Dentistry Today — March 2021

Inside this issue

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1. Page 6

   Frustration and Hope As we finish the first quarter of 2021, things are somewhat bittersweet. We all waited for 2020 to end and couldn't wait to be here. Surely, many people have been vaccinated, but at a rate far slower than we were hoping. There are still many who want to "wait and see," while others don't trust the vaccine at all. Hopefully, they are all still following basic common-sense guidelines (eg, mask use and social distancing). The return to "normal" is still a work in progress. In my practice, we are finding that patients are not as anxious about…

2. Page 8

   Artificial Intelligence and Its Use in Dentistry Artificial intelligence (AI) is an emerging and quickly growing branch of technology that will likely have a significant impact on how we practice dentistry in the near future. While still in its infancy, AI will continue to grow over the coming years, becoming more widely adopted and with more resources devoted to its growth. Even now, in other medical professions such as cancer diagnosis and precision medicine, its use is becoming something of a standard. The potential applications of AI not only apply to clinical practices through improvements in patient care but also…

3. Page 9

   on the radiographs. Companies such as Overjet (overjet.ai) are already providing tools to administrators in dentistry to allow insight into the care providers are rendering to ensure they are compliant and within acceptable guidelines. CONCLUSION We believe that the future for AI integration into the field of dentistry is bright and that our patient care will only improve as we adopt these emerging innovations. But before that happens, the dental industry will require a new crop of entrepreneurial companies, new types of funding sources, and an appreciation and understanding that open systems lead to innovations that will benefit the entire…

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   Using Technology in a Post-Pandemic World Martin Jablow, DMD, talks about how several technologies became more relevant due to the pandemic. Q: How can we use what we learned during the pandemic in the post-pandemic environment? A: Software products that allow for communication with patients are creating more efficient front desk workflows. Now that most dental offices are required to screen patients for COVID-19 viral symptoms, being able to communicate is essential. A text message to the patient the day before his or her appointment with a link to fill out the COVID-19 questionnaire results in saving the front desk…

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   New Imaging System Boasts State-of-the-Art Computing Power, Elegant Design SAN JOSE, Calif.–Align Technology's iTero Element 5D Plus imaging system in cart configuration is the latest generation of iTero Element scanners and imaging systems. It's a powerhouse of capabilities, suited to improve the practice and patient experience with state-of-the-art computing power, elegant design, and ergonomics. Enhanced, more detailed visualizations with wider viewing angles provide an unmatched patient experience. Powerful computing advancements enable a smoother and more intuitive scanning experience. The system is ergonomically designed to conform to how practices scan. The integrated intraoral camera eliminates the need for a second device…

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   Dental Chair Combines Technology of Electronics and Movements of Hydraulics SAN ANTONIO–Upgrade your practice with Ritter Dental USA's German engineered Vanguard and the Vanguard Smart dental packages. The Vanguard combines the technology of electronics and the smooth movements of hydraulics in Ritter Dental's most popular dental unit. The left right 360° unit can be very easily switched from right-hand use to left-hand use. The patient chair is synchronized and also offers a 30° swivel. This package comes standard with an upgraded LED operating light and all of the quality and features that you have come to expect from Ritter Dental.…

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   System Allows Clinicians to Perform Dentistry Without Air/Plumbing Connection WOODINVILLE, Wash.—Perform general dentistry or endodontic procedures—all with no connection to air/plumbing lines—with the AMC-15 Self-Contained Mobile Operatory from Aseptico. Just fill the two 1-water supply bottles and then power with either 115 V or 230 V, and you're fully operational with 2 high-speed handpieces, one low-speed handpiece, high-volume and low-volume suction, and an amalgam separator. Engineered to provide many years of reliable service, the AMC-15 moves easily and makes an efficient instant operatory. This is an excellent system for use in nursing homes or other institutional settings or for dental…

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   TECHNOLOGY 19 Solution Offers Aesthetically Demanding Restorations WOBURN, Mass.–The ChairsideCAD 2.3 Matera from exocad America has one of the widest ranges of indications for single-visit dentistry and the broadest selection of integrated open architecture devices. The software is intuitive and easy to learn, so users reliably deliver aesthetically demanding restorations. In a single patient session, ChairsideCAD (and modules) are integrated using exocad's proven and robust software platform that has been successfully in use for more than 10 years. With ChairsideCAD 2.3 Matera, exocad intuitively expands single-visit capabilities. The new features are available with 3.3 Matera, including (1) Smile Creator for…

9. Page 20

   Conservative Approach to Immediate Bone Grafting INTRODUCTION Bone preservation has become of paramount importance when tooth extractions are performed and full-arch dentures are indicated. Recently, research suggests that the physical and chemical composition of tooth-derived bone grafting materials makes them efficacious as an alternative bone grafting material in extraction sockets. This article discusses the characteristics of tooth-derived bone grafting materials, as well as the benefits of the chairside Smart Dentin Grinder device (KometaBio). A case presentation demonstrates the use of the device in the treatment of a patient who required extraction of her remaining maxillary dentition, immediate bone grafting, and…

10. Page 22

    Figure 2. The extracted teeth were prepared for grinding by using a high-speed handpiece to remove any cavities or foreign material, ensuring that only pristine tooth structure remained. Figure 3. Four of the prepared teeth were placed inside the Smart Dentin Grinder (Kometastu) chamber and adjacent to the blades. Figure 4. After closing the chamber cap and twisting and clicking it into place, the grinding time was set to the recommended 3 seconds. Figure 5. Once grinding was finished, the particles were sorted for 10 seconds, and no large particles were left in the grinding chamber. Figure 6. The ground…

11. Page 23

    TECHNOLOGY 23 the chairside use of the Smart Dentin Grinder when treating a patient who required extraction of her remaining maxillary dentition, immediate bone grafting, and delivery of an interim healing full-arch removable denture. Extraction Local anesthesia was administered to infiltrate both the buccal and palatal tissues. Care was taken to atraumatically extract teeth Nos. 3 to 9 and 11 to 13 with forceps. A simple extraction technique was performed with care taken to ensure that 3 or more bony walls (ie, lingual, mesial, distal, apical) remained intact. This would facilitate augmentation and preservation of the denuded sites and harmony…

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    Microscope's Features Revolutionize Practices DUBLIN, Calif.–The EXTARO 300 from ZEISS provides breakthrough visualization modes that introduce new applications to microdentistry. From more efficient caries detection to a simpler tooth restoration workflow, EXTARO 300 is poised to revolutionize and differentiate your practice. The integrated HD camera of the EXTARO 300 records wirelessly to the ZEISS Connect App, empowering patient interaction with images and videos directly transferred to your local network. With the ZEISS Connect App, one can show images of past and current patient conditions, as well as highlight areas requiring treatment, enabling patients to make informed decisions. For more information,…

13. Page 26

    Cleaning Solution Improves Life of Instruments and Burs HEATH, Ohio—Sani-Soak Ultra from Enzyme Industries is a dual-purpose, anticorrosive enzymatic cleaner that can be used in an ultrasonic and as a wet evacuation cleaner. Offered in 2 scents, Lemongrass Lavender and Cool Mint, it is highly concentrated, nontoxic, biodegradable, safe for the environment, and effective in removing debris while improving the life of instruments and burs. Multiple dispensing options are offered for ease of use and added convenience. For more information, call Enzyme Industries at (888) 236-9963 or visit the website located at enzymeindustries.com. FREEinfo, Flowable Restorative Offers Ideal Handling and…

14. Page 28

    Digital Radiography—Intraoral Sensors ACTEON North America The SOPIX² digital x-ray system integrates the best of modern technology, including fiber-optic-based CMOS, ensuring exceptional image quality. ACE technology (an ACTEON exclusivity) makes it possible to control the amount of x-rays accumulated by the sensor, protecting each image from overexposure and ensuring that they are always clear. Two sensor sizes are available: size 1 for 1 to 3 teeth and size 2 for bite-wing x-rays. The corners of the sensors are rounded for easier placement inside the mouth. For more information, call (800) 289-6367. FREEinfo, Apixia Digital Imaging Apixia Digital Imaging has introduced…

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    continued from page 28 Gendex The GXS 700 sensors are designed to make migrating from film or upgrading a digital system easier than ever. These intraoral sensors deliver brilliant images, patient comfort in 2 ergonomically designed sizes, and highly portable ease-of-use through direct USB connection. The sensors also offer smooth integration into practice management in addition to many imaging programs. For more information, call toll-free at (800) 323-8029, visit the website at gendex.com, or send email to info@gendex.com. FREEinfo, KaVo Kerr Group Imaging In addition to being smart, smart, and fast, as its predecessor was, the DIGORA Optime system demonstrates…

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    DIGITAL RADIOGRAPHY—INTRAORAL SENSORS Thanks to its ergonomic design—including rounded corners and beveled edges—making a digital radiograph is no longer uncomfortable. For more information, call (516) 858-5695, visit the website owandy.com, or send email to sales@owandy.us.com. FREEinfo, Planmeca USA ProSensor HD intraoral sensors (in three sizes, 0, 1, and 2) offer HD imaging with a theoretical resolution of 33 lp/mm. They can integrate with a Planmeca ProX intraoral x-ray sensor or be connected through Ethernet or USB port. ProSensor HD features a fiber-optic layer to capture sharp, low-noise, and high-contrast images. A sophisticated magnetic connector permits one-hand attachment, and the white…

17. Page 34

    Industry News JS Dental Manufacturing President Mats Engstrom Passes Away Mats Engstrom, president of JS Dental Manufacturing, died on December 30, 2020. According to the family, Engstrom "practically grew up in the dental business." After finishing school, he began working with his father, Gunnar, who opened up his endodontics business in the United States after moving part of his business from Sweden in 1983. After his father died in 2009, Engstrom took leadership of JS Dental Manufacturing. Noting his great personality, the family said that he was highly appreciated in the dental community and that he will be greatly missed.…

18. Page 35

    "Your mouth and gut are not separate islands," Hartmann said. "There are some microbes that we find both in the human gut and mouth, and those microbes are found on toothbrushes. But, again, those are probably coming from your mouth." The researchers also examined how many different types of microbes lived on the toothbrushes. People who regularly flossed and used mouthwash had toothbrushes with less diverse microbial communities. "If you practice good oral hygiene, then your toothbrush also will be relatively clean," Hartmann said. "But it's a small difference. It's not like people who regularly floss, brush, and use mouthwash…

19. Page 36

    Annual Meeting Goes Virtual in March The Academy of Osseointegration (AO) 2021 Virtual Annual Meeting will be held March 11 through March 14. With 235 presentations on the schedule, participants can earn up to 55 hours of ADA CERP credits. The virtual format will enable live interaction in real time with plenary speakers following their presentations, AO said. Also, meeting content will be available to access through December 2021, including all live and on demand recordings and corporate forums. "Perhaps it is fitting of destiny that this year's theme is 'Game Changers,' as certainly the Academy's timely and prompt pivot…

20. Page 37

    Solving a True Aesthetic Dilemma: A Case Report Here's a case I'm very proud of." That's the statement I use to introduce this case in my lectures. The audience is silent as they look at the operative image (Figure 1). Some of the faces in the audience seem perplexed, as if to say, "How can he be proud of that?" I wait a bit and then begin to discuss this case. BACKGROUND Our office phone rang. It was a mother searching for a solution to her daughter's dental problem. The mom prevailed on their orthodontist to give them the name…

21. Page 38

    Figure 1. Immediate postoperative result. Figure 2. Radiograph. Figure 3. Intraoral, preoperative photo. Figure 4. Pre-op smile. Figure 5. Planning the case on a model. Figure 6. Ideal gingival height. Figure 7. Ideal length-to-width ratio. Figure 8. Mockup for shade and effects. Figure 9. Removing the mockup. Figure 10. Limited gingivectomy to create the gingival zenith. Figure 11. An Ultrapak cord (Ultradent Products) on No. 9 and the start of addition to No. 8. Figure 12. Completion of No. 8 and the start of addition to No. 9. and if so, by how much? I explained to the patient and…

22. Page 40

    Matrix Systems Directa Dental The FenderMate Sectional matrix for Class II composite restorations is a pre-curved, one-piece sectional matrix and wedge that provides quick, safe, and predictable composite restorations with a tight contact and marginal sealing. It is designed to be inserted either buccally or lingually. The matrix reaches from the base of the wedge to just above the occlusal surface. The side of the wedge facing the adjacent tooth has an angled wing. During insertion, the wing presses the matrix firmly against the preparation. For more information, call (800) 537-8765 or visit directadental.com. FREEinfo, AMD Medicom The Pro-Matrix Curve…

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    Greater Curve The Greater Curve Matrix Bands are simple and fast to set up. There are no wedges and no separating springs. The dentist restores the tooth in a neutral, stable position. Direct Class II composites will have predictable broad and deep contacts. The dentist has complete control of the size and positioning of the contact. Contacts will be smooth and tight. These matrix bands are excellent for restoring with direct Class III, Class IV, and Class V composites. For more information, call (866) 493-3437 or visit the website located at greatercurve.com. FREEinfo, Polydentia Unica is a simple and ideal…

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    Solving Aesthetic Challenges With Mixed Restorations Due to the evolution of dental materials and the ever-increasing demand for aesthetic restorations, we now live in an era in which full-ceramic materials are the standard for rehabilitating compromised anterior dentition, while porcelain fused-to-metal crowns are almost becoming obsolete. In this era, the trend is also moving toward a minimally invasive type of dentistry in which the preservation of the dental tissues is a significant concern. This tissue-saving approach implies that partial-coverage restorations and porcelain veneers are gaining more relevance over more traditional full crowns. However, it is not always clear from a…

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    Solving Aesthetic Challenges With... continued from page 42 placed or not. It has been demonstrated that posts can cause root fractures during function due to stress. The strength of the tooth is directly related to the amount of remaining intradicular dentin. In other words, a post can actually weaken the tooth by having dentin removed from the canal. Therefore, the use of posts should be limited to endodontically treated teeth where there is insufficient tooth structure remaining. Thus, the purpose of the post is strictly to support a core foundation for the future crown restoration. In anterior teeth, with a…

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    AESTHETICS ceramic chosen to restore a case of combined full-ceramic crowns and veneers must fulfill certain requirements. All restorations (crowns and veneers) should be fabricated using the same ceramic system to ensure a homogenous aesthetic outcome. Because ceramic veneers rely entirely on adhesion, it is essential that the ceramic system used permits a chemical bond to the ceramic. In other words, adhesive cements must be feasible. Another important consideration is the aesthetics. The optical behavior of the ceramic should mimic that of the natural dentition. A range of translucent to more opaque cores should be available. Also, the ceramic restorations…

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    The Changing Face of Aesthetic Dentistry INTRODUCTION In an age driven largely by social media and photography, more young men are seeking to improve their smiles. Cosmetic procedures, once the nearly exclusive domain of women, are increasingly being requested by male patients. Whether surgical or non-surgical, the percentage of men seeking cosmetic and aesthetic procedures to enhance their appearance is on the rise.1,2,3 Recent research reveals that the percentage of men seeking non-surgical cosmetic treatments increased by 6% from 2018 to 2019 and that men requesting surgical treatments increased by 4%.4 Among all consumers researching cosmetic treatments online, interest in…

28. Page 48

    The Changing Face of Aesthetic... continued from page 46 with a scan of the patient's maximum intercuspation occlusion. The pre-op digital scans were used by the laboratory to virtually create the smile design proposal according to the prescription (Figure 1). A 3D printed model of the design and a putty matrix (Sil-Tech Plus [Ivoclar Vivadent]) were then made, which allowed for the transfer of the smile design to the mouth and was used to fabricate the provisional restorations chairside. Gingival Recontouring and Tooth Preparation Once the smile design was approved and the putty matrix (Sil-Tech Plus) was delivered, the patient…

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    CHAIRSIDE WITH DR.K THE SECRET TO MORE EFFECTIVE WHITENING No two patients are exactly the same. So why use just one whitening protocol to treat them all? At KGR Whitening, we recognize that each patient presents a different whitening challenge and that's why we developed a full line of whitening systems to meet your patient's individual need. And KGR Whitening is the first whitening system in the world to maintain potency of its entire line of whitening gels by constant refrigeration from the instant of manufacture until being received cold-packed at your office. Dr. Rod Kurthy #1 Proper Product and…

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    AESTHETICS CASE 2 Figure 10. Full-face photograph prior to treatment. Figure 11. Retracted, pre-op view. Figure 12. Pro-op view of the smile, demonstrating a lack of symmetry and smile architecture. Figure 13. CBCT scan axial focal bone loss at site No. 8, bone graft and implant placement planning. Figure 14. Digital design of teeth Nos. 8 and 9, showing replication of the implant abutment shape to the natural tooth prep of No. 9 for optimal optics with ceramic thickness. Figure 15. The patient's demeanor completely improved with the restored smile. Figure 16. Retracted view of the final restorations. Figure 17.…

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    Cosmetic procedures...are increasingly being requested by male patients. sen for enhancing the laterals. At the same appointment, a mm of gingiva was removed from the facial tooth No. 9 with a 12 blade, and tooth No. 9 was prepped for a full contour crown. A scap flag was placed in implant site No. 8, and the buccal intraoral cast TRIOS) was captured to send to the laboratory, along with a shade mapping photograph to help the laboratory select the appropriate shade for the full contour and implant restorations for teeth Nos. 8 and 9. The splinted provisional restorations were made…

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    DENTISTRY TODAY 11th ANNUAL READERS' CHOICE TOP 25 IMPLANT PRODUCTS Dentistry Today's 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. Zest Dental Solutions The LOCATOR R-Tx Removable Attachment System is the fourth generation of award-winning, patient-removable attachment systems. Featuring improved design, system simplicity, and Duratec Coating, the LOCATOR R-Tx is a better, simpler, stronger attachment system and comes with a 100% satisfaction guarantee. The new abutment coating is 30% harder and offers more than 25% greater wear resistance and…

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    Top 25 Implant Products TruAbutment The Angulated Screw Channel (ASC) was launched in 2018 to change the industry standard on implant restorations. This product is one of the most versatile tile options for any dentist wanting to restore an implant at any angulation and depth with a screw-type crown. TruAbutment offers this solution as a fulltitanium custom abutment and even provides a free ratchet driver with every order to ensure a safe and easy delivery every time. The product is available for most major implant platforms, and users may have the crown prior to receiving the abutment because TruAbutment guarantees…

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    Top 25 Implant Products OCO Biomedical The Engage bone level implant system product line leverages a 1-mm, machine-finished collar, which brings the junction of the implant and abutment above the crest of bone. This prevents bone loss and improves soft tissue preservation. The implant's proprietary auger tip, mini-cortico threads, and unique thread pattern lock directly into the bone, providing instant fixation. It features a platform-switching design on the 5.0- and 6.0mm Engage Plus implants that aids in maintaining biologic width. For more information, call (800) 228-0477 or visit ocobiom edical.com. FREEinfo, Shatkin F.I.R.S.T. TruLok Abutments will revolutionize the way one…

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    58 . 1 READERS' CHOICE Top 25 Implant Products Dentium USA Dentium provides a simple yet sophisticated dental implant system. With more than 18 years of documented clinical acclaim by dental professionals around the world, the company's comprehensive solutions complement the user's needs while simplifying complicated dental implant surgeries. Developed by clinicians, Dentium strives to focus on research and development as well as distinguished technology to offer total dental solutions. For more information, call (877) 336-8486, email cs@dentiumusa.com. FREEinfo, Dentsply Sirona Implants The Astra Tech Implant System EV helps clinicians deliver lifelong function and natural aesthetics to patients using a…

36. Page 59

    Top 25 Implant Products Bicon Dental Implants The SHORT implant design comprises plateaus; sloping shoulders; and a bacterially sealed, 1.5" locking taper to implant-to-abutment connection. With the plateau design, cortical-like bone forms around and between each plateau, which allows for the routine use of 5.0mm short implants. The sloping shoulder provides the necessary room for bone to support inter-dental papillae that is gingivally aesthetic. Bicon's 360° universal abutment positioning provides for the revolutionary cementless and screwless integrated Abutment Crown, consisting entirely offering a nonmetallic, aesthetic gingival margin. For more information, call (800) 882-4266. FREEinfo, MIS Implants V3's unique design has…

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    Implant Treatments Keep Evolving The education and instruction of our patients as to the benefits of our innovative and oftentimes relatively noninvasive procedures is paramount to financial and professional achievement. Certainly, as dentists, our goal is to restore function and esthetics through dental therapy. Treatment options are always provided to the best of our abilities and experiences. Conventional dental procedures, such as crown and bridges and removable appliances, are still viable alternatives. However, with the advent of Internet education and explantation and marketing commercials promoting the benefits of more advanced prosthetic applications, such as dental implants, our patients often come…

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    Restoring Function With Prosthetically Driven Implants INTRODUCTION Continuing education has changed our dental profession. When I graduated from dental school, there was hands-on training, but not like we have today. Today, I get emails regarding all CE types available, with opportunities to train in all dental specialties. We didn't have social media platforms such as YouTube, Facebook, and Instagram. With all of this knowledge at our fingertips, GPs are now doing more procedures in their offices that might have been referred out in the past. The advancements made in implant dentistry have led to GPs placing their own implants rather…

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    Figure 1. The advised treatment plan was to section the bridge and keep the abutment on No. 27 and extract No. 30. Figure 2. Being disappointed in her choice of the partial, the patient asked if implants were still an option on her lower right side. Figure 3. CT was taken to evaluate sites for implant placement. Figure 4. A full thickness flap was utilized to see the bony ridge. Purchase points were made on the ridge with a 2 mm round bur after careful calculation of the proper tooth size for the final prosthetics prior to the placement of…

40. Page 64

    Figure 10. A radiograph was taken to verify the seating of impression copings prior to taking the impression. Figure 11. The bridge was seated and verified by radiograph prior to checking the occlusion. Figure 12. The bridge was then polished to remove any imperfections. Figure 13. Both abutments were torqued to 35 Ncm each. Figure 14. Teflon tape was placed (instead of a cotton pellet) to protect the screw before sealing up the screw hole with composite. The occlusion was checked again to ensure the composite wasn't creating any occlusal discrepancies. and surgical guides without proper surgical implant training can…

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