Dentistry Today — June 2015

Inside this issue

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

1. Page 8

   Dentistry Has Its Challenges It probably does not seem that long ago to the more seasoned doctors—those who graduated in the mid-1960s and 1970s—that the basic dental material choices available in their early days came to several brands of composite resin, cast gold, gold foil, PFMs, feldspathic porcelain, and rubber base and dental composite impressions for various restorative and prosthodontic applications. Next to what doctors face these days, making a decision on which was the "best" product for any given situation was simple. This point jumps into perspective when one picks up this issue of Dentistry Today and reads (1)…

2. Page 10

   Prevention of Musculoskeletal Disorders "How much longer will I be able to practice?" Does pain from your neck, back, shoulder, or arm cause you concern for the viability of your career? Do numbness and tingling in your hands limit your dexterity and professional skills? You are not the only one! Eighty percent of dental clinicians suffer from pain associated with musculoskeletal disorders caused by their work, according to research. By their senior year, 70% of dental students suffer from the same conditions. The pain alone is difficult, but these health issues can have a mine greater impact. They can negatively…

3. Page 11

   Treatment cost doesn't have to keep him from smiling causes of pain and that a solution even exists. A vital component to restoring function and alleviating pain, which other interventions lack, is an awareness and understanding of the process that created the conditions as well as the steps that can be taken that can lead to a return to health. It is not only about what you do in the operatory, but how you want to live the rest of your life! Mr. Williamson, a personal trainer and nationally recognized Pilates practitioner, developed the Body Praxis system after successfully habilitating…

4. Page 12

   This month on Technique of the Week All-Ceramic Crown Demonstration Nicholas Conte Jr, DMD In this video, Dr. Nicholas Conte, Jr completes an all-ceramic, lithium silicate Celtra crown in the demonstration using DENTSPLY Caulk's Calibra Universal self adhesive resin cement. The steps include applying the self adhesive cement and seating the restoration. Dr. Conte then highlights the ease of excess cement cleanup due to Calibra Universal's wide tack-cure window and extended gel phase. The restoration is completed by finishing and polishing the crown. Watch now at . Live Blog Coverage CDA ANAHEIM 2015 Have you seen Dentistry Today's coverage of…

5. Page 16

   FOCUS ON: Restorative Materials With the ever-improving market of dental products, Daniel H. Ward, DDS, suggests that clinicians listen to trusted educators and evaluate products themselves. Q: I am amazed at how many new products I see every month in Dentistry Today. How do dentists decide which materials to implement into their practices? A: Years ago, dentists would wait for academic institutions to perform double-blind, no-year studies to determine if a material was suitable for use. Today, with so many new products being introduced and being constantly improved, these types of studies would be describing materials that are no longer…

6. Page 18

   NEW PRODUCTS PEDODONTIC PRODUCT LINE Angelus Dental With playful features and a bit of humor, the Angie line of pedodontic products offers products with an unique approach, presenting its DentalFriends characters with the mission to entertain and teach the child patient. Developed to promote a more positive environment when treating children while reducing the difficulties faced by the general practitioner and pododontist, the products exploit the concept of "who cares as a friend" as they delight dentists, children, and parents. For more information, call (855) 346-3682 or visit angie.angelusdental.com. FREEinfo, FIBER-OPTIC POSTS iLumi Sciences US-made iLumi Fiber Optic Dental Posts…

7. Page 20

   From the March 2015 Issue DRY MOUTH-RELIEVING DISCS OraHealth The introduction of XyliMelt Discs gives dentists an excellent and effective tool that stimulates saliva production to relieve dryness of the mouth and helps to reduce the incidence of cavities. The discs can be used comfortably during the daytime and sleeping. The medicinal ingredient is xylitol, a unique sugar that offers a sweet, salivating-stimulating taste and is completely indigestible to bacteria (hence no increase in caries). For additional information, call toll-free (877) 672-6541 or visit oracoat.com. FREEinfo, NATURAL ORAL HEALTHCARE PRODUCTS Dental Herb Co Tooth & Gums Tonic and Tooth &…

8. Page 22

   CLINICAL REVIEWS THE DENTAL ADVISOR Remin Pro +++++ VOCO | (888) 658-2584 | vocoamerica.com Consultants' Comments • "Place it in whitening trays for easy and mess-free delivery." • "Patients all reported a significant decrease in sensitivity." • "Good flavors." • "Add patient instructions to kit." • "Instructions should indicate recommended frequency of use." Description Remin Pro, a triple-protection paste containing hydroxyapatite, fluoride, and xylitol, is indicated for use after whitening and prophylaxis for the treatment and prevention of hypersensitivity, demineralization, and acid erosion. Formulated to provide added tooth protection by neutralizing acid challenges from cariogenic bacteria in plaque, it may…

9. Page 24

   TECHNOLOGY TODAY "Hey You, (Don't) Get Off of My Cloud" Paul Fuerstein, DMD As far as backing up data is concerned, in this day of HIPAA, the server and all backups should be encrypted, especially those taken off premises. This is a task that many practices ignore. The backbone of any dental practice is the management system. In its infancy, it merely replaced billing systems and the appointment book. As the systems became more complex and computing evolved, most practices assembled a robust network with full office connectivity and a central depot for information and network control called the server.…

10. Page 26

    Software Company Profiles MacPractice MacPractice DDS is the best-of-class practice management and clinical software for dentists who prefer Macs. With integrated administrative billing, next generation charting, Mac-native digital imaging, EHR, new patient marketing, and integrated online patient services, MacPractice is some of the most comprehensive and elegant practice management software in dentistry. MacPractice delivers high-quality software, reasonably priced with excellent support, and a full spectrum of integrated software and hardware solutions to increase practice profits while allowing your practice to focus on patient care and be more productive. For more information, call (402) 330-2430 or visit macpractice.com. FREEinfo, Citrix ShareFile…

11. Page 28

    SOFTWARE COMPANY PROFILES XLDent Wireless Tablet PCs are becoming mainstream, and XLDent is built from the ground up to work with this new technology. Many dentists are frustrated with the limitations that desktop computers, the keyboard, and mouse have in the treatment room. Dusty cables and keeping everything clean adds to this frustration. With XLDent, there are no cables because of its wireless design, plus it is totally mobile. Together, the intuitive turn-key system gives you the power to dramatically streamline clinical workflows. For more information, call (800) 328-2925 or visit xldent.com. FREEinfo, Curve Dental Curve Dental provides a bright,…

12. Page 29

    PreVu Software PreVu Software provides healthcare and aesthetic professionals with intuitive, fast, and easy-to-use digital simulation solutions for marketing, case presentation, and treatment planning. PreVu cosmetic simulation software offers patients a vision of their treatment outcome, which is a strong motivator for them to accept and schedule treatments. PreVu Dental can be used to simulate dental procedures, including teeth whitening, orthodontics, periodontics, cosmetic bonding, bridges and implants, posterior restorations, Botox, and lip augmentation as well as a full-mouth digital makeover. For more information, call (855) PREVu4 (773-8848) or visit the website prevusoftware.com. FREEinfo, Seattle Software Design AlterImage is the one…

13. Page 30

    SOFTWARE COMPANY PROFILES MOGO MOGO has dedicated more than 30 years to providing general dentists and specialists with advanced dental practice management software. The MOGO Cloud is innovative and cost-effective dental software powered by the Microsoft Cloud (Azure) for profession-leading security, ensuring safety and reliability. There are no add-ons with this software. The entire program, which is a complete DPM software from eReminders to imaging x-rays, offers a range of options from charting to reports—all on the cloud for a low monthly fee. For more information, call (800) 944-6646 or visit mogo.com. FREEinfo, QSIDental Web QSIDental Web cloud-based software provides…

14. Page 31

    Spotlight CBCT Units' Ultra-Low Dose Protocol Reduces Patient Radiation Exposure by an Average of 77% Without Loss of Image Quality ROSELLE, Ill—A new study published recently in the Journal of the International Association of Dental Research has determined that dentists utilizing Planmeca's ProMax CBCT units can substantially reduce the amount of patient radiation without losing the diagnostic quality of images. During the study, conducted by the University of North Carolina School of Dentistry, researchers found that using the ProMax units' Ultra-Low Dose (ULD) protocol resulted in an average of 77% reduction in radiation exposure when compared with standard imaging protocols.…

15. Page 32

    Spotlight Electronic Health Records Software Created Specifically for Dentists MESA, Ariz.–DentiMax's 2014 ONC ACB-certified electronic health records (EHR) software has been created specifically for dentists. With the purchase of the software, dentists who have 25 percent or more of their visits from Medicaid patients can qualify for an initial $21,250 government payment, plus additional $8,500 per year for years 2 and 3. Once future ONC specifications are established, DentiMax plans include updates that will allow for even more payments. In total, dentists will be able to collect $63,750 over five years. DentiMax also offers consultative services to help dentists qualify…

16. Page 34

    Spotlight Bulk-Fill Syringe Facilitates Administration of Anesthetics MORRISVILLE, N.C.— Approved by the FDA this past January, Anutra Medical's new, disposable, bulk-delivery Anutra Feedback Aspiration Syringe has been designed to overcome many of the shortcomings of traditional dental syringes. Until now, an aspiration dental syringe has been limited to holding only one cartridge at a time, one that typically holds 1.8 mL of fluid, and most dental restorative procedures require the use of multiple cartridges. As a result, Anutra Medical engineered its syringe to hold up to 5 mL of fluid. To further enhance the clinician's experience, Anutra's syringe is designed…

17. Page 35

    New Series of Air Compressors Introduced MELVILLE, NY–The new AirStar NEO series of air compressors combines Air Techniques' exclusive Membrane Dryer Technology with new integrated diagnostic monitoring functions for state-of-the-art performance. Air is quadruple filtered by the membrane dryer to ensure it is the cleanest and driest possible, and intelligent controls provide trouble-free performance by allowing easy access to user settings and setup controls from any room. Each AirStar NEO is 100% oil-free, compact in size, and features a full-color digital touchscreen display. Additionally, its smart alarms keep users informed of preventative maintenance. For additional information, visit airtechniques.com. FREEinfo, Cloud-Based…

18. Page 37

    Spotlight Implants System Features Single, External-Locking Taper Platform PORTSMOUTH, NH–The KAT Implants System features a single, external-locking taper platform that allows the same abutments to be used on implants ranging in diameter from 2.5 to 8.0 mm. The 2.5-mm implants are 2-piece implants that are FDA cleared to be used in long-term applications with long term crowns, bridges, and dentures. Abutments are retained via locking taper connection without cement or retaining screws. For more information, KAT Implants at (877) 528-7978 or visit the website katimplants.com. FREEinfo, Laser Tip Facilitates and Improves Peri-Implantitis Treatment IRVINE, Calif–To further advance the management of…

19. Page 38

    Dental Products' CORE-FLO DC Lite...Unmatched Excellence and Versatility Jack D Griffin Jr., DMD Build-up materials are often thought of by clinicians as strong, dentinlike dual-cure composites that are used to replace tooth structure under crown and fixed partial dentures. BISCO Dental Products' CORE-FLO DC Lite is much more than that. The versatility of this material is exceptional, with the strength and aesthetics needed for many applications in dentistry. CORE-FLO DC Lite's easy handling, strength, and aesthetics give clinicians a high level of confidence in a multitude of clinical situations, and its flowability gives it a self-leveling property without being overly…

20. Page 40

    Spotlight Popular Bulk-Fill Composite's Benefits Expanded With Enhanced Polishability and Durability and Extended Working Time ORANGE, Calif—Since Kerr Corp's SonicFill bulk-fill composite first came to market, thousands of dentists have seen tedious, repetitive posterior restorations transformed into easy and reliable Single-Fill placement, filling cavities up to 5 mm in depth in a single increment with a single material and no liner or capping layer. Now, with the availability of the SonicFill 2 Single-Fill Composite System, SonicFill's benefits have been expanded with enhanced polishability and durability and extended working time. SonicFill 2 retains the same, patented sonic-activation technology that made the…

21. Page 42

    Spotlight Dual-Cured Resin Luting Cement Optimized to Yield Stronger Restorations SCHAUMBURG, Ill—BISCO Dental Products' DUO LINK UNIVERSAL dual-cured resin luting cement is perfect for reliable, high-strength cementation with easy cleanup, and its extremely high and consistent degree of conversion in both self-cured and light cured modes addresses what's required for today's stronger restorations. In addition, its low film thickness assists in effective seating and offers diagnostic radiopacity for that perfect margin. DUO LINK UNIVERSAL has been maximized to reduce its sensitivity to operatory and curing lights, resulting in a longer gel phase and ease of use to cement all restorative…

22. Page 46

    NEWS/TRENDS Industry News Ultradent Products Honored At this year's CDA meeting, Ultradent Products was selected out of more than 3,000 companies to receive the Golden Hands Award of Excellence for Ethics and Truth in Advertising. Nominees for the award were selected by dental leaders based on criteria such as ethical conduct, dependable products, and knowledgeable personnel, then voted on by thousands of clinicians nationwide. "We are humbled to receive this recognition and will use it as a critical reminder of our duty to continue to be responsible and caring to those we serve, both inside and outside Ultradent," said Dan…

23. Page 48

    NEWS/TRENDS Industry News Flying Doctors of America Celebrates 25 Years of Helping the "Poorest of the Poor" Celebrating its 25th anniversary this year, Flying Doctors of America (FDA) brings dentists, physicians, and support staff to developing countries, helping thousands of the world's truly "poorest of poor." Since its inception in 1990, it has completed more than 220 missions, and its volunteers have treated more than 200,000 people with free medical/dental care. One such volunteer is Elliot Siegel, DMD, an oral maxillary surgeon from Massapequa, NY, who recently traveled with FDA to the Syrian refugee camps in Jordan. In a week,…

24. Page 54

    Travelers Spreading a Multidrug-Resistant Bacteria to the United States International travelers are bringing a multidrug resistant intestinal illness to the United States and spreading it to others who have not traveled, according to a report released by the Centers for Disease Control and Prevention (CDC). Shigella sonnei bacteria, resistant to the antibiotic cipro, sickened 243 people in 32 states and Puerto Rico between May 2014 and February 2015. Research by the CDC found that the drug-resistant illness was being repeatedly introduced as ill travelers returned and then infected other people in a series of outbreaks around the country. CDC and…

25. Page 56

    56 . 1 READERS' CHOICE TOP 25 FIRST IMPRESSIONS PRODUCTS Mystic Cup Prophy Angles Prophy Magic Dental prophylaxis is most commonly tasked to hygienists. It is important to remember that the rotation of the prophy cup should be quite slow (less than 4,000 rpm); the standard 40,000 rpm of the slow speed handpiece will heat up the tooth during polishing and irritate the marginal soft tissues. The Mystic Cup Prophy Angle is an ergonomic prophy angle that facilitates interproximal cleaning as it increases polishing efficiency. These innovative cups are 100% latex-free to avoid issues with latex sensitivity. Mystic Cups have…

26. Page 58

    58 . 1 READERS' CHOICE TOP 25 FIRST IMPRESSIONS PRODUCTS EPIC 10 BIOLASE Many practices have at least one laser for convenience and at-hand efficiency. The portable Epic 10 laser is indicated for soft tissue surgery, teeth whitening, and pain therapy, and it delivers up to 10W at peak power. Controlled through the intuitive touchscreen interface, there are 16 common procedure presets. Diode wavelengths cut soft tissues more cleanly and comfortably, while the Epic 10 toothbleaching session takes only 20 minutes. The deep-tissue handpiece for the temporary relief of minor oral pain is controlled for spot size, thus avoiding inadvertent…

27. Page 60

    READERS' CHOICE TOP25 FIRST IMPRESSIONS PRODUCTS MirrorImage Cosmedent Provisional restorations must be strong and aesthetic, easy to fabricate, simple to trim and polish, and ideally indicated for single and multiple units. MirrorImage is an automated, 2-component (10:1) provisional based on multifunctional methacrylic ester chemistry that allows thin, translucent, and aesthetic margins. It is methyl methacrylate-free and has minimal exothermic reaction and low polymerization shrinkage. Fast working and setting times are comfortable for patients and efficient for dentists. Excellent fit, easy finishability, great polish, and minimal occlusal adjustment make MirrorImage a stress-free material for shortand long-term temporary crowns or bridges, inlays,…

28. Page 62

    TOP 25 FIRST IMPRESSIONS PRODUCTS READERS' CHOICE STA System Aseptico The fear of pain keeps half the population out of the dental office. Local anesthetic for overcoming the fear factor has been available for more than 70 years but has created the discomfort of the injection process. The STA (Single Tooth Anesthesia) System selectively anesthetizes a single tooth for a limited amount of time by precisely administering an intraligamentary injection for gingival, periodontal, endodontic, and cosmetic practices. Onset is one to 2 minutes and typically lasts one hour. (A mandibular block, affecting the entire quadrant, takes 10 to 15 minutes…

29. Page 63

    TOP 25 FIRST IMPRESSIONS PRODUCTS Access Flo Centrix Cord-based gingival retraction does not rate among most dentists' favorite tasks. It is time consuming and frustrating. Cords tend to resist circumferential packing, often twisting out just as the last segment is teased into the sulcus. Many hemostatic retraction liquids are sulfite-based, interfering with polyvinyl polymerization. AccessFlo is a unique, clay-based gingival retraction paste indicated for all crown and bridge impression procedures. The clay-reinforced and hemostatic actions of the 15% aluminum chloride and kaolin clay components gently retract soft tissues as they control bleeding and seepage of fluids. Convenient, single-use, unit-dose Centrix…

30. Page 64

    Zygomatic Implant Options for the Atrophic Maxilla: Case Report This article discusses the use of zygomatic implants in treating the atrophic maxilla. A case report is presented in which an atrophic maxilla was treated with a fixed prosthesis supported by a combination of zygomatic and conventional implants, using 2 distinct surgical techniques. The use of zygomatic bone for implant placement can be a predictable alternative to certain other treatment techniques when rehabilitating the atrophic maxilla. Despite the high success rates of zygomatic implants, there is no consensus in the literature about the ideal surgical technique for their placement. Therefore, the…

31. Page 65

    intrasinus technique described by Brånemark et al.8 while in the right malar zygoma, a similar fixture was placed by the extrasinus technique described by Aparicio et al.11 The zygomatic implants' positions and the surgical techniques, intra or extrasinus, were determined during the surgical procedure according to the anatomy of the zygoma and surrounding structures, in order to improve the implant placement and to obtain a better prosthetic result. In addition, 4 additional conventional implants (2 implants of 3.75 x 11.5 mm, one implant of 3.75 x 13 mm, and one implant of 4.0 x 11 mm—Master Porous [Conexão Sistema de…

32. Page 68

    Simple Lab-Fabricated Aligner System continued from page 66 tooth movement using "force points" with no bonded attachments. MTM Clear Aligner Service Center is a clinician-friendly system because the required training can be accomplished online for a reasonable fee. This training also includes some appealing introductory offers to help the clinician get started. Because the Service Center truly focuses on minor tooth movement, cases submitted will almost always be addressing the teeth in the smile zone. Minor alignment issues, post-orthodontic relapse, finessing orthodontic cases, and preretractive cases are usually well suited for this system. This system further simplifies case submission by…

33. Page 69

    ORTHODONTICS 69 [Four sets of treatment plan documents from mtm shown on left side with detailed orthodontic diagrams and data tables] Figure 9 to 14. These images show a detailed summary of what each aligner would be addressing. directional forces that each aligner would apply to each target tooth. This case required 3 aligners for active movement and a fourth aligner for retention. Each aligner was delivered in its own numbered container (Figure 8). Included with the aligner container were instructions for the patient, including the cleaning and care of the aligners along with aligner [Image of clear aligner device…

34. Page 70

    Full-Mouth Rehabilitation: A Case Study INTRODUCTION Our society has become one of impatience in the quest for immediate satisfaction. In 2012, The Huffington Post's Pam Skoff said, "We can look up any question we have, (and) fact check the person you are having a conversation with on the Internet via smartphones, instantly. Having this capability has made us instant gratification junkies." The patients in our practices are no different, in that they are a reflection of the world that surrounds them. The direct effect on the dental profession has been a paradigm shift in dental implantology that has driven the…

35. Page 71

    sinus elevation surgery to increase vertical bone height in the posterior to facilitate implant placement. This article will now concentrate on the second phase of treatment, specifically the maxillary arch and its surgical and restorative protocol. Clinical and Restorative Protocol: Second Phase of Treatment After profound anesthesia was established in the maxillary arch with a 4% Septocaine (Septodont), teeth Nos. 5 to 12 were atraumatically extracted using conventional elevators and forceps (Figure 4). The key to facilitating immediate implant therapy is the ability to preserve as much hard bone as possible, done to minimize the hardand soft tissue changes that…

36. Page 72

    Figure 3. CBCT planning (ProXeon). Figure 4. Maxillary arch after extraction. Figure 5. Alveoloplasty completed. Figure 6. Pilot drill. Figure 7. Final osteotomy former. Figure 8. Osteotomy former with step-drill design. Figure 9. Esthetic Region Implant (OCO Biomedical). Figure 10. Delivering implant on carrier (Ultem [Solvic Global]). Figure 11. Implants in place. Figure 12. Shielded abutments (Offset-15° [OCO Biomedical]). Figure 13. Adjusting abutments with diamond bur. Figure 14. Fabricating temporary (Visalys Temp [Kettenbach LFI]). Figure 15. Completed temporary. Figure 16. Postoperative check. Figure 17. Excellent soft-tissue contours. Figure 18. Framework on model. erally. All implants were fully seated, then torqued…

37. Page 73

    IMPLANTS 73 plained, and no dietary restrictions were given. The patient returned to work the next day. Routine postoperative examinations were completed at one week, weeks, and at 3 months. During this time, both the hard and soft tissues healed predictably (Figure 16) and there were no prosthetic complications that affected treatment. Though the definitive restoration could have been fabricated at an earlier point in the treatment, complete integration and soft tissue healing was allowed to avoid any potential complications. Final impressions were taken at the fixture level with a combination of closed and open tray impression copings using a…

38. Page 74

    Figure 19. Abutments in place. Figure 20. Completed case. Figure 21. Final panoramic radiograph of completed case. the widest anterior-posterior distribution of the implants, they are able to resist the critical degree of micromovement at the bone-implant interface that could be detrimental to the outcome of the case. This, according to the literature, is between 50 and 150 μm of sliding movement. The ability to immediately load a restoration and microstimulate the implant-bone interface below the critical threshold can actually aid the action of osteointeg­ration.6 By using the combination of implants designed for immediate load and fixed interim restorations, a…

39. Page 75

    Mid-Decade Look: What's Hot in Materials and Instruments Our editor-in-chief, Dr. Damon Adams, interviews Howard Glazer, DDS, discussing new products and technologies that can make a difference for the clinician and team. What is your overall impression of where dentistry is today with regard to materials, products, and techniques? Dr. Glazer: There is no doubt in my mind that this is an absolutely wonderful time to be in dentistry. So many of the materials, products, and techniques we have today did not exist five years ago, and many will be replaced in the next 5 years. With today's materials and…

40. Page 76

    INTERVIEW LASERS), will continue to be important since it is a much better way to gently remove tissue in so many situations, none the least of which is in the daily operation of restorative dentistry. My mantra is you can only restore what you can see, and all too often, decay is subgingival. You need to access the decay, and the laser makes that very easy. The laser makes gingival retraction cord moot, ly obsoleted and is a must for implant dentistry when it comes to removing the healing cap and the resultant tissue tags that are so often found…

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