Dentistry Today — May 2012

Inside this issue

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

1. Page 12

   Specialty Recognition of Oral Medicine I have attended numerous ADA and dental society meetings, and I have been surprised by the lack of awareness and knowledge regarding the current status of oral medicine as a possible dental specialty. First of all, many dentists do not know the definition or the history of oral medicine, and secondly, many think that oral medicine is already a dental specialty recognized by the ADA. The definition of oral medicine is as follows: oral medicine is the discipline of dentistry concerned with the oral healthcare of medically complex patients and with the diagnosis and nonsurgical…

2. Page 14

   VIEWPOINT continued from page 12 responsible to the federal government for accrediting dental educational graduate programs. Oral medicine graduate residency programs were approved by CODA in 2007 and implemented in 2008. Graduate education approval is separate from the specialty recognition process. The latter requires approval by the ADA at multiple levels, beginning with Committee G, then the Council on Dental Education and Licensure (CDEL), and finally the House of Delegates. To gain specialty recognition, a sponsoring organization such as the AAOM has to comply with a strictly defined application process and meet all six of the following requirements as outlined…

3. Page 16

   Below is a letter to the editor received in response to the Viewpoint entitled, "Dental Lab Registration: Dentists Leading the Way" written by Eric J. Thorn, Esq, that ran in the February 2012 issue. The article is available on our Web site, . Dear Editor: In light of "Dental Lab Registration: Dentists Leading the Way" (Dentistry Today, February 2012), author and NADL executive Eric Thorn points out some interesting trends in states that are creating legislation that makes dental lab registration a requirement. But the article raises far more questions than it answers. Are dentists really leading the way, and…

4. Page 17

   FOCUS ON: CBCT Technology Scott D. Ganz, DMD, discusses the impact of cone beam computed tomography technology. Q: Many clinicians think that 3-dimensional (3-D) imaging is a recent development. Can you tell us how this technology has evolved? A: Originally, computed tomography (CT) scan images for dental were processed at a medical radiology center and delivered to the clinician in a series of large (chest x-ray) size films. The introduction of a graphical user interface known as Microsoft's Windows in the early 1990s combined with more powerful computers and graphics accelerator cards to speed up the processing power, and software…

5. Page 18

   Dentistry Today.com Providing you with news and information from the industry leader in clinical content. Visit Our Site Today! Check out our... LIVE ONLINE BLOG California Dental Association Meeting May 3 to 5, 2012 Photo courtesy of the California Dental Association Dentistry Today will be blogging from the CDA meeting in Anaheim, Thursday through Saturday. Interactive Coverage •Live video product demonstrations •Product releases •Announcements •Insight from clinicians on products •Interviews with manufacturers live-blog DENTISTRY TODAY Technique of the Week Dennis Wells, DDS No-Drill DURAthin Veneers In this Technique of the Week video, Dr. Dennis Wells describes the benefits of using…

6. Page 20

   From the February 2012 Issue WHITENING FILM CAO Group Sheer White is a thin, moldable whitening film that completely contours to the tooth—tightly adapting to each patient's anatomy. The film is effective and simple because it doesn't require a custom tray, which increases operatory turnaround and overall profitability. Your patients will love it because it's easy and comfortable to wear and whitens as well as other whitening systems. For more information, call (877) 238-4408. FREEinfo, POSTERIOR COMPOSITE VOCO America VOCO's xtra base is a fast-setting bulk-fill posterior composite that allows curing of 4 mm layers in only 10 seconds when…

7. Page 22

   Audiology Solutions SmartWear, designed for dental professionals who may already be experiencing high-frequency hearing loss, provides active hearing protection, never allowing sounds higher than 85 dB to enter the ear canal. At the same time, it enhances speech, making it louder and clearer in the presence of background noise. Heat-activated, it molds to the inside of the ear canal, providing a custom fit. For more information, call (800) 362-8153 or visit dentalear.com. FREEinfo, GUTTA PERCHA & PAPER POINTS DiaDent Dia-Pro W Gutta Percha Points and Paper Points are designed to complement WaveOne Files and make Dia Dent's line of gutta-percha…

8. Page 24

   To assist practitioners in their selection of essential dental products, Dentistry Today presents items reviewed by THE DENTAL ADVISOR's staff editors and consultants. Established in 1984, THE DENTAL ADVISOR, based in Ann Arbor, Mich, has provided dental professionals worldwide with objective, accurate information using in vivo and in vitro results on the performance of materials and equipment based on clinical and laboratory research. For more information, visit dentaladvisor.com or call (800) 347-1330. Aquasil Ultra +++++1/2 DENTSPLY Caulk | (800) 532-2855 | caulk.com Editors' Comments "Remarkable accuracy in a moist environment." "Excellent resistance to tearing, especially in thin areas." "The light-body…

9. Page 26

   QUICK TECHNIQUE BISCO's All-Bond Universal Dental Adhesive Compatibility and Speed for Everyday Effective Performance Alan Acierno, DDS The repair of normal wear and tear of the natural dentition requires the use of simple and predictable adhesion. BISCO recently introduced ALL-BOND UNIVERSAL with a special formula that allows for its use in either total-etch or self-etch modes. An example of the versatility of ALL-BOND UNIVERSAL is demonstrated with a recent patient who presented with a very slight distal incisal chip on tooth No. 9. In progressive, a slide into this area was noted. The patient has had this edge fixed several…

10. Page 28

    Spotlight Feature-Laden, iPad-Controlled Implantology Motor System Introduced IRVINE, Calif.—Offered by Bien-Air, iChirpro is a revolutionary new implantology motor system controlled from an iPad and equipped with some of the best-performing attachments ever designed. Its 2021 L Micro Series contra-angle handpiece is equipped with an internal irrigation system for greater comfort, and the lifetime lubricated ceramic ball bearings of its MX-i LED motor ensure an exceptional service life, with no maintenance required. The multi-user iChirpro application incorporates the complete sequences of the leading implant manufacturers, including Camlog, Straumann, Nobel Biocare, Zimmer, DENT-SPLY, Biomet 3i, Astra Tech, and more. It also offers…

11. Page 30

    Spotlight Kit's Instruments Simplify Seating of Full-Contour, All-Ceramic Restorations New Technology in Self-Tapping Implants Eliminates Need for Conventional Flutes and Vents ROCK HILL, SC-Offered by KOMET USA, the KOMET i.D. 0707 Kit offers an ideal range of rotary instruments designed to cut, finish, and polish full-contour restorations fabricated of zirconium oxide, lithium disilicate, aluminum oxide, or pressed ceramics. The kit includes a ZR Flash Polishers and 2 ZR Diamonds, all conveniently arranged and secured in a stainless steel sterilizable bur block. These instruments feature distinct polishing and cutting characteristics that specifically address the unique material properties of today's generation of…

12. Page 32

    Spotlight Attachment's Self-Aligning Feature, Retention, Durability, and Low Profile Cited ESCONDIDO, Calif.-When a case requires an overdenture bar, Zest Anchors' LOCATOR Bar Attachment provides the same self-aligning feature, superb retention, exceptional durability, and low profile design as the LOCATOR implant. Its innovative ability to pivot increases the attachment's resiliency and tolerance for the high mastication forces an attachment must withstand, while its unique dual retention innovation that includes inside and outside retention ensures long-lasting performance. The LOCATOR Bar Attachment offers 3 options allowing the fabrication of a resilient attachment on an implant-supported cast alloy or milled titanium bar, or casting…

13. Page 34

    Spotlight New Core Build-Up Composite and Post Cement's Exceptional Physical Properties Cited BRIARCLIFF MANOR, NY-VOCO introduces GrandioCORE DC, a dual-cured, 77%-filled nanohybrid core build-up composite and post cement. Due to VOCO's advanced nanotechnology used in all Grandio composites, it excels in its physical properties with a high compressive strength of 366 MPa and a dentin-like hardness of 107 MHV that makes it easy to work with out ditching when going from tooth structure to core material. Its stackable consistency and automix syringe delivery system make it easy to work with, and its extremely high radiopacity of 365% Al makes it…

14. Page 38

    Implant Temporary Cement's Ease of Use and Reliability Cited Spotlight Positioning System Can Reduce X-Ray Scatter by up to 70% MOUNTLAKE TERRACE, Wash.—Recent news stories have highlighted a growing concern, especially among parents, about the effects of unnecessary radiation exposure during dental imaging procedures. In response, more dental offices are now taking steps to reduce radiation exposure. In order to help dental offices adhere to the ALARA Principle for radiation protection, HealthFirst introduces the Tru-Align Laser-Aligned X-Ray Positioning System, which can reduce x-ray scatter radiation by up to 70% by delivering a targeted narrow beam though laser-aligned rectangular collimation. Because…

15. Page 40

    Spotlight Apex Locator Provides Precise Measurements in All Canal Environments WHITE PLAINS, NY-Offered by Dent Corp, the RomiApex A-15 microcontroller apex locator provides precise measurements to 0.25 mm in all canal environments. A capable unit offered with a 2-year manufacturer warranty, it provides a graphic display and audio depicting the position of the endodontic file, and among its features are the Root Wizard tracking algorithm, a virtual apex predetermined point, and a built-in soft reset. Additionally, it is fully automatic and offers auto shutdown. The RomiApex A-15 set includes the unit, a cradle, one AAA battery, a measuring cable, file…

16. Page 42

    ADVERTISING SUPPLEMENT QUICK TECHNIQUE Common Sense Endodontics At last count, there were somewhere between 50 to 60 different engine-driven endodontic canal shaping systems on the market. As perplexing as that is, start with wire that is square, triangular, or five-sided; select stainless steel, Ni-Ti, or some magic wire; then twist or grind the wire and slice it into landed or non-landed files or reamers. But wait, also included in the array are .02, .04, .06, and .08 consistent or variable taper instruments with different degrees of angulation for use in a rotary, reciprocating, or oscillating motion. Interestingly enough, with all…

17. Page 44

    NEWS/TRENDS Industry News DENTSPLY International Launches Implant Division DENTSPLY International announced recently that has united its dental implant-related businesses (DENTSPLY Friadent and Astra Tech Dental) into a new company—DENTSPLY Implants, which began marketing and selling products as DENTSPLY Implants in North America last month. DENTSPLY Implants offers a portfolio that is unique in its freedom to create predictable and lasting patient-specific implant solutions with an extensive line of implants, bone regenerative products, digital technologies, and professional development tools. Its portfolio includes ANKYLOS, XIVE, and the ASTRA TECH Implant System. It also includes ATLANTIS patient-specific CAD/CAM abutments as well as 3D…

18. Page 46

    NEWS/TRENDS Study Links Dental X-Rays... continued from page 44 about their history of dental work and the number of times they had the 5 types of dental x-rays taken throughout their lives. The researchers found that these diagnosed with meningiomas were than twice as likely as the comparison group to report ever having had bite-wing images taken. And regardless of the person's age when the bite-wings were taken, those who had them yearly or more frequently were a 40% and 50% higher risk all ages to be diagnosed with a brain tumor. Panoramic x-rays taken at a young age, especially…

19. Page 48

    Antiretroviral Human Immunodeficiency Virus Drugs and Birth Defects: Is There a Link? Human immunodeficiency virus (HIV) positive mothers have been able to guard against transmitting the disease to their babies by taking antiretroviral drugs during pregnancy. Although the drugs prevent children from being born with HIV, the drugs could cause birth defects, such as cleft lip and palate. A new study published in the Cleft Palate-Craniofacial Journal explores any links between antiretroviral prophylaxis and cleft lip and palate. The study analyzed 5 years of data from the Food and Drug Administration's Adverse Events Reporting System. This publicly available database offers…

20. Page 49

    Effect of Acidulated Phosphate Fluoride Gel Application Time A blind, crossover, in situ study by Dr. A. F. B. Calvo et al of the Piracicaba Dental School at the University of Campinas in Brazil, investigated the effect on caries reduction of application time (one minute versus 4 minutes) of acidulated phosphate fluoride gel (APF gel) in permanent and deciduous teeth. The 14-day study involved 16 adult volunteers who wore palatal appliances containing slabs of human permanent and deciduous enamel. At the beginning of each phase, the slabs were submitted to one of the following treatments: no APF application (negative control);…

21. Page 51

    Effect of Mouthrinses on Oral Malodor In a recent study, Dr. T. Blom and colleagues systematically reviewed the literature regarding the impact of mouthrinses on oral malodor, as well as current evidence for the treatment effects of mouthrinses on oral malodor. The authors searched the PUBMED-MEDLINE, the Cochrane-CENTRAL and EMBASE through February 10, 2012 to identify studies that met the review criteria. The outcome variables selected were: volatile sulphur compound measurements, organoleptic measurements, and tongue coating. The review independently screened 333 unique titles and paper abstracts, which resulted in 12 publications (12 experiments) that met the eligibility criteria. Means and…

22. Page 52

    In First Impressions, George Freedman, DDS, gives readers a brief summary of products that have recently been introduced to dentistry, based on his clinical experience. Xylishield Ultradent Products Xylitol was first developed in Finland as a sugar substitute during wartime when the commodity was unavailable. Originally isolated from birch trees, xylitol is a natural sweetener found in many fruits and vegetables. It can also be extracted from numerous plants, including raspberries, plums, and corn. In the 1970s, several university studies found that xylitol was able to reduce the risk of dental caries. It is well known that bacteria in the…

23. Page 54

    Flash Max P3 460 4W High Speed Curing Light CMS Dental Remember the 40-second cure? Halogen light-curing almost seems prehistoric. Composite restorations were painfully slow; the polymerization of a large Class II restoration could take more than 5 minutes! Diode curing lights have reduced the mean curing time to 10 to 15 seconds per layer, a significant increase in clinical efficiency. Now, the one-second cure is here. The FlashMax P3 460 4W High Speed Curing Light (distributed by Sharper Practice) is an ergonomic, high-intensity curing light that offers enough power intensity to polymerize a conventional composite layer in a single…

24. Page 56

    Top 25 Implant Products Dentistry Today's Second Annual Readers' Choice Top 25 Implant Products, selected on the basis of lead generation, represent some of the profession's most innovative implant products. The products appear in no particular order. 3M ESPE The MDI Mini Dental Implant System is minimally invasive and immediately stabilizes loose dentures using a 90-minute palatal protocol, often completed without a flap and frequently using the patient's existing denture. MDI mini dental implants are designed for stability in soft and dense bone, which is essential for immediate loading. Attachment designs are available for custom retention, with 3 retention options,…

25. Page 58

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

26. Page 59

    Where ANKYLOS goes, hard and soft tissue follow. Implant System It's time to measure tissue response in gains, not losses. Natural-looking esthetics that last. That's the beauty of the ANKYLOS Implant System. • Conical connection with no micro-movement¹ • Long-term hard and soft tissue stability² • Gain in papillae height³ Call 1-800-662-1202 for a bibliography of clinical studies or to learn more from a fellow clinician in your area. ANKYLOS Implants. Bringing the importance of tissue response front and center. C. Sachs, Little Silver, NJ* 2 years post placement Distributed By: DENTSPLY TULSA DENTAL SPECIALTIES 1-800-662-1202 www.kilsodentalsocieties.com Manufactured By: DENTSPLY…

27. Page 60

    Top 25 Implant Products . 1 Sun Dental Labs SunTech Custom Implant Abutments come in titanium, zirconia, and hybrid materials; are platform-independent; and are available for all major implant systems from several companies, including Astra, Nobel Biocare, Zimmer Dental, and BioHorizons. Its benefits include (1) the ability to be custom designed for each patient; (2) precision technology that minimizes manual adjustments; (3) optimized soft tissue contours and crown aesthetics; (4) the ability to ensure excellent gingival health; and (5) eliminating the need for stock inventory abutments. For more information, call (866) 561-9777 or visit sundentallabs.com. FREEinfo, Mega'Gen The AnyRidge Implant…

28. Page 62

    Top 25 Implant Products . 1 Glidewell Laboratories Inclusive Mini Implants are self-tapping, threaded titanium screws indicated for provisional and long-term applications. These devices allow for the immediate loading and long term stabilization of dentures in the presence of primary stability and appropriate occlusal loading. They can accommodate new or existing dentures, which are anchored to the heads of the mini implants via a simple and effective o-ring retention system, providing edentulous patients with new levels of comfort and confidence. Inclusive Mini Implants may be placed with a number of compatible surgical kits available today or with the Inclusive Mini…

29. Page 64

    64 . 1 READERS' CHOICE Top 25 Implant Products Zimmer Dental With more than 2 million units sold worldwide, the Tapered Screw Vent Implant has built a solid reputation of trust and performance. Available in 3.7, 4.1, 4.7, and 6.0mm sizes, its proprietary, friction-fit, internal hex platform reduces stress on crestal bone and resists abutment screw loosening. With triple-lead threads, MTX and MP-1 HA surfaces, and a tapered implant body, the versatile Tapered Screw-Vent Implant is now also available with crestal options and is the platform of choice for thousands of clinicians. For more information, call (800) 854-7019 or visit…

30. Page 66

    Top 25 Implant Products PREAT Corp The LOCATOR is the most widely used connector for anchoring overdentures to implants. LOCATOR implant abutments are available in a wide range of cuff heights and are compatible with all major implant systems. The morse taper connection of the male and female attachment provides a self-aligning prosthesis that is very easy for the patient to insert and remove with excellent stability and retention. Retention options range from 0.5 to 5 lbs per attachment. It has the lowest vertical height requirement of any implant overdenture abutment connector. The Extended Range males accommodate divergent implants up…

31. Page 70

    70 . 1 READERS' CHOICE Top 25 Implant Products BioHorizons Z-Systems USA Designed specifically for limited spaces in the aesthetic zone, the LaserLok 3.0 dental implant is ideal for high-profile cases. It's the first Zirconia, 3-mm dental implant designed to create a biologic seal and maintain crestal bone on the collar by using LaserLok microchannels. The LaserLok microchannels are a leading dental technology developed based on more than 20 years of in-depth research on dental implant surface optimization. These precisely engineered, cellular-paced channels are laser-machined onto the surface of the implants and have been shown to elicit a biologic response…

32. Page 71

    Top 25 Park Dental Research The Lew MDI implant has a reliable profile and these unique features: (1) golden anodized o-ball head; (2) platform-switching collar; (3) labyrinth groove banding; and (4) threading featuring progressive compression, reverse buttressing, and a cog lock. The right implant changes everything. You should let Park Dental Research's experience and research in implant dentistry work for you. For more information, visit parkdentalresearch.com. FREEinfo, Implant Direct Sybron International You can treat many clinical situations at less than half the cost with Sybron2 implants. Available in 3.7-, 4.2-, 4.7-, 5.7-, and 7.0 mm diameters with 5 lengths and…

33. Page 74

    Hygiene Update How Bacteria Fight Fluoride Yale University researchers have uncovered the molecular tricks used by bacteria to fight the effects of fluoride used in toothpaste and mouthwash to combat tooth decay. In the December 22, 2011, online issue of the journal Science, researchers report that sections of ribonucleic acid (RNA) messages called riboswitches— which control the expression of genes— detect the buildup of fluoride and activate the defenses of bacteria, including those that contribute to tooth decay. The senior author of the study states that these riboswitches are detectors made specifically to use fluoride. The riboswitches work to counteract…

34. Page 75

    Effect of Cigarette Smoking on Periodontal Surgery A study reviewing the effect of cigarette smoking on the clinical outcomes of periodontal surgical procedures was published in the American Journal of the Medical Sciences. Databases searched from 1968 to May 2010 using various combinations of the following key words: inflammation, mucoperiosteal flap, periodontal surgery, smoking, and tobacco. The inclusion criteria included all levels of available evidence. Articles published only in the English language were evaluated, and unpublished data were not sought. The study identified 24 clinical studies that met the criteria. The duration of smoking habit ranged from at least 5…

35. Page 76

    Get a "Yes!" for Nonsurgical Periodontal Treatment Watch Patients' Health Improve and Increase Your Profits! Today's dental practices are seeing a substantial amount of hemorrhaging, and I'm not just talking about bleeding gums. Dental practices' profits are hemorrhaging from last-minute hygiene appointment cancellations and countless missed opportunities in the nonsurgical periodontal treatment profit center. For too many patients are receiving just a prophy when they really need nonsurgical periodontal therapy or periodontal maintenance (also known as supportive periodontal therapy [SPT]). Many dental professionals are aware of this but don't know how to sign off the daily prophy treadmill, evaluate and…

36. Page 78

    Get a "Yes!" for Nonsurgical Periodontal... continued from page 76 lars, imagine the glowing potential of your entire practice and the value that you will bring as a member of the dental team. Now that we know the common barriers to getting a yes to the proper treatment plan, the goal of this article is to show you creative ways to overcome these barriers. In doing so, you will play a huge role in growing the nonsurgical periodontal treatment profit center in the dental hygiene department. So how do you get your patients to say yes to optimal health? ARM…

37. Page 80

    Get a "Yes!" for Nonsurgical Periodontal... continued from page 78 Table 2. Healthy Periodontium Versus Diseased Periodontium1,3,4 FIGURES 1 TO 10: A 50-YEAR-OLD FEMALE WITH HEALTHY PERIO. Figure 1 Figure 2 Figure 3 Figure 4 Figure 5 Figure 6 Figure 7 Figure 8 Figure 9 Figure 10 FIGURES 11 TO 13: CHRONIC PERIODONTITIS IN A MALE PATIENT OLDER THAN AGE 50 YEARS. Figure 11 Figure 12 Figure 13 Indicators | Healthy (Figures 1 to 10) | Diseased (Figures 11 to 13) Gingival Color | Coral pink, light pink, or dark pink. | Dark red or bluish red. (Color change may…

38. Page 82

    Get a "Yes!" for Nonsurgical Periodontal... continued from page 80 patients. Outline the treatment process with patients, step by step. You might even share with them a visual aid that shows the drastic difference between a prophy and periodontal therapy, or healthy versus diseased gums, such as chart 11 in Table 2 (Figures 1 to 13). To enhance an engaging communication process, ask open-ended questions, such as, "How do you feel about this treatment approach?" and "What are your concerns?" Then, invite the patient to ask questions. This is all part of the buy-in. Finally, explain that periodontal disease is…

39. Page 83

    DENTAL HYGIENE TODAY cessfully getting a yes from a patient. Most people will find a way to buy what they really want. People talk left and right about these "hard economic times," yet many of these same people carry smartphones, dine out regularly, and participate in expensive hobbies, such as skiing, golf, lib fishing, etc. I am not suggesting that true financial struggles do not exist for some people, but you may be surprised what people can pull photographs to show patients their areas of disease. If you don't have the technology to provide photos, give patients a hand mirror…

40. Page 84

    Product Focus PROPHY ANGLES Brasseler USA The gears in the HygienePro Disposable Prophy Angle are perfectly aligned, ensuring consistent torque with virtually no chatter. The soft, latex-free cups reduce splitter during use, making the polishing process more comfortable for you and your patients. These prophy angles are also available in a unique brush version to easily access hard-to-reach areas on occlusal and interproximal surfaces. For more information, call (800) 841-4522. FREEinfo, Sunstar Americas Research proves that Butler Paste-Free Prophy is safer for cosmetic restorations versus conventional prophy paste. It cleans as well as medium prophy paste. Its unique soft grip…

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