Dentistry Today — June 2012

Inside this issue

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

1. Page 4

   Now, combine the best live TV with your custom messaging. Introducing DIRECTV® Message Board. Only DIRECTV's industry-leading technology combines the best TV lineup with a powerful new marketing tool. Our revolutionary Message Board lets you overlay your messaging onto live TV so you can communicate with your customers in a way they can't ignore. This web-based system is simple to use and makes it easy for anyone to create or update messages within minutes across one or more locations, from anywhere at any time. You don't need expensive media players, special software, content, licenses or extra hardware. FREEinfo, on card…

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   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 eager to achieve a great smile with a virtually undetectable solution. The facts speak for themselves—and show how Invisalign could grow your dental practice: • 1.8 million patients have already chosen Invisalign • 93% of Invisalign patients are satisfied with their investment • Improved…

3. Page 12

   Growing With New Authors and Leaders For 50 years, Dentistry Today has been the nation's best read resource for clinical and practical report articles, industry news, cutting edge trends, product information, and an exciting variety of continuing education Web-based offerings. It has also been providing quality peer reviewed CE articles under the guidance of Dr. Phillip Bonner, our former editor-in-chief, who continues to run this department as our CE editor. We could not claim the high level of success without the continued efforts of our talented editorial, Web and media, and advertising sales teams (see Masthead on page 6) working…

4. Page 14

   Best Practices In my capacity as an executive board member of the William F. Ryan Community Health Center, which receives significant federal funding, I recently participated in a re-view conducted by a federal bureau, the Human Resources and Service Administration, of every aspect of our center. The concept of best practices came up often, and our center was benchmarked against best practices used in community health centers throughout the country in the areas of clinical performance, governance, finance, and leadership. This experience has led me to think more about dental practices. Would a best practice concept be a helpful way…

5. Page 17

   ADVERTISING SUPPLEMENT 17 INTERVIEW: Michael Küllmer, KOMET R&D WORLDWIDE 1 How does KOMET determine the instruments it manufactures ultimately and sells? We closely examine market demands and customer needs, particularly with respect to the materials and techniques dentists and technicians employ for restorative procedures and for cosmetic and aesthetic dentistry as well as for fixed and removable dental prosthetics. We also take care to consider the particular needs of periodontal, endodontic, and prosthodontic treatment protocols. An intensive dialogue with users of KOMET rotary and oscillating instruments allows us to provide demand-oriented solutions in line with our customers' specific requirements. We…

6. Page 18

   Dentistry Today.com Providing you with news and information from the industry leader in clinical content. Visit Our Site Today! Technique of the Week Sensitivity/Pain Management in Bleaching Marty Zase, DMD A Dentistry Today Leader in Continuing Education (CE), Marty Zase, DMD, delivers an exploration on how to control pain and sensitivity during bleaching without treating patient discomfort. Without using the scalloping technique that many dentists are taught to use, Dr. Zase uses a different method to remove the excess around the teeth. The gingival margin is sealed from leakage, and the full mouth receives the benefit of bleaching in this…

7. Page 20

   From the March 2012 Issue UNIVERSAL ADHESIVE BISCO ALL-BOND UNIVERSAL, an adhesive for total, self, and selective-etch techniques, offers single-bottle priming and bonding for direct and indirect indications. It works as well for desensitizing a tooth and intraoral repair. It can be used as a protective varnish for glass ionomer fillings. It bonds to all surfaces, including enamel, dentin, and metal, among others. For more information, call (800) 247-3368 or visit bisco.com. FREEinfo, TEMPORARY CEMENT Premier Dental Premier Implant Cement is a radiopaque, noneugenol resin cement designed for implant-retained crowns, and it is suitable for temporary cementation of provisional restorations…

8. Page 22

   Specially engineered for occlusal and lingual reduction in crown prep procedures, the S6368 football-shaped diamond features a unique diamond undersurface on its working portion, incorporating staggered plane surfaces to optimize material reduction, thereby saving operator time. It ensures maximal prints removal, facilitates cooling, and enhances patient comfort. For more information, call (868) 566-3887. FREEinfo, MAGNIFIERS Vision USA Included among TaskVision magnifiers for dental and medical professionals are bar magnifiers, dome magnifiers, digital magnifiers, handheld illuminated LED magnifiers, and handheld and pocket nonilluminated magnifiers. Offered in magnification powers up to 20x, the magnifiers feature aspherical lenses that are distortion free. For…

9. Page 24

   To assist practitioners in their selection of essential dental products, Dentistry Today presents items reviewed by THE DENTAL ADVISOR'S staff of editors and consultants. Established in 1984, THE DENTAL ADVISOR, based in Ann Arbor, Mich, has provided dental professionals worldwide with objective, accurate information using in vivo and in vitro results on the performance of materials and equipment based on clinical and laboratory research. For more information, visit dentaladvisor.com or call (800) 347-1330. Onset ++++½ Onpharma | (877) 336-6738 | onpharma.com Editors' Comments • "Easy to use and incorporate into the routine." • "Patients became anesthetized very quickly." • "Great…

10. Page 26

    Spotlight Provisional Offers Ideal Function, Superior Aesthetics, and High Patient Satisfaction BEFORE SANTA MARIA, Calif.—Whether for temporization or removable aesthetics, DenMat's Snap-On Smile provides the stability, function, and beauty every patient wants, perfecting provisional performance. It's noninvasive, it's easy to prescribe, and it eliminates uncomfortable and messy temporaries or complicated procedures requiring too much chair time. Finally, there's a temporary solution that's convenient and simple to place as well as comfortable and attractive for the patient. AFTER Snap-On Smile literally snaps over the existing dentition without impinging on the gingival tissue or covering the palate. It's completely toothborne; no adhesives…

11. Page 28

    Spotlight Complimentary iPad App Enhances Capabilities of Digital Pan/Ceph Imager CHARLOTTE, NC-MyRay, manufacturer of digital radiography equipment, introduces the Remote Panel iPad app for Hyperion, its digital pan/ceph unit that offers supreme image quality and proven ease of use. With the app, available as a free download from Apple's iTunes store via ipadappmy rayamerica.com, dental practices can now connect Hyperion to their iPads via Wi-Fi. The app offers a pleasant graphic interface and lets Hyperion owners pilot their machine and enhance the acquired radiograph on their iPad. Followers users to browse and select one of 28 diagnostic programs and then…

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    Spotlight Featuring Soft Consistency, Composite Delivers Outstanding Handling While Providing Minimal Shrinkage and High Strength SOUTH BEND, Ind.-Offered by Heraeus, Venus Pearl, a light curable, radiopaque nanohybrid composite, is indicated for adhesively bonded, tooth-colored restorations in the anterior and posterior regions. Due to its remarkably soft consistency, it delivers outstanding handling while still providing the minimal shrinkage stress and high flexural strength for which the Venus family of composites is known. It is available in preloaded capsules (predosed tip, [P3]) or syringes in 5 different introductory kits. The soft yet nonsticky consistency of Venus Pearl facilitates stress-free handling that is…

13. Page 32

    Bite Tabs Now Color-Coded for Easy Size Reference KENNSAW, Ga.-Offered by bite tabs are now available in seven, white, original (for small Film Flaps), and blue, Microcopy, Flaps cushioned color coding for easy size refnormally Flaps). Both sizes can be used on either film or sensor. Offered at an affordable price, these reusable, enjoying users use-and-toss convenience, and they make taking xrays easier, especially for children. For more information, call Microcopy at (800) 235 1803 or visit flapsbitc tabs.com. [IMAGE: Pink and magenta colored product boxes shown as "Bite Tabs"] [IMAGE: Three clinical photos showing stages of wound healing with…

14. Page 34

    Spotlight Digital Platform Changes Concept of Removable Dentistry SCOTTSDALE, Ariz-AvaDent Revolutionary Digital Technology brings the precision, speed, and profitability of CAD/CAM process automation to removable dentistry. Developed by a team of digital dentistry leaders, it makes it possible for dentists to offer their patients a precise-fitting, aesthetic denture in as few as 2 appointments. AvaDent, whose name is derived from Ava, meaning rebirth, and Dent, meaning dentition, allows dentists to offer a digital denture based on accepted clinical protocols using standard clinical procedures with no computer skills or capital investment required. AvaDent's all-important digital record allows dentists to offer their…

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    Cementation Navigation System Now Available as App for iPhone and iPad AMHERST, NY- In response to the increasing popularity of the mobile internet, Vivadent has developed an app version of its Cementation Navigation System (CNS) that allows users to gain an over-view of cementation options while on the move. It's now available for download in the iTunes Store as an app for both iPhones and iPads. CNS is a multimedia application that offers dentists practical orientation and guidance in the selection of the best luting material for each case. Since its launch in March 2011, CNS has been met with…

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    Disinfectant's Effectiveness Against More Than 25 Clinically Relevant Organisms Cited ANAHEIM, Calif.-TotalCare's all-new CaviCide+ next generation surface disinfectant is the only low-alcohol surface disinfectant/cleaner that offers a one-minute TB kill plus more than 25 other clinically relevant organism kill claims, including MRSA and Norovirus. A conveniently packaged, multipurpose, fragrance free disinfectant/decontaminant, it is available in 2-, 8-, and 24 oz sprays or in oneand 2.5 gal jugs. To receive a sample, visit trycavicider.com. For more information, call TotalCare at (866) 381-1428 or visit the Web site totalcareprotects.com. FREEinfo, Sensor Bite Blocks' All-in-One Versatility Cited DEER PARK, NY—Economically priced and fully…

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    Bulk-Fill Flowable Material Lets You Place Posterior Composites in 40% Less Time MILFORD, Del–DENTSPLY Caulk's Surefil SDR (stress reducing resin) flowable/material, the first ever bulk fill flowable base, lets you place posterior composites in 40% less time. The SDR system allows for bulk placements up to 4 mm with a 20-second cure time for universal shade and 40 seconds for shades A1, A2, and A3, and all the benefits desired in a flowable composite are offered: stress absorption and excellent cavity adaptation, now with the benefit of bulk filling. Surefil SDR flow can be placed up to the dentin enamel…

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    Spotlight Innovative Zirconia Implant Bridge Offered WOODSTOCK, NY-The Prettau Zirconia Implant Bridge revolutionizes dental prosthetics. As INCISUM's mild and designed screw-retained dental implant bridge, it is created out of Zirconia's proprietary Prettau Zirconia as acryllic, no chipping, no staining. Used in Europe for the past 5 years, Woodstock, NY-based Tischler Dental Laboratory, under the direction of Michael Tischler, DDS, is one of only a few dental laboratories in the United States to provide the Prettau Implant Bridge. The laboratory guides dentists through the entire protocol of creating the bridge, including the treatment planning process. The protocol is built on the…

19. Page 40

    ADVERTISING SUPPLEMENT QUICK TECHNIQUE Using Ivoclar Vivadent's Tetric EvoCeram for Posterior Restorations and as a Core Buildup Amanda Seay, DDS Tetric EvoCeram is a direct composite that resolves many issues dentists typically encounter with conventional composite materials. For example, a special additive incorporated into the photoinitiator system allows Tetric EvoCeram to be less reactive to ambient light while remaining highly reactive to curing lights; it will not prematurely cure until placement is finalized and will polymerize quickly when cured. Additionally, Tetric EvoCeram features a high translucency (approximately 20%) before shading to facilitate shade matching and adaptation in direct restorations. As…

20. Page 42

    NEWS/TRENDS Industry News DenMat Relocates to Lompoc, Calif To accommodate its current needs and enable future expansion for future growth, Santa Maria, Calif.-based DenMat Holdings LLC announced recently the relocation of its operations to a new facility in Lompoc, Calif. DenMat expects to relocate its 350-plus employees over a 6-month period, commencing this month. "Our current and future space needs dictate a move to a facility where we can consolidate operations into one roof as well as provide room for expansion," said Steve Sammelmayer, DenMat's CEO. "Many of our employees have been with DenMat for quite a few years, so…

21. Page 44

    Major League Baseball Limits Use and Visibility of Smokeless Tobacco For the first time in history, Major League Baseball (MLB) teams this season will be playing ball with limits on the usage and visibility of smokeless tobacco on the field and in front of fans and cameras. As part of a 5 year collective bargaining agreement reached this past November between MLB and its Players Association, players, coaches, managers, and other team personnel will no longer be permitted to stash a car or package of smokeless tobacco in their back pockets or anywhere else in their uniforms when taking to…

22. Page 46

    Aspirin May Help Form New Bone In 1899, German doctors and pharmacists began receiving the first of the sample packets from the drug company Bayer AG. The packets contained a fluffy white powder, called acetylsalicylic acid, which Bayer executives described as the latest modern miracle from the emerging field of organic chemistry. They asked the practitioners, in modern terms, to pilot test the compound on their patients, explaining that it had been shown in their initial human studies to relieve common pain and inflammation without the debilitating side effects of other drugs. But, as they also explained, other uses certainly…

23. 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. GripStrip Centrix Dental Finishing strips should be tremendously useful in dental practice; unfortunately, conventional strips are virtually impossible to use intraorally while wearing gloves. There are several problems: the strip ends (or handles) are smooth and small, making a secure grip with wet gloves difficult. The end corners come to 90°, perforating the gloves and/or lacerating the cheeks. The strips are often too thick or too wide, destroying the contact that they are meant to…

24. Page 49

    Blue View VariStrip Garrison Dental Solutions The clear matrix band has been a placement with maximal nificant part of anterior restoratives adaptation to the rounded since the earliest days of composite margins of the preparation. dentistry. It has been an excellent The Blue View VariStrip re translucent shaping tool that allowed sists deformation during cure-through polymerization as well placement. Since there is as a source of considerable frustration less stress on the matrix as its flatness and one-size-fits-all if it is positioned, it is dimensions required considerable highmore readily wedged and reand low-speed polishing definition tained throughout the entire restoraafter…

25. Page 50

    Software Company Profiles XLDent XLDent version 11.7 is proven to be easy-to-use practice management software developed by a company celebrating 41 years of serving dentists. It is the first dental software designed for today's mobile and wireless technology. Some of its highlights include the following: eMessages (text and text message reminders); integrated XLDent Dashboard (providing websites and support); one-click claim status; real-time eligibility; user-defined treatment plan updates that can be approved by the patient on a tablet PC in the treatment room; a new periodontal chart; and more. For more information, call (800) 328-2025 or the Web site visit xldent.com.…

26. Page 51

    Patterson Dental Patterson Dental is a leading distributor of dental products, equipment, and services. Eaglesoft 16 Clinical and Practice Management Software is one of the most adaptive and technologically advanced software programs on the market, integrating digital products for office, clinical, and imaging procedures. Compatible with the RevenueWell practice marketing and Communications Suite, it increases efficiency, reduces staffing costs, and saves time with automated tasks. CAESY Education Systems—now available via the Cloud—is accessible on PC, iPad, iPod, and Smartphones. For more information, call (800) 294-8504 or visit pattersondental.com. FREEinfo, Paperless Technologies Paperless Technologies (PT) allows you to automatically send email…

27. Page 52

    Foxteeth Software With Foxteeth's Visual Fox-Pro database, reports and bills are no longer a daylorg chore. A monthly billing cycle with 200 open accounts prints in 15 minutes, and recall postcards take 5 minutes to print (for an entire month). Periodontal charting is also a snap with Foxteeth's built-in voice recognition software. For more information, call (800) 851-1243 or visit the Web site foxteeth.com. FREEinfo, Henry Schein Easy Dental Henry Schein Easy Dental is one of the easiest, most affordable dental practice management systems to own and use. It gives budget-conscious practices powerful features to automate their offices without the…

28. Page 53

    CamSight CDM practice management software is one of the most comprehensive and user-friendly dental management software programs, making patient management, billing, office reports, and appointment scheduling easier than ever. It generates computerized prescriptions, progress notes, and patient medical histories. The electronic claims feature eliminates cluttered paperwork so disorganized patient files are no longer a problem. For more information, call (877) 477-5580, FREEinfo, Sesame Communications Sesame Communications is the leader in online patient communication and engagement tools designed exclusively for dentistry. These solutions encompass the entire patient lifecycle, with features including Web site design, search engine marketing, social media, reminders, patient…

29. Page 54

    Salivary Diagnostics: Moving to the Next Level SALIVA—MORE THAN WATER "Saliva doesn't have the drama of blood, it doesn't have the integrity of sweat, it doesn't have the emotional appeal of tears," stated Dr. Irwin Mandel,1 professor emeritus at the Columbia University College of Dental Medicine (New York City). Most of the time, saliva only attracts people's attention when it is absent. The center of interest for diagnostic purposes has always been blood, while saliva was at best sidelined. One of the primary reasons for this lack of appreciation might be the fact that saliva contains 99% water. However, the…

30. Page 56

    Salivary Diagnostics... continued from page 54 stages, the 5-year survival rate for oral cancer patients ranges from 71% to 96% depending on tumor location, while at late and progressed stages it drops to only 30% to 48%.⁶ Sixty percent or 75% of all oral cancer cases are only diagnosed at Stage III or IV, which presents the main reason for the high fatality rate.¹⁰ Oral cancer is one of the most expensive cancers to treat, and the healthcare expenses for therapy increase exponentially as the tumor progresses, while the patient's life quality after treatment drops dramatically. Not only would early…

31. Page 57

    ORAL MEDICINE come. The oral fluid nanosensor test device (OFNAST) presents a chair side, handheld device detecting salivary constituents within minutes, with the potential of providing a highly sensitive medical diagnostic infrastructure to the general public or even the most deprived regions in the world. Among the huge number of microsensor prototypes that are developed by companies and research groups around the globe, the OFNSET is the first platform that allows parallel multiple detection of RNA and protein markers. It has been optimized for salivary biomarker detection and has recently proven its value in a cohort of Indian oral cancer…

32. Page 58

    Test 150 Expiration date of this CE article is June 1, 2015. To submit Continuing Education (CE) answers, use the answer sheet on page 59. Circle the letter corresponding to the answer you believe is correct, detach the answer sheet from the magazine, and mail to Dentistry Today Department of Continuing Education. Or, use our easy online option at dentaltoday.com. This article is available for 2 hours of CE credit. The following 16 questions were derived from the article "Salivary Diagnostics: Moving to the Next Level," by Ole Brinkmann, DMD, PhD, et al on pages 54 to 57. Learning Objectives…

33. Page 60

    Improving Aesthetics: Harmonizing the White and Pink INTRODUCTION Frequently, when treating the aesthetic concerns of the patient, practitioners focus on the teeth (the white) and ignore the gingiva (the pink). But, both these aspects need to be addressed to provide the best aesthetic outcome and to correct what is either naturally present or the result of wear and tear over the years. It is not unusual to restore the anterior maxillary teeth with direct resin veneers, porcelain veneers, or full coverage crowns, and end up with a patient who may not be completely satisfied with the result. This is often…

34. Page 62

    Improving Aesthetics... continued from page 60 clinical crown.5 These visual findings are confirmed with clinical information obtained by bone sounding.6 Bone sounding involves using a periodontal probe to locate the CEJ, and determining whether it can be felt within the gingival sulcus or only when the probe penetrates through the base of the sulcus.8 The periodontal probe is also used to feel for the crest of bone. Normally, the crest of bone is located 2 to 3 mm apical to the CEJ.7 When considering the display of the gingival margin on the facial aspect of the teeth (in a healthy…

35. Page 63

    lar teeth as well. This provides the central incisors, canines, and premolars with a subtle distal root inclination which is associated with a beautiful smile. On the other hand, the lateral incisor has its apical at the mid line of the long axis of the tooth. Additionally, the height of the gingival crest for the labial incisor should be positioned ideally 1.0 mm more coronal than the gingival margins of the central incisor and canine. The resulting healed and healthy gingival margins should have a "knife-edge" emergence margin.17 The gingival tissue can be corrected by a variety of methods, including…

36. Page 64

    AESTHETICS incisors in this case could be length-ened initially 2.0 mm. Since the patient had adequate anterior guid-ance, we would use the established guidance with respect to the direct resin veneer. The composite resin would be added in a buccal and incisal direction with no extension onto the lingual surface. This would be done so that, during protrusion, the lower incisal edges would slide over the natural tooth surfaces and continue onto the veneer with no inter-ferences. The author prefers using composite versus wax for "washing" the cast, as the composite can be molded and shaped until the desired contours…

37. Page 65

    Figure 20. Demonstrating the ideal length to width proportions of the completed direct resin veneers with the Chu proportion instrument. Figure 21. Comparison of the patient prior to treatment and immediately following gingival recontouring and direct resin veneers, demonstrating better gingival display and tooth spacing to width proportions. Figure 22. The patient's new smile one week posing/ual recontouring and with direct resin veneers. utilized to make a mark where the new zenith would be established for the anterior teeth (Figure 12). The bipolar electrosurgery unit was then used to remove a crescent-shaped piece of gingival tissue at each anterior tooth…

38. Page 66

    USA) on a mandrel in a slow-speed handpiece with fine diamond polishing paste; moderate pressure was used to create a high polish. The gingival contouring and direct composite resin veneers helped improve or correct the "gummy" smile. Balanced the occlusal plane to correct the tip to the right, and replaced length to the worn incisal edges (Figure 21). The patient was checked at one week following treatment to confirm that the anterior guidance had not changed, and that no functional interferences existed on the extended incisal edges. The gingival tissue was healing well and minimal inflammation was noted (Figure 22).…

39. Page 67

    Figure 26. Comparison of the before treatment and after dental treatment and aesthetic augmentation with Botox and dermafilr, creating a more youthful appearance and bringing out the patient's natural beauty. The patient presented with normal aging lines on the areas resulting from decreased elasticity of the skin (accentuated creases and wrinkles) due to the loss of hyaluronic acid within the skin and underlying tissue. Examination noted furrowed brow lines in the forehead, prominent Procerus muscles with the establishment of "11"s between the eyebrows, "crow's feet" at the lateral boarders of the eyes, deep nasolabial folds, thin lips (especially the upper…

40. Page 68

    The Creation of an Emergence Profile, Part 2 Pontic-Guided Implant Placement in the Aesthetic Zone This is part 2 of a 2-part article series. Part 1 by Bereznicki and Danucci's article was published in the April 2012 issue of Dentistry Today and can be found in our online articles on . Tom Bereznicki, BDS (Edin) Andrew Danucci, MBD, RCS, MSc, BDS INTRODUCTION Part 1 of this series dealt with the creation of an emergence profile prior to implant placement, along with implant placement and provision of an immediately-loaded fixed partial denture (FPD) used to support and maintain the created profile.…

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