100-count kits and not requiring refrigeration, the easy-to-handle, orange-colored unit-doses improve efficiency and reduce the potential of cross-contamination. ALL-BOND UNIVERSAL is indicated for direct and indirect restorations as well as resin-ization/sealing of the tooth, intraoral repair, and as a protective varnish for glass ionomer fillings. For more information, call toll-free (800) 247-3368 or visit bisco.com. FREEinfo, ALL-CERAMIC POLISHERS Cosmedent Cosmedent's All-Ceramic Polishers create an unbelievable polish on zirconia, IPS e.max and other lithium disilicates, feldspathic porcelain, and all milled CAD/CAM ceramics.…

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   From the April and May 2015 Issues INTRAORAL COMPOSITE POLISHING SYSTEM Brasseler The DiaComp Feather Lite 2-Step Polishing System provides consistent and reliable results for the polishing of the widest variety of composite materials. Its diamond-infused polishers are extremely versatile and work well on all types of classic restorative composite materials as well as new hybrid composites. The polishers' unique finger design and flexible spirals create an aesthetically pleasing, enamel-like finish while respecting existing surface differentiation. For more information, call (800) 841-4522 or visit the website brasselerusa dental.com. FREEinfo, MULTICOLORED MASKS Medicom When mask comfort, fit, and protection cannot be…

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   Fools Rush In Paul Feuerstein, DMD Examining new trends in caries detection utilizing fluoroscopy, laser reflection, transillumination, laser photothermal and luminescence imaging, digital radiograph analysis, and others... There are patients who have low caries susceptibility. Commonly, there are small lesions found on radiographs, especially interproximally, that started and then—for whatever reason—were arrested. There is no greater thrill for a hygienist to report on a new lesion! Really? With all the patients, it behooves the practitioner to check the prior notes and images before rushing to the restoration. The digital radiographs and software allow for easy side-by-side comparisons to see the…

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   Evolution of Comprehensive Care, Part 4 Direct Restorations This is part 4 in a 6 part article series. Part 3 of Dr. Kurtzman's article was published in the May 2015 issue of Dentistry Today and can be found in the Online Courses section of the website dentalcetoday.com. Gregori M. Kurtzman, DDS INTRODUCTION Restorative dentistry is the backbone of most general dental practices, with direct restoratives comprising a significant portion of these treatment modalities. Throughout the years, restorative materials and philosophies have evolved in this aspect of dental care. The following discussion will address some of the current ideations of direct…

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    TECHNOLOGY FIGURE 7. Bio-Cap (DenMat) applied over the radial exposure for a direct pulp cap and light-cured. FIGURE 8. A self-etch adhesive (Tenure DenMat) was applied and light-cured. FIGURE 9. Virtuoso Universal nanocomposite (DenMat) was placed incrementally to restore the tooth. FIGURE 10. The wedge and sectional matrix (Composimat 3D-30 light clear compound, leaving the restoration ready for finishing. Evolution of Comprehensive Care... continued from page 22 PULPAL EXPOSURE? Pulpal exposures happen in clinical practice, and these are usually related to caries exposure, trauma (coronal tooth fracture), or mechanical exposure during treatment. Prognosis and treatment are determined by the size…

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    Evolution of Comprehensive Care... continued from page 24 duced in recent years as a dentin replacement and pulp capping material.45 As a 2-component, self-cure biocompatible material, it has an initial setting time of approximately 12 minutes, allowing overlaying of the final composite at the same time as pulp capping. Biodirine stratified good adhesion to both dentin and the overlying composite (Figures 1 to 5). A favorable feature of Biodentine is that blood contamination has no effect on the push-out bond strength, irrespective of the duration of setting time, unlike MTA, which is affected during setting.46 Resin ionomers have demonstrated an…

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    Spotlight Open CAD/CAM System Facilitates Creation of Restorations Individually Crafted to Perfection RICHARDSON, Tex—Planmeca FIT, the new name of Planmeca's open CAD/CAM system, provides a fully integrated digital workflow to create restorations that are individually crafted to perfection. It offers clinicians the ultimate chairside digital solution for operational efficiency and profitability within the dental practice. Use the PlanScan scanner to accurately scan the tooth; intuitively design a high-quality restoration with the PlanCAD software; and with PlanMill 40, quickly mill out the restoration, all in the same day. With this complete system integration, clinicians can produce chairside restorations with a perfect…

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    Spotlight Narrow-Diameter Implant System's Unique Features Cited ESCONDIDO, Calif.–ZEST Anchors' SATURNO Narrow Diameter Implant System features a one-piece narrow diameter im plant with a 1.8-mm o-ball connection that incorporates unique features not found in mini o-ball implants currently on the market. These features include the following: (1) a 20° angled o-ball implant that addresses the challenges associated with implant placement in the maxillary ridge; (2) a protecting cap technology that provides maximal resiliency while maintaining a minimized profile; (3) a narrow-body implant design that incorporates progressive threads for increased primary stability; (4) a self-tapping feature for ease of implant insertion;…

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    Piezo Ultrasonic Devices Treat Tooth Surfaces Gently While Removing the Toughest Calculus SOUTH JORDAN, Utah–Ul-tradent Products' Ultravac and Ultravac XS Piezo Ultrasonic Devices are designed for clinicians seeking a power scaler that is gentle to the tooth surface yet powerful enough to remove the toughest calculus. Their ultrasonic piezoelectric linear motion moves back and forth, in contrast to the ellipse of magnetostrictive competitive devices, providing more complete scaling with less effort. This linear motion also provides greater consistency and faster performance while treating the tooth more gently. And thanks to their intuitive Reflex technology, both devices offer optimized performance, reduced…

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    Panoramic X-Ray Delivers Unmatched Sharpness With Unmatched Ease MELVILLE, NY-From a single exposure, Air Techniques' Provecta S-Pan Panoramic X-Ray captures 20 layers of images and slices each of them into 1,000 fragments. Of these 20,000 fragments, the best 1,000 are selected and recompiled to generate a single, exceptionally sharp panoramic image automatically. All sections of the image are as sharp as possible because they include individual anatomical features and the patient's position. This means that important diagnostic information is sharply displayed, and the mandibular canal and bone structure are clear. For more information, call Air Techniques at (800) AIR-TECH. FREEinfo,…

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    CLINICAL REVIEWS THE DENTAL ADVISOR AirStar 70 Dental Air System +++++ Air Techniques | (800) AIR-TECH | airtechniques.com Consultants' Comments • "Quiet and requires little maintenance while providing consistent air pressure." • "Very low maintenance; no oily smell." • "Handpieces run strong, all lines are moisture free, and many operators are able to work at one time." • "Unit is large." Description The AirStar 70 Dental Air System, a 100% oil free air compressor, features membrane drying technology designed to provide the driest possible compressed air at all times, on demand, with no interruptions. The system's Teflon technology removes the…

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    INNOVATIONS . 1 Spotlight Self-Adhesive Cement Makes Cement Cleanup a Snap, Ensuring Creation of a Beautiful Restoration That Will Last MILFORD, Del— DENTSPLY Caulk's new Calibra Universal self-adhesive resin cement offers a wide tack-cure window of up to 10 seconds and an extended 45 second gel phase, providing dentists with the ability to perform a thorough and effective cleanup and ensuring the creation of a beautiful restoration that will last. Conventional resin cements only allow light curing for one or 2 seconds before they harden to the point where a burr may be required to remove the excess. But Calibra…

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    Combination Pilot Drill/Surgical Guide Provides Alternative to Fabricating Conventional Surgical Guide DETROIT–Golden Dental Solutions' MD Guide offers an alternative method to fabricating a conventional surgical guide. What is clinically useful about the guide is that you are not changing your current surgical protocol or your dental implant system; the guide just allows you to drill your pilot hole more accurately in terms of mesio-distal spacing and parallism. Instead of using the pilot drill with your implant system, the guide can be used instead. It is a pilot drill and an alternative surgical guide combined. An MD Guide Intro Kit contains…

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    Surgical Laser Upgraded With Enhanced Graphical User Interface CERRITOS, Calif.–Millennium Dental Technologies' PerioLase MVP-7 surgical laser has been upgraded with an Enhanced Graphical User Interface (eGUI) offering important features synthesized from the most impactful portions of the Institute for Advanced Laser Dentistry (IALD) training continuum. The eGUI integrates with clinicians' training achievements and professional certifications issued by the IALD. PerioLase MVP-7 owners operating their devices without the eGUI may upgrade their PerioLase MVP-7 systems. Leveraging backward compatibility, an eGUI upgrade is available at a nominal cost to ensure that each of Millennium's clinicians will be able to perform the treatment…

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    Diamond's Bonding Technology Yields Superior Hardness, Exposes More Cutting Surface KENNESAW, Ga–NeoDiamond, America's highest-rated, No. 1-selling diamond bur (based on SDM dealer sales), features Advanced Triton bonding technology that fastens diamonds to the Swiss-made XactFit shank with superior hardness and exposes 30% more cutting surface for a faster cut with less chair time. The shank is heat-treated stainless steel machined to strict tolerances, which ensures a secure fit in your handpiece (.001, .005). Additionally, each bur is individually packaged and sterilized for safety and convenience. For more information, call Microcopv at (800) 235-1863 or visit neodiamond.com. FREEinfo, Two-Instrument Endodontic System's…

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    Force-Absorbing CAD/CAM Block Combines Strength and Aesthetics Spotlight Dual-Cured Resin Luting Cement Optimized to Yield Stronger Restorations SCHAUMBURG, Ill-BISCO Dental Products' DUO-LINK UNIVERSAL dual-cured resin luting cement is perfect for reliable, high-strength cementation with easy cleanup, and is extremely high and consistent degree of conversion in both self-cured and light-cured modes addresses what's required for today's stronger restorations. In addition, its low film thickness assists in effective sealing and offers diagnostic radiopacity for that perfect margin. DUO-LINK UNIVERSAL has been maximized to reduce its sensitivity to operator and curing times, resulting in a longer gel phase and ease of use…

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    Caries Detection System Now Integrates With Practice Management Systems TORONTO–Quantum Dental Technologies, manufacturer of the caries-detecting Canary System, introduces The Canary Bridge, a software application that allows dentists to access the system directly from their practice management software. The Canary System is not simply a caries detection tool; it has the ability to safely and securely store data and images of the tools and surface being examined so clinicians can review, graph, and prepare reports on changes in caries during the course of treatment. With its unique crystal structure diagnostics, it allows clinicians to detect, track, and monitor decay on…

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    NEWS/TRENDS AAE and AAOMR Issue Position Statement on 3-D Imaging in Endodontics Evidence-Based Recommendations Identify Clinical Situations for Appropriate Use of CBCT In response to new developments and research indicating the effectiveness of 3D imaging for endodontic diagnosis and treatment, the American Association of Endodontists (AAE) and the American Academy of Oral and Maxillofacial Radiology (AAOMR) have issued a revised position statement on the use of CBCT in endodontics. The joint statement is an update to a 2010 position on CBCT use in endodontics. An AAE and AAOMR committee reviewed the scientific literature from the past 5 years and updated…

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    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. ANEW Narrow Body Implants Dentatus Dentists face the following 2 problems in implant delivery: insufficient arch bone width and limited mesiodistal space between existing teeth. Conventional implants require a minimum of buccal and lingual osseous support, and the tipping of teeth around an earlier extraction often leaves less interdental space than the diameter of the implant. Dentatus' FDA-approved ANEW Narrow Body Implants System offers both fixed and removable prosthetic options for even the most compromised…

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    Dental Implants Result in Better Quality of Life for Osteoporotic Women As postmenopausal women with osteoporosis age, they are at greater risk of losing their teeth. But what treatment for tooth loss provides women with the highest degree of satisfaction in their work and social lives? A new study by Case Western Reserve University School of Dental Medicine researchers suggests dental implants may be the best route to take, according to Dr. Leena Palomo, associate professor of periodontics and corresponding author of "Dental Implant Supported Restorations Improve the Quality of Life in Osteoporotic Women." Their findings were reported in the…

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    dentalCEtoday.com Go online to earn credit for reading this CE article. IMPLANTS 54 Overdenture Implants A Simplified and Contemporary Approach to Planning and Placement Michael D. Scherer, DMD, MS Figure 1. Mandibular implant positions are based upon interforaminal regions (A, B, D, E) corresponding to teeth nos. 28, 26, 23, and 21. In many clinical situations, insufficient bone exists to place implants posterior to the mental foramina. Implant positioning should follow the distribution of implants in some clinical situations, sufficient bone exists in the first molar region (RIGHT). Giving wider distribution of implants. Figure 2. Maxillary implant positions are based…

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    Experience the advantages of Hahn™ Implants "The Hahn™ Tapered Implant System offers practitioners some distinct advantages: an easy-to-use surgical kit with length-specific drills, a thread pattern that engages bone precisely as directed with a high degree of initial stability, and esthetic healing and restorative components for a natural emergence profile. Add to this the support of an industry-leading laboratory, and you won't find a more complete implant system anywhere on the market." – Timothy Kosinski, DDS, MAGD; Bingham Farms, Michigan "The simplified surgical protocol of the Hahn Tapered Implant System has helped me boost my case efficiency, with the wide-ranging…

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    Overdenture Implants... continued from page 54 and posterior distance between implants.1,2 Maximizing implant distribution, number, and parallelism between implants results in a reduction with less antero-posterior movement, greater lateral stability, and enhanced patient satisfaction. Adequate bone volume and the presence of critical anatomical structures, such as nerves, vascular structures, or sinus cavities, can limit the number and distribution of implants. Implant positions for the mandibular arch are often limited to the anterior, interforaminal portion of the mandible. This is typically compounded by years of denture or partial denture use resulting in substantial posterior ridge resorption. As a result, implants are…

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    Figure 10. Virtual implants are placed according to bone volume and tooth position within computer software. Figure 11. The software is manipulated to visualize the anterior-posterior tilt of the implants in relation to the patient's denture. Figure 12. The software allows a parasagittal orientation of the occlusal surface of the denture, giving the clinician visualization of the proposed implant positions in relation to the anatomical structures of the denture. processed into dental imaging software (Invivo [Anatomage]), and the implants are planned according to available bone within the virtual rendering of the bone volume (Figure 6). While this method of radiographic…

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    Figure 13. Holes are prepared through a clear duplication of the patient's denture using a 1.6 mm drill corresponding to the implant positions and angulation in the virtual plan, illustrated in Figures 10 to 12. Figure 14. Initial osteotomy is prepared using the pilot drill through the holes in the clear surgical guide. The guide is removed, final osteotomy holes are prepared, and implants are placed (LOCATOR ZEST Anchors). Figure 15. The abutments (LOCATOR ZEST Anchors) were placed on the implants. Figure 16. A simplified yet complete armamentarium of denture preparation materials (Denture Prep & Polish kit ZEST Anchors) and…

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    PARTNERING WITH YOU IN THE ADVANCEMENT OF OVERDENTURE TREATMENT BEST-IN-CLASS PRODUCTS. END-TO-END PATIENT SOLUTIONS. Clinician preferred around the globe. Stay tuned for the next generation of the world's leading overdenture attachment system coming in January 2016! Nearly 2 million satisfied patients. For more than 40 years, ZEST Anchors has been an innovator in the design and manufacturing of dental solutions for the treatment of fully or partially edentulous patients. We pioneered pivoting, self-aligning attachments that substantially reduced the damage caused by the improper seating of overdentures. Our flagship product, LOCATOR®, is a reliable restorative solution that the industry, clinician community,…

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    While seemingly simple, proper planning and surgical procedures can be a confusing and challenging to clinicians. Figure 28. A patient with an extremely broad and flat maxillary arch opposing palatal dentition wished for enhanced stability of his denture. Figure 19. Radiopaque VPS is placed onto the intaglio surface of the denture and cotton rolls are placed buccal to the denture. A CBCT scan is made of the patient wearing the denture. A second CBCT scan is made of the denture alone. model in relation to the denture out line (Figure 20). The verified, final surgical plan was uploaded to the…

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    dentalbyersguide.com BUYERS' GUIDE 19th Annual Implant Systems Michael Tischler, DDS According to the US Centers for Disease Control, total edentulism in the United States totals 65 years and older ranges from 15% to 43% in various states. The average percentage of total edentulism of American adults aged 65 or older is 21%. The percentage numbers of partially edentulous people in the United States are even higher, with 178 million people missing one or more teeth. These numbers certainly constitute a large population of patients who would benefit from tooth replacement by receiving dental implants. There is another segment of the…

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    Discover the truth in our vial All-in-1 Packaging Includes implant, cover screw, healing collar & carrier/transfer – $150 SBM $435 TRUE SAVINGS for Straumann Customers we dare to compare All-in-1 Packaging Includes implant, cover screw, healing collar & new fixture-mount that provides simply accurate impression taking as well as functions as a preparable final abutment – $225 SBM, $250 HA surface $421 TRUE SAVINGS for Zimmer Customers we dare to compare All-in-1 Packaging Includes implant, cover screw, healing collar & new fixture-mount that provides simply accurate impression taking as well as functions as a preparable final abutment – $225 SBM…

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    continued from page 62 versal abutment positioning provides for the revolutionary cementless and screwless integrated Abutment Crown, consistently providing a nonmetallic aesthetic gingival margin. For more information, call (800) 882-4266. FREEinfo, BioHorizons The Tapered Internal family of implants provides excellent primary stability, maximal bone maintenance, and a soft-tissue attachment for predictable results. This family of implants can be placed with the same instrument kit, giving you surgical convenience and flexibility to choose the ideal implant for each patient's needs. The Laser-Lok implant surface has been developed from more than 25 years of research and has been shown to establish a…

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    IMPLANT SYSTEMS continued from page 64 ing placement, efficient insertion, and excellent primary stability. With implant-specific drills and a collection of time-tested features enhanced by cutting-edge design, the Hahn Tapered Implant System enables today's clinicians to enhance the quality of treatment while reducing the cost of care. For more information, call (800) 407-3379 or visit hahnimplant.com. FREEinfo, Inclusive Tapered Implants combine RBM surface technology with time-tested design features for achieving high primary stability, crestal bone preservation, and soft tissue maintenance. These high-strength fixtures are available in 4 major diameters, with a standard platform sizes to minimize the number of system…

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    IMPLANT SYSTEMS continued from page 66 excellent initial stability. It has diameters of 6.0, 6.5, 7.0, 7.5, and 8.0 mm. The 5° internal connection and platform switch results in maintenance of crestal bone, which eliminates screw loosening. XPEED surface provides faster and stronger osseointegration and a safer, acid-free, biocompatible surface. All lengths begin from 6.0 mm. For more information, call (866) 277-5662 or visit the website istemegagen.com. FREEinfo, Intra-Lock Intra Lock offers several architectures and thread designs, which are engineered to be site-specific. Its comprehensive array of implant systems ranges from (1) 2 to 6 mm in diameter (2) tapered…

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    IMPLANT SYSTEMS 69 platform shifting. It has an expanding tapered body with double variable threads and a dual function prosthetic connection. Its apical drilling blades enable "active" directional changes for optimal positioning, while macroscopic grooving and the unique TiUnite surface enhance osseointegration and soft-tissue response. Nobel-Active is recommended for clinicians experienced in implant placement. For more information, call (800) 322-5001. FREEinfo, OCO Biomedical OCO Biomedical is a worldwide leader in immediate load dental implant technology. The patented Dual Stabilization dental implants achieve a biomechanical lock at placement, and are engineered to stimulate bone growth. The patented implant body design, with…

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    continued from page 69 addressing the issues of highest concern to patients and dentists. Its unique design incorporates safety features, lower costs, simple crown-and-bridge dentistry, and a superior cosmetic outcome. PerioSeal incorporates conventional dentistry principles (ferrule crown attachment) to implant dentistry. For more information, call (888) 416-7126 or visit perioseal.com. FREEinfo, Ritter Implants The German-made, titanium 5 alloy with an SB/LA treatment dental implant is at the heart of the Complete Implant and Restorative System. The CIR system includes everything needed to implement an efficient digital workflow in your practice. When you prescribe Ritter implants, you can say goodbye to…

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    IMPLANT SYSTEMS breakage, underscoring the confidence in the Prettau zirconia. With custom shades, custom shapes, no chipping, no staining, no acrylic, and less prosthetic space needed than a hybrid bridge, the Prettau zirconia bridge offers all the benefits over the alternative choices, with lower pricing. For more information, call (888) 969-2737 or visit zrbridge.com. FREEinfo, Z-Systems USA The FDA-approved Zirkolith Zsc is a 2-piece, all-zirconia implant. It is the essence of more than 12 years of clinical experience in metal-free, highly aesthetic zirconia implants. Zsc features a patented laser surface technology and straight, 15°, or customizable zirconia abutments. It is…

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