Dentistry Today — June 2024

Inside this issue

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

1. Page 8

   Every Breath You Take I met Dr. Robert Martino a few years ago and was immediately impressed by his career accomplishments. He built an extremely successful network of dental offices, with more than 700 employees in West Virginia. He also created a company that repairs airplanes and engines! His philanthropic ventures include coats for the needy, a day of free dental care for children, and more. He also, and importantly, founded and am quoting him here! Freedom Day USA, a national thank you movement for our active military and their immediate family members, along with our veterans. Freedom Day USA…

2. Page 12

   VIEWPOINT continued from page 10 rience officer at Cleveland Clinic, notes, "As patient trust is tested, service represents an opportunity to differentiate in this new world, but I have yet to see most organizations make substantial investments in service training, even though the cost of getting a new patient is multiple factors higher than keeping the one you have."13 What Is NPS? NPS, simply put, is a measure of how likely your patients are to recommend your dental practice to other people. There are many articles about the origins of NPS, how it's measured, and its peer-reviewed applications in healthcare.…

3. Page 14

   Embracing AI in Dentistry Alex Sanders, DDS, PhD, founder of Diagnocat AI, explores the profound impact of AI on dentistry and advocates for its adoption to enhance patient care. Q: Will AI replace dentists? A: During a practical course about our AI software at a leading dental clinic, a radiology technician expressed concerns about losing her job to AI. And she's not alone in that feeling. A recent dentalyorg study suggests that 57% of dental professionals fear that AI will replace certain aspects of dentistry, rendering their expertise obsolete. This sentiment is understandable, as AI can automate tasks such as…

4. Page 16

   Sensor Prioritizes Patient Comfort and Durability QUAKERTOWN, Pa.–Elevate your 2D imaging experience with the next generation of DEXIS sensors. The Ti2 sensor was designed to prioritize patient comfort and durability, elevating diagnostic capabilities with AI powered software dental findings available through a direct integration with DTX Studio Clinic) and real-time monitoring to ensure smooth operation in your practice. With twice the durability of previous sensors, Ti2 was engineered to deliver long lasting performance and the strength needed to capture high-quality images. Utilize AI features through DEXIS imaging suite software or DTX Studio Clinic to easily identify up to 6 dental…

5. Page 18

   Bien-Air USA Handpiece System Easily Controlled Through Tablet IRVINE, Calif.–Whether you are planning to upgrade your dental practice with the latest technology or you are just about to start your professional career, iOptimalNT is an all-in-one solution offering the full range of treatment options seamlessly integrated into your dental chair. No need for additional equipment anymore because the iOptimalNT lets you perform all restorative procedures; endo treatments (including reciprocating mode); and surgical procedures, including implant placement. A piezo scaling function is included as well. Installed directly into the existing dental unit, the system is easily controlled through an Apple tablet.…

6. Page 20

   Ritter Dental Dental Chair Provides Easy Access for Patients, Increased Mobility for Clinicians SAN ANTONIO—The Vanguard Dental Unit features a seamless hydraulic lift with adjustable speed and has the ability to withstand 400 lbs. The unit is ambidextrous with a 30" swivel that provides easy access for the patient and increased mobility for the clinician. The Vanguard includes Dentist and Assistant Delivery. The assistant side features up to 4 instruments and an integrated control panel. The dentist side features up to 5 instruments, including 3 active handpiece positions and an integrated control panel. The Vanguard is available with or without…

7. Page 22

   SureSmile Aligners Provide Better Experience for Dentists and Patients Megan Weisenberger, DMD, discusses implementing a new treatment method into her practice. Q: Please provide an overview of your career in dentistry. A: After graduating from Case Western in 2010, I returned to Cincinnati, initially as an associate, before acquiring my fee-for-service practice in 2017. It's fully digitalized, including PlanScan (Dentsply Sirona). Q: When and why did you begin working with SureSmile Clear Aligners (Dentsply Sirona)? A: I began using SureSmile Aligners in 2020 due to increasing malocclusion and restorative cases. I trusted Dentsply Sirona and colleagues' positive experiences with SureSmile,…

8. Page 24

   Ceramir–A Division of DirectaDentalGroup Pediatric Crowns Mimic Anatomy of Primary Teeth NEWTOWN, Conn.–Ceramir Pediatric Crowns set a new standard in restorative dentistry for children. The patented, laser sintering technology creates a homogeneous glass-like structure, giving the material a natural translucency and high gloss surface. The crowns mimic the anatomy of primary teeth in color and shape. This technology makes it possible to produce Ceramir Pediatric Crowns with very thin walls. The crowns can easily be repaired chairside with additional composite material. This allows one to work minimally invasively and preserve as much tooth structure as possible. The introduction of Ceramir…

9. Page 26

   Tokuyama Dental America Restorative Material Offers Ability to Match Any Tooth Color ENCINITAS, Calif.–OMNICHROMA is an innovative dental restorative material. It utilizes Smart Chromatic Technology and supranano spherical fillers—a groundbreaking combination—allowing it to be the first universal composite capable of shade matching any tooth color, from A1 to D4. Strong, durable, and versatile OMNICHROMA streamlines the restorative process, saving time and money for dental professionals. It seamlessly blends with any tooth shade before and after bleaching. Dentists appreciate its ease of use and ability to achieve a natural finish. It delivers reliable results for direct anterior and posterior restorations, direct…

10. Page 28

    Orodeka Rotary Files Feature Unique Designs and Capabilities NEW DISTRICT JINING CITY, Shandong Province, China—ORODEKA, established in 2015, manufactures endodontic rotary files, including FLEX V. This file is the ideal rotary system for managing of curved canals and complex anatomies. Manufactured using an exclusive thermal process these files, especially the 15/03 path file, produce many benefits compared to other NiTi files. The files feature CM wire allow with special heat treatment, which results in high resistance to flexural fatigue. The files can be precurved and have extreme efficiency in the most curved canals. FLEX RC ONE is a reciprocating file…

11. Page 29

    Dental Composite Provides Easy, Failure-Free Placement THE VILLAGES, Fla.–Bright Temporary C&B is a self-curing composite for temporary crowns, bridges, inlays, and onlays. It is a unique combination of nanosized particles and ideally-sized glass filler that provides enhanced composite strength. Its esthetic properties provide easy, failure-free placement with the added advantage of the company's Chameleon Effect that matches shade, opacity, and fluorescence for a natural look. It offers 2 significant benefits, including (1) a short trim and finish time of 3 minutes, which eliminates the need for glazing and polishing, and (2) includes a 1:1 ratio that is compatible with most…

12. Page 30

    Pac-Dent Resin Material's Stain-Resistant Finish Produces Durable Appliances BREA, Calif.–Rodin Flexisplint seamlessly integrates aesthetics, durability, and user-friendliness with exceptional flexibility to ensure a snug, comfortable fit that minimizes discomfort and enhances the patient's overall experience. These characteristics create an ideal candidate for printing comfort nightguards, occlusal bite splints, and snoring appliances. Its clear and stain-resistant finish ensures appliances are durable but also aesthetically pleasing, blending seamlessly with the natural look of teeth. Engineered with patient comfort as a priority, the printed appliances offer exceptional wear resistance and flexibility to ensure a secure fit. It is tested for biocompatibility to guarantee…

13. Page 31

    INNOVATIONS 31 SPOTLIGHT NSK Dental Handpieces Ensure Superior Degree of Smoothness During Cutting Operations HOFFMAN ESTATES, Ill.—The Ti-Max Z Premium Series Air Driven High-Speed Dental Handpieces offer an unprecedented 44 W/41 W of cutting power (7990L/7890L). The new dynamic power system 3X ensures a superior degree of smoothness during cutting operations with an extended power cylinder and expanded roto bucket and exhaust groove. Operability and visibility are significantly improved by the 100° angled head. The solid titanium body is 30% lighter than stainless steel and comes with scratch-resistant DURAGRIP. DURAPOWER CHUCK has double the burr gripping power. Contamination reduction is…

14. Page 32

    Experience Revolutionary Dental Air Purification Technology The Unhealthy Reality Dental professionals, the unsung heroes of oral health, deserve a spotlight on the air they breathe. Shockingly, their work environment has earned the title of "most unhealthy" in North America. Brace yourself for some eye-opening statistics: 74% of North Americans suffer from indoor air quality anxiety (data on file), and 6 of 10 employees quit over poor indoor air quality in their places of business (data on file). But worry not; we're here to revolutionize their indoor air quality and transform their work environments, aligning with the latest guidelines advocating for…

15. Page 38

    38 2nd Annual NATIONWIDE LABORATORIES To Consider in 2024 Redefining Partnership in Dentistry Glidewell is one of the world's leading providers of custom restorative services, dental materials, continuing education, and cutting-edge dental technologies. Founded in 1970 in Orange County, Calif., Glidewell is dedicated to driving innovations that simplify treatment and improve lives. The company offers a wide array of restorative, implant, and preventive services created with CAD/CAM workflows that enhance quality and maintain affordability for dentist and patient alike. Backed by decades of experience, Glidewell empowers practitioners with high-quality laboratory services, resources, and customer support. For more information, call (800)…

16. Page 39

    2nd Annual NATIONWIDE LABORATORIES To Consider in 2024 gained as one of the world's largest dental laboratories, Glidewell has unparalleled insight into the needs and challenges of practitioners. The company's engineers and scientists rely on these insights as they create and evaluate new materials, ensuring that they yield benefits applicable to everyday dentistry. Glidewell's most famous creation to date is BruxZir Zirconia, the No. 1 brand of monolithic zirconia. 3. Technology Alongside its new and ever-changing material solutions, Glidewell also has a dedicated team of computer scientists and engineers who strive to create advanced systems for labs and dentists. Recently,…

17. Page 40

    2nd Annual NATIONWIDE LABORATORIES To Consider in 2024 Keating Dental Lab Produces Innovation in Dental Restorations and Services Keating Dental Lab is a family-run, full-service dental laboratory founded in 2002 by industry veteran Shaun Keating, CDT. As a full-service dental lab, the company can integrate any combined treatment plan requiring simultaneous, fixed, removable, and for implant-supported restorations. All products are designed, fabricated, and shipped from the company's facility in Orange County, Calif. The lab is one of the leading dental labs in the United States, offering a variety of dental laboratory products and services. The company's highly experienced team of…

18. Page 42

    42 2nd Annual NATIONWIDE LABORATORIES To Consider in 2024 National Dentex Lab Network: Kaizen Pathway to Dental Breakthroughs National Dentex (NDX) has the largest network of dental labs in the United States, with more than 45 locations. The labs specialize in aesthetics, full arch, digital dentures, and aligners. Many of the labs are also full-service, providing crowns, single implant restorations, and various appliances. But the one thing that distinguishes this vast network is the universal operating model based on kaizen. Kaizen means continuous improvement, and at NDX it involves tools, techniques, and a team of experts in kaizen implementation. The…

19. Page 44

    44 2nd Annual NATIONWIDE LABORATORIES To Consider in 2024 ROE Dental Laboratory: Pioneering the Future of Full-Arch Dentistry In the ever-evolving world of dentistry, ROE Dental Laboratory stands out as the largest privately held laboratory in the country. With a strong focus on full-arch dentistry, ROE has been involved in more than 40,000 surgical and restorative, full-arch cases in the past 5 years. The company's success can be attributed to its innovative approach, state-of-the-art technology, and commitment to education. ROE's international team of implant planners and surgical guide and prosthetic designers and their high-tech production equipment are the flagship of…

20. Page 48

    Industry News Glidewell Unveils Glidewell HT Implant System Glidewell recently announced a rebrand of its flagship Hahn Tapered Implant System, now known as the Glidewell HT Implant System. Developed in partnership with renowned implant pioneer Dr. Jack Hahn—creator of the NobelReplace implant—the original Hahn Tapered Implant System has been adopted by thousands of doctors due to its simplified surgical protocol, 99.2% success rate, and competitive price point. The Glidewell HT Implant System will retain the same proven design features that made the Hahn Tapered Implant System such a reliable solution. The rebrand is intended to embrace Glidewell's long-standing reputation as…

21. Page 51

    Dr. Ross Nash Full-Mouth Reconstruction Course Comes to New Jersey The world-renowned cosmetic dentist Dr. Ross Nash, DDS, will be partnering with New Jersey's premier cosmetic dentist, Anthony Vocaturo, DDS, to present the comprehensive 2-day, hands-on program "Full Mouth Reconstruction: High-Tech, High Touch." IADE Institute of Advanced Dental Education (IADE) located in Colts Neck, NJ, on July 10 to July 20. The IADE was recently designated as an authorized Nash Institute Affiliate, and as such, will serve as the Nash Institute's New Jersey Campus. This is the first time that the celebrated and insightful 2-day course from Drs. Ross Nash…

22. Page 52

    Dr. Martino will present a FREE LIVE & WEBINAR on August 26, 2024 expanding on this article's topic. Scan QR code or visit webinar to register. Fighting Biofilm With Oral Rinses INTRODUCTION The control of biofilm is probably the most important factor in a patient's oral health. The control of biofilm is probably the most important factor in a patient's oral health. Yes, you read that twice because it is that important; however, as dental professionals and patients, we tend to use the same mechanical methods of controlling biofilm. Brushing, flossing, and professional cleanings are not helping us to decrease…

23. Page 54

    Fighting Biofilm With Oral Rinses continued from page 52 substantivity, can actually increase biofilm buildup. THE TRIAD To properly fight biofilm, you must have these 3 criteria: You must break up/penetrate the biofilm, kill the bacteria and other microbes in the biofilm, and prevent new biofilm from forming. The product OraCare addresses all 3 by combining chlorine dioxide and poloxamer 407. Let's take a look at both of these compounds and how they work to fight biofilm. CHLORINE DIOXIDE Chlorine dioxide is a powerful, selective oxidizing biocide. It attacks micro-organisms by disrupting the cell's ability to create essential proteins. This…

24. Page 55

    ORAL HYGIENE 55 Figure 9. The patient is seen every 4 months due to heavy bleeding and calculus formation. The patient was brushing twice per day using an electric toothbrush in the morning and a manual toothbrush at night and had been using an over the counter mouthwash. Figure 10. The following visit. The patient continued to brush 2 times per day with an electric manual brush and floss daily. The patient replaced the over-the-counter rinse with a professional rinse, which resulted in less plaque and calculus accumulation. step added, the dental team decided not to move forward with the…

25. Page 56

    Bone Grafting Using Calcium Apatite Plugs Timothy F. Kosinski, DDS Understanding and appreciating the benefits of grafting socket sites before preparation for dental implants, or even as support for conventional dental restorations, are critical concepts to improve the prognosis of integration and elevating prosthetic esthetics and function. Without grafting, following extraction, bone will potentially shrink vertically and horizontally and can result in collapse of the sinus floor. This may result in physiologic reactions that may make future placement of any type of fixture challenging without a much more invasive and expensive surgical intervention. This includes autogenous block grafting, harvesting from…

26. Page 58

    Dr. Schlesinger will present a FREE LIVE & WEBINAR on Wednesday, July 10, 2024 expanding on this article's topic. Scan QR code or visit webinar to register. Advanced Grafting Materials and Techniques INTRODUCTION Historically, everything from autogenous bone to xenografts, allografts, and alloplastic materials has been used and studied in dentistry when a graft or graft substitute is needed. These different materials have all been used with great success over the years, and they continue to provide clinically successful results. The alloplastic class over the years has become an exciting class since it is continually being advanced at a greater…

27. Page 60

    Advanced Grafting Materials and... continued from page 58 Caution: Not all mineralized graft materials are the same. ALLOPLASTS Historically, many substances have been used as components for grafting in dentistry, either by themselves or as a binder with other graft materials. This author has used many of these with varying results. Calcium phosphate is one substrate that has been used as a cement either to deliver antibiotics locally or to bind allografts and xenograft particles. One example of this type of product is Fusion Bone Binder (Park Compounding Pharmacy). Bi-phasic calcium phosphate products such as Augma Biomaterials 3D Bond (Augma…

28. Page 61

    IMPLANTS 61 ing bone substitutes involve their biological stability and volume maintenance, which allow cell infiltration and remodeling." Originally HA ceramic and β-TCP products comprised 80% of all alloplastic bone graft products in the market. Xenografts can be derived from sources including bovine and porcine origins, with bovine being the most prominent graft source in the industry. Xenografts carry with them the potential for immunologic reaction resulting in the patient mounting a host immune response against the grafting material. The long-term clinical use and safety of xenografts and their potential association with severe immune responses, as well as objections to…

29. Page 62

    IMPLANTS a 60% improvement when grafting with an OsteoGen Plug as osg mm was lost vertically with the plug compared to 1.47 mm lost in the control. When looking at horizontal grafting, 0.9 mm was lost horizontally compared to 2.26 mm in the control. This minimal amount of bone loss is comparable to levels lost when utilizing an allograft and a membrane,19 although Yosuf et al14 achieved these results with a Plug alone and no membrane. Jones et al20 directly compared an OsteoGen Plug to a Collagen Xenograft Plug (Salvin Dental Specialties) and human bone allograft. It was found that…

30. Page 63

    IMPLANTS 63 In 2012, Chu et al27 showed that the most predictable hardand soft-tissue changes and aesthetic results when immediately placing implants in a fresh extraction socket occurs when the gap between the implant and the alveolus is grafted. IMMEDIATE PLACEMENT CASE Presenting with a failing maxillary right central (Figure 8a), this patient opted for extraction and immediate placement of an implant. After an atraumatic extraction of the tooth (Figure 8b), the tooth was evaluated to determine the amount and position of graft material to be placed. By laying an osteotomy bur on the root, this calculation is very easy…

31. Page 64

    What They Didn't Tell You About the TMJ in Dental School INTRODUCTION Let's face it. Most of us have had some exposure to the TMJ in dental school, but it was just too complicated or too abstract that we just didn't pay attention. How can this joint so far away from the teeth affect our dental work? We focused on the details and the techniques of cavity and crown prep, did the lab work necessary for our prosthetics course, and paid lip service to the diagnostic sciences. But where did this TMJ thing fit in? If a TMD condition arises,…

32. Page 66

    What They Didn't Tell You About... continued from page 64 stand the role of that joint and its dysfunction in the emergence of bite changes. One orthopedically unstable occlusion is called "dual bite formation," which is technically a CR-CO discrepancy, as it has been called in the past. It can form as a result of an acquired anterior position of the mandible. This anterior position can be due to auto-advancement or iatrogenic factors, which draw the condyles down and forward (Figure 1). Patients can auto-advance and hold their mandibles forward for various reasons, such as vanity because of a recessive…

33. Page 67

    Figure 4. (a) Bilateral end-stage degenerative joint disease with condylar height reduction and seating in the fossae has resulted in (b) the posterior rotation of the mandible and (b and c) the anterior open bite. Figure 5. Unilateral condylar height loss due to osteoarthritic degenerative joint disease resulted in (a) seating of the condyle and (b to d) subsequent changes in mandibular symmetry and (c and d) occlusal canting (d), with the right side (affected side) being more elevated. TMJ condition is unilateral, one can expect a subsequent rotation of the mandible in the coronal plane to seat the smaller…

34. Page 68

    Speech Deficiency Caused by a Rare Calculus Mass INTRODUCTION A patient's chief concern is to be taken seriously if we consider ourselves caring professionals. Too often, as practitioners consider diving into treatment without first addressing the reason why the patient has sought care from us in the first place. Sometimes, this is due to treatment phasing and ensuring that treatment is completed in the proper order. Therefore, it is fortunate for all involved when a patient's chief concern aligns with treatment that can be completed at his or her initial appointment. This case report demonstrates how a patient with an…

35. Page 69

    plaque and calculus present (Figure 8), but the soft tissue had fully healed with the exception of the areas adjacent to the teeth, where calculus was present. The patient shared at this appointment that she was pleased with the results from her initial treatment, but she didn't want to return for continued care. Although an extensive treatment plan remained, it was determined at this time that the calculus mass removal procedure successfully resolved the patient's chief concern. CONCLUSION This case report briefly illustrates how an uncomplicated dental procedure can greatly impact a patient's comfort and quality of life. It also…

36. Page 72

    Simplifying Prosthodontics in the Digital Dentistry Era Dinesh Sinha, BDS, PhD, interviews Julián Conejo, DDS, MSc, clinical CAD/CAM director in the Department of Preventive and Restorative Sciences at the University of Pennsylvania (UPenn) School of Dental Medicine, on his restorative protocol. Q: Please explain your day-to-day work. A: I am the clinical CAD/CAM director at UPenn, and we see a variety of patients with different restorative needs. Q: How do you use digital dentistry to assist your cases? A: It would be accurate to say that we no longer practice dentistry without the implementation of digital tools. We use them…