Dentistry Today — FEBRUARY 2014

Inside this issue

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

1. Page 6

   Why take cash? When you could potentially make 2-5 times more* with HENRY SCHEIN® DENTAL ARGEN® REFINING "I'll never take cash on the spot again. I expected to get $800 for my scrap material, but Argen gave me over $10,000! I'll never take cash on the spot again. With Argen's scientific and innovative approach to refining, you truly receive the most for your material." – Dr. Bill Fan, DDS "Argen has been our choice for precious metal recovery for over 10 years. We have performed 48 third party assays to confirm Argen's results, and all 48 assays proved the accuracy…

2. Page 12

   New Directions Begin as Dreams Every so often, a dream becomes a concept, the concept a plan, and the implemented plan an expressed reality. Ask that dream. Relatively few among us have the vision and passion required to do something that has the potential to impact our entire profession. Those individuals, who set their personal and professional bars high in their zeal to improve the profession, most often end up being our most respected leaders and teachers. Thus, dreams, concepts, and plans usually continue to evolve into anything but a static reality. Deshed Gordon and Rella Christensen are remarkable examples…

3. Page 14

   How to Replace Lost Production and Profit According to the Levin Group Data Center, 75% of dental practices have declined in production in the last 4 years. This is due to changes faster to as The Permanent Game Changers, which are reshaping the dental profession, including the following: • Fewer new patients entering dental practices • Lower case acceptance • Reduced insurance reimbursements. To compete in this new environment, dental practices today can no longer operate without using proven business models. Practices that are doing well today—and there are many—employ real-world business methodologies to increase production. Roger P. Levin, DDS…

4. Page 16

   VIEWPOINT continued from page 14 and the level of case acceptance is not sufficient to increase production 8% to 18% each year, every new and recurring patient matters more than ever. Make Patient Retention the Practice's Highest Priority Dental practices cannot afford to lose patients as they may have been alive in the past. While some patients will invariably be lost to the practice due to reasons beyond the practice's control (relocation, death, etc.), the vast majority of patients become inactive simply because the practice did not try hard enough to retain them. In the recent recession, many patients stopped…

5. Page 18

   Visit Our Site Today! Technique of the Week Class II Composite Restoration Darren Simpson, DDS Darren Simpson, DDS, of Downers Grove, Ill, demonstrates the use of BISCO's TheraCal LC as a light-cured, resin-modified calcium silicate-filled liner, designed for use in direct and indirect pulp capping. TheraCal is used as a protective base/liner under composites, amalgams, cements, and other base materials. In this video, watch as Dr. Simpson completes a Class II resin based composite restoration. For more information and to view the video, visit . Coverage From the Show Floor Live Blog From the CMW Dentistry Today will once again…

6. Page 20

   FOCUS ON: Infection Control In light of a recent public health investigation, John Molinari, PhD, and Peri Nelson, BS, discuss the transmission of hepatitis C virus in an oral surgery practice. Q: What happened in the dental public health investigation in Tulsa, Oklahoma? A: In March 2013, the Oklahoma State Department of Health started an investigation into the possible transmission of hepatitis C virus (HCV) in an oral surgery practice. This investigation began when patient X, a routine blood donor, tested positive for acute HCV. When the patient was interviewed, no traditional risk factors for HCV transmission were found. However,…

7. Page 22

   From the November 2013 Issue CROWN AND BRIDGE MATERIAL Ultradent Products The new ExperTemp temporary crown and bridge material maintains both the function and aesthetics of natural dentition and can also be used to fabricate inlays, onlays, and long-term temporaries that closely resemble the final restoration. A bis-acryl composite provisional material, it comprises a 1:01 self-cure chemistry, making it easy to work with, while providing exceptional strength, flexibility, and abrasion resistance. For more information, call (800) 552-5512 or visit ultradent.com. FREEinfo, TOOTHBRUSH Philips Sonicare The new Philips Sonicare DiamondClean Black Edition is part of an ongoing commitment to improving people's…

8. Page 24

   Global Dental Solutions, LLC Available in all 16 classic VITA shades, the Thermoflex Overpartial is a timeand cost-efficient removable cosmetic solution that snaps over existing dentition. It can accommodate pontics, and since no margin stops at the gumline, so there is no coverage of gingival tissue. Addition-itis time is minimal since adjustment is seldom needed. For more information, call (866) 905-1111 or e-mail the Web site sales@globaldentalsoultions.com. FREEinfo, EVACUATION SYSTEM CLEANER ASI The KeepClear Enzymatic Evacuation System Cleaner is a superconcentrate, non-foaming enzymatic cleaner that breaks down protein-based solids and increases their water solubility. This action allows protein-based soils to…

9. Page 26

   CLINICAL REVIEWS THE DENTAL ADVISOR Tetric EvoCeram Bulk Fill +++++ ONE YEAR CLINICAL PERFORMANCE Ivoclar Vivadent | ivoclarvivadent.com Consultants' Comments • "An excellent composite." • "Good results without layering." • "This is now my 'go-to' product for posterior composites." • "Great esthetics." • "Easy to place, finish, and polish; not sticky; very dentist-friendly." Description/Clinical Evaluation Protocol Tetric EvoCeram Bulk Fill, a nanohybrid composite for direct restorations in posterior teeth, contains (1) patented prepolymers that reduce shrinkage stress, (2) the photo-initiator ivocerin (for a deeper depth of cure), and (3) light-sensitivity filters for extended working time. More than 1,100 restorations were…

10. Page 28

    Spotlight Dentistry's Most Powerful Air-Driven Handpiece Introduced HOFFMAN ESTATES, Ill.-NSK Dental Products introduces the 26W, standard-head Ti-Max Z900L, the dental profession's most powerful air-driven handpiece, and the 23W, miniature-head Ti-Max Z800L. The Ti-Max Z900L is dentistry's first air-driven handpiece to deliver 26W of power, producing unprecedented torque that reduces treatment time and provides remarkably smooth handling due to high power output and a unique new turbine design. Both the Ti-Max Z900L and Z800L feature (1) a new cartridge design to dramatically improve durability, (2) smaller head sizes to enhance operational visibility, and (3) cartridges that can be easily replaced chairside.…

11. Page 30

    Spotlight Handpiece Features Angled Head for Superior Access to Posterior Areas Device Provides the Fastest, Easiest Way to Measure Tooth Shades MALVERN, Pa.-DentalEZ Group's 430-45, the newest member of its classic 430 handpiece line, is available in 2 configurations—the 430 SWL 45 and the 430 SW 45—and both are equipped with a unique 4° angled head that provides unprecedented access to hard-to-reach posterior areas of cavity. The 430-45 has been designed to be the perfect handpiece for surgical procedures commonly performed by the general dentist such as removal of impacted molars, crown lengthening, and apicectomies, specifically designed side ports effectively…

12. Page 32

    Spotlight Cloud Service Makes It Easy to Send, Share, and Protect Patient Files RALEIGH, NC–Citrix ShareFile introduces the Citrix ShareFile Cloud for Healthcare, a dedicated virtual private cloud for protected health information. With updated architecture to provide enhanced encryption and security for ShareFile's healthcare customers, it can help dental practices table compliance rules for the safety of patient information. ShareFile specializes in secure filesharing solutions for healthcare organizations, and adoption of ShareFile within the health care market has increased by 137% during the past year alone. With ShareFile, practitioners can easily organize, store, and share patient files and information with…

13. Page 35

    Breakthrough Alternative to Existing Aligner Treatments Introduced SARASOTA, Fla.–DENTSPLY Raintree Essix, a division of DENTSPLY International, introduces to the US market its new clear aligner service center treatment, MTM (Minor Tooth Movement) Clear•Aligner. The treatment, backed by more than a decade of development and clinical testing, combines proven chairside techniques and advanced digital modeling to provide clinicians with a streamlined solution for treating minor anterior or misalignments. "Research shows that up to 50% of adult patients currently have some form of anterior misalignment that can be easily and cost-effectively addressed by MTM Clear•Aligner," said Brad Clatt, business unit manager for…

14. Page 36

    Root Canal Treatment With a Multiple-or Single-File Instrumentation System Simplification of endodontium Ni-Ti file systems to reach a generally predictable canal shape has been a primary and continuing goal of instrument manufacturers. Desirably, the finished canal shape will enhance irrigation disinfection and infection throughout the canal system, resulting in successful root canal treatment (RCT). For the practitioner, safe reduction of the number of files, thereby reducing the cost, the simplification process will hopefully yield high-quality results in less time. In the author's hands, the canal shape that has produced consistently good results is finishing the RCT to a size 40…

15. Page 38

    INNOVATIONS . 1 Spotlight New Universal Bond's Versatility Cited NEW YORK CITY—Kuraray America introduces CLEARFIL Universal Bond, a single-component, light cure bonding agent indicated for all direct and indirect restorations in combination with all etching techniques (total-etch, self-etch, or selective etch). It is also indicated for surface treatment of zirconia and silica-based glass ceramics (ie, lithium silicate), making it truly "universal" without the need for a separate silane coupling agent. CLEARFIL Universal Bond contains the "ORIGINAL MDP" adhesive monomer developed and introduced by Kuraray in 1983, and dentists' chair time is reduced due to its quick application. For more information,…

16. Page 40

    Spotlight Eyewear Designed to Improve Ergonomics and User Comfort LOMPOC, Calif.–Offered by DenMat, PeriOptix lights and loupes feature lightweight frames and headlamps designed to improve ergonomics, resulting in less neck strain and an overall more comfortable working experience. The frames are designed by premium brand companies such as Adidas, Hoggs, and Uvex, allowing DenMat to offer clinicians exceptional quality, class, and value. Since being founded in 1999, PeriOptix, a leader in magnification and illumination technologies, has introduced a number of innovations, including (1) a unique modular frame system, (2) their portable LED light source, and (3) a proprietary locking mechanism…

17. Page 42

    Spotlight Universal Nanohybrid Composite Hailed as Being the Most Tooth-Like Composite Ever Developed BRIARCLIFF MANOR, NY—VOCO's GrandioSO, a substrate-optimized universal nanohybrid composite, offers a unique combination of superior handling, esthetics, and physical properties that make it the most tooth-like composite ever developed. GrandioSO achieves a remarkably low shrinkage rate of 1.6% through its innovative nanotechnology. In composite materials, polymerization shrinkage occurs only in the resin matrix. Therefore, the greater the percentage of filler in the composite, the more that shrinkage is reduced. The best that most universal restoratives can achieve is in the range of 77% to 80% filler particles.…

18. Page 45

    Impression Material's Setting Time Hailed As the Fastest on the Dental Market ST. PAUL, Minn.-With a set time of just 7.5 seconds, 3M ESPE's Imprint 4 VPS Impression Material is the fastest-setting impression material on the dental market. It gives dentists the same long working time they've known from Imprint 3 VPS Impression Material but speeds up the set time with an innovative active self-warming feature, developed exclusively for it. A unique chemical reaction causes the material to quickly warm up to body temperature after the working time, substantially accelerating the intraoral setting. The usual working time is not affected;…

19. Page 46

    Curing Light Features Built-In Radiometer TORONTO—Offered by Beyes, the Slimax-C Plus Curing Light features an innovative built-in digital radiometer that gives users an instant output measurement; they can now be more confident than ever when calculating curing time. The light, equipped with a LED display panel to give users the control they need, is powered by a rechargeable Samsung lithium-ion battery that provides up to 850 curing times per charge. It generates a powerful output of up to 2,000 mW/cm2 at 1 mm, and it is offered with a full one-year warranty. For more information, call Beyes at (877) 793-3582…

20. Page 47

    Award-Winning Bulk-Fill Composite's Popularity and Dependability Cited ORANGE, Calif.—Since its launch in June 2011, Kerr's SonicFill bulk-fill composite has received numerous awards and recognition as an innovative solution to one of the most common, tedious, time-consuming procedures dentists complete each day—posterior restorations. And, in addition to these awards and recognition, the clinical community has widely embraced SonicFill, with more than 12,000 users and a million tips sold to dentists in the United States alone. These dentists cite better patient outcomes, shorter appointment times, more consistent results, and incredible ease of use as just some of SonicFill's many benefits. With more…

21. Page 48

    Video Showcases Flexible Partial Denture's Benefits SUGAR HILL, Calif.-Offered by TCS Dental, the tcs Flexible Partial Dentures video is designed to familiarize patients with the partial's benefits and demonstrates how it compares to a conventional metal and acrylic partial. It also illustrates how—with its tooth-colored clasps—it blends naturally in the mouth. The video is an excellent tool to show potential patients who are considering a removable as a permanent solution and for implant patients who need an interim restoration during their treatment. View the video online at tcsdentalsm.com. It is also available on CD and for upload to a Web…

22. Page 50

    NEWS/TRENDS Industry News Ivoclar Vivadent Announces Managerial Appointment Ivoclar Vivadent announced recently the promotion of Sarah Anders to the new position of senior vice president of North America sales. In this role, Ms. Anders, who was recognized by Dental Products Report last year as one of the Top 25 Most Influential Women in Dentistry, will be responsible for all sales operations in the United States and Canada, working with Pierre Lamouré, vice president of US clinical sales; Wynne Ledford, vice president of US technical sales; and Chad Garner, director of inside sales. Ms. Anders, who joined Ivoclar Vivadent in 2003,…

23. Page 52

    NEWS/TRENDS Providing Dental Insurance Not Enough to Induce Americans to Seek Care Researchers Suggest That Outreach and Education Are Also Needed Providing people with dental insurance does not necessarily mean that they will use it and seek dental care, according to a new study from the University of Maryland School of Dentistry, published online recently in the American Journal of Public Health. The research suggests that outreach and education are also needed to ensure that people value their dental health and use their coverage to seek appropriate dental care. According to the study's first author, Richard J. Manski, DDS, MBA,…

24. Page 57

    NEWS/TRENDS Free Introduction to Orthodontics Progressive Orthodontics announces its free one-day introductory seminar to comprehensive orthodontics. Los locations include California, Washington, Arizona, Michigan, Illinois, Utah, Texas, New York, New Jersey, Pennsylvania, Florida, Vancouver, and Washington, DC. There is also free 3-day case review in the Internet-assisted training program for those who cannot be there in person. Cases will show the basics of orthodontic diagnosis, treatment selection and alternatives, introduction to diagnosis software, computer ceph tracings, model predictions, appliances, and more. Up to 8 CE credits are available. For more information, call (866) 443-3706 or visit posortho.com. Composite Veneers Dr. David…

25. Page 58

    Improved Implant Surface and Hygiene Boost Restoration Success Should a person's teeth be saved at all costs? During the last decade, the answer has shifted from yes to no in favor of replacing diseased and damaged teeth with implants. But treatment of patients with periodontitis remains controversial because artificial tooth roots are more likely to fail. An article in the Journal of Oral Implantology looks at long-term treatment for a patient who experienced odontoid damage. The authors anticipated the higher risk of implant failure in this patient would be offset by coating the implants with a rough, oxidized surface called…

26. Page 60

    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. Zolar Photon Laser Zolar Technology For the better part of 2 decades, dental lasers were a fascinating but largely inaccessible technology for most dental practices. Lasers were too expensive and too complicated. Two parallel trends have helped to change this situation. The expansion of clinical indications for laser use within the dental practice has made this technology as essential as the dental handpiece. The contraction of the laser price point has helped to make it…

27. Page 62

    Imprint 4 3M ESPE The ultimate test of an impression material is its precision. The task of impression material is to capture every minute detail of the hard and soft tissues in a moist environment. The accuracy of the impression material is the very foundation of the indirect restorative procedure. Even the slightest discrepancy at this early stage can sabotage the final restoration, often beyond repair. The practitioner can choose among many vinyl polysiloxane (VPS) materials; unfortunately, not all deliver good balance and clinical properties, often requiring the sacrifice of one benefit to achieve another. Imprint 4, an impression material…

28. Page 63

    FIRST IMPRESSIONS NANOCERAM-BRIGHT DMP Dental USA Important characteristics for a successful hybrid restorative material are superior ease of placement, restorative strength, and tooth-blending esthetics. However, there are many other parameters that contribute to the practitioner's clinical achievements, and all of them impact on the selection of a particular product. NANOCERAM-BRIGHT by DMP Dental USA is a light-cured, nanohybrid composite formulated with a special blend of nanoand micro-fillers. The superior esthetics results from an advanced method for integrating the nanoparticles in the resin matrix. The nanoparticles have an average size of 2 nm, permitting an ultrarapid polish after polymerization and exhibiting…

29. Page 64

    Midwinter Product Showcase The Midwinter Product Showcase highlights products that will be featured at the Chicago Dental Society's 149th Midwinter Meeting IMPRESSION SYSTEM DENTSPLY CAULK's Aquasil Ultra Cordless is the first and only tissue-managing impression system that does not require tissue retraction. There's no need for a cord and no need for paste; just an easy, one-step system that places super-light water strength wash material precisely into the sulcus within seconds. For more information, call (800) LD-CAULK or visit aquasiltracordless.com. FREEinfo, ADHESIVE CEMENTATION SYSTEM BISCO Dental Products' DUO LINK UNIVERSAL is an adhesive cementation system designed to effectively address the…

30. Page 66

    Midwinter Product Showcase FIBER POSTS PENTRON's FibreKleer 4x Fiber Posts feature outstanding radioactivity of up to 400% of aluminum. Translucent glass fibers provide outstanding flexural strength and help to preserve the natural fiblike esthetics. A dentinlike flexural modulus results in a post that flexes with the tooth and transmits stress more evenly along the remaining root structure. For more information, call (800) 551-0283. FREEinfo, ANESTHESIA SYSTEM Aseptico's Wand delivers a computer-regulated flow of anesthetic, allowing you to consistently administer anesthesia below the patient's pain threshold every time. The Wand's ergonomic handpiece eliminates wrist strain and muscle fatigue, allowing your last…

31. Page 68

    Midwinter Product Showcase CARIES DETECTOR/INTRAORAL CAMERA ACTEON North America's SoproCARE was developed to answer the needs of the dental professional during caries detection, prophylaxis, and periodontal treatment in the clinical environment. Utilizing patented fluorescence technology, SoproCARE illuminates dental tissue to reveal occlusal caries, plaque, tartar, and gingival inflammation. It can also be used as an intraoral camera. For more information, call (800) 289-6367. FREEinfo, UNIVERSAL COMPOSITE Danville Materials' Nano zirconia filler results in high strength, durability, stain resistance, and polish. It also produces for shades due to a chameleon effect. It is nonskid and ideal for handling. For more information,…

32. Page 70

    Midwinter Product Showcase ISOLATION SYSTEM Isolite Systems' new Isovac is the most versatile and affordable clinical option for practices that want the advantages of state-of-the-art dental isolation. The adapter modifies a standard IPS so that any of the family of Isolite mouthpieces can be easily attached. Isovac is an excellent addition to hygiene or for affordably extending state-of-the-art isolation throughout your practice. For more information, call (800) 560-6066 or visit isolitesystems.com. FREEinfo, SHADE-MATCHING SYSTEM Vident's all-new VITA Easyshade Advance 4.0 delivers the fastest, easiest way to measure tooth shades under any lighting condition. It gives you the ability to compare…

33. Page 72

    Midwinter Product Showcase UNIVERSAL COMPOSITE Tokuyama Dental America's Sigma Quick is a 100% spherical filled universal composite. Utilizing patented Radical Amplified Polymerization Technology, it offers an extended working time, reduced curing time, and 3 new shades. Other benefits include outstanding polishability, high gloss retention, a wide shade matching range, minimal shrinkage, and excellent radiopacity. For more information, call (877) 378-3548. FREEinfo, SMALL-DIAMETER IMPLANTS KAT Implants' Iom-KAT 2.5- and 3.1-mm implants are 2-piece implants that have FDA clearance to be used in long-term applications with long-term crowns, bridges, and dentures. Abutments are retained via locking taper connection without cement or retaining…

34. Page 74

    Midwinter Product Showcase ULTRASONIC SCALER Coltene's BioSonic SUVI piezoelectric ultrasonic scaler is the ultimate multi-purpose device for treatment scaling in addition to endodontics, periodontics, implant maintenance, and restorative treatments. The Elite Series provides all the features of the Premier Series and includes an air polisher to create one versatile tool for ultrasonic and polishing treatments. For more information, call (800) 221-3046. FREEinfo, BITE GUARD Keller Laboratories' NTI-tss Plus Soft provides maximum patient comfort and significantly reduced chair time. It is a sophisticated device that comprises hard/soft thermo formed material with a clinically unbreakable Clear 450 Discluding Element. The hard/soft material…

35. Page 76

    Midwinter Product Showcase PAN/CEPH SYSTEM Planmeca's ProMax S3 pan/ceph has a versatile design for unlimited imaging options. Its patented SCARA technology is 3-D ready and allows you to take anatomically accurate bite-wings extraorally. Additional features that limit radiation provide all the necessary tools for safe, confident treatment planning. It comes with Romexis open-architecture software for image processing and viewing. For more information, visit planmecausa.com. FREEinfo, CAD/CAM SYSTEM Sirona Dental Systems' CEREC Omnicam's aim-rounded camera tube and tiny camera tip, which are designed for access, guarantee the best lens positioning anywhere in the mouth. Powder-free scanning and Sirona's profession leading precision…

36. Page 77

    . 1 SOFT-TISSUE LASER Zila Pharmaceuticals' NV soft-tissue laser represents the newest technology in the profession. It will cut with a very small zone of necrosis, allowing you to perform a wide array of soft-tissue procedures with little to no discomfort. For more information, call (800) 228-5595. FREEinfo, FIBER REINFORCEMENT MATERIALS PREAT Corp's eFiber and Mesh is the best toolbox in a dental practice. It includes chairside costs of dentures, partial dentures, intraoral periodontal splinting, temporaries, space maintainers, reinforced overdentures, and much more. The reinforcement material bonds to all composites and resins, is translucent, and is very easy to grind…

37. Page 78

    Midwinter Product Showcase FIBER REINFORCEMENT Ribbon's thinnest fiber reinforcement, Ribbon Ultra provides fracture toughness for periodontal splints, directly bonded bridges, composite restorations, and more. Its thinner transverse fibers let axial fibers lay straighter, providing enhanced strength properties, and the transverse fibers still offer the multidirectional fracture toughness associated with Ribbon's lock-stitch leno-weave. Ribbon-Ultra is also more adaptable and lays flatter against the teeth. For more information, call (800) 624-4554 or visit ribbon.com. FREEinfo, FILE Charles B. Schwed's C Files are ideal for negotiating calcified, tortuous, or severely curved canals. The files are available in 21- and 25-mm lengths and size…

38. Page 79

    . 1 ZIRCONIA CROWN Assured Dental Laboratory's Zeno-star is a 100% full-milled zirconia restoration with no porcelain overlay, resulting in no porcelain fractures. Its benefits include (1) being less than half the price of gold crowns, (2) being an aesthetic alternative to gold restoration and PFM, (3) 1,200 MPa flexural strength, (4) conventional chamfer prep and cementation, and (5) offering an excellent marginal fit. Its indications are for posterior crowns and bridges. For more information, call (877) 283-5351 or visit assureddentallab.com. FREEinfo, MECHANICAL PERIOTOME Directa Dental's Luxator LX mechanical periotome offers improved safety, precision, and access. Its vertically reciprocating tip…

39. Page 80

    Midwinter Product Showcase INSTRUMENT WASHING MACHINE ESMA's E789 Ultrasonic Washer, engineered to perform all the tasks of ultrasonic cleaning, rinsing, and drying automatically, allows for automated instruments to be reprocessed prior to sterilization, all at the push of a button. Instruments can go directly from the chair to the E789 Ultrasonic Washer, eliminating scrubbing. When the 30-minute cycle is complete, the instruments are ultrasonically cleaned, rinsed, and dried and ready for bagging and sterilizing. For more information, call (800) 276-2466 or visit esmainc.com. FREEinfo, MILLING CENTER Atlantic Precious Metal Refining's Strategy Milling is a revolutionary milling center providing dental professionals…

40. Page 81

    . 1 ENDODONTIC POSTS/PINS Filhol Dental's FILPIN denture retention pins and FILPOST root canal posts are engineered to be faster, easier, and safer to use. Made of pure (99.8%) titanium, they are biocompatible and compatible with all dental materials. The FILPIN PIN BENDER is for use with FILPIN for added precision and accuracy. For more information, visit filhol.com or e-mail info@filhol.com. FREEinfo, IMPLANT HIOSSEN's ETIII Implant is the optimal bone level fixture for both clinical and esthetic results. Its surface is sand-blasted with alumina and acid-etched to increase surface morphology and roughness and to quickly activate cell differentiation, proliferation, and…

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