Dentistry Today — February 2019

Inside this issue

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1. Page 8

   Game-Changing Advancements Each February, Dentistry Today has traditionally focused on "new directions," and this year is no exception. This particular overall topic emphasis is deliberately placed in the same month as one of the most well-attended dental meetings in the country, the Chicago Dental Society's 154th Midwinter Meeting. It is no coincidence that, at this major and strategically located dental meeting in North America, manufacturers find the event to be a natural fit for the introduction of any new products and innovative techniques. With this in mind, it should be no real surprise to learn that several of the clinical…

2. Page 10

   Culture of Gratitude Recently, over lunch with an old friend of mine, we were talking about his challenges in presenting workshops in health centers that were designed to provide assistance in how to follow guidelines that were clearly laid out by the Health Resources Service Administration, an agency of the US Department of Health and Human Services. After some conversation that left us in the weeds of abstraction, we both realized that the problem with connecting to folks in a deep way was not a technical issue. The subject matter was clear, the guidelines were clear, but something was getting…

3. Page 12

   VIEWPOINT continued from page 10 The Leader Let me start with the role of the practice leader. This person has to truly believe that the day of "command and control" leadership (you know, the kind that screams "I'm up here and you are down there") is dead. This old concept of leadership is certainly near the final curtain, but its replacement is still trying to figure out how to do this leadership thing. Let me offer some suggestions: • Read the work of Robert Greenleaf on Servant Leadership (greenleaf.org). He posits that to be a good leader, one first has…

4. Page 14

   Bio: Jack T. Krauser, DMD, was a scholar athlete in college. He attended the University of Pennsylvania School of Dental Medicine, followed by Boston University for advanced training in periodontics. He is a Fellow in the prestigious Academy of Osseointegration and has lectured in 6 continents on more than one occasion. He is the coauthor of the implant textbook Dental Implants: The Art and Science. Dr. Krauser is a member of the National Association of Dental Laboratories because he loves to merge the newest surgical concepts with the newest prosthetic materials. He currently runs an exclusive implant practice focusing on…

5. Page 16

   FOCUS ON: Infection Control John A. Molinari, PhD, discusses the past, present, and future of infection control precautions. Wouldn't it be interesting to observe how a dentist, a hygienist, and an assistant from a circa-1980 practice would react if they were transported in a time machine into a 2019 dental practice? Chances are they would be very surprised by the additional precautions and procedures that today's dental professionals perform on a daily basis. The following discussion will attempt to briefly review a few of the changes they might notice. Personal Protection The first and most obvious difference they would see…

6. Page 18

   Fuji Automix LC: Providing Simple and Reliable Bioactive SMART Restorations John Frachella, DMD Public health pediatric and family dentists see many patients per day, making the speed, efficiency, and ease of efficacious caries preventive materials important. To encourage patient compliance with regular dental appointments, atraumatic dental protocols are significant in treating caries as the first approach, rather than surgical interventions that often lead to dental phobias and/or recurrent decay. Silver diamine fluoride (SDF) and glass ionomers (GI) are components of Silver Modified Atraumatic Restorative Treatment (SMART), a minimally invasive approach for treating caries in vital, asymptomatic teeth. SDF and GIs…

7. Page 20

   CLINICAL REVIEWS DA DENTAL ADVISOR ASAP INDIRECT+ ★★★★★ (91%) CLINICIAN'S CHOICE Dental Products | (800) 263-3444 | cliniciancschoice.com Consultants' Comments • "Easy to use, efficient polishing, and great results." • "It's easy to retain the surface anatomy with these polishers." • "I used it on zirconia crowns, and it never was great." • "The adjusters were very effective." • "The spiral wheels adapt well to all surfaces and can get into tight areas." • "I like that you can attach it to a latch slow-speed handpiece for intraoral use." • "The polishers left a surface that was almost better than…

8. Page 22

   Make Me Smile Paul Fuerstein, DMD Everyone will have to find his or her comfort zone on how far to let computers run the treatments. It is surely an interesting journey we are on. How many times have we heard the phrase "I want to improve my smile?" In many situations, the patients' idea of what they want might be totally different from our natural response. Sometimes it is as simple as wanting a whiter smile. The definition of "white teeth" to many patients is also far different from ours. Some of these patients are still bleaching their veneers in…

9. Page 24

   Spotlight System's Innovations Enable Users to Produce High-Quality Images ATLANTA—Carestream Dental's 9600 features breakthrough innovations that enable users to produce high quality images regardless of their level of experience. Video cameras, not lasers, provide live positioning feedback on the built-in SmartPad. Interactive guides are superimposed onto an image of the patient's face so users can properly position them, which aids in capturing accurate scans the first time, as well as with repeatability. Additionally, the CS 9600 includes patented metal artifact reduction algorithms—CS MAR—that lead to better image quality and even let users compare images live with and without a filter…

10. Page 26

    Spotlight Digital Treatment Planning Service Helps Clinicians Perform Implant Surgery NEWPORT BEACH, Calif.–Glidewell Laboratories is now offering digital treatment planning and surgical guide fabrication to implant dentists. Pairing the dental lab's restorative expertise with 3-D treatment planning technology, the new DTP service is devoted to helping clinicians perform implant surgery with maximal safety and predictability while maintaining a prosthetically driven approach throughout treatment. Cases, including a full-arch CBCT scan and a digital or physical impression, can be digitally uploaded via the My Account feature, and shipped to the lab. Available for most major guided surgery systems, the DTP service combines…

11. Page 27

    Handpiece's Coating Creates Firm, Controlled Grip HOFFMAN ESTATES, ILL- NSK Dental features an ultra-premium line of air turbines, the Ti-Max Z handpiece line. The handpieces are engineered for maximal durability, consistent performance, smooth cutting, and optimal access to all areas of the mouth. The standard head Ti-Max Z900L delivers a profession leading 20 W of power and operates between 330,000 and 400,000 rpm. A proprietary, specially shaped turbine makes these power outputs possible and enables fast cutting for reduced treatment time. There's also a smooth, consistent cutting feel for comfortable operation. The handpieces feature solid titanium bodies. The ergonomic shaped…

12. Page 28

    Restoring Anterior Trauma With Root Submergence Maintaining the Alveolar Ridge to Maximize Long-Term Success Michael J. Skramstad, DDS INTRODUCTION One of the biggest challenges we have as dentists is treating dental alveolar trauma. Not only are the patients often in pain, but they are emotional over the fracture and/or loss of teeth. From a dentist's perspective, the most difficult part is often treatment planning the best long-term solution for the patient. There is a need to balance the immediate expectations of the patients with what is in his or her best long-term interests. When evaluating the trauma, the number of…

13. Page 30

    Restoring Anterior Trauma With... continued from page 28 lingual fracture was at the alveolar crest, and the root length was not sufficient to extrude the tooth the necessary 4.0 mm to establish a proper ferrule. Tooth No. 9 was also fractured extensively down the lingual, but it was likely that it could be restored. Since the patient was not interested in implants until after his career was over, a treatment plan was created to not only address his immediate concerns but also to provide options for the future. The decision was made for endodontic to be performed on both teeth.…

14. Page 31

    TECHNOLOGY 31 The final IPS emax CAD MT cantilever bridge was milled, contoured, and glazed chairside and bonded into place with 35% phosphoric gel (Ultra-Etch), a universal adhesive (Adhese [Ivoclar Vivadent]), and light-cure resin (Variolink Esthetic LC Neutral [Ivoclar Vivadent]). A 2-month postoperative visit showed a nice esthetic result and, more importantly, maintenance of the soft-tissue architecture around the pontic area (Figure 12). CLOSING COMMENTS The RST, an often underutilized procedure, is an excellent way to prevent the biological resorption of alveolar bone. It can help maintain the dimension of the alveolar ridge and surrounding tissues. It is especially effective…

15. Page 32

    Spotlight Desensitizer's Effectiveness for Any Clinical Requirement Cited IRVINE, Calif.–KoR Whitening'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, KoR Complete 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, 7 to 12 μm deep within dentinal tubules. In addition…

16. Page 34

    Spotlight Universal Composite Matches All Patients' Tooth Shades ENCINITAS, Calif.-Tokuyama Dental America's OMNICHROMA is the first universal composite that matches every patient's tooth shade, from A1 to D4, with a single shade of composite. This revolutionary composite has been developed through the culmination of 35 years of research and development experience. OMNICHROMA's innovative technology utilizes structural color to match every tooth shade. Its 260-nm fillers are the precise shape and size necessary to generate red-to-yellow structural color as ambient light passes through the composite. The red-to-yellow color combines with the reflected color of the tooth's surrounding dentition, resulting in a…

17. Page 36

    Spotlight Gel Fights Harmful Bacteria and Inflammation LANCASTER, NH—Dental Herb Company's PerioSpot is a new, powerful gum therapy gel designed to fight harmful bacteria and inflammation directly on the spot. Formulated with the same truly natural ingredients as Dental Herb Company's award-winning Tooth & Gums Tonic, this sticky gel can be placed directly on the affected site to provide an antimicrobial boost where the gums need it most. PerioSpot is perfect for stubborn inflammation after or to enhance preventative care after dental procedures. It is indicated for in-office, post-procedure treatment and patient home care. For more information or to request…

18. Page 37

    INNOVATIONS 37 Desensitizing Solution's Antimicrobial Action Increases Bond Strength LAKE ORION, Mich.-Advantage Dental's HS&C has been rated the best overall desensitizer in a study of o products because of its antimicrobial action (4% chlorhexidine with HEMA), increase of bond strength, and nonirritating compatibility with soft tissue. It can be used in deep carious lesions at a fraction of the price of the glutaraldehyde products. When combined with a self-etch or total-etch adhesive, it provides no-excuse performance. For more information, call Advantage Dental at (800) 388-6319 or visit advantagedentalinc.com. FREEinfo, Strips Provide Ability to Perform Any Amount of Interproximal Reduction VANCOUVER,…

19. Page 38

    Top Innovative Products Dentistry Today's Third Annual Top Innovative Products are selected based on lead generation. These products appeared in our Innovations section throughout the past year. Booth numbers for the Chicago Dental Society's 154th Midwinter Meeting are included. Owandy Radiology Sleek and Lightweight 3-D System Mounts to Wall When it comes to owning a 3-D panoramic digital radiography unit, cost and physical space are the most common obstacles for many dentists. The I-Max 3D effectively addresses both issues, which is why it is selling briskly in many other parts of the world. The I-Max 3D provides a perfect balance…

20. Page 40

    Top Innovative Products Zest Dental Solutions Cement Demonstrates Exceptional Bond Strength, Reliable Adhesion Cem EZ is an award-winning, dual-cure resin cement that is delivered in generous 2- x 5-g automix syringes with ready-to-use mixing tips. Indicated for a permanent luting of crowns, inlays/onlays, and posts fabricated from zirconia and lithium disilicate, Cem EZ demonstrates an exceptional bond strength, reliable adhesion with optimal viscosity, and easy cleanup in a simple tack-cure procedure. Featuring the company's proprietary Intellitek Technology, which is proven to eliminate gap formation and microleakage, Cem EZ facilitates restorations that are reliable and clinically functional long term. And, for…

21. Page 42

    Top Innovative Products Glidewell Laboratories Zirconia Exhibits Natural Vitality BruxZir Esthetic Solid Zirconia for dental crowns and bridges is an all-new formula developed from the industry-leading BruxZir Solid Zirconia. BruxZir Esthetic Zirconia is a strong and profoundly beautiful material unique enough to represent a new category of dental ceramic. Benefiting from advancements in Glidewell Laboratories' proprietary colloidal fabrication process, BruxZir Esthetic Zirconia exhibits natural vitality and enhanced shade consistency, resulting in incredibly lifelike restorations. Along with its impressive aesthetics, the material boasts an average flexural strength of 870 MPa and requires minimal tooth preparation of only 0.7 mm. For more…

22. Page 44

    Top Innovative Products Align Technology Scanner Transforms Restorative and Orthodontic Workflows Designed to work with the trusted iTero digital platform, the iTero Element 2 scanner transforms restorative and orthodontic workflows using next-generation computing power. With startups that are twice as fast and 25% faster scan processing time than the original iTero Element scanner, one can now streamline digital workflow and chairside consultations. The comprehensive offering includes laboratory workflows, custom-milled models, open STL export, custom implant abutments, and chairside milling. The improved 21.5-in monitor and 16:9 widescreen viewing format enhances screen resolution while minimizing scanner footprint. This enables one to visualize…

23. Page 46

    Top Innovative Products KöR Whitening Desensitizer Strongly Fuses to Hydroxyapatite Molecules The 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 openings of dentinal tubules, KöR Complete 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, 7 to 12 μm deep within dentinal tubules. In addition…

24. Page 48

    Top Innovative Products Pulpdent Composite Contains Resin Component and Bioactive Fillers Mimicking Teeth ACTIVA BioCACTIVE is a highly esthetic, bioactive composite that delivers all of the advantages of glass ionomers in a strong, resilient, resin matrix that will not chip or crumble. It (1) chemically bonds to teeth; (2) seals against microleakage; (3) releases and recharges calcium, phosphate, and fluoride; and (4) is more fracture resistant than composites. This versatile restorative material can be used for all classes of restorations and on patients of any age. ACTIVA BioCACTIVE contains a shock-absorbing resin component and bioactive fillers that mimic the physical…

25. Page 49

    Directa Dental Periodontal Ligament Knives Ease Tooth From Socket Luxator instruments are periodontal ligament knives used to aid in atraumatic extractions. The fine tapered blade compresses the alveolar bone, cuts the membrane, and eases the tooth from its socket. The handle is designed for tactile control while minimizing force during use. The tip is thin and sharp so it inserts easily between bone and root with minimal damage to the tissues. The instrument handles are color-coded and numbers are marked on the shaft for identification. For more information, call (203) 491-2273 or visit directadental.com. CDS BOOTH NUMBER: 3407 FREEinfo, Essential…

26. Page 50

    Top Innovative Products Brasseler USA Handpiece Designed for Maximal Durability and Performance The NLXS high-speed air handpiece is designed for maximal durability and performance. The innovative turbine design provides up to 26 W of power, resulting in smoother cutting efficiency while reducing procedure time. Precision manufacturing and enhanced bearing technology offer improved durability backed by an industry-leading 3-year warranty. Equipped with ComfortGRIP coating, lightweight titanium construction, and a thin neck design for improved visibility, the NLXS delivers a powerful performance. For more information, call (800) 841-4522 or visit shop.brasselerusa.com. CDS BOOTH NUMBER: 2202 FREEinfo, Impladent Ltd Bone Grafting Plug Works…

27. Page 52

    Top Innovative Products Beyes Dental Canada High-Speed Handpiece Delivers Innovative Features This premium high-speed model delivers some of the best and most innovative features. The AirLight M800X's instant-stop capability eliminates the dangers of backflow and accidental injury when the unit is turned off. It also includes a built-in generator with a bright direct LED light—no need for a fiberoptic system. Enjoy maximal accessibility and visibility with the M800X's mini-sized head and one of the brightest lights available on the market. It is extra quiet and features a nonslip, stainless steel body; X ball bearings in special coating material for extended…

28. Page 53

    ContacEZ Instruments Remove Guesswork From Crown Preparations PrepSure is a set of 3 innovative crown prep instruments to monitor and confirm ideal reduction of tooth structure for crowns and onlays. Achieve ideal abutments with proper occlusal, buccal, lingual, and gingival clearances by evaluating with PrepSure while reducing dental structure with burs and discs. These ergonomic instruments remove all of the guesswork from crown preparations, making them essential for improving accuracy and efficiency. The instruments are available in 1.0-, 1.5-, and 2.0mm sizes to work with all common crown materials. PrepSure brings quality dental care to every patient by preventing the…

29. Page 54

    Top Innovative Products BISCO Dental Products Resin Cement Indicated for Luting Various Objects TheraCem is a dual-cured, calcium and fluoride-releasing, self-adhesive resin cement indicated for luting crowns, bridges, inlays, onlays, and all types of posts. Delivering a strong bond to zirconia and most substrates, along with easy cleanup and high radiopacity. TheraCem offers clinicians reliable and durable cementation of most indirect restorations. Due to innovative chemistry, it achieves a high degree of chemical conversion, which ensures high physical strength. TheraCem allows clinicians to simplify their cementation protocols, decrease chair time, and increase longterm peace of mind while providing patients with…

30. Page 56

    Top Innovative Products DMP USA Nanohybrid Composite Offers Extremely Low Water Sorption Properties With NANOCERAM BRIGHT's adaptive chameleon-like technology, one can easily and confidently create long-lasting, natural-looking restorations that patients won't stop raving about. For more than 30 years, DMP has developed an innovative manufacturing process that integrates a unique blend of microand nano-fillers into the resin matrix, creating an easy-to-sculpt nanohybrid composite for Class I to IV restorations. Adaptive chameleon-like technology achieves excellent color matching, high polishability, and lifelike translucency, allowing the restoration to blend into the natural tooth structure and surrounding area. NANOCERAM BRIGHT outperforms the competition with…

31. Page 57

    PROVEN PERFORMANCE ◆ AWARD-WINNING QUALITY DMP Composites DENTISTRY TODAY TOP Innovative Products 2019 QwikStrips Serrated Strips Designed to Prevent Soft-Tissue Injuries The industry-leading Qwik-Strips are an interproximal solution for removing cement from between teeth and also for creating the precise spacing needed (IPR) for minor tooth movement. The challenge of removing cement after cementation of crowns, inlays, onlays, and veneers has been answered. QwikStrip serrated strips were designed to make cleaning simple and safe. The depth limiting design prevents soft-tissue injuries, while the unique handle provides a comfortable grip for optimal tactile control, giving doctors easy access to interproximal spaces.…

32. Page 58

    Top Innovative Products VOCO America Restorative Material Reduces Shrinkage and Shrinkage Stress Admira Fusion is the world's first all-ceramic-based direct restorative material. It is a universal, nano-ORMOCER (Organically MOdified CERamic), pure silicate technology (the fillers and matrix are based purely on silicon oxide) that offers enhanced physical properties and more aesthetic results for today's dentist. This groundbreaking technology reduces shrinkage and shrinkage stress by up to 50% compared to conventional composites. Its nano-ORMOCER technology utilizes none of the classic monomers (no BisGMA, UDMA, TegDMA, HEMA, etc), creating an entirely new level of biocompatibility for its users, and it has a…

33. Page 59

    Top Innovative Products OraCoat Oral-Adhering Disc Coats, Moisturizes, and Lubricates Dry Mouth 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 a dry mouth, day and night, and reduce the risk of tooth decay. They are the only dry mouth remedy for use while sleeping when dry mouth is worst. To reduce caries, XyliMelts slowly release an effective level of xylitol while sleeping when saliva flow is lowest. Additional benefits of XyliMelts include (1) a nonacid pH of 8 to neutralize acids, (2) the ability…

34. Page 60

    Top Innovative Products Dentsply Sirona Restorative System Offers Powerful and New Way to Deliver Low-Viscosity Materials The digit Power Dispenser provides a powerful and radically new way to deliver low-viscosity materials. It is a battery-powered, precision delivery system for Aquasil Ultra+ material's low-viscosity products available in digit power cartridges and is available for purchase through approved Dentsply Sirona distributors. Developed with input from clinicians around the world, digit Power Dispenser tackles the key challenges present during the final impression taking procedure—access, visibility, precision, control, predictability, material waste, and compliance. Current low-viscosity impression delivery systems are built around the material—not the…

35. Page 62

    Top Innovative Products DrQuickLook Dental Tablet Allows Users to Easily Transfer Data The PDA Dental Tablet Works right out of the box and stores patients by name. Place it in your patients' hands to bring your diagnoses to life. Watch your case acceptance soar as patients see what you see with crisp intraoral and extraoral images captured on a large touchscreen. The tablet's not dependent on computers or unpredictable integration, yet users can easily transfer data with the included thumb drive to any practice software or any computer or Wi-Fi to your network. For more information, call (888) 346-6153 or…

36. Page 63

    Top Innovative Products Sentry Dental Products System Offers Ability to Customize Teeth Whitening Program The Sentry White 50 Pack provides a convenient, economical, and professional way to customize your teeth whitening program. Each syringe is individually packaged with a set of patient instructions. Highly flavored carbamide peroxide gel is available in 10%, 16%, 22%, and 30% options to address individual patient needs. Fast treatment times of 15 minutes to 2 hours will optimize patient compliance, comfort, and esthetic results. Improve your teeth whitening program with this unbeatable value. For more information, call (800) 603-1224 or visit sentrydental.com. FREEinfo, TAUB Products…

37. Page 64

    Top Innovative Products Perio Protect Trays Deliver and Hold Medication Deep Into Periodontal Pockets Harness the power of oxygen with prescription Perio Tray delivery of 1.7% hydrogen peroxide. The FDA-cleared Perio Tray has internal peripheral seals to deliver and hold medication deep into periodontal pockets. The trays are ideal for patients with generalized pocketing or struggling with maintenance and for cosmetic, restorative, and geriatric cases. Research shows Perio Tray delivery of 1.7% hydrogen peroxide and SRP achieves better results than SRP alone. Hygienists note reductions in inflammation and pocket depth scores while also reporting more efficient appointments. Perio Trays are…

38. Page 66

    Top Innovative Products Eclipse Loupes Loupes Provide Option to Be Adjusted for Any Case The Custom Prism Loupe has magnifications ranging from 4.0x to 6.0x as a high-powered, efficient set of loupes for all dentists. The expanded field of view allows a full-mouth or single-tooth focus and has adjustability for each case. These loupes are fully customizable to the dentist's need. Ergonomic and light, the Custom Prism Loupe is an important tool in the operatory. There is a lifetime warranty on all loupes. For more information, call toll-free at (877) 585-4045 or visit the website located at eclipseloupeandproducts.com/loupes. CDS BOOTH…

39. Page 67

    Top Innovative Products Nacera Zirconia Provides Natural-Looking Vitality Nacera Q3 ultratranslucent, multilayer, 600-MPa zirconia has been designed and manufactured by the same engineers responsible for the high-strength, precision zirconia parts found in BMW, Mercedes, and Bugatti automobiles. Relying upon color spectrometers to verify shades and translucency, the precise manufacturing methods provide natural-looking vitality and make full-contour zirconia not only one of the most predictable ceramics available but now one of the most aesthetic. Unlike other materials, Nacera Q3 is manufactured with a natural shade transition from the gingival to the occlusal/incisal where the shade simultaneously lightens and decreases in intensity…

40. Page 68

    Top Innovative Products Enzyme Industries Cleaning Solution Improves Life of Instruments Sani-Soak Ultra is a dual-purpose, anticorrosive enzymatic cleaner that can be used in an ultrasonic unit and as a wet evacuation cleaner. Offered in 2 scents, Lemongrass Lavender and Cool Mint, it is highly concentrated, nontoxic, biodegradable, safe for the environment, and effective in removing organic debris while improving the life of instruments and burs. Multiple dispensing options are offered for ease of use and added convenience. For more information, call toll-free at (888) 236-9963 or visit enzymeindustries.com. FREEinfo, The Ultimate 3-in-1 Solution! sani-street plus Enzymatic Cleaner ✓ Evacuation…

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