Dentistry Today — January/February 2023

Inside this issue

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1. Page 4

   The New Open Sensor Works With Your Software and Budget New Open Sensor The Open Sensor by DentMax is a true open sensor that works with all major imaging software. It's designed as a high-quality, affordable replacement sensor that produces excellent diagnostic x-ray images. "We wanted a sensor to easily plug and play and work with the office's current imaging software," said David Arnett, DentiMax president. He added: "Image quality is a high priority and we couldn't be happier with the results and feedback we've received." Image Quality The Open Sensor produces excellent diagnostic x-ray images with quality comparable to…

2. Page 8

   Smile a Little Smile for Me This year begins with an issue full of brand-new processes and products. We are also tackling some tried and true procedures and thinking not only out of the box, but in some new ones. First of all, new from Israel, Dr. Yuval Wald shows us a new composite material, Infinix by Nobio, that has antimicrobial properties. This will reduce recurrent marginal decay in many of our noncompliant patients and those who cannot do proper maintenance for various reasons. Dr. Hugh Fisk takes on a typical restorative case but introduces some digital treatment planning and…

3. Page 10

   Not Just Another Dental Equipment Manufacturer Dr. Sang Chul Lee is the founder and CEO of Ray Co Ltd, a company that has been operating in the dental industry for 18 years. He was one of the first individuals to receive a doctorate in engineering in medical imaging. Dentistry Today recently spoke to him about the company. Dr. Sang Chul Lee RAYFace 3D facial scanner. RAYIOS intraoral scanner. Q: How did it all begin? A: If I had started my career as an employee, I would not have had the opportunity to start my own company. In 2004, however, with…

4. Page 14

   VIEWPOINT continued from page 12 there is almost universally a lack of a pulpal and periapical diagnosis prior to initiating treatment or making a treatment decision (ie, referral, lack of referral, delay in treatment, etc.). Co tango with the lack of diagnosis mentioned above, there is generally a complete omission of the history and appropriate testing. More specifically, the medical, dental, clinical history and examination are not recorded (if it happened at all). In short, a case has not been built to determine the current pulpal and periapical status and treatment is, for practical purposes, started without evidence. While writing…

5. Page 16

   Changing Dental Insurance Nationally Dr. Mouhab Rizkallah, DDS, MSD, explains what to expect after he personally authored, funded, and won the first dental ballot law in history—described as a "watershed moment for the nation" by the ADA president. On November 8, 2022, Massachusetts voters overwhelmingly voted yes for Dr Mouhab Rizkallah's creation, "Question 2," which requires Massachusetts dental insurance companies to pay at least 83% of premium revenue for patient claims. That means insurers can now only keep 17% for administrative expenses and profit; this first of its kind law in dentistry will now change the nation. Q: What is…

6. Page 18

   DirectaDentalGroup DIRECTA topdental ORSING parkell physics for reps RØNVIG TrollDental Sendoline CONTACTEZ ceramir ceramir FOCUS Ceramir - Founded in 1987 Doxa Dental in Uppsala Sweden, began developing and manufacturing bioceramic dental materials. Doxa's Ceramir product line was acquired by DirectaDental Group January 2023 and is excited to bring Ceramir's nanotechnology and unique properties into its portfolio. Crown & Bridge Quickcap Flagship products Ceramir's Crown and Bridge Quickcap Bioceramic Cement is resin free, designed to minimize the risk of secondary decay. The combination of the Ceramir technology with glass ionomer technology gives material properties specific for crown and bridge. The low…

7. Page 20

   Software Integrates With Intraoral Scanner Product Line ROSLYN, NY–Owandy Radiology recently integrated its QuickVision 3D implant planning software with the Medit i700 intraoral scanner product line. QuickVision 3D software is a comprehensive, open-architecture implant planning solution that can serve as the heart of Owandy's extensive product suite or as the digital workflow hub capable of integrating digital technologies from other manufacturers. The Medit i700 intraoral scanner features plug and scan simplicity, super fast scan speeds, and an open architecture for the efficient sharing of patient records. The i700 wireless scanner delivers superior convenience and mobility. QuickVision 3D software creates a…

8. Page 22

   Shade-Matching Light's Setting and Filters Produce Complete Analysis DANBURY, Conn.–AdDent's Rite-Lite PRO Shade Matching Light with high CRI LEDs has color temperatures plus a black light spectrum. The operator takes the shade with 5,500 K and then verifies the shade match under incandescent (3,000 K), ambient (3,200 K), and black light. The chosen shade should match in all 4 wavelengths. This aids in a more accurate matching of teeth and all types of dental restorations, regardless of lighting environment, and features a fluorescent setting and polarizing filter for complete shade analysis. For more information, call AdDent at (203) 778-0200 or…

9. Page 23

   Teledentistry Solution Conveniently Connects Clinicians and Patients METUCHEN, NJ–Award winning TeleDent from MouthWatch was upgraded to improve patient care and profitability in a post-pandemic world. Thanks to its intuitive, mobile field patient portal and streamlined workflows within dental teams, it's the smart choice when it comes to connect with patients in the safe and convenient way they need—and that many now demand. New patient consultations, post-op evaluations, home care instructions, specialist referrals, and emergency evaluations can all be conducted with the highest degree of simplicity, security, and safety. Unlike "teledentistry lite" solutions, TeleDent's professional-grade, enterprise-level technology can serve as the…

10. Page 26

    Contemporary Pulp Protection A Restorative Approach Using Calcium-Releasing Materials Figure 1. Preoperative photo of the tooth with failing amalgam restoration. Figure 2. Bite-wing x-ray of the tooth. Figure 3. The tooth with recurrent caries. Figure 4. Soft caries being removed. Figure 5. The tooth after all the caries were removed. Figure 6. After the placement of TheraCal LC (BISCO). Figure 7. After TheraBase (BISCO) was placed. Figure 8. After the placement of a sectional matrix. Figure 9. Selective enamel etching. Figure 10. The final restoration. James Chae, DDS A 40-year-old female patient presented with a failing amalgam restoration with recurrent…

11. Page 28

    Unique Base Bonds and Demineralizes Dentin SOUTH HACKENSACK, NJ—Unlike other bases/liners, Bio-LCB from Essential Dental Systems provides superior strength, bonds to dentin, and promotes dentin remineralization. The proprietary UDMA-based formulation forms calcium hydroxide ion curing, which results in an increase in pH. This action protects the pulp, stimulating pulpal cells to form dentin and decreasing the risk of secondary decay. This unique composition also contains remineralizing agents, which are released upon setting to form hydroxyapatite and further aid in the remineralization of the surrounding dentition. Bio-LCB's advanced features include (1) bonding to dentin to prevent bacterial leakage and secondary decay;…

12. Page 30

    Stent-Based Technique Allows for Transformation of Smiles PENRITH, England–SmileFast offers a groundbreaking, stent-based technique that has transformed the way dentists deliver composite smile makeovers to their patients. What makes this solution so unique is the patented SmileFast stent, which has tooth separators built into it. This means one can load the stent with his or her favored paste composite resin and then deliver it up to 10 teeth—all in one go. All the teeth remain separated, which means that one just needs to refine the margins and polish the composite. With bespoke smile planning and stent delivered shape and texture,…

13. Page 32

    Top Innovative Products Dentistry Today's Seventh Annual Top Innovative Products are selected based on lead generation. These products appeared in our Innovations section throughout the past year. BISCO Calcium Silicate Helps Maintain Tooth Vitality 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 pulpal complex. Its chemical formulation consists of synthetic Portland cement calcium silicate particles in a unique hydrophilic matrix that facilitates calcium release. It is radiopaque, allowing for easy identification and differentiation from recurrent decay and other restorative materials. TheraCal…

14. Page 34

    Top Innovative Products GC America Resin Cement Demonstrates Excellent Bond Strength G-CEM ONE is a truly universal self-adhesive resin cement, with nontechnique sensitivity, high bond strength, and excellent self-curing ability. It is effective in all adhesive and self-adhesive procedures for any type of restorations and demonstrates excellent bond strength to enamel, dentin, and all indirect restorations. For increased bond strength in challenging clinical situations, such as low retentive surfaces, the optional Adhesion Enhancing Primer (AEP) and its innovative GC Touch Cure feature play an important role. When applied to the tooth surface, the chemical initiator in the AEP accelerates the…

15. Page 36

    Top Innovative Products Align Technology Intraoral Scanner Delivers Outstanding Visualization Capabilities The iTero Element intraoral scanner propels today's dental practice into the future by enhancing the patient experience and elevating clinical precision. Parallel confocal imaging technology uses optical and laser scanning to achieve accurate scans in color. The iTero intraoral scanner engages practitioners practices in orthodontic and restorative dentistry with its innovative technology. The scans are engineered to work with the Invisalign System, the exclusive Invisalign Element Simulator and Progress Assessment tool. What's more, it connects to restorative and orthodontic labs, bite-ramp treatment planning, custom implant abutment, chairside milling, and…

16. Page 38

    Top Innovative Products VOCO Composite Eliminates Steps and Delivers Viscosity of Flowables VisCaolor built is the world's first thermoviscous bulkfill composite that offers an entirely new 2-in-1 technology. Once warmed, it delivers the viscosity of a flowable, then rapidly cools to body temperature once placed—allowing for the immediate sculptability of a packable. With an 83% fill rate by weight and a 4 mm depth of cure, VisCaolor bulk saves time by eliminating procedural steps and the need for additional materials used as a restorative base, liner, or occusal capping layer, effectively making it 2 restoratives in one. For more information,…

17. Page 40

    Top Innovative Products TruAbutment Abutment Offers Versatility for Restoring Implants The Angulated Screw Channel (ASC) was launched in 2018 to change the industry standard on implant restorations. This product is one of the most versatile options for any dentist wanting to restore an implant at any angulation and depth with a screw crown. TruAbutment offers this solution as a full titanium custom abutment and even provides a free ratchet driver with every order to ensure a safe and easy delivery every time. The product is available for most major implant platforms, and users may have the crown prior to receiving…

18. Page 42

    Top Innovative Products Quest Products Dry-Mouth Melts Comfortably Adhere to Gums XyliMelts are one of the only overnight treatments for xerostomia. The stick-on melts comfortably and safely adhere to your patients' gums during the day or while they sleep to relieve dry-mouth symptoms for up to 8 hours. For more information, call (800) 656-0113 or visit oracoat.com. FREEinfo, AdDent Light Provides Accurate Shade Matching in Any Environment Rite-Lite PRO Shade Matching Light with high-CRI LEDs has 3 color temperatures plus a black light spectrum. The operator takes the shade with 5,500 K, and then verifies the shade match under incandescent…

19. Page 43

    Top Innovative Products IMPLADENT LTD One-Step Bone-Grafting Solution Designed for Socket Preservation Without Membrane The OsteoGen Bioactive Bone Grafting Plug is a readily applied, one-step clinical procedure for one root extraction. Entirely remove the infected OsteoGen+ Non-Ceramic Bioactive Crystal Bone Graft Type I Bovine Achilles Tendon Collagen periodontal ligament, twice, flush out, and partially remove the lamina dura at alveolar process lower half of root. Deliver the plug dry to the socket and let it soak up blood. Condense the plug to make a membrane sealgy below soft-tissue thickness and passively crisscross suture, not through the plug. The OsteoGen Bone…

20. Page 44

    Top Innovative Products Directa–A Division of DirectaDentalGroup Prophy Paste Proven Effective for Stain Removal and Polishing In one step, ProphyCare HAp provides effective stain removal and gentle final polishing and effectively contributes to the relief of hypersensitivity. Because of its unique composite of hydroxyapatite, ProphyCare HAp helps to effectively block the open dentin tubules on an exposed dentin surface. Studies have shown that products containing hydroxyapatite show better remineralizing properties than traditional fluoride products. In one step, the same paste is used for effective stain removal and polishing because of its high cleaning power and gentle polishing as the sizes…

21. Page 46

    Top Innovative Products CHROME GuidedSMILE Surgical/Restorative Guide Offers Unique Attributes CHROME GuidedSMILE is the ultimate all-on-x surgical/restorative guide, offering unique attributes superior to plastic systems. It has been adopted by specialists, implantologists, and institutions and has become an international guide of choice for thousands of doctors. It is developed for dentists who desire a safer, faster, smaller, and stronger pre-planned, full-arch, immediate solution. For more information, visit chromeguidedsmilenow. FREEinfo, Advantage Dental Products Desensitizing Solution Reduces Microleakage, Enhances Bond Strength Utilized extensively in clinical dentistry for nearly 20 years, Hemaseal & Cide is a 4% chlorhexidine-based, glutaraldehyde-free desensitizing solution that has…

22. Page 47

    Top Innovative Products BrandMax Enzymatic Cleaning Solution Lifts Away Infectious Bioburden Tri-Clean Triple Enzymatic Cleaners provide superior cleaning power to effectively remove bioburden. Its proprietary formula contains proteases enzymes for attacking attached blood and proteins, amylase enzymes for attacking starches, sugars, and carbohydrates, as well as lipase enzymes for body fats and oils. In addition, the company offers a proprietary surfactant blend, which reduces surface tension to assist in lifting away infectious bioburden. The solution's formula contains rust inhibitors, has a neutral pH, and is non-corrosive. It is safe for all instruments. BrandMax's proprietary blend of enzymes and pleasant lavender…

23. Page 48

    Top Innovative Products Angelus Bioceramic Repair Cement Showcases Enhanced Formula MTA Repair HP is a bioceramic repair cement that maintains all indications, as well as 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. Enhanced formula with calcium tungstate does not stain the tooth. Setting in only 15 minutes allows treatment in single visits. It provides exclusive vials and capsules that guarantee a 3-year shelf life. The box is good for 25 cases.…

24. Page 49

    Top Innovative Products Meisinger USA Single-Use Polishers Produce High-Quality Restorations Composite Singles are single-use polishers designed to quickly produce a brilliant luster on all composite materials in the market. This new line of polishers allows for ergonomic access to all surfaces of the tooth for a predictable, high-quality restoration. Additionally, this simple 2-step polishing system saves time from processing and is intended for use with all hybrid composites, micro-filled composite restoratives, and high-density restorative materials. Now, one can achieve a lustrous, natural shine with universal shade composites in just seconds. Composite Singles are available in an introductory kit with an…

25. Page 50

    Top Innovative Products DMP USA Nanohybrid Composite Achieves Excellent Color Matching With NANOCERAM-BRIGHT's adaptive, chameleon-like technology, one can easily and confidently create long-lasting, natural 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 nanofillers 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 lifetime translucency, allowing the restoration to blend into the natural tooth structure and surrounding area. NANOCERAM-BRIGHT outperforms the competition with extremely low water sorption…

26. Page 51

    Top Innovative Products MouthWatch Intraoral Camera Provides Stunning Image Detail The MouthWatch Plus+ Intraoral Camera captures true 1080p HD images at 60 frames per second for stunning intraoral image detail at a fraction of the cost of other HD intraoral cameras. The camera includes 4-level adjustable LED lighting to match illumination to clinical needs. Dual buttons on the top and bottom of the camera for lighting and capture control offer multiple ergonomic grasp options. The camera goes into a power-saving standby mode whenever the camera is untouched for 30 seconds and automatically returns to normal operating mode with the press…

27. Page 52

    Top Innovative Products Align Technology Aligners Minimize Unwanted Movement Invisalign G8 with SmartForce Aligner Activation is informed by the company's foundational biomechanics for clear aligners and its database of more than 14 million Invisalign patients to optimize tooth movements and further improve predictability for frequently heavier crowding, crossbite, and deep bite cases. With SmartForce Aligner Activation, select areas of the aligner surface are specifically configured to apply optimal forces to the tooth surfaces to control the location, direction, and intensity of the force to produce the desired outcome and minimize unwanted movement. Specific, strategic contact areas between the aligner and…

28. Page 53

    Top Innovative Products Scientific Metals Metal Refining Uses State-of-the-Art Incineration Systems Scientific Metals provides a wide variety of precious metal services primarily for the dental and jewelry industries. The company accepts solids such as crowns, bridges, PFGs, inlays, casting sprues, and buttons, as well as grindings, floor pan sweeps, carpets, and filters. Each lot is melted one at a time, and a sample is taken via capillary action through a narrow glass cylinder called a vacuum pin tube. A unique combination of cutting-edge science and age-old skills, Scientific Metals has decades of combined experience melting and refining gold, platinum, palladium,…

29. Page 54

    Top Innovative Products Assured Dental Lab Restorative Creates Excellent Marginal Fit Z Brux is a 100% full-milled, high-translucency zirconia restorative with no porcelain overlay, resulting in no porcelain fractures. Clinicians can offer Z Brux with confidence that it is a high-performance restoration that meets patients' aesthetic expectations. The benefits of this proprietary product include (1) a 1,250-MPa flexural strength, (2) translucency, and (3) an aesthetic alternative to gold restoration and PFM. For more information, call (877) 883-5351 or visit assureddentallab.com. FREEinfo, Curaprox ToothPaste Provides Enzymatic Whitening BeYou Toothpaste is offered in watermelon and peach + apricot. The 2 flavors offer…

30. Page 55

    Top Innovative Products DiaDent MTA Sealer Induces Hard-Tissue Regeneration The DiaBoot Bio Sealer is a highly radiopaque, pre-mixed, and pre-filled bioceramic calcium silicate-based MTA sealer in a syringe. It has high biocompatibility to induce hard-tissue regeneration and low solubility to maintain an excellent seal inside the canal. It also has optimal flowability to ensure all canals are reached and a high pH for antibacterial action. For more information, call (877) 342-3368 visit diadent.com. FREE info, ClearCorrect Clear Aligners Utilize Material Optimized for Stress Retention ClearCorrect delivers a comprehensive, digitally driven, intuitive orthodontic experience featuring high-quality products and software engineered with…

31. Page 56

    Grammetry—the Intraoral Scanning Alternative to Photogrammetry Isaac D Tawil, DDS, and Scott Garz, DMD Full-arch digital workflows are permeating today's All-On-X full-arch community. The latest protocol allows the clinician to capture and transfer accurate digital records at time of surgery directly to the trained laboratory technician who can quickly design a digital virtual prosthesis. The file can then be electronically returned to the clinician for in-office 3D printing and intraoral seating. Until recently, the primary method to acquire accurate immediate digital records required an expensive analog device that captured and measured 3D data and was known as photogrammetry. The process…

32. Page 58

    Industry News Ivoclar North America Announces Organizational Changes Ivoclar has announced organizational changes within the company's North American executive team to strategically meet the ever-changing dynamics of the dental marketplace. On January 1, Chris Holden assumed the role of president of Ivoclar Inc. North America, while Christian Brutzer has assumed a new role at Ivoclar Group's Corporate Management as chief commercial officer of high growth markets, overseeing Latin America, Africa, and APAC. Mr. Holden joined Ivoclar in 2017 as senior vice president of business development and new markets and was promoted that same year to executive vice president chief administrator.…

33. Page 60

    Simplicity in the Modern Dental Practice Five Questions With Zinnovi's Chief Clinical Officer Bhumika Patel, DDS Q: How do you define simplicity in a dental setting? A: Simplicity boils down to a few letters: identify the essential and eliminate the rest. Since 2014, our goal has been to leverage technology to simplify processes, reduce costs, and empower staff and patients. In other words, simplicity means intuitiveness. Have you ever noticed how you can close your eyes and still get a spoon to reach your mouth perfectly; you don't need to think about how it'll work or whether you'll hit the…

34. Page 63

    MEETINGS & SEMINARS 63 GDIA Offers Training Courses in Tijuana and Puerto Vallarta The Global Dental Implant Academy (GDIA) is offering live patient surgical training courses in Tijuana and Puerto Vallarta, Mexico. The first course will take place from February 22 through February 23 in Tijuana, and the final one will be in Puerto Vallarta in October. The Tijuana program offers 3 different levels of dental implant surgical training-fundamental, intermediate, and advanced. All levels will cover diagnosis, treatment planning, and live patient surgery. The GDIA Puerto Vallarta program is an innovative continuing professional live patient training course that focuses on…

35. Page 64

    Orlando to Host the National Oral Health Conference The National Oral Health Conference (NOHC) will take place from April 17 through April 19 at the DoubleTree by Hilton Universal Studies in Orlando, Fla. This is the premier meeting for those interested in continued education and networking opportunities within the discipline of dental public health. This year marks the 24th joint meeting of the Association of State and Territorial Dental Directors (ASTDD) and the American Association of Public Health Dentistry (AAPHD). NOHC offers educational sessions on a diverse array of topics by leaders in the field and is designed for dentists,…

36. Page 65

    Implant Ninja Offers Online Courses Implant Ninja's vision is to create a world in which doctors can receive high-quality surgical training through innovative online experiences. It offers a library of online courses that aim to kickstart surgical skills in various topics, such as implant surgery, extractions, bone grafting, and more. Its hands-on course Implant Surgery 101, is great for those who want to learn how to place implants. The course includes the fundamentals of implant surgery, treatment planning, and clinical videos, as well as insightful and actionable PDF downloads and quizzes to supplement your learning. Implant Ninja can help you…

37. Page 66

    Free-standing Implant Crowns vs Splinting There are many challenges today to the surgical placement of dental implants in compromised situations. Educators promote aesthetics and function. Visualizing the case finished is an art form that has been elevated with the use of digital design. Ideal implant placement is achieved through CBCT diagnosis, understanding vital anatomy, and even guided surgical techniques. Emergence profile is determined both by the fixture size and position in the available hard tissue. Design placement in an arch, interocclusal spacing, and parafunctional habits are considered to maximize form and function. There are specific rules that need to be…

38. Page 68

    To Splint, or Not to Splint? INTRODUCTION When restoring adjacent implants in the partially edentulous patient, the decision on whether or not to splint them is a common clinical question. Although this situation has been researched by several home chemical models and clinical studies, there remains much controversy, and many times, the decision is made based on misconceptions, outdated dogma, and/or clinician preference. RATIONALE FOR SPLINTING—BIOLOGIC COMPLICATIONS The influence of splinting vs non-splinting dental implants has been evaluated by several biomechanical models. In general, stress analysis models show that splinting crowns leads to a better distribution of stresses in the…

39. Page 70

    IMPLANTS FIGURE 1. Preoperative view of a failed bridge and an atrophic ridge. FIGURE 2. Placement of an 8.0-mm implant in the grafted ridge. FIGURE 3. Occlusal view of the 2 implants in grafted bone. FIGURE 4. The implant crowns were not splinted as the crown height was ≤ 10 mm. To Split, or Not to Split? continued from page 68 ing, component fracture, and even implant neck fracture. A photoelastic study evaluated the effect of splinting implants with different crown heights using gauges to measure the strain.23 Under non-axial loads, a significant increase in strain around the implants when…

40. Page 71

    Dentists should reserve the splinting of implant crowns to clinical situations that may risk technical complications, such as excessive crown height (> 10 mm), parafunctional habits, loss of anterior guidance, malposed or angled implant positions, or narrower diameter implants replacing molars. Whenever possible, splinting should be avoided for easier oral hygiene, passive prosthetic fit, and easier repair. References 1. Resnik R. Chapter 7: Stress treatment theorem in implant dentistry. In: Resnik R, ed. Misch's Contemporary Implant Dentistry, 4th ed. Elsevier; 2020:152-74. 2. Pierrisnard L, Renouard F, Renault P, Barquins M. Influence of implant length and bicortical anchorage on implant stress…

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