Dentistry Today — May 2013

Inside this issue

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

1. Page 8

   Calling All Artists! Heartfelt inspiration, love, pain, happiness, sadness, and the whole gamut of hopes, thoughts, and life's experiences make up human-created works of art. This form of "communication" allows us to see and feel what the artist may or may not have intended to portray. A small glimpse of the artist's reality may often impact our life and realities. It is hard to imagine a world where technology would completely trump the human mind, human touch, and the human eye (often referred to as the window into the soul) as it relates to optimal artistic (aesthetic) expression. Until such…

2. Page 10

   The Beauty of Balance Like many of you, I am a dentist. In fact, some of you may know me from lectures I've given around the country on dental materials, or from the publications I'm very proud of, THE DENTAL ADVISOR. So yes, I'm a dentist. That's who I am. Which begs the question: How the heck did I end up running with a goat on a balmy Saturday morning in Michigan? RUNNING WITH GOATS? There he was—thin and young, with good form and a strong, confident pace, not to mention a beard and horns. There I was—also thin, with…

3. Page 12

   VIEWPOINT continued from page 10 Find ourselves working so hard, so incredibly hard that we forget about the other parts of our life that are just as important, if not more so. Balance is critical. And for me, almost nothing helps me maintain that sense of balance, as a human being, more than running. Throughout 35 years of trial and error in my profession, here's what I've discovered: aside from simply being in good shape, running before I come to work helps me to focus us throughout the day. I have more energy, I move with more precision, and the…

4. Page 13

   PermaCem 2.0 Zirconia Inseparable: Zirconia and PermaCem 2.0 NEW! PermaCem 2.0 has the Strongest Adhesion to Zirconia than any Leading Self-Adhesive Permanent Cement* PermaCem 2.0 is proven to provide one of the strongest bonds to Zirconia restorations compared to the other leading self-adhesive cements. Incorporating a recently developed adhesive monomer formula, the dual curing properties deliver an exceptional bond across all substrates. Formulated for easy clean-up, the optimized viscosity and no-drip formulation provide for the fastest and easiest removal of excess of all other self-adhesive cements, resulting in less stress and chair time. Plus as a single-step cement, it provides…

5. Page 14

   Dentistry Today.com Providing you with news and information from the industry leader in clinical content. Visit Our Site Today! CDA Blog from Anaheim NOW SHOWING dentistrytodaycom/live-blog MacPractice This video contains an explanation of the new technology that makes it possible for MacPractice's software to wirelessly transmit images to an iPad. Philips Oral Healthcare Matt Dufour, marketing manager, Philips Oral Healthcare, speaks about the Philips Sonicare Flexcare Platinum. SciCan Doug Braendlie, U.S. product manager, SciCan, discusses one of the features of the Coi W Instrument Washer. Exclusively from DENTISTRY TODAY dentistrytodaycom/live-blog Technique of the Week Sponsored by Seating a Restoration: Step…

6. Page 16

   FOCUS ON: Endodontics Clifford J. Ruddle, DDS, discusses innovations in endodontics. Q: What is the most urgent challenge facing the specialty of endodontics? A: The biggest and most urgent challenge facing international endodontics is the need for superb, relevant, and focused education. Although many dentists believe they have received good endodontic training, oftentimes this training occurred many years earlier. We should all appreciate that good is the enemy of great. Meaningful continuing education (CE) should be conducted in an environment and a manner that is inspiring. Relevant CE should close the gap between prior training and what is currently possible.…

7. Page 18

   From the February 2013 Issue MATRIX SYSTEM Garrison Dental Solutions The Composi-Tight 3D XR Sectional Matrix System is an ultraretentive matrix ring designed for use with short or malpositioned teeth, including areas between the canine and first bicuspid. The enhanced, Soft Face silicone ensures the matrix band adaptation, which reduces both flash and finishing time, while improved contacts. For more information, call (888) 437-0032 or visit garrisondental.com. FREEinfo, CLEANING PASTE Ivoclar Vivadent You can achieve higher bond strength by cleaning your restoration with Ivoclean. Studies show that water and phosphoric acid do not adequately clean contact surfaces to establish a…

8. Page 19

   America FIT CHECKER ADVANCED and FIT CHECKER ADVANCED BLUE incorporate new features and benefits, including excellent detail and accuracy, minimal film thickness, optimal flowability, and excellent transparency. FIT CHECKER ADVANCED BLUE is also indicated for checking occlusal contact. For more information, visit gcamerica.com. FREEinfo, TEMPORARY MATERIAL EXACTA Dental Direct By taking the successful original formula and utilizing new nanoparticle technology, the new generation of EXACTA Temp Xtra temporary material allows users to create provisionals that are now stronger and appear more natural. Its unique ability to bond to itself allows for easy repair of voids, and it is ideal for…

9. Page 20

   NEW PRODUCTS MODELING INSTRUMENT Ivoclar Vivadent OptraSculpt Pad is a new modeling instrument featuring foam pad attachments designed for the nonsonic placement of composite materials. It allows composite filling materials to be placed and shaped with ease and efficiency, and it is particularly suited for the placement of Class III, IV, and V restorations and direct veneers. For more information, call (800) 533-6825 or visit the Web site ivoclarvivadent.com. FREEinfo, IMPLANT ATTACHMENT Sterngold The ERA DE female part is made of stainless steel or titanium. Its stainless steel is primarily used for casting into a crown, bridge, or bar structure…

10. Page 21

    The Complete Composite System comprises 3 types of composites, including (1) NanoCeram Universal, a light-curing nanohybrid composite suitable for all direct anterior and posterior restorations, (2) NanoCeram Flowable, and (3) Bright Posterior. They are offered in syringes of 4 g and unit-dose capsules as well as 2 g syringes of flowable. For more information, call (908) 553-3196 or visit spee@monmouth.com. FREEinfo, LED SYSTEM High Q Dental The C3 LED delivers clean, defined, brilliant LED intensity, and it features an adjustable spot size and nearly 8 hours of continuous use at its highest intensity from a lightweight, lithium ion battery pack.…

11. Page 22

    CompCore AF SyringeMix Stack ++++1/2 Premier Dental Products | (888) 670-6100 | premusa.com Consultants' Comments • "Excellent depth of cure for deep cores." • "Adapts well to tooth." • "Convenient storage—no refrigeration required." • "Stacks and stays in place." • "Quick curing time." • "Radiopaque." • "Cured material is softer than some others." • "I would like the curing time printed on the label." Description CompCore AF SyringeMix Stack, a dual-cured, fluoride-releasing, radiopaque composite core build-up material, is indicated for the fabrication of core buildups in vital and nonvital teeth. Advantages in the formulation include increased translucency resulting in significant…

12. Page 24

    Carestream Dental's CS 3500 Intraoral Scanner—a Portable, Intuitive Tool for Capturing Digital Impressions Carestream Dental has ushered in the new reality of restorative dentistry with its CS Solutions portfolio, a collection of CAD/CAM products that allows clinicians to go from scanning a patient's mouth to designing and milling a restoration in less than an hour. One of the highlights of the CS Solutions lineup is the CS 3500 intraoral scanner, which captures digital impressions of a patient's mouth and features color 3-D imaging for a portable, intuitive design. The CS 3500 delivers exceptional image precision (up to 30 µm) to…

13. Page 26

    Spotlight Implant Designed Exclusively for Overdentures ESCONDIDO, Calif.—Offered by Zest Anchors, the LOCATOR Overdenture Implant System (LODIS) features (1) innovative surgical instrumentation designed with safety in mind, (2) narrow-diameter implants, (3) LOCATOR, the world's leading overdenture attachment, and (4) a male processing pack. Combined, these elements offer a less invasive, predictable, and durable implant-retained overdenture for patients requiring an effective, cost-conscious technique for securing their denture. The LODI System incorporates a unique 2-piece coronal design not found with o-ball mini implants, a critical feature optimizing patient satisfaction by providing flexibility for simple attachment interchangeability and replacement should wear occur throughout…

14. Page 30

    Spotlight Applicator Offers New Approach for the Application of Dental Liquids and Gels Now With a US-Based Office, Business Hailed as the "Complete Recycling Company" PARSIPPANY, NJ—Serving the European market for more than 28 years, Medentex GmbH of Bielefeld, Germany, is a leading provider of amalgam collection and recycling services. It is a complete recycling company; each component of dental amalgam is reclaimed from the dental sludge, separated, and sold back to industry. Dentists can be assured that no mercury enters either a landfill, where it can seep into rivers and streams, or in incinerators, where vapor may enter the…

15. Page 31

    Temporary Veneer Cementation Using Ultradent's ClearTemp LC ClearTemp LC is a temporary cement designed specifically for luting provisional veneers. Its lightcured resin formula provides the additional strength needed to ensure that temporary veneers will not fall off between appointments. In addition to its optimally formulated strength, ClearTemp LC includes fluorescing properties that cause it to glow under a black light for easy detection. Placement Before placing ClearTemp LC, remove it from the refrigerator and bring it to room temperature for ideal handling and viscosity. Clean, rinse, and lightly dry the preparation. Remove the cap from the syringe (no tip is…

16. Page 34

    Spotlight Spiral Finishing and Polishing Wheels Offer New Way to Put Natural-Looking Gloss on Restorations ST. PAUL, Minn.—3M ESPE's new, single use SofLex Spiral Finishing and Polishing Wheels offer a new way to put a natural-looking gloss on restorations. Featuring an innovative spiral shape that adapts to all tooth surfaces, they provide dentists with a versatile and simple alternative to traditional points, cups, discs, and brushes. Ideal for use with composites such as 3M ESPE Filtek Supreme Ultra Universal restorative, resin-modified glass ionomers, bis-acrylic temporary materials, and precious and semiprecious metal, the wheels are designed with flexible spiral "fingers" that…

17. Page 36

    Spotlight New Universal Composite's Exceptional Aesthetics, Polishability, and Durability Cited SAN RAMON, Calif.—ZNano, Danville Materials' new, state-of-the-art nano-filled universal composite, has a high percentage (75% by weight) of inorgania/silica-based filler (80 nm), creating exceptional aesthetics, polishability, and durability. It offers very high physical properties when compared to other composites, and at a radiopacity of 205% of aluminum, it is easy to read. Its shades closely match VITA shades. For more information, call Danville Materials at (800) 827-7940 or visit danvillematerials.com. FREEinfo, Relax your patient. Manage your work space! We know how important it is to minimize the cords and hoses…

18. Page 38

    Needle Penetrates Smoothly With Less Tissue Displacement LANCASTER, Pa.—Featuring an innovative, patented, scalpel-designed bevel, the SeptoJect Evolution needle is designed for smoother penetration with less tissue displacement. Research shows that it requires 39% less force than standard needles to penetrate tissue. This means less discomfort for patients, even when used for multiple injections. Also, the need for less force combined with significantly reduced deflection offers dentists better control and accuracy. For more information, call Septodont at (800) 872-8305. FREEinfo, Spotlight System Provides Safe and Effective Way to Achieve a Beautiful, White Smile SOUTH JORDAN, Utah—Opalescence Boost, a 40% hydrogen peroxide…

19. Page 39

    Time-Tested Reline Materials Provide Long-Lasting Comfort, Strong Adhesion ENCINITAS, Calif.-Sofreliner easy to handle and polish. Tough, Tokuyama's soft denture reline, celebrates its 15th anniversary this year while Rebase II, its hard denture reline, celebrates its 25th. Both products utilize easy and quick chairside procedures that provide long-lasting comfort and strong adhesion. Formulated without methylmethacrylate monomer, Rebase II has no odor or taste and doesn't generate heat or chemical irritation, and it's considered by clinicians to be Sofreliner Tough comes in an automix delivery system and lasts up to 2 years without losing its superb softness, tear strength, and adhesion to…

20. Page 40

    QUICK TECHNIQUE 3M ESPE's Sof-Lex Finishing and Polishing Tools Streamline the Restorative Process Michael Melkers, DDS Many dentists have become accustomed to using a series of points, cups, discs, and brushes for final finishing and polishing. These tools have served us well, but if there is one improvement that we are always open to in the operatory, it is likely a streamlined technique. A new tool for finishing and polishing is offering just that—3M ESPE's Sof Lex Spiral Finishing and Polishing Wheels, designed with flexible spiral fingers that adapt easily to all tooth surfaces, both convex and concave. Abrasive particles…

21. Page 42

    Vident, a VITA Company Revolutionizing the Dental Industry—Again Figure 2. VITA ENAMIC. Figure 3. VITA SUPRINITY. Figure 1. The Easyshade Advance 4.0. VITA, one of the world's foremost innovators in the field of dentistry, follows its groundbreaking VITA shade systems with more industry-changing products. In 2013 and 2014, several new materials will be developed from VITA to reinforce the message that the VITA shade system—the most used shade system in the world—features a complementary selection of materials for every indication. The all-new Easyshade Advance 4.0 (Figure 1) was previewed at the IDS in Cologne, Germany, and will be entering the…

22. Page 44

    NEWS/TRENDS Industry News D4D Expands Management Team Richardson, Texas-based D4D Technologies, developer of digital technologies for dentistry, announced recently that Fahad Kajani has accepted the position of vice president of business development and strategy, an addition that reflects the company's commitment to aggressively pursue strategic partnerships that will expand business opportunities in US and global markets. Mr. Kajani joins D4D with many years of business development experience, most recently with Henry Schein, where he served as director of its global prosthetic solutions team, working to implement the team's strategic plan and business development efforts in digital technology and prosthetics. Aspen…

23. Page 46

    NEWS/TRENDS Tragedy in Tulsa Oral Surgeon Being Investigated for Poor Sterilization Practices and Possibly Exposing 7,000 Patients to Disease The Tulsa Health Department is warning 7,000 patients of a local dentist's office that they could have contracted HIV, hepatitis B, or hepatitis C from poor sterilization practices. Dr. Wayne Harrington, an oral surgeon with a practice in Tulsa, Okla. is being investigated by the state dental board, the state bureau of narcotics, and the federal Drug Enforcement Agency because one of his patients recently tested positive for hepatitis C and HIV without known risk factors other than receiving dental treatment.…

24. Page 47

    NEWS/TRENDS An Infection Control Breach: OSAP Responds The news that broke on March 28 of an Oklahoma oral surgeon who treated patients under unsanitary and unsafe conditions is as shocking to dental healthcare professionals as it is to the patients for whom we provide oral health care. While none of us outside of that practice and the officials investigating the reported violations can know all of the details, the Associated Press reports and other news agencies suggest that there is at least one suspected case of HCV transmission to a patient. The press also reports that the dentist used instruments…

25. Page 50

    Digital Cameras SNAP Imaging Systems The Pro30 utilizes the 14.1-megapixel Canon S3x0 IS camera. The true 3 to 840-mm optical zoom, a pop up flash, and Auto Smart technology make it one of the easiest-to-use low-cost cameras available for professional dental photography. With its 8MM cosmetic simulation software, it instantly produces convincing before-and-after simulation photos, showing patients how great they could look. The picture mode will show the spouse, family, and friends. For more information, call (866) 987-7627 or visit snapdental.com. FREEinfo, CliniPix Canon T31 (18 megapixels) couples a dedicated wireless ring flash and a 90-mm macro lens, yielding some…

26. 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. Monarch Hydrating Instant Hand Sanitizer Air Techniques The Centers for Disease Control and Prevention recommends that caregivers should thoroughly wash their hands in between, and sometimes during, clinical procedures. First proposed by Professor Semmelweis, this is a practice that has been well established for more than a century. A major problem facing dental practitioners and staff is that soaps and water, combined with repeated cycles of drying, up to 100 handwashes per day in busy…

27. Page 54

    Visalys Temp Kettenbach Today's indirect procedures assume that the practitioner will place a provisional restoration in the patient's mouth between preparation and cementation appointments. These temporary restorations are required to protect the remaining dentition, to predict functional stability in the final PFM or ceramic materials (composite can be adjusted far more quickly and easily than ceramic), and to offer an interim aesthetically acceptable appearance to the patient. The official material should ideally be suited to anterior and posterior applications as well as single or multiple units, offer an easy clinical application technique to the dentist or designated auxiliary staff member,…

28. Page 56

    Top 25 Implant Products Dentistry Today's Third 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. Hiossen The new ETIII SA Implant features a sand-blasted, acid-etched surface that creates an ideal surface morphology and roughness for optimal biological response. In fact, early osteoblast cell response and bone healing with the ETIII SA Implants is 20% faster than Resorbable Blast Media implants. In addition to shortened healing time, the unique surface texture improves secondary attachment strength with increased mechanical stability…

29. Page 58

    Top 25 Implant Products 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. This provides edentulous patients with new levels of comfort and confidence. These implants can be placed with a number of compatible surgical kits available today or with the Inclusive Mini Implant surgical instrumentation…

30. Page 60

    Top 25 Implant Products Z-Systems USA The FDA-approved Z-Look3 Zirkolith dental implants are manufactured in a proprietary process from some of the highest quality zirconia, a material successfully used for medical devices like hip replacements since the 1980s. While most dental implants today are still made of metal gray titanium, the Zirkolith implants overcome the aesthetic limitations and combine high biocompatibility with excellent osseointegration and reliability. It took many years of research, development, and refinement of the zirconia mixture production process and the development of a proprietary surface technology (Surface Laser Modified) to achieve the highest standards of reliability that…

31. Page 62

    Top 25 Implant Products Mega'Gen The AnyRidge System is a landmark implant designed for minimal disturbance of crestal bone and soft-tissue volume. This ensures high initial stability for easy loading and flexible treatment options. It also makes it possible for a beautiful and natural-looking aesthetic result with an innovative S-line abutment, providing a seam less, natural-looking emergence profile. These implants are specially engineered with a 5° internal magnetic connection and platform switch to maintain crestal bone. The system provides an array of prosthetic options for fixed and removable restorations to satisfy the clinician's needs. The design of AnyRidge allows clinicians…

32. Page 63

    Implant Products Top 25 READERS' CHOICE Straumann USA Roxolid for All is an advanced combination of Roxolid material, SLActive surface technology, and the new Loxim transfer piece for simplified implant handling. Roxolid and SLActive each received the Frost & Sullivan Medical Device Technology of the Year Award. This award, which recognizes excellence in technological innovation, is one of the best practices awards bestowed by Frost & Sullivan, the global growth consulting company. In 2005, SLActive was noted as a next-generation dental implant surface technology and in 2009, Roxolid was noted as an innovative, high-performance material for dental implants. Roxolid for…

33. Page 64

    Top 25 Implant Products MIS Implants Technologies The Seven system creates a simple solution for dentists with all levels of experience in implantology. They offer implant diameters ranging from 3.3 to 6.0 mm and in varying lengths from 6 to 16 mm with an internal hex connection. Each implant is packaged with a sterile final drill made to the specifications for the length and diameter of each implant. Micropores and macropores on the surface of the implant, created by a large particle blasting and acid-etch treatment, allow for excellent osseointegration. The Seven implants are self-tapping. With the thread thickness changing…

34. Page 65

    . 1 Implant Products Top 25 READERS' CHOICE Intra-Lock Mini Drive-Lock, a one-piece, small-diameter implant, is ideal for long-term denture stabilization of fixed prosthetics. Patented Cement-Over Abutments, available in 6 configurations, simply fit over the o-ball assembly and convert the implant from removable to fixed or orthodontic treatment options. The system's unique Drive-Lock instrument reduces delivery and placement to one fluid motion. For more information, call (877) 330-0338 or visit intra-lock.com. FREEinfo, Zest Anchors The LOCATOR attachment for overdentures is designed with the primary benefits of ease of insertion and removal, customizable levels of retention, low vertical profile, and durability.…

35. Page 66

    Top 25 Implant Products Implant Direct Sybron International You can treat many versatile clinical situations at less than half the cost with Legacy2 implants. Available in 3.7-, 4.2-, 4.7-, 5.7-, and 7.0 mm diameters with 5 lengths and 2 surface options (SBM and HA), Legacy2 offers an incredible selection. Each implant is packaged with a cover screw, extender, and a carrier that can be used as an implant level transfer and a titanium temporary abutment for maximum value. Legacy2 features a profession-standard internal hex connection and a tapered body with buttress threads plus 3 self-tapping grooves. The body shape facilitates…

36. Page 67

    . 1 Implant Products Top 25 READERS' CHOICE 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, BIOMET 3i, 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 emergence profile for enhancing crown esthetics, (4) and the ability to ensure excellent gingival health. For more information, call (866) 561-9777 or visit suntechdentalabs.com. FREEinfo, OCO Biomedical Loaded with innovative design features, the…

37. Page 68

    Test 161 dentalCEtoday.com The Enigma of the Bilayered Zirconia Restoration For years, the dental profession has been searching for an aesthetic, strong, and predictable alternative for the PFM restoration. Because of their biocompatibility and aesthetic nature, several different ceramic materials have been tried; however, their brittle nature and minimal flexural strength have limited their use. In the late 1990s, the introduction of partially stabilized zirconia, in combination with CAD/CAM technology, opened a new opportunity for the use of all-ceramic restorations throughout the entire mouth. The partially stabilized zirconia—yttrium tetragonal zirconia polycrystals (Y-TZP)—possesses the flexural strength and superior fracture toughness required…

38. Page 70

    The Enigma of the Bilayered... continued from page 68 CORE DESIGN AND CERAMIC VENEER A second source of discrepancy in results among the various clinical studies is the design of the zirconia core. Early CAD software did not provide for incorporation of porcelain veneer supporting features in the underlying core, and it is not surprising that many of the earlier clinical studies reported much higher instances of porcelain chipping (chipping) and debonding than later studies. Subsequent in vitro studies substantiated the hypotheses of those clinical researchers who incorporated supporting design features into the core in an attempt to improve the…

39. Page 71

    DENTAL MATERIALS 71 and reported thermal coefficients for porcelain and zirconia, this crown temperature profiling was accomplished. (The values for porcelain will vary among different brands, and the values for zirconia will very depending on the porosity of the sample.) Porcelain Furnace: Size—5" diameter x 6" tall Furnace BTU: 1.2 Watt/hr Furnace Heat Flux: (1 x 10⁴) Watt/m² Vacuum: 50 m Torr Zirconia: Conductivity (k) 3 YTZP zirconia @ 60°C = 2.6 W/mK³⁶ Diffusivity (a) 3 YTZP zirconia @ 60°C = 7.6 x 10⁷ m²/s⁴⁷ Porcelain: Conductivity (k) porcelain @ 63°C = 1.55 WmK³⁶ Diffusivity (a) porcelain = 7.38 x…

40. Page 73

    Test 161 Expiration date of this CE article is May 1, 2016. To submit Continuing Education (CE) answers, use the answer sheet below. Or, use our easy online option at dentalcetoday.com. This article is available for 2 hours of CE credit. The following 16 questions were derived from the article "The Enigma of the Bilayered Zirconia Restoration" by Bernard E. Klough, DMD, et al on pages 68-72. Learning Objectives: After reading the article, the individual will learn: (1) certain factors contributing to the controversy regarding zirconia laminated restorations, and (2) requirements for successful zirconia laminated restorations. 1. The t to…

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