Dentistry Today — February 2018

Inside this issue

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

1. Page 6

   The Winds of Change Continue to Blow In so many areas of dentistry, nothing seems to stay the same anymore. In my opinion, no one has witnessed this more than the practicing dentists who graduated from their respective dental schools 25- to 30-plus years ago! The profession has been rapidly morphing over the past 3 decades via many different and powerful technological advancements with innovations and new developments in technology and dental materials being arguably of the most notable areas. Overall, the dramatic changes we have been witnessing are a good thing, but the continual evolution in the profession also…

2. Page 8

   Three Practice Promises to Keep in 2018 Forget resolutions—the word is tainted with failure. As soon as "This is my New Year's resolution" is uttered, you can almost feel the weight of resolutions, make promises. They carry more weight, and we tend to follow through with them. Resolutions have a built-in failure rate, whereas promises are sturdier. If we break them, it hurts. I can hear some outcry here saying, "Come on, Roger, you're just playing the game of semantics." I would argue that words matter and that some words are better than others, especially when it comes to motivating…

3. Page 10

   VIEWPOINT continued from page 8 may have to consider the fact that your exterior may be scaring some of them away. For many people, just the thought of visiting the dentist induces fear and anxiety. You don't want an unattractive exterior triggering any additional negative emotions. Interior. When was the last time your office was painted or wallpapered? If it has been longer than 5 years, it might be time to repaint the look of your dental office, at least in high-traffic areas. In addition, thoroughly inspect your entire facility: walls, doors, windows, floors, furnishings, carpets, bathrooms, operatories, consult room,…

4. Page 12

   Simplified and Predictable Aesthetic Adhesive Cementation of Indirect Restorations Howard S. Glazer, DDS, FAGD Choosing an appropriate adhesive cement for definitive cementation of indirect restorations can be challenging for patients requiring restorative treatment. Ideal strength is necessary to ensure functional treatment durability. Likewise, cement shadeability is also important for long term aesthetics; the color of adhesive resin cements affects how the shade of tooth substrates interacts with the optical properties of restorative materials and also affects shade matching with adjacent restorations or natural teeth. To simplify durable and aesthetic cementation of indirect restorations, a universal dual-cure adhesive resin cement system…

5. Page 14

   What's New on Chicago Midwinter Meeting Video Blog Coverage The Dentistry Today film crew will be present at the Chicago Dental Society 153rd Midwinter Meeting held at McCormick Place West in Chicago, from February 22 to February 24. The theme for this year's meeting is A Dental Triad: Pride • Passion • Professionalism. We plan to cover the many new releases, announcements, and exciting moments that the Midwinter Meeting is known for. Plan to visit our website, , post show to watch our video blogs featuring the latest technology launches and other exciting industry updates. Dentistry Today On the Go…

6. Page 16

   FOCUS ON: Insurance Benefits Tom Limoli discusses the 3 parts of a patient's plan and why you can't have one without the others. Q: What is this love-hate relationship between doctors and the dental insurance industry? A: I believe no greater dichotomy exists in all the professions of healthcare than that of the love-hate relationship between doctors and the fiduciary responsibilities of today's insurance-benefit industry. One provides the loving compassion expressed in the art and science of prevention and healing, while the other coldly enforces contractual financial provisions established by both themselves and their clients. It seems that there is…

7. Page 18

   From the October and November 2017 Issues UNIVERSAL COMPOSITE Dentsply Sirona Restorative The new TPH Spectra ST universal composite is uniquely designed with new and novel filter technology, SphereTEC. It simplifies the path to longlasting, aesthetic restorations. The composite lets you choose your preferred viscosity—creamy and spreadable or firm and packable—and enjoy elevated performance in the areas that matter most, including (1) easy adaptation to the cavity, (2) nonstickiness to your instrument, and (3) excellent sculptability. For more information, call (800) 532-2855 or visit class2restorations.com/tphspectrast. FREEinfo, TOOTHPASTE GC America MI Paste ONE combines the caries prevention of fluoride, the sensitivity…

8. Page 20

   Seiler Instrument The design and functionality of the Alpha Air 6 enhances the dental microscope performs and operates. It is ergonomically designed for superior maneuverability and usability. It offers (1) six levels of magnification, (2) apochromatic lenses for superior optics, (3) one of the brightest LED illuminations on the market, and (4) the ability to be customized to accommodate a full HD video camera capable of capturing 4K video. For more information, call (800) 489-2282 or visit seilermicro.com. FREEinfo, MILLING MACHINE Ivoclar Vivadent The PrograMill One is a compact, 5axis milling machine designed to mill beautiful, aesthetic IPS e.max restorations.…

9. Page 22

   CLINICAL REVIEWS DENTAL ADVISOR GC FujiCEM2 ★★★★★ (96%) GC America | (800) 323-7063 | gcamerica.com Consultants' Comments • "The fluoride release is reassuring." • "Easy to clean excess cement." • "GC FujiCEM 2 is our go-to cement for all restorations that do not require aesthetic cementation." Description GC FujiCEM 2 is a resin-modified glass ionomer luting cement. Compared to original GC FujiCEM, it has increased bond strength to tooth structure and restorative materials. GC FujiCEM 2 is indicated for permanent cementation of all types of metal, resin, alloys, and zirconia-based inlays, onlays, crowns, bridges, and endodontic posts. Working time is…

10. Page 24

    When I Need You Paul Feuerstein, DMD Most of us are guilty of sending x-rays, images, or other information via email, but if it is not a secure portal, you are in violation of Federal law and subject to extraordinary fines. Telemedicine is here. You can contact an MD from an app on your smartphone and get medical advice 24/7. For fees as low as $3, you can have a medical consultation, get prescriptions, take a photo of your issue, and have a video chat and a remote diagnosis. There is insurance reimbursement for these "visits." Here are a few…

11. Page 26

    26 . 1 TECHNOLOGY Spotlight Milling Machine's Design Offers High Precision and Convenience AMHERST, NY- Ivoclar Vivadent announces the release of the PrograMill One, a compact, 5 axis milling machine designed to mill beautiful, aesthetic IPS e.max restorations. The fresh design allows for high precision and convenience due to a self-contained milling system. This distinguishes it from other mills on the market that necessitate separate filtration or suction units. PrograMill One is wireless, which enables it to be positioned anywhere within the practice or dental laboratory. It can be controlled using the mill's corresponding app on a tablet or smartphone.…

12. Page 28

    Spotlight Device Offers Ability to Place Restoration Immediately System's Ability to Process Virtually Any Milling Material Cited SIMI VALLEY, Calif.–Considered to be one of the biggest innovations in dental implants since the early work of P.I. Brånemark, Biodent's Ultratooth is the first and only FDA-approved device that allows you to extract a tooth and replace it with a fully functioning final or provisional restoration at the time of placement. Due to the capability of immediate restoration, Ultratooth preserves the original emergence profile of the tooth, which is essential in the aesthetic zone. Because of the Eiffel Tower design of the…

13. Page 29

    Laser's Variable-Speed Foot Pedal Provides Ability To Cut Any Tissue NEEDHAM, Mass-Convergent Dental's Solea is the first and only laser that can cut any tissue by using a variable-speed foot pedal, giving the user total control. Its revolutionary software is so easy to use that any dentist can become a laser dentist. This simple and seamless technology works for tooth structure as well as bone and soft tissue, enabling dentists to reliably deliver anesthesia-free, blood-free, suture-free, and pain-free results. Simply turn it on, direct the beam at the desired tissue, and step on the variable speed foot pedal. Dentists experience…

14. Page 30

    Spotlight Loupes Blend Aesthetics, Mechanical Design, and Precision Engineering DUNCANVILLE, Texas—Q Optics through the Lens (TTL) loupes are truly customized and not an off-the-shelf system. Each pair is precision made to align to the user's facial features. The proprietary, True Fit Digital Measurement process drives customization and alignment, resulting in industry-leading accuracy and personalization. Q Optics prismatic loupes harmoniously blend aesthetics, mechanical design, and precision engineering producing class-defining optical systems. Experience some of the lightest and most ergonomically correct expanded-field loupes ever introduced. When mounted on the Q Optics Eclipse Titanium frame, total system weight starts at an unprecedented 5.4…

15. Page 31

    System Produces One-Visit Restorations and Digital Orthodontics CHARLOTTE, NC-CEREC AC with Omnicam is a chairside solution designed to accomplish single-visit restorations, digital orthodontics, and integrated implantology. Designed with the dentists' and patients' comfort in mind, the small, rounded, handheld camera is ideal for rotation in the intraoral space and captures lifelike 3-D scans without the use of powder or impression material. The camera system, PC, and screen comprise one mobile unit, making CEREC AC with Omnicam an optimal solution for most dental practices. With easy-to-learn software, detailed instructions guide the user step by step through the scanning, design, and/or production…

16. Page 32

    Spotlight Organizer Kit Provides Unique Storage Solution For Endodontic Files BEAVERTON, Ore—The Endoring File Caddy from Jordco organizer provides a unique bulk storage solution for all endodontic files. The clinician places multiple files securely into the special foam insert, closes the lid, and steam autoclaves the entire Endoring FileCaddy organizer. Single handed operation allows easy opening of the protective lid to access the processed files at chair side. For more information, call Jordco at (800) 752-2812. FREEinfo, EndoRing II Hand-held Endodontic Instrument Reduces the risk of cross-contamination and minimizes the passing of sharps between dentist and staff Enables the clinician…

17. Page 34

    Bulk Fill Composite Ensures Profitability and Aesthetics Figure 1. Estelle Bulk Fill Flow (Tokuyama Dental America) does not require a capping layer. No additional layers or composites are needed up to 4 mm. Figure 2. The preoperative view of teeth Nos. 18 and 19 demonstrate the tired, aged, and failing amalgam restorations in need of replacement. Figure 3. Completed restorations are beautiful and can blend in seamlessly with the surrounding tooth structure. Figure 4. This preoperative photo indicates the significant cervical decay present in teeth Nos. 13 and 12 that may require excavation. Figure 5. The final restoration is highly…

18. Page 36

    Material Choices for CAD/CAM Dentistry Sameer Puri, DDS Thirty-five years ago, Dr. Werner Moorman, along with an engineer named Marco Brandestini, developed the first CAD/CAM system for dentistry. After developing the hardware for the system, Dr. Moorman, who practiced in Zurich, Switzerland, approached the VITA company, which was in nearby Bad Säkingen, Germany, to develop a block that could be milled from his new CAD/CAM system. Composite restorations were becoming more popular as the restoration of choice over amalgam for patients who were concerned about aesthetics. However, Dr. Moorman was seeing mill-failed composites in his practice, as these materials were…

19. Page 38

    Figure 2. The Mark II Block (VITA North America) high-glass block. Figure 3. Anterior aesthetic high-glass porcelain blocks. Figure 4. Multilayered blocks designed to maximize the aesthetic impact. Aesthetic Ceramic Blocks VITA North America Mark II GC America GC Initial Blocks Ivoclar Vivadent IPS Empress CAD Resin-Based Blocks 3M LAVA Ultimate GC America CERASMART 3M Paradigm Coltene BRILLIANT Crios VITA North America VITA ENAMIC Figure 5. Resin nano-ceramic and resin hybrid blocks. Figure 6. VITA ENAMIC (VITA North America) is a hybrid ceramic and is composed of a feldspathic block that has been infiltrated with a polymer component. Material Choices…

20. Page 40

    Figure 7. A lithium disilicate block (IPS e.max [Ivoclar Vivadent]). Figure 8. Celtra Duo (Dentsply Sirona). Zirconia VITA North America VITA Ivoclar Vivadent ZirCAD Dentsply Sirona Zirconia Kuraray America KATANA Figure 9. Zirconia blocks available for CEREC. Material Choices for CAD/CAM... continued from page 38 success when using the blocks for full-coverage restorations. Because the resin component of these blocks is already highly polymerized, one major advantage is that the restorations created with them are less susceptible to the potential polymerization shrinkage that may occur with direct composite materials, depending on the material chosen and following a strict placement protocol.…

21. Page 41

    TECHNOLOGY the middle that allows the blocks to be cemented to a titanium base, which is then screwed into the implant. Ivoclar Vivadent Blocks that can be used for full-contour restorations and cement retained restorations. The size 14 MO (medium opacity) block is ideal for abutments. The medium opacity of the block helps to block out the underlying titanium base. The size 16 LT (low translucency) block can be used for full-contour screw retained restorations. The Telio CAD (Ivoclar Vivadent) block (described further below) can be used for screw retained provisional restorations. Today, virtually any class of material is available…

22. Page 42

    Air-Driven Handpieces George Freedman, DDS Most clinical procedures involve the use of dental handpieces. They are typically in active service for most of the working day. Their efficiency of use, ease of sterilization, and speed of operation impact directly on practice overhead. Considering the long clinical working day, accompanied by a multitude of practice stresses, every little ergonomic bit helps. Dentists must be careful to select handpieces that are specifically appropriate to their practices, tuned to the most frequently performed procedures. Air-driven handpieces must be easy to use, comfortable to manipulate, and intuitive. More specifically, they must provide adequate torque,…

23. Page 44

    AIR-DRIVEN HANDPIECES continued from page 42 Handpiece 360° Swivel A 360° swivel attachment between the handpiece and the hose absorbs and dissipates rotational stresses that can lead to significant operator hand and arm fatigue. Repetitive strain causes cumulative damage during months and years, possibly shortening the practitioner's career. Quick Disconnect Sterilization is something that's mandatory for high-speed handpieces when being used for multiple patients. A quick disconnect saves valuable chairside and assistant time by allowing efficient handpiece replacement between patients. A-dec | W&H Doctors choose air handpieces for the tactile sensation of the bur with applied pressure. A-dec W&H ensures…

24. Page 46

    continued from page 44 patented ceramic bearing retainer extends life, its innovative chuck facilitates easy bur release after heavy cutting, and its distinctive head shaping offers excellent grip and control. For more information, call (800) 800-2888 or visit dentsply.com. FREEinfo, Now with ceramic ball bearings and up to 30W, the T2 and T3 high-speed attachments offer the best in quality, choice, and durability. The T2 line offers 3 different head sizes—mini, Boost, and CONTROL—with available LED illumination. The T3 is available with mini, Boost, or Racer heads and is nonfiberoptic. For more information, call (800) 659-5977 or visit strona.com. FREEinfo,…

25. Page 50

    continued from page 46 This allows you to cut smoothly and confidently without being bogged down. The unique chuck design is capable of holding up to 6 lbs, eliminating the risk of bur slippage and ensuring patient and doctor safety. For more information, call (866) 234-0950 or visit medidenta.com. FREEinfo, MK-dent Germany The HC20KL - Power Edition is the latest innovation from MK-dent. It features an incredible 30V of torque at only 170,000 rpm, which allows efficient cutting without stalling. The groundbreaking turbine is equipped with MK-dent's integrated carbide technology and highest grade ceramic ball bearings for long-term durability. It…

26. Page 52

    Spotlight Composite Offers Faster and Simpler Single-Increment Restorations ENCINITAS, Calif.-New from the makers of Estelite Sigma Quick, Tokuyama Dental America is proud to announce the launch of Estelite Bulk Fill Flow, a new flowable bulk fill composite that is aesthetic and strong all on its own—no capping layer is needed. Further improving on the speed offered by other flowable bulk fills, Estelite Bulk Fill Flow requires no additional composites for outstanding aesthetics and strength. It offers faster and simpler single-increment restorations up to 4 mm. Utilizing the Estelite Spherical Filler technology, Estelite Bulk Fill Flow provides more natural-looking bulk fill…

27. Page 54

    Spotlight Toothpaste's Formula Promotes Healthy Gums and Teeth LANCASTER, NH–Dental Herb Company introduces Tooth & Gums Essentials, a truly natural toothpaste formulated for daily brushing to promote healthy gums and teeth. With a blend of powerful essential oils and herbal extracts, Tooth & Gums Essentials can reduce harmful bacteria and inflammation commonly associated with unhealthy gums. Additionally, Tooth & Gums Essentials contains xylitol and aloe for their proven oral benefits and protection. Use alone in combination with the award-winning Tooth & Gums Tonic rinse. Tooth & Gums Essentials is available in 4 oz tubes and trial packs. For more information,…

28. Page 56

    Spotlight Matrix Band Provides Easier Placement and Improved Visibility MONTREAL–AMD Medicom's Pro Matrix is a next generation matrix band designed to meet the evolving needs of dentistry, including simplifying procedures through easier placement and improved visibility. Available in 2 sizes, 6 mm and 4.5 mm, the Pro Matrix has a sliding band deflector and a smooth tightening mechanism. All you have to do is slide it in and turn. The wider blue ones are used for permanent molars, while the narrower green ones are used for pedo teeth and premolars. They're suited for single patient use, so the cleanup is…

29. Page 58

    Device Finds Submerged Implants Spotlight Desensitizer Uses a Chelation Reaction to Fuse to Hydroxyapatite Molecule in Tooth Structure IRVINE, Calif.–KöR's Complete Desensitizer is a unique, oxalate desensitizer that strongly fuses to hydroxyapatite molecules of highly mineralized enamel (96% mineral) and peritubular dentin (92% to 93% mineral) to provide immediate closure of open dentinal tubules. Unlike oxalate desensitizing products that simply clog up the open orifices of dentinal tubules, the Complete Desensitizer reacts with, and fuses to, the hydroxyapatite molecule in tooth structure via a chelation reaction. This forms a durable compound of calcium oxalate mineral crystals fused to peritubular hydroxyapatite,…

30. Page 59

    Flowable Composite Offers Excellent Handling, Ease of Placement, and Enhanced Regenerative Properties SCHAUMBURG, Ill.–BISCO Dental Products' TheraCal LC is a radiopaque, light-curable flowable composite containing "apatite-stimulating" calcium silicates to protect and stimulate pulpal and dentin repair. It is the ideal replacement for calcium hydroxide, glass ionomer based, or RMGi materials due to its excellent handling, ease of placement, and enhanced regenerative properties. TheraCal LC performs as a barrier and protectant of the dental pulp complex. With high physical properties and low solubility immediately following light-curing, TheraCal LC is ideally suited for all deep cavity preparations. Ease of placement is facilitated…

31. Page 60

    Oral-Adhering Discs Release Effective Level of Xylitol to Alleviate Dry Mouth SEATTLE-OraCoat's XyliMelts for dry mouth are all-natural, great tasting, oral adhering discs that slowly release 550 mg of xylitol and oral lubricant to coat, moisturize, and lubricate dry mouths day and night while reducing the risk of tooth decay. They are the only dry mouth remedy for use while sleeping, the time when dry mouth is at its worst. To produce acres, XyliMelts slowly release an effective level of xylitol while sleeping, when saliva flow is lowest. Additional benefits of XyliMelts include: (1) a noncidic pH of 8.1; (2)…

32. Page 61

    Spotlight Digital Dental Platform Improves Efficiency and Patient Care METUCHEN, NJ–TeleDent by MouthWatch, the all-in-one teledentistry platform, has been field tested in public health settings and is now poised to revolutionize private practice dentistry. With TeleDent, patient data, clinical information, intraoral images, and video can be shared live or recorded and stored for review later. The system enhances referrals, consultations, and collaboration between general practitioners and specialists, group practice locations and hygiene settings, and even between dentists and physicians. The result is improved efficiency, increased profitability, and an elevated standard of patient care. What's more, TeleDent takes care of HIPAA…

33. Page 63

    INNOVATIONS 63 Spotlight Hot Refreshment Towels Increase Patient Satisfaction FORT WORTH, Texas—Patients judge your practice—and you—by the way they are treated. Watch patient satisfaction increase dramatically, along with referrals, thanks to steaming hot refreshment towels from White Towel Services. They are available in 100% cotton or synthetic. The towels are premoistened, individually wrapped, single-use, and scented with essential oils. For more information, call White Towel Services at (817) 868-7900 or visit wtowel.com. FREEinfo, CAD/CAM Blocks Offer Enhanced Marginal Integrity and Overall Longevity INDIAN LAND, SC—VOCO's Grandio blocs are a new, 86%-filled, nanoceramic resin hybrid CAD/CAM blocks indicated for crowns, inlays/onlays,…

34. Page 64

    NEWS/TRENDS Industry News Glidewell Dental Names Brenneise VP of Sales Glidewell Dental has named Robert Brenneise its vice president of sales, CAD/CAM. Brenneise has more than 25 years of experience in the implementation and development of sales strategy for some of the most well-known brands in the dental industry, including VIAX Dental Technologies, Dental Lab Holdings, Experience Dental Studio, and DenMat. Glidewell Dental reports. His new initiatives at the company include leading its approach to elevating same-day dentistry through the glidewell.com Office Solution. For more information, visit blog.glidewelldental.com. Robert Brenneise Baldwin Named Director of Sales at Air Techniques Air Techniques…

35. Page 66

    NEWS/TRENDS Canary System Measures Lesion Depth More Accurately Than Other Methods Assessing the size of the area that tooth decay can impact is a major clinical challenge. Visually, the area may appear as a white or brown spot, but what's going on beneath the surface is difficult to tell. The Canary System from Quantum Dental Technologies, however, measures caries lesion depth more accurately than other methods, according to a recent study. The researchers correlated the lesion depth of natural cavities measured with Polarized Light Microscopy to Canary Numbers derived from the Canary System, numerical readings from DIAGNOdent, and lesion scores…

36. Page 68

    NEWS/TRENDS Disparities Affect Orthodontic Treatment Completion in Appalachia Orthodontic care, including braces, bite plates, and retainers, typically costs between $3,000-$8,000. But only half of the orthodontia patients in Appalachia complete their treatment, reports the West Virginia University School of Dentistry. By more accurately predicting which patients may have more difficulty finishing treatment, though, researchers believe dentists and orthodontists can intervene. The researchers examined 5 years of data from a general dentistry office in rural West Virginia and looked for patterns in who did or didn't complete treatment. Of the 219 patients whose treatment plans and follow-ups were reviewed, only 49.8%…

37. Page 69

    NEWS/TRENDS 69 Bisphosphonates May Trigger Dental Implant Failures Postmenopausal women often suffer from osteoporosis and its resulting loss of bone mass and strength. While bisphosphonates (BPs) help slow or prevent these effects, they also may affect the mandible and lead to failed dental implant surgeries, report Kanagawa Dental University Hospital and Tokyo Medical and Dental University. Researchers evaluated the bone mineral density and cortical bone thickness of the mandible as well as how long-term BP therapy affected early implant failure in 25 female patients age 60 years or older who had dental implant surgery in the mandible between January 2010…

38. Page 70

    MEETINGS/SEMINARS A Whirlwind of CE at the HINMAN Meeting Approximately 19,500 people are expected to attend the 106th Annual Thomas P. Hinman Dental Meeting (HINMAN), which is being held from March 22 to March 24 at the Georgia World Congress Center in Atlanta. The purpose of the HINMAN Meeting is to provide a very large and comprehensive continuing education experience. Available courses cover topics such as practice management, restorative dentistry, oral surgery, dental assisting, patients with special needs, aesthetic dentistry, maxillofacial injuries, case acceptance, implants, endodontics, airway problems, bleaching, fillers, oral cancer, periodontics, forensic dentistry, oral pathology, anesthesia, lasers, and…

39. Page 72

    Oral Pathogens Predict Precancerous Stomach Cancer Lesions Elevated pathogen colonization and a lack of bacterial diversity in the mouth were identified in people with precancerous lesions that could lead to stomach cancer, according to a study led by the New York University College of Dentistry and the New York University School of Medicine. The findings provide new evidence that the increase in pathogens associated with periodontal disease could contribute to the development of precancerous lesions of stomach cancer. Although some risk factors such as Helicobacter pylori colonization, cigarette smoking, and eating salty and preserved foods have previously been confirmed to…

40. Page 73

    CLINICAL UPDATE 73 Bacterium to Blame for Rampant Caries in Certain Children Researchers at Umeå University in Sweden have made a novel discovery connecting highly virulent types of the caries bacterium Streptococcus mutans and their adhesive function to children with rampant caries and increased risk of dental caries. The results, which can lead to a better way of identifying high-risk patients and treating their caries, were published in the journal EBioMedicine. In a 5-year study, in which saliva from a large number of children was analyzed and their dental health monitored, researchers established that high-risk children have a more virulent…

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