Dentistry Today — January/February 2021

Inside this issue

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

1. Page 6

   Beginnings Welcome to 2021, and I hope we will all be seeing a bright new year. Enough has been written and said about your know what, and now we must get back on track. It has been an honor to have worked with Dr. Damon Adams for these past years, and he taught me a lot about dentistry as well as the inner workings of the publishing side of a dental magazine. Since the beginning of YAK, I have made my presence felt in these pages with at least one technology column every month (more than 240, but who's counting?),…

2. Page 8

   How Dentistry Continues to Struggle to Be Inclusive The demographic numbers are changing in dentistry. From a policy standpoint, dentistry looks pretty good on paper. The ADA, for example, reports a large increase of women and minorities who are entering and graduating from dental schools. In 2001, 16% of the dentists in the United States were women, and in 2019, 33.4% of US dentists were women.¹ In terms of representation of the US population in dentistry, women still lag behind. Women represent only 33.4% of dentists yet make up 50.8% of the population. With the exception of Asian Americans, ethnic…

3. Page 9

   knowledge, take an implicit bias test, and uncover what perceptions you may unknowingly possess, and with this knowledge, be more intentional in day to day activities. Caring4Health explains the original well-known test called the Harvard Project Implicit: "Harvard's Project Implicit developed The Implicit Association Test (IAT). The test, created 20 years ago, measures social attitudes and beliefs that people may be unwilling or unable to realize. "The various implicit bias assessments focus on gender, race, skin color, weight, and more. There is no Implicit-Lean focused test, though."5 These kinds of tests have their limitations and can yield surprisingly under-standing the…

4. Page 10

   Defining the Patient Experience Bruce V. Freeman, DDS, DOrtho, MSc, answers some common questions about developing empathy and putting patients at ease. Q: How do we define the patient experience? A: When I hear this question, I think of the poet Elizabeth Barrett Browning, who wrote "How do I love thee, let me count the ways" when thinking about her feelings (so history guesses) for Mr. Browning. The patient experience is one of those concepts for which everyone has different ideas on what it is all about. Everyone on the clinic team may think they know what is best, but…

5. Page 12

   Sterilizer's Technology Delivers Bone-Dry Loads to Protect Patients, Mitigate Risk NEWBERG, Ore.—A dec allows for some of the best sterilization practices with the Lexa Sterilizer from W&H. Patented vacuum technology delivers bone-dry loads to help protect patients and mitigate risk. The large capacity makes it easy to combine loads and customize cycles, increasing efficiency. Closed-door vacuum drying keeps the door locked throughout entire cycle. A single-use water system ensures water is never reused. The system sterilizes and dries loads in as little as 30 minutes. Its 11-in diameter chamber holds up to 18 lbs of dental instruments. Six pre-programmed and…

6. Page 14

   Digitally Designed, 3D-Printed Solution Combats Effects of Bruxism NEWPORT BEACH, Calif.—The Comfort3D Bite Splint from Glidewell is a digitally designed, 3D-printed occlusal splint. This new addition to the company's family of preventive products will help dentists provide their patients with a reliable and cost-effective solution for the effects of bruxing and clenching. In addition to keeping healthy dentition safe from the damage of bruxism, the Comfort3D Bite Splint can also be prescribed to protect dental restorations, such as veneers, crowns and bridges, and implant prostheses. The Comfort3D Bite Splint comes in a clear color and covers the full occlusal plane…

7. Page 16

   Radiometer Allows Testing of Curing Lights at Any Time HALIFAX, NS, Canada–Bluelight Analytics announced it is joining forces with 3M Oral Care to introduce the Bluelight CheckUp Radiometer to help dentists improve the outcomes of their restorative procedures. Dentists rely on restora­tive procedures for about half of their income (data file), and yet they often overlook the impor­tance of light curing to the success of those procedures. Patient care can be compromised, and a den­tist's reputation and revenue can be put at risk in those crucial few seconds when they rely on their curing lights. CheckUp offers a solution that…

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   SPECIAL ADVERTISING SECTION 17 CASE STUDY A Clinician's Positive Results Using the Ortek-ECD A 22 year-old patient came to the office complaining of tooth sensitivity when eating sweets. Clinical examination showed obvious decay in the disto-occlusal pit on the maxillary first molar (Figure 1, site 3). Upon further examination, the mesio-occlusal pit (Figure 1, site 2) was suspicious, but there was no evidence of cavitation from visual and radiographic methods, making a treatment decision difficult. A second mesio-occlusal pit appeared sound (Figure 1, site 1). This case was ideal to evaluate the digital caries score indicated by the Ortek-ECD, as…

9. Page 18

   New Scan Bodies Simplify Digital Impression Process for Implant Restorations NEWPORT BEACH, Calif.—Following extensive research and development, as well as manufacturing innovations, Glidewell has released newly designed scan bodies that simplify the digital impression process for implant restorations. The new Hahn Tapered Implant Titanium Scan Body and the Inclusive Titanium Scan Body, available for most major implant systems, are produced from medical-grade titanium with features designed to streamline the restorative process. Suitable for use in the anterior and posterior, the new scan bodies feature a microtextured surface that does not require powder or sprays. They are also durable and can…

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    Endodontic Instrumentation System Provides Unparalleled Root Canal Treatment SOUTH HACKENSACK, NJ—SafeSiders HF from Essential Dental Systems is a patent-pending rotary endodontic instrumentation system designed with a relieved helical flat that rotates in the opposite direction of the cutting flutes. This relieved helical flat, along with a proprietary NiTi treatment process, provides the dentist with unparalleled root canal treatment. Its advanced features include (1) being highly resistant to breakage, (2) increased flexibility, (3) self-advancing design for fast instrumentation to the apex without being drawn-in, and (4) less resistance and easier negotiation of canals. For optimal use and safety, the affordable SafeSiders…

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    Top Innovative Products Dentistry Today's Fifth Annual Top Innovative Products are selected based on lead generation. These products appeared in our Innovations section throughout the past year. BISCO Dental Products Resin-Modified Calcium Silicate Maintains Tooth Vitality Ultradent Products Matrix Designed to Perfectly Customize Any Preparation TheraCal PT is a biocompatible, dual-cured, resin-modified calcium silicate designed for pulpotomy treatment. It maintains tooth vitality by performing as a barrier and protectant of the dental pulp complex. TheraCal PT's chemical formulation consists of synthetic Portland Cement calcium silicate particles in a unique hydrophilic matrix that facilitates calcium release. TheraCal PT is radiopaque, allowing…

12. Page 22

    Top Innovative Products MEISINGER USA Polishers Produce Brilliant Luster on All Composite Materials The new COMPOSITE SINGLES are single-patient-use polishers designed to produce a brilliant luster on all composite materials on the market. This new line of polishers allows for easy access to all surfaces of the tooth for a successful and lustrous restoration. These single-use polishers eliminate any risk of cross contamination while also saving time from processing. The COMPOSITE SINGLES are available in 4 shapes, including Pearl, Cup, and the new Squid shape, allowing operators to access hard-to-reach areas. In particular, the Squid shape, which was designed for…

13. Page 24

    Top Innovative Products Tokuyama Dental America Universal Composite Matches All Tooth Shades OMNICHROMA is the first universal composite that matches every patient's tooth shade, from A1 to D4, with a single shade of composite. Rather than relying on dyes or pigments to achieve a certain shade, this unique composite utilizes a phenomenon called structural color. It comprises OMNICHROMA's 260-nm supranano spherical fillers, which are the precise shape and size necessary to generate a red-to-yellow color. As ambient light reflects off the surrounding dentin and passes through the composite, it creates a perfect match. This revolutionary technology has been developed through…

14. Page 25

    Patient rebates The right oral care for every patient We know every patient is different, and that's why we offer a range of power toothbrushes and whitening solutions to help them achieve a healthier, brighter smile. Now patients can take advantage of exclusive rebates on Philips Sonicare and Philips Zoom! solutions. Together, we make life better. Contact your Philips representative or call (800) 422-9448 for more information. Stay in the loop — sign up for our dental pro newsletter and follow us on social media. @PhilipsSonicarePro /showcase/oral-healthcare innovation + you Patient Rebates Up to $20 rebate on select Sonicare! handles…

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    Top Innovative Products 2C MedTech System's Technology Reduces Amount of Air-Borne Pathogens CASPR Medik In-Duct employs no-touch technology that works operator-free to provide continuous reduction of micro-burdens across an entire practice. Its highly effective oxidizing molecules are generated at low levels, which are safe for occupied space and well within NIOSH and OSHA standards. Studied in multiple hospital trials, CASPR has demonstrated the ability to reduce average bacterial and fungal micro-burdens by up to 80% while significantly eliminating the incidence of MRSA and VRE. A trial in the ICU of a 532-bed hospital showed that the installation of CASPR contributed…

16. Page 27

    CHAIRSIDE WITH DR.K THE SECRET TO MORE EFFECTIVE WHITENING No two patients are exactly the same. So why use just one whitening protocol to treat them all? At KoR Whitening, we recognize that each patient presents a different whitening challenge and that's why we develop a full line of whitening systems to meet your patient's individual need. And KoR Whitening is the first whitening system in the world to maintain potency of its entire line of whitening gels by constant refrigeration from the instant of manufacture until being received cold-packed at your office. Dr. Rod Kurthy #1 Proper Product and…

17. Page 28

    Top Innovative Products Shatkin F.I.R.S.T. Abutment Revolutionizes How Clinicians Cement Crowns, Bridges, and Roundhouses Tru-Lok Abutments will revolutionize the way one cements crowns, bridges, and roundhouses on Shatkin F.I.R.S.T.'s O-Ball Mini Dental Implants. This patent-pending abutment allows the dentist the ability to retrieve these restorations without any damage to the o-ball implant and without having to cut off the restoration. One can cement directly to the abutment, not the o-ball. This has been a great advancement for those who are not comfortable cementing a restoration directly to the mini dental implant. For more information, call (888) 4-SHATKIN (474-2854) or visit…

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    Top Innovative Products Angelus Bioceramic Repair Cement Maintains Properties of Original MTA Repair HP is a new bioceramic repair cement that maintains all indications and chemical and biological properties of the original MTA. In a putty form, it drastically facilitates its application. The handling was a cause of stress reported by clinicians when using conventional MTA due to its sandy consistency. The enhanced formula with calcium tungstate does not stain the tooth. Setting in only 15 minutes allows treatment in single visits. Exclusive vials and capsules guarantee a 3-year shelf life. The box is good for up to 25 cases.…

19. Page 32

    Top Innovative Products Directa Dental Faceshield Thwarts Droplets and Aerosols CareShield by Orsing offers an easy-to-use, transparent screen with an integrated HVE suction function that removes droplets and aerosols that harbor potentially dangerous pathogens. During dental procedures, general practitioners, hygienists, dental assistants, and patients are exposed to aerosols and organic fluids, such as blood and saliva. These fluids can spread and contaminate personal protective equipment as well as surfaces around the clinic. CareShield helps reduce cross contamination by removing aerosols and droplets through the HVE system during treatment. Easy to connect and use, CareShield ensures prevention contamination procedures will occur…

20. Page 33

    Nanohybrid Composite Creates Long-Lasting, Natural-Looking Restorations With NANOCERAM-BRIGHT's adaptive, chameleon-like technology, one can easily and confidently create long-lasting, natural-looking restorations that patients won't stop smiling 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 area. NANOCERAM-BRIGHT outperforms the competition with extremely low water sorption properties, minimal polymerization shrinkage, and high…

21. Page 34

    Top Innovative Products Premier Dental Universal Resin Cement Makes Final Cementation Simple ZR-Cem is an innovative, self-adhesive universal resin cement specially formulated for zirconia restorations. It's an excellent choice for all other substrates, such as metal, glass ceramic, and composite. Available in 3 shades (translucent, A2, and opaque white), dual-cured ZR-Cem features an MDP-containing formula that enables a strong bond to all ceramic materials, dentin, and enamel, ensuring superior retention and marginal integrity. And unlike other cements, ZR-Cem's BPO/amine-free initiation system translates to lasting color stability and room temperature storage. There's no need for refrigeration. ZR-Cem is straightforward to use.…

22. Page 35

    3M Dry Mouth Relief Spray Achieves Relief by Moistening and Lubricating Mucosa Xerostomia Relief Spray is a new, clinically-proven solution that provides prescription-strength relief of xerostomia symptoms for up to 4 hours per use. As a lipid-based spray, it achieves relief by moistening and lubricating mucosa. It showed an improvement in dry mouth symptoms in 92% of clinical study participants. Available only by prescription from a dental professional, the spray is conveniently portable and ready to use without any premixing preparation requirements. For some, xerostomia is a minor inconvenience. For others, it is a debilitating symptom that can make it…

23. Page 36

    Top Innovative Products Parkell Composite Stimulates Mineral Apatite Formation and Remineralization Predicta Bioactive Bulk is a dual-cure, bulk-fill resin composite that releases fluoride, calcium, and phosphate ions to stimulate mineral apatite formation and remineralization at the material-tooth interface. The material's innovative ability to recharge and release fluoride ions provides a unique combination of physical and chemical properties. It is stable and durable to withstand occlusal forces. It has unlimited depth of cure while also being highly polishable and fluorescent for a natural appearance. Predicta Bulk is radiopaque; indicated for Class I, II, III, IV and V restorations; and comes in…

24. Page 38

    Top Innovative Products B&L Biotech Implant Scaling Tip Avoids Pain for Hypersensitive Patients IS Tip is a smart choice for implant scaling. The tip is bendable, which allows easy access and leaves no scratches on implant abutments and porcelain restorations. There is no pain for hypersensitive patients, and there are no scratches on veneer restorations. For more information, visit blbio.com or email customerservice@blbio.com. FREEinfo, Oxford Scientific Composite Material Enables Precise Crown Preps and Easy Cementation Zircone NANO is a dual-cure, radiopaque composite material for core buildup and post cementing. It contains nano-silica, nano-zirconia, and nano calcium fluoride, yielding excellent mechanical…

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    Top Innovative Products Pulpdent Bioactive Restorative Material Recharges Significant Amounts of Mineral Components ACTIVA BIOACTIVE RESTORATIVE is the first in a new generation of aesthetic, durable, bioactive restorative materials that play an active role in maintaining oral health with the release and recharge of significant amounts of calcium, phosphate, and fluoride. ACTIVA is a smart material that responds to pH cycles with release and recharge of its mineral components. It helps stimulate formation of a connective layer of mineral apatite that is the defining requirement of bioactive materials. This process knits the restoration and the tooth together, penetrates and fills…

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    Top Innovative Products ContacEZ Interproximal Reduction System Avoids Risk of Creating Sharp Corners The IPR Strip System is an innovative, interproximal reduction system that makes enamel stripping safe, quick, accurate, and stress-free without the risk of creating sharp corners or subgingival ledges. Designed for use with Invisalign, ClearCorrect, eLigner, Six Month Smiles, and other orthodontic treatments, these flexible diamond strips cure and conform to the natural contours of the teeth to easily prevent leaving flat contacts. The IPR Strip System is also the only brand to have specifications printed right on the handle, eliminating the need to memorize measurements or…

27. Page 43

    Top Innovative Products QwikStrips Strips Provide Ultimate Solution for Performing IPR Industry-leading QwikStrips are a complete solution for removing cement from between teeth and also for creating precise interproximal reduction. The strips offer (1) the ability to be autoclave; (2) a unique design; (3) greater safety for the patient and doctor; (4) single-handed use; (5) optimal tactile control; (6) depth-limiting design; and (7) single-sided, double-sided, curved, and serrated options. Removing cement after the cementation of crowns, inlays, onlays, and veneers has never been easier. QwikStrip serrated strips make cleanup simple and safe. Cutting of the patient's lips or gums is…

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    Top Innovative Products Ascentcare Dental Products Mouth Prop System Helps Maintain Access to Work Area Efficiently facilitate all your unique needs with the patented Bite Buddy mouth prop system. Comprising several quick and easy-to-interchange attachments, this multi-use mouth prop system was designed to maintain an open access work area while meeting a wide array of clinical applications. Its easy adaptability is what sets the Bite Buddy mouth prop system apart from all others on the market. Easily interchange between a placement tool, saliva ejector tube holder, or tongue guard by sliding the different attachments into the secure, magnetic track to…

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    Top Innovative Products Filhol Dental Posts Provide Ability to Be Customized to Suit Restorations FILPOST is the only prefabricated post system that can be customized to suit restorations for root post and core buildups. The posts can be bent and shortened to suit canals without risk of fracture, enabling easy insertion of multiple posts into converging canals. The posts are engineered to be easier to place, even in difficult cases, in a faster, safer manner. They are more preserving of healthy tooth structure and stronger in use via the unique, passive interlocking system. The posts comprise 99.8% pure titanium and…

30. Page 46

    Industry News Smiles for All Supports Dental Care During the Pandemic As millions of Americans have lost their health insurance, including dental coverage during the COVID-19 pandemic, many people are seeking treatment at free and low-cost dental clinics. But these clinics are struggling to meet the growing demand with their limited resources. "We're living day by day unsure when we will run out of supplies," said Loretta Lam, DDS, a dentist at Well Child Center, a nonprofit that provides care to underserved populations in Elgin, Ill. "The only other nonprofit dental clinic in our area is fully booked out for…

31. Page 48

    Helmet... continued from page 46 against the flow and minimize their chance of escape through the opening, allowing for a smoother flow transition than reduces patient discomfort generated by flow turbulence. And while a negative pressure room with air filtration can cost tens of thousands of dollars, the cost of each helmet could be as cheap as a couple of dollars if they are made to be disposable, the researchers said. Medical grade HEPA filter negative air machines designed to protect the helmets are readily available and cost around a thousand dollars, the researcher added. "Our next step is to…

32. Page 50

    Removable Implant Prosthetics to the Rescue Timothy F. Kosinski, DDS Implant dentistry has gone through many positive transitions in the 35 years since I placed my first implant. Technology has improved our long-term prognosis with exceptional implant designs and manufacturing, surgical tools, and techniques. Advances in diagnosis, including digital 2D radiographs, advances in CBCT analysis and virtual design; and using sophisticated software have allowed even an inexperienced dentist to plan and visualize the case finished prior to any surgical intervention. However, many of us still have issues with the prosthetic fabrication of appliances that are acceptable to our patients. Patients…

33. Page 52

    Personalized Dental Implant Solutions: One Size Fits None INTRODUCTION Being a general dentist usually makes you the first to be approached by patients seeking treatment for simple and more often these days, complex situations. This means it is essential to be familiar with and, ideally, proficient in the wide spectrum of dental treatment options available to anyone walking through your dental office door. Continuing education opportunities have become more readily available to any dental practitioner wanting to advance his or her knowledge and skills in almost any treatment modality you can think of. This, in turn, allows us to diagnose…

34. Page 53

    only has one arm, and that hand doesn't have a thumb nor an index finger, leaving him with decreased fine motor skills. This was an important factor to consider as his ability to maintain hygiene of his prosthesis was greatly affected. We'd have to find a solution where he would be able to clean his prosthesis without the help of a caregiver. A fixed prosthesis was out of the question because of his inability to clean it adequately, and the patient wasn't interested in an RP 5 due to the concern of too much bulk in the prosthesis potentially impacting…

35. Page 54

    Understanding and recognizing our limitations is very important, and making use of the appropriate referral channels will ensure that our patients are taken care of and treated with the highest level of care and expertise. Digital dentistry, CBCT, smile design, and great laboratory communication allow us to streamline processes and treat patients more predictably. Dental implants are giving us so many treatment options, and by respecting the patient's biology and inherent anatomical limitations, it aids us in drawing up a customized plan unique to each individual. CASE 1 Figure 1. Full preoperative smile of the patient in Case 1. Figure…

36. Page 55

    Efficient Chairside Attachment Processing Made Simple Edentulous patients who are resigned to using conventional complete dentures may experience many negative issues affecting their overall health and psychological well-being. Methods to improve chewing ability can positively affect the digestive process, providing better nutrition to the patient. Dental implant overdentures have proven to be a viable alternative to conventional dentures and are now able to be a cost-effective treatment modality for many of our patients. Also important is the indication that implants that support an overdenture help preserve residual bone.¹ Our patients need to be aware that over time, as their teeth…

37. Page 56

    Figure 1. Following surgical placement of dental implants, the proper processing technique is critical (LOCATOR Solutions) for implant-retained overdenture stability by choosing the correct height. Soft tissue is measured from the crest to the base of the dental implant. This measurement is used to determine the proper LOCATOR to be ordered. The abutment will extend 1.5 mm above the crest of the ridge. Figure 2. Here, all 4 LOCATOR attachments are examined. These attachments can be ordered directly by the dentist or chosen by the dental laboratory. Figure 3. The horseshoe-shaped overdenture is designed by the dentist using conventional denture…

38. Page 58

    Efficient Chairside Attachment... continued from page 56 overdenture prior to processing the LOCATOR attachments, occlusion is verified with a bite relation. Chairside pressing of the female housing and retentive device is the most reliable method of proper stabilization (Figure 4). If the dental lab processes the housing, they have to accommodate not only the ridged LOCATOR male abutment but also the soft tissue. Preventing Inaccuracies of the Final Prosthesis Implant overdentures are both hard-and soft tissue retained, so any movement of the soft tissue can result in inaccuracies of the final prosthesis. Note that intralab laboratory processed LOCATOR attachments often…

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    ELECTRIC TOOTH BRUSHING WHAT'S NEW AND WHAT IS THE EVIDENCE? Dr. Liran Levin, DMD, FRCD(C), FIADT, FICD Professor of periodontology, University of Alberta, Canada. When we are practicing dentistry, often we are used to hearing our colleagues say: 'it works in my hands' or, 'I believe in this material'. However, we need to remember, that even when we feel 'it works in our hands' it is not always necessarily the case. We need to collect data properly and analyze it in a way that will be comprehensive and unbiased. When we are talking about evidence-based practice, there is a pyramid…

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    Reconstruction of the Nose and the Maxillary Arch The Gift of a Challenge Joseph J. Massad, DDS Lila T. Garcia, DDS, MS Charles Goodacre, DDS, MSD Swati Ahuja, BDS, MDS Brett Shirley, DDS, MD INTRODUCTION Squamous cell carcinoma (SCC) is the most common type of head and neck malignancy.1,2 This type of carcinoma accounts for greater than 50% of the malignancies of the paranasal sinuses and the nasal cavity.3,4 SCCs may be treated by surgical excision, cryotherapy, and/or radiation.5 Depending on the lesion size and location, surgical removal may result in a defect requiring reconstruction. Large defects may affect phonetics,…

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