Dentistry Today — JUNE 2014

Inside this issue

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

1. Page 8

   Embezzlement Cases: Who is Responsible? While browsing the Web under "embezzlement cases in dentistry," I came across the following: • A Lawrenceville, Ga. family was charged with embezzling more than $2 million from a practice in Sandy Springs. • An office manager for a pediatric dentist in Chicago was found guilty of embezzling $135,000 in cash payments from patients during a 5-year period. • In a huge case of embezzlement from a north Spokane dental office, a former employee confessed to taking $250,000 throughout the course of her nearly 11-year employment. • A former dental office manager in San Antonio…

2. Page 10

   Figure 1. DentiMax Practice Management software offers easy-to-use security levels that can then be tracked in the audit report. Table. 6/14/2013 12:08 a.m. Transaction Changed MINDY Old Value: 1029 CORSO 692 5/23/2013 PATCASH -1000 New Values: 1029 CORSO 692 5/23/2013 PATCASH -500 continued from page 8 agreement software? DentiMax Dental Practice Management software allows you to track all of this information in an easy-to-use, low-cost option, and training is even included with the purchase. WHO'S TO BLAME? I believe it goes back to the dental schools. It isn't the dentist's fault that business classes are not part of the current…

3. Page 12

   Below is a Letter to the Editor that Dentistry Today received regarding the article, "Minimally Invasive Treatment of Brown Spot Fluorosis," which ran in May 2014 on pages 140 to 143. Dear Editor: I have a concern with the case that shows the bleaching of stained teeth in a 12-year-old boy. The child shows a classic picture of brown and white enamel "dysmineralization," which means there is altered superficial mineral content of the enamel of the permanent maxillary central incisors. The authors need to document that the boy had excessive fluoride ingestion during the years of amelogenesis of those teeth;…

4. Page 15

   ENSURE A DRY WORKING ENVIRONMENT EVERY TIME WITH DRYZ™ 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 seating restorations, placing rubber dam clamps (controlling bleeding), bleaching teeth (to manage moisture) and restoring subgingival cavities. PARKELL SMARTSAVE Parkell's Dryz™ Value Pack contains 25 syringes and 55 applicator tips, so you'll order less often and SAVE ALMOST A DOLLAR PER SYRINGE! Dryz™ is terrific for use…

5. Page 18

   From the March 2014 Issue AUTOMATIC MIXING DEVICE 3M ESPE The new Pentamix Lite Automatic Mixing Unit offers dentists an entry-level model into the world of automatic mixing. As an affordable, portable mixer, it works with all 3M ESPE cartridge materials and is built with convenience in mind. From high-viscosity putty to medium-bodied materials, the Pentamix Lite consistently delivers a homogenous, reproducible mixing quality for void-free impressions. For more information, call (800) 634-2249 or visit the Web site 3mespe.com/pentamixlite. FREEinfo, SECTIONAL MATRIX SYSTEM DENTSPLY Caulk The Palodent Plus Sectional Matrix System offers a wide variety of applications for sectional matrix…

6. Page 20

   NEW PRODUCTS ULTRASONIC SCALERS ACTEON North America ACTEON/SATELEC, the originators of piezo-ultrasonics in dentistry, introduce the all-new, completely redesigned NEWTRON P5 XS (shown), NEWTRON P5, and NEWTRON BOOSTER ultrasonic scalers. They feature such items as a new handpiece and a glowing power dial designed to make scaling, en-dontics, and any other procedure you choose easier, more effective, and better for patients. For more information, call (800) 289-6367 or visit acteonusa.com. FREEinfo, BITE MATERIAL 3M ESPE New to the Imprint 4 family, Imprint 4 Bite VPS Material is suited for open and closed bite occlusal registration. It replaces the existing Imprint…

7. Page 22

   CLINICAL REVIEWS THE DENTAL ADVISOR TheraCal LC Pulp Protectant/Liner (One Year) +++++ BISCO Dental Products | bisco.com Consultants' Comments • "TheraCal LC has become part of my daily practice in the placement of direct restorations." • "TheraCal LC is truly effective in preventing the postoperative sensitivity often associated with deeper restorations." • "I am convinced this liner actually helped prevent some root canal treatments." Methodology One hundred sixty-five restorations were evaluated at placement for level of caries risk, type of pulp cap, bonding agent used, restorative material, and reported patient sensitivity. Types of restorations included Class II (60%), Class I…

8. Page 24

   CLINICAL REVIEWS THE DENTAL ADVISOR Munce Discovery Burs +++++ CJM Engineering | cjmengineering.com Consultants' Comments • "The Munce Discovery Burs are by far the best long-shank endo burs available." • "They cut efficiently and do not clog." • "I had never used endodontic burs before. I liked the ability to more easily locate hidden canals and open constructed canals." • "It was easy to maneuver them in the confined space of a root canal opening. The thin shaft was a superb enhancement to the management of tight access!" • "Everyone doing endo should keep these on hand." • "Make a…

9. Page 25

   Gazelle Nano Composite Polishers +++++ Microcopy | neodiamond.com Consultants' Comments • "Final polish was fantastic!" • "High-gloss finish." • "Very durable for a single-use product." • "Color coding makes it easy to differentiate the 2 polishers." Description Gazelle Nano Composite Polishers are single-use composite polishers, individually packaged and presterilized. The Satin polishers (white) contain aluminum oxide and are appropriate for universal composite restorations. The Hi-Gloss polishers (blue) contain diamond particles and are designed for more aesthetic restorations. Both are available in a point, cup, or disc and should be used at a maximum speed of 5,000 rpm. Evaluated by 32…

10. Page 26

    Spotlight New Pen-Style LED Curing Light Hailed for Its Reliability, Ergonomics, and Simplicity MILFORD, Del.-Light curing is an essential procedural step in the placement of composite resin restorations, and esthetic edge delivery to the base of the restoration is critical for success. To achieve this success, put confidence in your hands with DENTSPLY Caulk's new SmartLite Focus Pen-style LED Curing Light, designed to ensure reliable curing all the way to the floor of the proximal box, the most vulnerable interface in a Class II restoration. The SmartLite Focus' collimated light beam reduces light divergence for a dependable cure over larger…

11. Page 28

    Spotlight Service Provides Clinicians With an Innovative Alternative to Existing Aligner Treatments New Intraoral Sensor Streamlines Workflow, Offers Maximal Diagnostic Precision ATLANTA—Offering clinicians a streamlined, 3-step workflow—position, expose, and view—Carestream Dental's new RVG 6200 digital intraoral sensor, with true resolution of 24 line pairs/mm, promotes maximal diagnostic precision and provides crystal clear images every time it's used for improved diagnoses. Additionally, it comes with a convenient dose indicator that identifies overor underexposures so practitioners can quickly adjust settings and reduce the need for retakes, making the imaging process more efficient for clinicians and patients alike. Clinicians can optimize image contrast…

12. Page 29

    Eyewear Designed to Improve Ergonomics, Create More Comfortable Working Experience LOMPOC, Calif.—Offered by DenMat, PeriOptix lights and loupes feature lights weight frames and headgear designed to improve ergonomics, resulting in less neck strain and an overall more comfortable working experience. The frames are designed by premium brand names such as Adidas, Hogies, and Univet, allowing clinicians exceptional quality, class, and value. Since being founded in 1999, PeriOptix, a leader in magnification and illumination technologies, has introduced a number of innovations. They include (1) a modular frame system, (2) the first portable LED light source, and (3) a proprietary locking mechanism…

13. Page 30

    New Apex Locator Delivers Proven, Precise Length Determination TULSA, Okla—DENTSPLY Tulsa Dental Specialties' new PROMARK Apex Locator, independently eval­uated from multifire-query accuracy and repeatability (data on file), delivers precise length de­termination for dentists performing root canal therapy. Folded, it measures just 4.25 x 4 x 1 in unfolded, it reveals an adjustable-tilt color touchscreen with full canal and apical zoom views that allows dentists to see a close-up view of the allapical section between apical constric­tion and apical foramen. The screen also displays an apical indication line with corresponding audio cues that provide dentists with valuable length determination flexibility. FREEinfo,…

14. Page 31

    Safety Device Eliminates Risks Associated With Diamond Discs VANCOUVER, Wash— Using a diamond disc is an integral part of a dentist's work, but it comes with the risk of cutting a patient's lips or tongue. To eliminate this risk, ContactZ introduces Snap-On DiscGuard, which facilitates disc change while ensuring patient safety. A single use safety device, it has a snap-on/snap-off mechanism, and its transparent plastic offers a clear view of the spinning disc, allowing dentists to perform procedures without obstruction or apprehension. It fits diamond discs up to 22 mm in diameter on slow-speed handpiece. For more information, visit the…

15. Page 32

    An Alternative to Cutting or Splitting Crowns That Actually Works! The WAMkey Crown & Bridge Removal System Timothy Kosinski, MS, DDS In my practice, I have historically cut or split crowns with a burr in a high-speed handpiece, which can be a time-consuming procedure that can put wear on your handpiece and use several expensive burs. Let's face it—removing a crown or bridge is not likely your favorite procedure. When a crown or bridge needs to be removed, we have to physically destroy the porcelain or PFM. Monolithic zirconia crowns create an entirely different problem. Sectioning the crown can result…

16. Page 33

    should be made closer to the occlusal surface for metal crowns and especially when below the crown occlusal surface and the margin for porcelain or PFM crowns. Step 2: Locate the crown occlusal interface. In most cases, the interface is located in Step 1. But if not, the opening made in Step 1 would have to be progressively enlarged until the cement seal becomes visible. Visual assistance devices such as surgical loupes or a microscope can be extremely helpful in this process. It is critical that you are working in the cement layer. Step 3: Create a tunnel between the…

17. Page 34

    Spotlight New Gutta-Percha Delivers Smooth Consistency and Control at a Lower Working Temperature ALGONQUIN, ILL–Obtura Spartan Endodontics' new, latex-free Flow 150 Gutta-Percha features a unique nano formula that produces optimal consistency and smoothness at a lower working temperature for better clinical application. Designed to work best when heated between 145°C and 165°C, it is easily manipulated for a longer period of time without cooling or shrinking. Because Flow requires a lower working temperature to produce a desirable flow, clinicians will be able to bring a heating plugger deeper into the root canal space for a better 3-D fill. It is…

18. Page 36

    Spotlight Featuring a 40,000-Hz Tip Frequency, Cordless Ultrasonic Activator Significantly Improves Irrigant Penetration RACINE, Wis—Science has shown that irrigants are more effective when electromechanically activated, and acoustic streaming and cavitation of intracanal irrigants significantly enhances the cleansing of difficult anatomy. To help clinicians utilize these benefits, VISTA Dental Products introduces the EndoUltra, the only cordless activator capable of generating the tip frequency required to create sufficient acoustic streaming and the cavitation necessary to effectively clean, penetrate, and remove vapor lock, resulting in significantly improved outcomes. Utilizing a tip frequency of 40,000 Hz, you have more than sonic devices, it disrupts…

19. Page 37

    Four-in-One Tool Facilitates Implant Procedures IRVINE, Calif.–A practical, cost-effective 4-in-one implant tool that eliminates any guesswork among the surgeon, restoring doctor, technician, and patient, Keating Dental Arts' Delineator—exclusive to Keating—is a radiographic guide, surgical stent, provisional restoration, and implant locator. See for yourself by prescribing the Delineator as the first step of your next implant case. Include a diagnostic model indicating the proposed implant location(s) to initiate your case with Keating Dental Arts. For more information, call Keating Dental Arts at (800) 433-9833 or visit the Web site located at keatingdentalarts.com. FREEinfo, Ultrasonic Inserts Designed to Improve Comfort and Performance…

20. Page 38

    Needles' Dual-Vent Design Creates More Effective Irrigation MADISON, Conn.—Transcendent's Flexible Steel Irrigation Needles are the latest innovation from the German company, whose engineers have improved traditional irrigation needles by creating a dual-vent, sterile irrigation needle. The dual vents create a unique swirl effect for more effective irrigation. In designing the needles, the engineers also selected the best surgical specialty steel available today—high-quality, thin-walled steel that improves flexibility and flow rate. The needles, which have a standard luer connection, are available in 4 sizes—gauges 23, 25, 27, and 30. To try a box of needles at no charge, visit getmedia.com. For…

21. Page 39

    Spotlight Gingival Retraction Device's Versatility Cited POINTE-CLAIRE, Quebec - G-Cuff is a nontraumatic gingival retraction device with many applications. Originally developed for a direct impression technique to improve the passive fit of multi-unit fixtures, dentists have now found other interesting uses for it: (1) to use a device as a caries and cementation barrier, (2) use as a device for digital intraoral scanning, (3) use as an ergonomic carrier for abutments into the patient's mouth, and (4) for emergence profile contouring. Painless and easy to use, G-Cuff works with different implant systems and brands. A starter kit includes 48 assorted…

22. Page 40

    Introducing SciCan's SANAO Line of Precision Handpieces SciCan is proud to introduce its new SANAO line of precision handpieces. SANAO is perfectly balanced to reduce wrist strain, optimally miniaturized for maneuverability, and optimally equipped with glass rod fiber optics to illuminate the oral cavity. The handpieces offer innovation in every detail. POWER Exceeding 200,000 rpm, the SANAO 200L bur cuts faster and smoother for unparalleled efficiency. Combine the powerful SANAO 200L with SciCan's E-STATIS SLM, the smallest torque controlled motor in the industry (up to 35% shorter and lighter), and you have a stress-reducing combination that can save the day—less…

23. Page 42

    NEWS/TRENDS Industry News Kerr Corp Partners With Recycling Company to Offer Online CE Course Orange, California-based Kerr Corp, manufacturer of innovative dental products, announced recently that it has partnered with Dental Recycling North America (DRNA) to offer an online CE course on public health and environmental responsibility. Kerr customers will be able to participate in the 3-credit course, designed to educate dentists and their teams on the latest public health and environment best practices and regulatory compliance issues. They will also be entitled to savings on DRNA's Amalgam Recycling Kits and maintenance-free Amalgam Separators. For more information, call (800) 363-0041,…

24. Page 43

    Personal Attention Guaranteed. Global Dental Solutions, LLC since 2001 full service dental laboratory FREE STARTER KIT 866-905-1111 Brad Hal The Abramson Brothers Your #1 full service dental laboratory. Our consistently low remake rate and competitive pricing make us the laboratory capable of handling all of your needs. We offer free round-trip shipping, via FedEx preprinted labels or local courier. Additionally, our co-founders, Hal and Brad, are in the laboratory 5 days a week. We've been dedicated to your success since 2001. FLEXIBLE PARTIALS Vueloplast tcs CERTIFIED LABORATORY DIGITAL DENTISTRY CEREC CADENT iTero. CROWN & BRIDGE For zirconia, we offer: Full…

25. Page 44

    Launches Online MERS Tool Kit In response to recent reports of Middle East Respiratory Syndrome (MERS) cases in the United States, the Organization for Safety, Asepsis and Prevention (OSAP) has developed an online tool kit specifically for oral healthcare professionals. Designed to bring dental professionals up to date on a disease that has only recently begun to make headlines in the United States, the tool kit (s) links to CDC recommendations for prevention and control of MERS, (2) best clinical practices for prevention and early spread of MERS, (3) a "talking points" script for front office staff for addressing the…

26. Page 45

    NEWS/TRENDS California... continued from page 42 highest percentage of new dentists, who made up 15% of the total supply. A noteworthy development analysis showed one group, women, made up almost half of all newly licensed dentists in California in 2012. Age may also affect supply. Nearly one quarter of actively licensed dentists in California have been practicing for 30 years or more and are close to retirement age. Northern and Sierra counties had the highest proportion of dentists nearing retirement, at 40%. The report also suggests that it may become tougher for adults to get basic oral care than gum…

27. 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. ClearTemp LC Ultradent Products Provisional cements have long been problematic for dental practitioners. They must be strong, but not too strong. They must be retentive, but not too retentive. They must be invisible during function, but must be readily visible during removal. With all these conflicting requirements (and more), it is not surprising that most provisional cements were "compromise" materials, with flying some parameters but completely missing others. The most current temporary cements are opaque…

28. Page 50

    50 . 1 4th ANNUAL READERS' CHOICE Top 25 Implant Products Dentistry Today's Fourth Annual Readers' Choice Top 25 Implant Products, selected on the basis of lead generation, represent some of the profession's most innovative implant products. The products appear in no particular order. Aseptico The AEU 7000E 70V provides the ultimate return on investment. A unique handpiece calibration system automatically detects the internal properties of individual reduction handpieces at the time of treatment, ensuring highly accurate speed and torque results. Existing handpieces can be used, resulting in additional cost savings. Reduction handpiece ratios include 4:1 through 16:1 for endo,…

29. Page 52

    52 4TH ANNUAL READERS' CHOICE Top 25 Implant Products . 1 OCO Biomedical The 3.0 implant is the perfect solution for denture stabilization or single-tooth replacement when either the patient's budget or bone quantity are limited. In 2002, it was the first one-piece, 3.0mm mini implant introduced into the US market. After years of unparalleled success, the 3.0 has become dentists' choice for small inter-dental spaces or denture stabilization. The 3.0 is the only 3-mm diameter implant on the market with the patented Bull Nose Auger tip, providing unparalleled primary stability for immediate load capability. No other implant on the…

30. Page 54

    54 4TH ANNUAL READERS' CHOICE Top 25 Implant Products . 1 Sterngold Before the ERA concept was developed, dental professionals and their patients were experiencing problems with some resilient attachments. They were too expensive, difficult to fabricate, and too fragile or unreliable for long-term patient service. The ERA System alleviates these problems by using new materials and patented designs. All attachments comprise a metal female component, which is intraorally fixed. There's also a replaceable, high-density nylon male anchor in the denture base. By eliminating the machining of expensive gold alloy components, ERA attachments are affordable to many more patients. They…

31. Page 56

    Use FREE info Card on pg. 1 4TH ANNUAL READERS' CHOICE Top 25 Implant Products Implant Direct Treat many versatile clinical situations at less than half the cost of some others with Legacy2 implants. Available in 3.2-, 3.7-, 4.2-, 4.7-, 5.2-, 5.7-, and 7.0-mm diameters with 6 lengths and 2 surface options (SBM and HA), the implant offers an incredible selection. Each Legacy2 implant is packaged with a cover screw, extender, and a carrier that can be used as an implant/head transfer and a titanium temporary abutment for maximum value. Legacy2 features a profession standard internal hex connection and a…

32. Page 58

    58 4TH ANNUAL READERS' CHOICE Top 25 Implant Products . 1 integrated dental systems With its patented, innovative KnifeThread design, the AnyRidge Implant System is specifically designed for minimal disturbance of crestal bone and soft-tissue volume, while ensuring both high initial and ongoing stability and better aesthetic outcomes in even the most challenging applications. The unique design, which features 10 implant diameters with 3 core sizes, allows you to match the implant to the patient's bone density, cut through the bone smoothly, and condense it simultaneously. AnyRidge delivers progressive bone condensing, ridge expansion, maximized compressive force resistance, and minimal shear…

33. Page 59

    . 1 59 4TH ANNUAL READERS' CHOICE Implant Products Top 25 KAT Implants Zimmer Dental The KAT system is built around a single external locking taper platform, which allows the same abutments to be used on implants ranging in diameter from 2.5 to 8 mm and in length from 0.6 to 14.0 mm. Solid-body design, locking taper connection, and the absence of a microga between abutments and implants are just a few of the aspects that distinguish the implant system from the competition. Recently introduced Tint Implants allow primary stability as well as length and diameter verification prior to final…

34. Page 60

    60 4TH ANNUAL READERS' CHOICE Top 25 Implant Products . 1 Dentatus The Atlas System is designed for long-term use to effectively retain and stabilize dentures. This one hour chairside procedure for the Atlas makes it the only system on the market today that eliminates the hardware typically associated with overdentures. This makes it affordable for many more patients. The unique TurLink silicone retine provides the retention to the implants and is secured within the denture by an undercut. TurLink provides the Atlas System with a cushioned fit for stress-free denture insertion, retention, and removal. TurLink needs to be replaced…

35. Page 61

    BioHorizons LaserLok dental implants are ideal for the aesthetic zone because of their dual-affinity nature to attract both hard and soft tissue. Unique in the profession, these implants have been shown through 25 years of research to elicit a precise biologic response that includes the inhibition of epithelial downgrowth and the establishment of a physical, connective tissue seal that protects and maintains crestal bone. LaserLok dental implants are available in bone level, tissue level, and small diameters. The 3-mm versions have been shown to be significantly stronger than competitors' implants. This strength advantage is critical for small diameter implants. All…

36. Page 62

    62 4TH ANNUAL READERS' CHOICE Top 25 Implant Products . 1 Intra-Lock Park Dental Research Mini Drive-Lock, a one-piece, small-diameter implant, is ideal for long-term denture stabilization or fixed prosthetics. Patented Cement-Over Abutments, available in 15 configurations, simply fit over the o-ball assembly and convert the implant from removable to fixed or orthodontic treatment options. The system's unique Drive-Lock instrument reduces delivery and placement to one fluid motion. For more information, call (877) 330-0338 or visit Intra-lock.com. The Lew MDI implant has a reliable profile and unique features, including (1) the platform-switching collar that provides a smooth interface for soft…

37. Page 64

    Small-Diameter Implants for Single-Unit Restorations INTRODUCTION By now, many dentists have heard about the use of mini dental implants (MDIs) (also referred to as small-diameter implants [SDIs] for denture stabilization. The benefits of this procedure—in terms of greater affordability, a lower investment, and suitability for a broader range of patients—have made it very well received by both patients and practitioners. And while some clinicians may still consider MDIs a relatively new treatment on the market, studies and meta-analysis have now proven their long-term efficacy. The benefits of the MDI procedure can also apply in cases beyond denture stabilization, as many…

38. Page 66

    Small-Diameter Implants for... continued from page 64 demand and bite forces are lower, such as lower central or laterals and upper laterals, as will be demonstrated here. CASE REPORT A female in her late 50s was missing her left cuspid and lateral incisor and sought a solution to fill the gap in her smile (Figure 1). Due largely to her budget, the patient opted for treatment with a crown supported by an MDI. CLINICAL PROTOCOL At the implant placement appointment, the soft tissue at the implant site was probed and the thickness was recorded. Soft tissue was removed with a…

39. Page 68

    Augmentation Versus Amputation Implementing Noninvasive and Minimally Invasive Protocols for Maximum Success INTRODUCTION Minimally invasive dentistry is a buzz phrase that means different things to many clini-cians. One dentist may think a three quarter porcelain veneer is conservative, where another believes it too destructive of tooth structure. During the last several years, tech-nological developments have allowed clini-cians to more respectful of tooth structure. G. V. Black's classification of cavity prepara-tion was based on the restorative needs of the materials used at a particular time in our den-tal history. It was necessary to create resist-ance and retention form so the restoration…

40. Page 70

    AESTHETICS CASE 1 Figure 5. Pre-op occlusal view. Figure 6. Etching gel (Ultra-Etch [Ultradent Products]) placed on left lateral incisor (No. 10). Figure 7. Mortified composite resin (Renamel [Cosmedent]) was then placed and sculpted. Figure 8. Etch placed on left central incisor (No. 9). Figure 9. Polished interproximal of left corner. Figure 10. Post-op restorations (teeth Nos. 7 to 10) prior to polish. Figure 11. Post-op restorations after polish. Figure 12. Post-op smile showing the completed aesthetic and noninvasive restorations on teeth Nos. 7 to 10. Augmentation Versus Amputation... continued from page 68 conservative concept of the adhesive tooth preparation…

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