Dentistry Today — JULY 2014

Inside this issue

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1. Page 6

   Yet Another New Era? This month, our editorial focus is mainly on restorative dentistry. Advances in direct-enamel dental materials and their associated techniques have been coming at a rapid pace in recent years. We are witnessing an explosion of new products, primarily as a result of research driving development and improvements from a field of competitive manufacturers. In naming but a few of the areas directly affecting restorative dentistry we can see the remarkable progress in quality composite resins, adhesives, and cements now available—proven all-ceramics that can deliver reliable long-term strength and more biomimetic esthetic characteristics; versatile provisional materials with…

2. Page 10

   VIEWPOINT continued from page 8 health issues. Is the patient's medical condition stable or unstable? What exactly are the therapeutic goals? Is the patient presently using? What is the A1c value? What are the results of the blood studies? What is the INR value? It is important for the dentist to gain relevant treatment information rather than to have the physician impart his or her opinions, because many of the physicians' opinions may be out of date or simply incorrect. Lauber et al14 surveyed physicians and dentists to determine the recommendations of physicians and dentists with regard to antibiotic prophylaxis.…

3. Page 12

   VIEWPOINT continued from page 10 1. The patient requires a medical evaluation and therapy. 2. The dentist requires specific medical information which may impact upon the patient's dental treatment, and 3. The dentist requests a change in the patient's medical therapy in order to benefit the patient's oral condition. Furthermore, the dentist has a duty to refer the patient for a medical consultation whenever the medical complexities of the patient exceed the expertise of the dentist. The concept of the standard of care is often construed as an amorphous notion that is not clearly understood. However, the standard of care…

4. Page 14

   Visit Our Site Today! Technique of the Week Metal Refining for Your Practice DDS Refining, a division of Medidenta, offers full-service scrap metal refining for gold crowns, PFM crowns, inlays, and onlays. This video outlines the easy process for getting the full value for the precious metals in your dental office, including an explanation of the free, insured UPS shipping that is provided by DDS Refining's facility. To watch this video, visit . Summer Promotion Free CE Course Dentistry Today has extended the "buy one, get one free" continuing education (CE) course offer, based on the extremely positive response from…

5. Page 16

   The DEXIS CariVu Portable Caries Detection Device The DEXIS CariVu is a compact, portable caries detection device that uses patented transillumination technology to support the identification of occlusal, interproximal, and recurrent carious lesions and cracks. The device detects these lesions without the use of ionizing radiation. Easy to operate, CariVu hugs the tooth and bathes it in safe, near-infrared light. The unit's transillumination technology makes the enamel appear transparent, while porous lesions trap and absorb the light. This allows the clinician to see through the tooth, exposing its structure and the actual structure of any carious lesions with very high…

6. Page 18

   FOCUS ON: Impressions Robert C. Margeas, DDS, advocates for digital impression technology and discusses the advancements that are improving the procedure for clinicians. Q: What are your current thoughts on and clinical experience with digital impression technology? A: Digital impression technology is continuing to evolve with dentists gradually accepting new procedures. I have colleagues who have not made a conventional impression in more than a years and would not go back to the traditional physical impressions. Personally, I was a bit slow to embrace and implement this technology. Understandably, as with most clinicians, it takes time to fully incorporate any…

7. Page 19

   Ensure a dry working environment EVERY TIME. Dryz™ Gingival Hemostatic Retraction Paste Stops gingival bleeding and seepage that may interfere with impression taking. Fast-acting. Light green color makes the material easy to detect. Fraction of the cost of other retraction materials. Great for tissue management when sealing restorations, placing rubber dam clamps (controlling bleeding), bleaching teeth (no damage moisture) and restoring subgingival cavities. Introduce Dryz™ into the gingival sulcus, making sure to fully contact all of the soft tissue of the gingival sulcus. Rinsing off the Dryz using copious amounts of water, revealing the clean and retracted gingival sulcus and…

8. Page 20

   CLINICAL REVIEWS THE DENTAL ADVISOR 3M ESPE Filtek Supreme Plus (10 years) Long-Term Clinical Performance ++++ 3M ESPE | 3mespe.com/us Consultants' Comments • "3M ESPE Filtek Supreme Plus has proven to be a reliable all-around composite." • "Fillings still look great." • "Holds up well, even in large posterior restorations." • "Shades are stable." • "Some chipping of marginal ridges has occurred." Description 3M ESPE Filtek Supreme Plus is a universal composite indicated for all anterior and posterior direct restorations. It is available in 7 dentin shades, 17 body shades, 8 enamel shades, and 4 translucent shades. Clinical Evaluation Protocol…

9. Page 21

   THE DENTAL ADVISOR THE DENTAL ADVISOR Ghost Mfg. Multi-Axis Spiral Suction (M.A.S.S.) +++++ Ghost Mfg | massuction.com Consultants' Comments • "One tip serves the function of an HVE tip and a saliva ejector." • "Does not grab soft tissue." • "The first real advance in HVE tips in 40 years." • "Keeps water mist off of the doctor's mirror." • "Angled design allows better visibility." Description The Multi-Axis Spiral Suction (M.A.S.S.) dental HVE tip has a spiral vented design, an angled barrel wall, and a rolled edge. Available in 100-count packages, it was evaluated by 34 consultants in 769 uses,…

10. Page 22

    Spotlight With New Design and Features, Handpiece Reintroduced to Classic High-Speed Line MALVERN, Pa.–Recently reintroduced to its StarDental 430 high-speed handpiece line, DentalEZ Group's 430 SWL Flex has been designed with a new look and brought with numerous performance-enhancing features, making conversion to the classic StarDental line fast, seamless, and less costly. For dental professionals who are currently using MULTIflex swivels in their practices, there is no need to purchase new couplers to make the conversion. The satin-finished 430 SWL Flex includes solid glass-rod fiber optics and is available in a lubricated version or in StarDental's traditional LubrFree version, which…

11. Page 24

    Spotlight New Series of High-Speed Handpieces Introduced Cloud-Based Management Software Helps Practices Operate More Efficiently [IMAGE: Cloud-based management system diagram showing multiple connected devices] [IMAGE: High-speed handpiece photograph] ATLANTA-Introduced at the CDA Meeting in Anaheim this past May, Carestream Dental's CS SoftDent Cloud practice management software has been designed to help even the busiest practices operate more efficiently. It offers a full suite of practice management software tools to increase productivity and streamline daily workflow. CS SoftDent Cloud's features enable practices to effectively manage their day-to-day business— including insurance benefits tracking, electronic patient charts, and detailed financial reports—at any time,…

12. Page 26

    Spotlight Affordable E-Style Contra Angle Offered New Stool Merges Best of Both Worlds LAS VEGAS–Offered by Medidenta, the affordable Interprox e-style contra angle is ideal for any procedure that requires a back-and-forth reciprocating motion (1.6 mm). It is also ideal for interproximal procedures such as reduction, polishing, or restorative work that require judicious stripping of enamel, and it can be used for finishing and fine trimming. For more information, call Medidenta at (800) 221-0750 or visit medidenta.com. BRISTOL, RI–RGP's new 400D Hybrid Stool is a blend between the classic RGP 300D Operator's Stool and the popular RGP Straddle Stool. Not…

13. Page 28

    After 50 Years of Working Alongside Dentists, A-dec Is Still Driven to Make the Best Better A-dec provides a lifetime of product support. Expect answers from experts. Three out of 4 members of the A-dec Customer Service Team started out in manufacturing. More than a few have been part of A-dec for more than 20 years. A-dec CEO and President Scott Parrish (left) with co-founder Ken Austin. Celebrating its 50-year anniversary, A-dec is a leading manufacturer of dental chairs, delivery systems, dental lights, and dental cabinetry, with co-brands A-decW&H electric and air-driven handpieces. Aside from the company's attention to detail…

14. Page 30

    Spotlight Items Added to Family of Impression Materials Facilitate Everyday Dental Procedures ST. PAUL, Minn—3M ESPE's new additions to its Imprint 4 family of impression materials—3M ESPE Imprint 4 Preliminary VPS Preliminary Impression Material and 3M ESPE Imprint 4 Bite VPS Bite Registration Material—add control and convenience to everyday dental procedures, and both are compatible, providing dentists with easy access to CAD/CAM solutions. Imprint 4 Preliminary VPS material (shown), available in both superquick and regular setting times, stands to replace alginates for dentists seeking a convenient, time-saving alternative. The material, which replaces 3M ESPE Penta VPS Preliminary Impression Material, works…

15. Page 32

    Spotlight Universal Adhesive's Delivery System Substantially Decreases Cost Per Application AMHERST, NY—Adhese Universal, Ivoclar Vivadent's single-component, light-cured universal adhesive available in the revolutionary VivaFen delivery form as well as in the traditional bottle delivery form. The ergonomically designed VivaFen enables the adhesive to be delivered directly to the preparation in a fast and convenient manner with virtually no waste. It delivers up to 190 single-tooth applications, significantly more than a traditional adhesive bottle. This substantially decreases cost per application, contributing to more cost-effective treatments. Studies have shown that the bond strength of adhesive materials decreases over time as the solvent…

16. Page 34

    Versatile Light-Cure and Dual-Cure Cements Offered JERSEY CITY, NJ—FUSION-Zr Multi Purpose Veneer Cement and Dual Cure Resin Cement are self-adhesive and offered in light-cure or dual-cure formulas. They are indicated for the permanent cementation of all-ceramic restorations, zirconia, lithium disilicate, CAD/CAM materials, veneer, crown and bridges, inlays/onlays, PFM, and metal titanium, and fiber posts. Bonding agents can be used, but they are not required. Among the cements' enhanced features are the following: self-adhesive strength to zirconia and all restorative substrates; highly favorable handling; color stability; and remarkably fast and easy cleanup. Trusted by renowned clinicians, the cements are implemented into…

17. Page 36

    Spotlight Partial Recommended by 93% of CLINICIANS REPORT Evaluators HVE Tip Prevents Soft-Tissue Grab and Offers Numerous Advancements ST. JOSEPH, Mich.—Hailed by a DENTAL ADVISOR consultant as "the first real advance in HVE tips in 40 years," Ghost Mfg's Multi- Axis Spiral Suction HVE suction tip features a spiral vented design, an angled barrel wall, and a rolled edge. These innovative features create an HVE tip that (1) does not grab soft tissue, (2) provides continuous suction, even if the end is occluded, (3) is angled for better visibility and ergonomic hand positioning, (4) prevents backflow of fluids and tissue…

18. Page 37

    DMP DENTAL 29 Years of Clinical Excellence Nanoceram Universal, Nano Ceram Bright Flowable and Bright Posterior Completed with only ONE shade of composite! Photos courtesy of Dr. Ross Nash NanoCeram Universal composites' special blend of Nano and Micro Fillers produce superlative aesthetic results achieved through a sophisticated nanomanufacturing process integrating the Nano fillers in the resin matrix resulting in excellent polishability and very high 'gloss' and 'light bending' tooth-like qualities. High strength, fracture and abrasion resistance values make it unlikely to chip or fracture. Bright posterior has the lowest water sorption, water solubility and polymerization shrink values; clear indicators of…

19. Page 38

    Capturing Fine Marginal Detail With the 3M ESPE Retraction Capsule James Braun, DDS, MS Soft-tissue retraction is a critical step in the impression phase of the restorative process that isn't necessarily discussed often, but it has an important impact on the treatment's final success. For this reason, dentists must stay on top of the tools available to them to perform retraction efficiently and effectively for routine cases. In deeper preparations, soft-tissue displacement is often accomplished by placement of a retraction cord or implementation of a soft-tissue laser for gingiplasty purposes. But in many of the simpler cases dentists treat, retraction…

20. Page 40

    NEWS/TRENDS Industry News Directa AB Appoints New CEO Directa AB, a privately owned Swedish company founded in 1916 that is one of the fastest growing manufacturers of dental products in the Nordic region, announced recently that its board of directors has appointed Henrik Karsk as new CEO, effective as of September 1, 2013. "I look forward to lead Directa into the future," said Mr. Karsk. "With our unique and innovative products and close customer relationships, we have a very strong position to expand our business." Most recently, Mr. Karsk was Directa's sales and marketing manager, a position he held since…

21. Page 41

    High-Need Dental Clinic Coming to St. Louis The Missouri Foundation for Health (MFH) has awarded a $1 million grant (effective April 1, 2014) to A. T. Still University (ATSU) to assist it with the design and construction of a 70,000-square-foot dental education and oral health clinic in St. Louis. A high-need dental clinic, it will serve as the primary clinical education site for dental students in ATSU's Missouri School of Dentistry & Oral Health (ATSU-MOSDOH), enabling more than 39,000 patient visits per year in the St. Louis metro area. It is expected to have up to 95 dental chairs for…

22. Page 42

    NEWS/TRENDS Dental Schools Name New Deans One Hundred-Millionth! The University of Maryland School of Dentistry and Case Western Reserve University School of Dental Medicine announced recently the appointment of new deans. University of Maryland, Baltimore President Jay A. Perman, MD, appointed Mark A. Reynolds, DDS, PhD, MA, the dean of the University of Maryland School of Dentistry. The selection was made after a national search and became effective June 2. Dr. Reynolds, a 1986 graduate of the University of Maryland School of Dentistry, has served as its interim dean since last year and has been with the school in various…

23. Page 46

    Periodontal Disease Associated With Cardiovascular Risk Periodontal disorders, such as tooth loss and gingivitis, have been identified as a potential risk marker for cardiovascular disease (CVD) in a large study. More than 9,500 patients with chronic coronary heart disease (CHD) provided information on their dental health, with results showing that indicators of periodontal disease (fewer remaining teeth, gum bleeding) were common in this patient group and associated with numerous cardiovascular and socioeconomic risk factors. Conversely, a lower prevalence of tooth loss was associated with lower levels of CVD risk factors, including lower glucose levels, low-density lipoprotein cholesterol levels, systolic blood…

24. Page 47

    Pins Fairfax Dental The Stabilok pin is designed to achieve 2 criteria: self-shearing with maximal reliability and insertion with maximal ease. The wide-pitch thread provides excellent retention for the pins, which are available in either the purest commercially available titanium or stainless steel. The pins and drills are dispensed from the box through apertures, which can be set to either the hermetically sealed position or the open position by hinged flap. For more information, call (800) 233-3352 or visit stabilok.com. FREEinfo, Coltene The TMS, TMS LINK Series Pins, and MAX Restorative Pins are easy-to-use, colorcoded, self-threading, retentive pin systems that…

25. Page 48

    In First Impressions, George Freedman, DDS, gives readers a brief summary of products that have recently been introduced to dentistry, based on his clinical experience. iZolation Dry Field Isolation System iZolation The isolation of the treatment area is a must with many of today's restorative techniques. The materials are sensitive to saliva, and might irritate the patient's mouth. While a rubber dam is the gold standard in isolation, it is not greatly appreciated by most patients and not popular with all dentists, and the associated clamps may damage the attached gingiva unless great care is exercised during placement. The iZolation…

26. Page 50

    28th Annual TOP 100 PRODUCTS CTS In-Office Whitening System Opalescence Boost PF 40% is Ultradent's chemically activated, powerful in-office whitening product. Syringe-to-syringe mixing activates Opalescence Boost just prior to application, so it doesn't require the use of a light for whitening. The activated 40% hydrogen peroxide gel is conveniently delivered via syringe for precise delivery. Opalescence Boost is also easy to see, allowing for complete removal between applications. Apply two 20-minute applications for a total of 40 minutes of treatment time. For more information, call (800) 552-5512 or visit ultradent.com. FREEinfo, AIR TECHNIQUES Caries Detection Aid Spectra is a noninvasive…

27. Page 54

    28th Annual TOP 100 PRODUCTS Y Aligner Align Technology and Henry Schein Dental have partnered to distribute Realine, a straightforward, 5-stage clear aligner designed for very minor crowding and spacing issues such as orthodontic relapse that dentists see in their practices every day. An affordable, easy-to-use product for patients with very limited treatment goals, it is available in the United States exclusively through Henry Schein Dental. For more information, visit henryschein.com. FREEinfo, CONVERGENT DENTAL Laser Solea, the first CO2 laser system cleared by the FDA for hard and soft tissue, nearly eliminates the drill from dentistry. At 9.3 μm, it's…

28. Page 55

    MAKE A CLEAR IMPACT TO YOUR PRACTICE WITH INVISALIGN® More patients want the solution they can barely see 9 out of 10 patients recommend Invisalign Many solutions claim to grow your practice, yet fall short of delivering the clinical results you expect. Invisalign not only delivers improved clinical outcomes, but it also delivers demand. Patients are easier to achieve a great smile with a virtually undetectable solution. The facts speak for themselves—and show how Invisalign could grow your dental practice: • More than 2.6 million patients have chosen Invisalign treatment • 93% of Invisalign patients are satisfied with their investment…

29. Page 56

    28th Annual TOP 100 PRODUCTS ODUCTS Composite Applicator Therma-Flo Composite Applicator is uniquely engineered to utilize heat for optimal performance of any composite material. It's cordless, compact, and ergonomically designed to reduce hand fatigue for easy point of delivery to maintain flowability throughout procedures. Motorized extrusion offers greater versatility to enhance all restorations in a wide variety of applications with the same clinical ease as flowables. This is done without sacrificing strength, hardness, or wear resistance. For more information, call (262) 635-3393 or visit vista-dental.com. FREEinfo, ZIMMER DENTAL Dental Implant The US-made 3.7-mmD Zimmer Trabecular Metal Dental Implant combines the…

30. Page 58

    28th Annual TOP 100 PRODUCTS orative System EQUIA Fil is a comprehensive, glass ionomer-based, bulk fill, rapid restorative system. It is a self-adhesive posterior restorative system that combines easy handling and rapid application with excellent aesthetics. It is indicated for Class I, II, and V cavities and as an alternative to amalgams and composites, particularly in the pediatric, geriatric, and special-needs situations. It can be used for high-caries-risk patients and as a core build-up material. For more information, call (800) 323-7063 or visit gcamerica.com. FREEinfo, OBTURA SPARTAN Ultrasonic Unit The Spartan Wave Piezo Electric Ultrasonic Unit gives clinicians a complete…

31. Page 60

    28th Annual TOP 100 PRODUCTS e Laser Designed for the first-time laser dentist and hygienist, the Picasso Lite's affordable price point, ease of use, and sleek design qualities have earned it recognition as one of the world's most popular lasers. It's the perfect replacement for a scalpel and electrosurge for the use of treating soft tissue. Picasso Lite cuts and coagulates tissue with reduced trauma, bleeding, and necrosis of tissue and is used for soft-tissue surgical procedures. For more information, call (866) 999-2635 or visit amdlasers.com. FREEinfo, COLTENE Direct Composite Veneer System COMPONEER offers the newest innovation in anterior composite…

32. Page 62

    PRODUCTS 3M ESPE Impression Material With the fastest setting impression material on the market, Imprint 4 VPS Impression Material sets in just 75 seconds thanks to unique, active-self warming technology. Working time is not compromised, so dentists can observe good technique and ensure reliable results. Imprint 4 is also available in regular set, which sets in 2 minutes. The material's superhydrophilicity means precise details and outstanding accuracy. For more information, call (800) 634-2249 or visit 3mespe.com/imprint4. FREEinfo, HIOSSEN Implant The ETIII Implant is the optimal bone level fixture for both clinical and aesthetic results. Its surface is sand-blasted with alumina…

33. Page 64

    28th Annual TOP 100 PRODUCTS elivery Trays Prescription Perio Trays are innovative tools for adjunctive periodontal care. They have internal peripheral seals to deliver medication into shallow and deep pockets (greater than 6 mm), making them ideal for patients with generalized pocketing or who are struggling between maintenance visits. Research shows that Perio Tray delivery of 1.7% hydrogen peroxide gel, combined with SRP, achieves better results than SRP alone. They are comfortable, convenient, and easy to use. For more information, call (877) 434-GUMS (4867) or visit perioprotect.com/doctor_info.asp. FREEinfo, BIOLASE All-Tissue Laser The WaterLase iPlus laser offers the benefits of advanced…

34. Page 66

    28th Annual TOP 100 PRODUCTS e The new line of SANAO precision handpieces offers innovation in every detail. The handpieces are perfectly balanced to reduce wrist strain, optimally miniaturized for maneuverability, and optionally equipped with glass-rod fiber optics to illuminate the oral cavity. As debris can often lead to handpiece failure, SciCan filled the area where debris can collect, between the inner and outer sleeve, with hygiene protection system resin. For more information, call (800) 572-1211 or visit scicanausa.com. FREEinfo, ORTEK THERAPEUTICS Oral Health-Promoting Soft Chews The new BasicBites are delicious, sugar-free chocolate soft chews that help maintain healthy teeth…

35. Page 68

    68 100 PRODUCTS VOCO AMERICA Universal Adhesive Futurabond U is the first single-dose, dual-cure universal adhesive that does not require additional primers or activators. It is the one adhesive for all of your adhesive dentistry, giving you the options of self-etch, selective-etch, or total-etch. There are no solvent evaporation concerns. With fast and easy one-coat application, you can apply it dry and cure in 35 seconds. For more information, call (888) 658-2584 or visit vocoamerica.com. FREEinfo, TRANSCOJECT AMERICA Applicator Precision-molded from medical-grade materials, APPLIQUATOR, available in 2 sizes and 2 degrees of stiffness, offers a completely new approach for the…

36. Page 70

    28th Annual TOP 100 PRODUCTS ht The Demi Ultra LED Ultracapacitor curing light utilizes a new generation of cordless curing light technology, providing dentists with a battery-free option. It is powered by the revolutionary U-40 Ultracapacitor—exclusive technology that enables a full charge in less than 40 seconds for incomparable convenience. The new LED light system also features Kerr's proprietary C.U.R.E. technology, which rapidly delivers uniform depth of cure with profession-leading low temperatures. For more information, call (877) 685-1484 or visit kerrdental.com/demiltra. FREEinfo, GLIDEWELL LABORATORIES Implant System The Inclusive Tooth Replacement System has everything necessary for single-tooth implant cases, from start…

37. Page 71

    Improve the gingival esthetics of your implant cases The patient presented with a fractured root on tooth #9. The patient wore a flipper, which served as a transitional appliance throughout the healing phase. Four months after placing the implant and custom healing abutment, the soft tissue had healed nicely, exhibiting optimal margins and gingival contours. The crown on tooth #8 was removed. Removal of the custom healing abutment revealed anatomically correct contours for a seamless transition between the implant and the restoration. The final gingival contours, established during the healing phase, facilitated an esthetic emergence profile for the final custom…

38. Page 72

    28th Annual TOP 100 PRODUCTS Obturation Gun The Beta Obturation device is designed for warm gutta-percha techniques, such as backfilling a canal with warm vertical obturation or with a complete fill technique (injecting from the apex up). Perfectly complementing the Alpha heat source, the Beta unit offers: (1) simplicity; (2) operator ease and comfort; and (3) durability in a cordless, injectable obturation gun. The Beta will give more than 4 hours of continuous use on a single charge. For more information, call (949) 581-3636, visit bnlbio.com, or e-mail bdshefsky@bnlbio.com. FREEinfo, DIGITAL DOC Intraoral Camera The IRIS intraoral camera provides dual-capture…

39. Page 74

    28th Annual TOP 100 PRODUCTS Implant Bridge The Prettau Zirconia Implant Bridge is a screw-retained implant bridge that revolutionizes implant prosthetics. Its all-inclusive pricing is less than most hybrid bridges, bar overdentures, or PFM screw-retained bridges, and there is a 5-year warranty against chipping or breakage, underscoring the confidence in the Prettau zirconia. With custom shades, custom shapes, no chipping, no staining, no acrylic, and less prosthetic space needed than a hybrid bridge, it offers all the benefits over alternative choices. For more information, call (845) 679-2737 or visit zrbridge.com. FREEinfo, ADDENT Shade-Matching Device The Rite-lite 2 shade-matching light is…

40. Page 76

    28th Annual TOP 100 PRODUCTS orary Cement Developed using proprietary prismatic nanofillers, ZONEfree has the ability to blend to any adjacent surface, making it a terrific option for all your temporary cementing needs, especially for aesthetic cases. It is a zinc-oxide noneugenol temporary cement that gives you effortless cleanup and unsurpassed ease of removal. This translucent temporary cement sets in 2 minutes without a curing light. For more information, call (800) 833-8267 or visit duxdental.com/zonefree. FREEinfo, DENTIMAX Digital Radiography Intraoral Sensor The Dream Sensor is a boxless sensor that represents the latest in CMOS digital radiography. Having received an "excellent/good"…

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