Dentistry Today — March 2024

Inside this issue

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

1. Page 6

   Your Gold Teeth When you see the name Dr. Bill Strupp, your first thoughts are amazing gold restorations. Since 1969, Dr. Strupp has placed more than 63,000 units of crowns and bridges, and he is happy to show you 50 year old restorations that are still in service. She's the partnership with Dr. Michael Brumm, they have been teaching their techniques and protocols at their own sold out Strupp/Brumm seminars as well as conferences around the world. In this issue, though, they are looking at the understructure of the teeth being repaired: building up what seems to be non-restorable teeth.…

2. Page 8

   The Downside of Clinical Rapport To achieve truly unlimited dental practice success, great clinical skills are essential. However, don't kid yourself into thinking that clinical skill is all you need. I learned that the hard way. Many a talented clinician with the best of intentions has ended up with a failed practice. The goal of this article is to share with practicing dentists and their dental teams a proven way to complement clinical excellence by investing no more than 1 to 2 minutes of your time per patient (during the day (meaning every patient), the result of which has the…

3. Page 10

   VIEWPOINT continued from page 8 any way, that clinical rapport is not important. It is important, however, it should be obvious by now that for the biggest bang for your minimal investment in time, personal rapport must lead, followed by clinical rapport. In other words, "chairside manner" is most effective as a combination of skilled personal rapport and skilled clinical rapport. a new dental patient for the first time. The initial patient phone call, the patient presenting at the front desk for his or her first appointment, the team member who walks the patient to the operatory or consultation room,…

4. Page 12

   Data Breaches and HIPAA Josh Brower, DDS, discusses legal questions that you need to know to ask regarding your data. Q: Can I be sued more than once for the same information getting out? A: Yes, cyber regulation and healthcare regulation have merged in many ways for dental offices, making compliance necessary, more expensive, and more complicated than ever before. During treatment with your patients, many types of sensitive data will be exchanged, but sensitive data is defined differently by both HIPAA and by different state laws. This may include names, social security numbers, and personal health information (PHI), among…

5. Page 13

   SPECIAL ADVERTISING SECTION CORPORATE PROFILE Fast-Growing Patient Financing Company Increases Access to Care For many dental patients, coming into the office for care can result in increased stress over how to pay for necessary treatment or procedures. Sunbit is a technology company that helps patients pay over time for dental-related expenses. The company's services help patients from all walks of life who need care receive the treatment they need without worrying about the upfront costs. Areo Dental Group has implemented Sunbit financing to allow patients to receive the care they need regardless of their financial situation. "The biggest barrier to…

6. Page 14

   Dentsply Sirona Retainers Designed for All Orthodontic Patients ENCINITAS, Calif.–Help prevent patients' teeth from relapsing by providing SureSmile Retainers once they've completed their orthodontic treatment. These retainers can be used on patients who have had their teeth straightened using any type of orthodontic treatment, not just SureSmile. With SureSmile Retainers, you get the freedom and flexibility to order exactly what your patients need. Whether it's multiple sets of retainers for a patient who just completed his or her orthodontic treatment or a single-arch replacement for a patient that has lost his or her retainer, SureSmile has that covered. SureSmile Retainers…

7. Page 16

   Ritter Dental Dental Chair Features Intensity-Adjustable LED Operating Light 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 5 active handpiece positions and an integrated control panel. The Vanguard is available with or without cuspidor. Some additional features the…

8. Page 18

   PreXion CBCT System Does Not Require Computer Graphics Card Updates SAN JOSE, Calif.—The Excelsior PRO 3D CBCT system provides high-quality image clarity with its 0.3-mm focal spot, which allows for improved diagnostics of many conditions. Its 4 fields of view include 5 x 5 cm, 10 x 5 cm, 10 x 8 cm, and 15 x 8 cm for a large number of applications, including, but not limited to, implant placement, bone quality studies, pathology, periodontics, and endodontics. An optional 15-x 13 cm field of view is available. In addition, an optional cephalometric arm attachment can be added. Excelsior PRO…

9. Page 19

   Software Helps Eliminate Tedious Manual Tasks QUAKERTOWN, Pa.—Leverage the power of assisted intelligence with DTX Studio Clinic. With this software, one can seamlessly integrate 2D and 3D images, intraoral scans, and clinical photographs, streamlining patient care processes. The AI-powered features of DTX Studio Clinic allow one to eliminate tedious manual tasks and produce a more efficient workflow. The advanced algorithms assist with image analysis and confident diagnosis, saving valuable time and enhancing the overall patient experience. Imagine having all patient records, treatment plans, and diagnostic tools conveniently managed in one place, on one screen. DTX Studio Clinic seamlessly integrates with…

10. Page 20

    Great Lakes Dental Technologies Appliance Provides Exceptional Fit, Retention, and Patient Comfort TONAWANDA, NY- The Rhea Occlusal Appliance is ideal for patients with occlusal and certain intracapsular disorders, as well as for long-term wear. It is fabricated with unique, heat-softening material using an innovative manufacturing process to provide exceptional fit, retention, and patient comfort. The appliances are custom formed to original models, and chairside seating is only necessary to fine tune fit and adjust for minor variations. It is available as a wearguard, flat occlusal plane, or full contact with an anterior guidance splint. For more information, call (800) 828-7626…

11. Page 21

    Dental Handpieces Offer Improved Operability and Visibility HOFFMAN ESTATES, Ill.—The new Ti-Max Z Premium Series Air-Driven High-Speed Handpieces offer an unprecedented 44 W/41 W of cutting power (ZgoL/Z89oL). 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 'roo' angled head. The solid titanium body is 30% lighter than stainless steel and comes with scratch-resistant DURAGRIP. DURAPOWER CHUCK has double the bur gripping power. Contamination reduction is provided with the DualDefense System with the clean…

12. Page 22

    Aseptico Mobile Dental Cart Engineered to Offer Years of Reliable Service WOODINVILLE, Wash.–Designed for easy and affordable mobility, the AMC-15 Mobile Dental Cart is equipped for general dentistry with a automatic high-speed air connections, one low-speed handpiece connection, internal vacuum and air, a water supply tank, a large waste tank with automatic overflow protection, and an amalgam separator. This is an excellent dental delivery system for use in nursing homes and institutional settings or for the dental practice that wants a new, fully equipped operatory at low cost. The AMC-15 mobile dental cart is easily moved, sets up quickly to…

13. Page 24

    Dental Plus USA Zirconia Alternative Boasts Extraordinary Strength SOUTH JORDAN, Utah—G-CAM is a state-of-the-art dental material that has been gaining widespread recognition for its exceptional properties and versatility. The graphene nano-reinforced biopolymer G-CAM disc, specially designed for prominent dental structures, is available in different chromatic shades that have an extremely natural aesthetic appearance and resolves g all the mechanical, physiochemical, and biological failures of the rest of the materials currently used in the sector, like zirconia. Developed specifically for dental restorations, it offers an ideal combination of strength, aesthetics, and longevity, making it an excellent choice for a range of…

14. Page 26

    GuruNanda Revolutionary Essential Oil Pulling Mouthwash Elevates Oral Care Routines BUENA PARK, Calif.–GuruNanda Oil Pulling Mouthwash revolutionizes the oral care routine for patients. Embrace the future of dentistry with this innovative product, crafted to elevate patients' oral care hygiene routines. Experience the power of coconut oil in a refreshing minty formula that goes beyond ordinary mouthwashes. Clinical studies have demonstrated that with twice daily use, you can experience up to 24-hour breath freshness and teeth brightening of up to 3 shades in just 2 weeks. Built on Ayurvedic foundations, this mouthwash leverages the benefits of coconut oil to maintain oral…

15. Page 29

    Composite Eliminates Need for Glazing and Polishing THE VILLAGES, Fla.–Bright Temporary C&B is a self-curing composite for temporary crowns, bridges, inlays, and onlays. C&B is a unique combination of nanosized particles and ideally sized glass filler that provides enhanced composite strength. Its elastic properties provide easy, failure-free placement with the added advantage of the "chameleon effect" that matches shade, opacity, and fluorescence for a natural look. Big benefits are its short time and finish time of 3 minutes, which eliminates the need for glazing and polishing. It also offers convenience, with a 1:1 ratio available that is compatible with most…

16. Page 30

    Steri-Shield Sensor Holders Provide Ultimate Patient Comfort FERNANDINA BEACH, Fla.—Wingers digital sensor holders were introduced in 1998 as the first calibrated sensor holders in dentistry. Since then, Steri-Shield has continued to expand the product line with versatile and innovative designs. The disposable sensor holders are made of a soft material for ultimate patient comfort and dependable image capture. Wingers fit all popular No. 1 and 2 sensors and are easy to use. Steri-Shield is dedicated to producing products like the Wingers line to help dental clinics offer a high standard of care at an affordable price. For more information, visit…

17. Page 31

    Filhol Dental Prefabricated Posts Designed for Simple Placement ORLANDO–FILPOST is the only prefabricated post system that can be customized to suit restorations for root post and core buildup. The posts can be bent and shortened to suit canals without risk of fracture, enabling easy insertion of multiple posts into converging canals. The posts are engineered to be easier to place, even in difficult cases, in a faster, safer manner. They are more preserving of healthy tooth structure and stronger in use via the unique, passive interlocking system. The posts comprise 99.8% pure titanium and are biocompatible and compatible with all…

18. 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, and 6 of 10 employees quit over poor indoor air quality in their places of business. 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 air changes per hour in…

19. Page 34

    DENTISTRY TODAY 14TH ANNUAL 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. Implant Direct SMARTbase is a complete range of TiBase abutments. It is designed to device esthetics with a dual-lug anodization while unlocking restorative flexibility for the clinician and laboratory. It is now available in non-engaging and engaging with a new retentive design. For more information, call (888) 649-6425 or visit ImplantDirect.com/us/smartbase. s For predictable replacement of maxillary laterals and mandibular incisors…

20. Page 35

    Top 25 Implant Products Glidewell If you are among the growing number of dentists seeking to expand the implant services you offer patients, the Hahn Tapered Implant System can help your practice thrive through world-class education, everyday cost savings, and the strongest warranty in implant dentistry—from Hahn implants to BruxZir restorations. The Hahn implant is available at a fraction of the price of other premium implant systems. Plus, you get 20% off every time you restore your Hahn case at Glidewell. The design of the Hahn implant is based on Dr. Jack Hahn's more than 50 years of clinical experience,…

21. Page 36

    Top 25 Implant Products Ray America FAYFace is one of best AI-driven 3D facial scanners, set to revolutionize communication among patients, technicians, and clinicians while seamlessly integrating patients' facial, intraoral, and CBCT data into a unified solution. The implications are clear, with a positive impact on a practice's return on investment, improved clinical outcomes, and reduced costs. With a simple mouse click, it effortlessly captures high-resolution 3D images, rendering traditional methods like custom impression trays and external scan body devices obsolete. The end result is a comprehensive patient profile, allowing for a precise restoration design that perfectly complements the patient's…

22. Page 37

    Top 25 Implant Products Preat Corporation The LOCATOR R-Tx Removable Attachment System features a Duratec titanium carbon nitride coating that is aesthetic, harder, and more corrosion-resistant. The added dual-retentive surfaces allow patients to easily seat their overdentures. This unique design also has an increased pivot technology that improves the maximum divergence between implants. Additionally, the redesigned denture housing features deeper external grooves and flats that resist movements. Each abutment is packaged with everything one will need for the case. With system simplicity, clinicians are quickly realizing the practical benefits of upgrading to LOCATOR R-Tx. The dynamic features of R-Tx bring…

23. Page 38

    Top 25 Implant Products Bicon Dental Implants The SHORT Implant design comprises plateaus, sloping shoulders, and a bacterially sealed, 1.5° locking taper implant-to-abutment connection. With the plateau design, cortical-like bone forms around the implants 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 interdental papillae that is gingivally esthetic. Bicon's 360° universal abutment positioning provided for the revolutionary cementless and screwless integrated Abutment Crown, consistently offering a monolithic esthetic gingival margin. For more information, call (800) 882-4266. ly narrow-body implant with a screw-retained prosthetic system.…

24. Page 39

    Top 25 Implant Products Nobel Biocare TiUltra is a novel implant surface that features an ultra-hydrophilic, anodized surface. It features a gradual change in topography along its length, going from minimally rough and non-porous at the collar to becoming moderately rough and porous toward the implant apex. Owing to its unique surface chemistry and topography, TiUltra promotes early osseointegration and long-term stability of hard and soft tissues. Its surface chemistry and hydrophilicity are preserved by a protective layer, which ensures every implant arrives in pristine condition. When paired with NobelActive, NobelParallel, or NobelReplace implant systems, there is surgical versatility to…

25. Page 40

    Injection Molding With a Single-Shade Flowable Composite Figure 1. Preoperative view of the Tooth No. 10 peg lateral. Figure 2. VPS matrix of the diagnostic wax-up. Figure 3. OMNICHROMA Flow (Tokuyama Dental America) injected into the VPS matrix. Figure 4. Excess composite from the access chimney. Figure 5. Simple cleanup of excess composite. Figure 6. Immediate postoperative view of the injection molding restoration. Kevin Brown, DDS Peg lateral incisors are a common issue that many orthodontists and restorative dentists must collaborate on for good results. Although there are a variety of treatment methods that must be considered, this article will…

26. Page 42

    Industry News Spear Education Welcomes Dr. Effie Habsha as Esteemed Faculty Member Spear Education, a leading provider of dental education, is delighted to welcome Dr. Effie Habsha to its esteemed faculty. Renowned for her expertise in prosthodontics and her pioneering efforts in championing women in dentistry, Dr. Habsha's addition enhances Spear Education's commitment to providing top-notch dental education. Dr. Habsha will be the instructor for a number of Spear's in-person workshops and seminars, including "Restoring the Edentulous Arch." A Fellow of the Royal College of Dentists of Canada (RCDC) and an examiner and former section head for oral examination in…

27. Page 44

    New ADA Study Updates Dental Radiography Safety Recommendations The ADA Council on Scientific Affairs, through an expert panel, has issued updated recommendations regarding radiation protection in dental radiography, marking a significant departure from previous practices. The guidelines, published in the Journal of the American Dental Association, advocate against the use of lead abdominal aprons or thyroid collars during dental x-rays, citing advancements in technology and diagnostic protocols. The panel's recommendations, developed with support from medical physicists at the US Food and Drug Administration, emphasize the importance of considering the diagnostic information needed from x-rays to optimize patient care and clinical…

28. Page 46

    Q&A Dentsply Sirona: Practical Tips for a More Sustainable Dental Practice Sustainability is evolving from a nice-to-have to a must across all aspects of life—dentistry included. But how can we turn sustainability into concrete actions? Erania Brackett, Head of Sustainability at Dentsply Sirona, and Dr. Steven Mulligan, founding member of the FDI World Dental Federation Sustainability in Dentistry Task Team, discuss the many ways in which dental professionals can act more sustainably at work each day. Q: What advice do you have for dental professionals just starting out on their sustainability journey? SM: Take the time to learn about sustainability…

29. Page 48

    Presents Returns to Anaheim Experience CDA Presents The Art and Science of Dentistry from May 16 to May 18. Attend 1, 2, or all 3 days of the California Dental Association's (CDA's) next convention. Gain fresh insights on trending practice management and clinical topics, including dedicated tracks for hygiene, the dental team, and early career dentists. Earn CE at your choice of more than 200 hands-on workshops and lectures, get inspired by more than 130 leading speakers, and explore demos and deals from more than 350 exhibitors. Enjoy after-hours fun at CDA's party in the Grand Plaza, attend an on-site…

30. Page 50

    ThriveLive Celebrates 3-Year Anniversary THRIVELIVE 2024 PRESENTED BY HENRY SCHEIN THRIVELIVE 2024 is scheduled for May 2 to May 4. The event will take place at the Bellagio Hotel in Las Vegas. Celebrating its third year, THRIVELIVE welcomes all dental professionals for 3 incredible days of nonstop learning, entertainment, and pure fun. This year's theme, "Accelerating Dentistry, Business & Technology," is open to dentists, hygienists, dental assistants, office managers, or other members of the dental team. Attendees can immerse themselves in over 60 sessions, connect with peers, and unwind with top-notch entertainment. The event boasts more than 70 speakers and…

31. Page 52

    Bien-Air Micro-Series: A New Generation of Electric Handpieces The iOptima INT, coupled with the NOVA 1.5MS, has all of the restorative features a dentist needs. Howard S. Glazer, DDS Dentistry has evolved from the archaic means of cutting and preparing teeth via a belt-driven, foot pedal-operated drill to upon this method of sophisticated instruments that allow the operator to perform better. Ben Franklin was right; electricity is a powerful tool. Electric motor handpieces are not necessarily new but what is new are the size, power, and control afforded the operator with a new series of ultrashort handpieces in corporation with…

32. Page 54

    Posts and Core Buildups in the 21st Century INTRODUCTION Clinical procedures concerning the need for posts and the protocol for core buildups in endodontically treated teeth have evolved significantly over the last few decades with the advent of dentin bonding protocols. Likewise, the dental literature has evolved yet is fraught with contradictions. However, the consensus in the literature today is that posts weaken teeth, and when adequate tooth volume is present, a post is contraindicated, and only a core buildup should be done. There is a misconception often quoted in the literature that the reason a post is needed is…

33. Page 55

    Figure 1. Recurrent decay around and under 30-year-old porcelain-fused-to-gold restorations. Figure 2. Black discoloration along the labial porcelain butt joints. Figure 3. After removing the old restorations. Figure 4. Extensive loss of tooth volume. alcohol or acetone in primers simply will not take the substrate to the hydrophobic level necessary for successful bonding. 12. Teeth with core buildups that have adequate dimensions to resist fracture do not need posts. Molar teeth with posts result in many catastrophic failures. 13. Core buildups should always be separate from the crown. Casting, pressing, or milling the core as part of the crown is…

34. Page 56

    Figure 5. OpalDam Green (Ultradent Products) was used to cover the substrates and post spaces. Figure 6. Core buildups were done for Nos. 6, 8, 9, and 11. Figure 7. Titanium ParaPost XP (Coltene) posts. Figure 8. Definitive preparations were done. ated a "cosmetic need" for the patient. The degree of pathology under the restorations was not clinically evident. Most restorations cemented with acid-soluble cement should be replaced after 4 to 5 decades, even if they "look" good (Figure 2). After removing the old restorations, a significant amount of tooth structure was decayed because of the leaking restorations and dissolution…

35. Page 57

    Figure 15. The cosmetic outcome was approved by the patient. Figure 16. Results using Pure 4% CHG (Best Buy Discount Dental Supply). Figure 17. Patient before and after photos. Figure 18. Preoperative image of an 88-year-old patient. Figure 19. Extract, implant, or restore? Figure 20. Hopeless? Figure 21. CFBF and 1 month later. not saved. The second pour cast is used for checking proximal contacts on the final restorations after the soft tissue zones are trimmed away from the margins to ensure a definitive seat of the final restorations (Figure 11). Case 11: Provisional restorations that fit perfectly and are…

36. Page 58

    Figure 22. CRBF and 7 months later. Figure 23. Preparations. Figure 24. Seven months post closed-flap biologic shaping. Figure 25. Photo 2.5 years after placement. Figure 26. Prep shim with hole drilled just lingual to the incisal edge. Figure 27. The sequence is important. Figure 28. Posts properly covered. Figure 29. No metal shows. and closed-flap biologic shaping was accomplished with the plan to marginate at the crest of the tissue on core paste after healing. The core buildup on No. 10 was in violation of the biologic width, but it was reshaped along with tooth structure apical to it,…

37. Page 62

    A Simplified and Predictable Approach to Crestal Sinus Elevation INTRODUCTION Implant placement in an edentulous posterior maxillary site faces challenges related to the resorption of the crestal ridge and enlargement of the maxillary sinus. Both of these events are normal occurrences following the loss of the premolar or molar in the posterior maxilla. The result is insufficient crestal height to accommodate implant placement. In 1994, Summers was first to publish on the use of osteotomes utilizing a crestal approach to elevate the maxillary sinus membrane. These osteotomes graft material to increase the crestal height to allow implant placement in the…

38. Page 63

    FIGURE 2. Drill series for crestal sinus elevation with 2° tapered depth stops utilized. FIGURE 3. Steps 1 to 3: initial steps to determine the level of the sinus membrane and thickness of the crestal bone. FIGURE 4. Steps 4 to 6 utilized to push additional autogenous bone particulate into the sinus. FIGURE 5. Steps 7 to 9 utilized to push additional graft material with apical pressure to further elevate the sinus membrane. This maneuver involves pinching the patient's nose and having the person try to blow his or her nose while you watch to see if any bubbles escape…

39. Page 64

    Figure 6. Periapical radiograph demonstrating an estimated crestal height at site 3 of 6 mm. Figure 7. CBCT views during the planning stage with Guide Right sleeves in the diagnostic stent with measurement of the crestal bone height and overlaying soft tissue available at site 3. Figure 8. During virtual planning, it was determined an angle correction of 12° would be required based on the anatomy presented on the virtual axis of Guide Right sleeve, blue line; apex of the virtual implant, red line: angle correction required to be incorporated into the surgical guide design. Figure 9. Periapical radiograph following…

40. Page 65

    IMPLANTS results in a simpler, more predictable approach to implant placement in the resorbed posterior maxilla. Additional cases using this technique are in the online version of this article at .• Figure 11. CBCT views during the planning stage with Guide Right sleeves in the diagnostic stent illustrating the 3.0 4-mm crestal bone height available. Figure 12. Periapical radiographs taken at various stages of the crestal elevation (left: following initial membrane elevation and sinus floor undermining; right: following placement). Figure 13. CBCT views following crestal sinus elevation and implant placement illustrating the graft material to accommodate the implant at site…

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