Dentistry Today — May 2015

Inside this issue

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

1. Page 10

   Honoring Our Endodontists In this month's issue, we have placed a particular emphasis on endodontics with our cover-featured article, written by Dr. Cliff Ruddle, and a Viewpoint by Dr. James Gutmann, both revolving around endodontic topics. As in other areas of dentistry, many things have changed in the field of endodontics and will continue to do so into the future. I read Dr. Gutmann's Viewpoint with particular interest during the editorial review process. It struck me how we as a profession comprising mostly general practitioners (GPs) tend to think (like our patients) of our endodontists as only the "root canal…

2. Page 14

   VIEWPOINT continued from page 12 ing as the Foundation for the approval of endodontics as a specialty in the United States in 1963. Diagnosis Difficult diagnostic challenges are a part of daily practice for both the specialist and generalist. The diagnostic phase of what is done within the scope of endodontics is just as important as what instrument to use, what material, what technique it is used to fill the root canal system. Yet when the filling is positioned apically However, its essence is within the focus on endodontics as being just root canal treatment or therapy, with the glory…

3. Page 15

   favor tooth retention as opposed to a rapid condemning of the tooth and extraction following traumatic injuries, especially midroot and coronal tract fractures. Socket Preservation The reader might question why an endodontist would become involved in socket preservation. There are many cases, during the diagnostic or treatment phase, in which the patient is already anesthetized, and a complication arises that would doom the tooth, eg. identification of a vertical fracture. In these cases, discussion with the patient and the referring source will often result in an agreement to remove the offending tooth at that time, when the patient is anesthetized.…

4. Page 16

   This month on Technique of the Week Full Patient Case Presented Using the eCEMENT System Giancarlo Romero, DDS In a full step-by-step case of a live patient presented by Dr. Giancarlo Romero, this video demonstrates the use of eCEMENT, a resin-based cementation system specifically designed to be used with lithium disilicate restorations. Dr. Romero uses each of the system's components in order to properly cement the restorations. The steps include tooth preparation treatment for bonding, surface priming of the restoration, and proper seating of restorations with the resin cement. For more information, visit our home page, . Dental News Network…

5. Page 20

   FOCUS ON: Practice Management Roger P. Levin, DDS, discusses what dentists can do to succeed in today's challenging dental economy. Q: What happened to make the current economy so challenging for dentists? A: We have entered a new era in dentistry, one that was ushered in during the Great Recession. But it wasn't just the recession; it was a combination of 7 other factors as well. Together, I call them The 8 Permanent Game Changers: (1) the Great Recession and uninsured consumer recovery, (2) changes in consumer purchasing habits, (3) the opening of new dental schools, (4) decrease in insurance…

6. Page 22

   22 . 1 NEW PRODUCTS SELF-ADHESIVE RESIN CEMENT DENTSPLY Caulk By utilizing Calibra Universal self-adhesive resin cement, dentists can benefit from the swiftness of tack curing without the stress of overcuring. It offers a wide tackcure window of up to 10 seconds and an extended 45-second gel phase, providing dentists with the opportunity for a more thorough and effective cleanup. For additional information, call toll free (800) 532-2855 or visit the website located at calibrecement.com. FREEinfo, FIBER POST JS Dental Glassix•plus, JS Dental's light-transmitting fiber post, is anatomically shaped to fit the root canal and features twisted grooves for improved…

7. Page 24

   From the February 2015 Issue TOOTHPASTE Colgate Colgate Enamel Health works in 2 ways to transform enamel from rough and weakened to smooth and strong: (1) it replenishes natural calcium and phosphate back into weakened enamel to fill in rough spots; and (2) it gently polishes the tooth surface so it's smoother, and bacteria are less likely to stick. For more information, visit the website colgateproFessional.com/enamelhealth. FREEinfo, BONDING AGENT DenMat Tenure4G, a dual-solvent bonding agent for bonding any resin restorative to all intraoral surfaces, features a formulation improved over the popular Tenure MPB bonding system. It is a 4th generation,…

8. Page 25

   Ivoclar Vivadent Variolink Esthetic is a new, dual-curing adhesive cement that provides dentists with aesthetic cementation made simple. Indicated for the permanent adhesive cementation of demanding ceramic and composite restorations, Variolink Esthetic represents the next generation of the well-established Variolink aesthetic luting composite. This adhesive luting composite demonstrates exceptional aesthetics. For additional information, call (800) 533-6825. For clinicians residing in Canada, call (800) 263-8182. FREEinfo, APEX LOCATOR Ultradent Products Endo-Eze FIND is an electronic device used for apex localization and working length determination during root canal treatment. It offers (1) unsurpassed accuracy with a convenient, easy-to-read, full-color graphic display, (2)…

9. Page 26

   Spotlight New, Feature-Laden Narrow-Diameter Implant System Introduced ESCONDIDO, Calif.–ZEST Anchors introduces the SATURNO Narrow Diameter Implant System featuring an innovative angled o-ball implant option and patented pivoting o-ring technology. The SATURNO implant is a one-piece, narrow diameter implant with a 1.8-mm o-ball connection that incorporates unique features not found in mini o-ball implants currently on the market. These features include: (1) a 20° angled o-ball implant that addresses the challenges associated with implant placement in the maxillary ridge, (2) pivoting cap technology that provides maximal resiliency while maintaining a minimized profile, (3) a narrow-body implant design that incorporates progressive threads…

10. Page 27

    SATURNO NARROW DIAMETER IMPLANT SYSTEM THE NEW ANGLE ON O-BALL IMPLANTS Introducing the new SATURNO™ Narrow Diameter Implant System. SATURNO is a narrow diameter, O-Ball implant designed as a permanent solution for overdenture retention. Engineered with straight and innovative 20° angled O-Ball implant options, SATURNO gives clinicians something new in a narrow diameter, O-Ball implant—flexibility. The 20° angled O-Ball implant option allows for placement following the natural slope of the maxillary ridge. This ZEST Anchors innovation diminishes O-Ball facial emergence, a problem that could produce areas of thin denture acrylic and compromise denture strength and/or esthetics. Both SATURNO implants provide…

11. Page 28

    Spotlight Popular Take-Home Whitening Strips are Economical, Efficient, and Effective WEST JORDAN, Utah—This year marks 15 years of innovative dental product development for CAO Group, and its Sheer White! take-home whitening strips are no exception. Henry Schein's No. 1 take-home whitening product, the strips are easy to apply and conform tightly to patients' teeth, with no leakage. And Sheer Film technology ensures a comfortable fit for up to 2 hours of whitening. With the strips' 20% carbamide peroxide formulation, patients receive a pleasant whitening experience with less sensitivity and no effect on daily activities. The strips can be worn anytime…

12. Page 29

    Air-Flossing Device Clinically Proven Effective in Improving Gingival Health STAMFORD, Conn.—The new Philips Sonicare AirFloss Pro is clinically proven to be as effective as floss in improving gingival health (data on the at philips.com/airfloss/faq). Cleaning interproximally with it takes 60 seconds, making it simple for patients to add it to their daily oral care regimen, and in a survey of US dental patients, 95% said it was easy to use, and 89% said it was easier to use than string floss. AirFloss Pro delivers a triple burst of air and liquid microdroplets to remove plaque along the gumline and in…

13. Page 30

    Spotlight Units' Exclusive Endodontic Imaging Mode Facilitates Diagnostics and Treatment Planning ROSELLE, Ill.–The Planmeca ProMax 3Ds and 3D imaging units, designed for capturing the smallest anatomical details with precision, feature an exclusive imaging mode for endodontics that offers high-resolution images with a 75-μm voxel size. Facilitating precise diagnostics and endodontic treatment planning, the imaging mode also has a noise-optimizing filter and Planmeca's innovative artifact removal algorithm, which removes shadows and streaks from the 3-D image such as those caused by metal and root fillings. The Planmeca Adaptive Image Noise Optimizer removes noise from CBCT images without losing valuable details. It…

14. Page 32

    Improving Patient Acceptance and Clinical Results With DuraFlex Flexible Partials [Three images showing: Material adjustments, Occlusal adjustments, and Polishing] James Swartout and Lary C. George Jr., DDS, MS Cobalt chrome alloy and nylon, 2 materials still commonly used today in dentistry, were invented nearly 80 years ago. The use of cobalt chrome for removable partial denture frameworks gained popularity in the 1950s after the price of gold had doubled. Nylon, the first commercially successful synthetic polymer, was invented in 1938 and used to make toothbrush bristles; 20 years later, it began to be used as a flexible removable partial denture…

15. Page 34

    Paul Feuerstein, DMD, offers readers insight into dentistry's latest technologies, based on his clinical experience. — Take a Look at Me Now — A common scenario after a new patient exam is that the findings do not concur with what the previous dentist had found or had been "watching." The patient often leaves, stating that he or she could not believe "all that work" that was needed. The patient laments, "I have been seeing 'Dr. Oldguy' for years, and I've never had to have a filling replaced, and I haven't had a cavity for ages!" If there is not a…

16. Page 35

    Streamlining Class II Restorations Using Trident's V3 Sectional Matrix System Trident's V3 System with SuperCurve Figure 1. Figure 2. Figure 3. Figure 4. Figure 5. Figure 6. Figure 7. Time is money, and clinicians find that it's the little things that somehow sneak into daily procedures, stealing bits of precious time and money from the office. Products clinicians have become accustomed to using may be taking extra time due to additional prep work, finishing, etc. However, if they were to consider innovative products and ways to fine-tune their everyday routine, they could reap huge benefits for both their practice and…

17. Page 36

    CLINICAL REVIEWS THE DENTAL ADVISOR ClearView Single-Use Nasal Hoods ++++½ Accutron | (800) 531-2221 | accutron-inc.com Consultants' Comments • "Nice variety of scents." • "Patients say they are comfortable." • "Seals well around the nose." Description ClearView Single-Use Nasal Hoods, used to deliver nitrous oxide, have a double-hood design that includes a colored, scented inner hood as well as a transparent outer hood. The addition of the transparent outer hood gives clinicians a visible indication (in the form of condensation) that the patient is properly breathing the nitrous oxide. Low-profile and latex-free, the hoods are contoured for adaptation to the…

18. Page 38

    Spotlight Nonstick Matrices Facilitate Creation of High-Quality Class II Restorations SOUTH JORDAN, Utah—Trident and Ultradent Products, Trident's exclusive US distributor, introduce the V3 SuperCurve kit, which combines the benefits of Trident's best-in-class V3 Ring Matrix System with the SuperCurve nonstick matrix, the ultimate anatomical, contoured, sectional matrix for the creation of seamless, predictable, high-quality Class II restorations. Utilizing the kit's components, clinicians will immediately see a difference in anatomy and finishing time. The V3 Ring Matrix System provides tight contacts and a superb seal to the matrix, requiring minimal finishing, and the Ni-Ti V3 ring provides the widest indications for…

19. Page 40

    Spotlight Cubic Zirconia Combines Translucency With Strength PEORIA, Ill.-Dental Arts Laboratories' cubeX2 Cubic Zirconia, recently granted 510k compliance by the FDA, combines the known positive properties of zirconia with a significant increase in translucency (49%), making it ideal for anterior and posterior applications (single units and 3-unit bridges work in all tooth positions). Highly biocompatible, cubeX2 offers the translucency of a lithium disilicate while retaining the strength of zirconia (720 MPa flexural strength). Additionally, cubeX2 requires less tooth preparation than that required for lithium disilicate. Ideally, an 0.8-mm chamber or rounded shoulder prep is preferred; however, a feather-edge margin is…

20. Page 42

    Bioactive Varnish Offered SAN MARCOS, Calif–Offered by Shofu Dental, FRG Barrier Coat effectively treats dental hypersensitivity by providing immediate and long-lasting relief. A light-cured bioactive varnish with extended protection time of up to 6 months, it incorporates Shofu's proprietary GIOMER technology, "Surface Pre-Reacted Glass," for high fluoride release and recharge, acid neutralization, and antiplaque benefits. For more information, call Shofu Dental at (800) 827-4638 or visit shofu.com. FREEinfo, What can I say. People love me. See why thousands of dental professionals prefer the powerful natural alternative to chlorhexidine. Tooth & Gums Tonic® Non Staining • Alcohol Free • Antimicrobial Request…

21. Page 45

    System Hailed as Complete Implant Posterior Solution YORBA LINDA, Calif.-Large extraction sockets, limited accessibility, tough-to-remove excess cement, and high occlusal forces are just some of the challenges clinicians face when restoring a single tooth in the posterior. And with molar replacement being among the most common indications, these challenges are encountered repeatedly. A solution that addresses these problems in an efficient and predictable manner will make life easier for clinicians and their patients. That's precisely why Nobel Biocare is bringing innovation back to the posterior region with its new complete implant system. Choose from new, urable platform implants designed for…

22. Page 46

    NEWS/TRENDS Industry News DentalEZ Appoints New President DentalEZ announced recently the appointment of Heather Trombley as president, effective March 31. She succeeds former president Gordon Hagler, who announced his retirement this past July following a decade of service with DentalEZ. Ms. Trombley comes to DentalEZ with 25 years of business leadership, most recently as vice president of marketing for CONMED Corporation's orthodontics division. She holds a BS in industrial engineering from Purdue University and an MBA from Vanderbilt University. Braseler USA and Ivoclar Vivadent Announce Collaboration Braseler USA and Ivoclar Vivadent announced recently a partnership whereby Braseler USA's Innovations team…

23. Page 48

    NEWS/TRENDS Risk of Heart Disease... continued from page 46 "This project has the potential to make a real difference for people with CKD," said Dr. Dias. "If we can prove managing periodontitis reduces the threat of cardiovascular disease, then it may well represent an efficient and costeffective treatment for CKD." In conjunction with our study, I will be talking to dental schools about alternative ways of helping periodontal patients. Dr. Dias' study will include 80 people, 60 with CKD. Some will also have diagnosed periodontitis. There will be a group of 20 people with CKD and periodontitis who will be…

24. Page 49

    Welcome to the more possibilities Club. Introducing a new concept in patient financing: More. • True No-Interest Plans¹ — no retroactive interest at the end of the promotional period avoids unwelcome surprises for your patients • Extended Plans² — fixed APR as low as 3.99% based on term length and applicant's credit, with financing up to $50K • Expanded Credit Policy — for more patient approvals than ever before All so you can treat more patients. Springstone Patient Financing SM, known for offering patient-friendly products and excellent customer service, has joined Lending Club, the world's largest online credit marketplace, and…

25. 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. ZERO-G Bio-Implant Cement TAUB Products The demand for effective and dependable implant cements is growing rapidly as more practitioners are delivering this treatment modality. The implant cement category has several distinctive requirements: biocompatibility with soft and hard tissues, low film thickness, highly visible radiopacity, dual-cure setting, and low intraoral solubility. Clinically, it is essential that all excess implant cement be cleaned off so as not to endanger the health of the peri-implant tissues. TAUB Products…

26. Page 54

    Cherubism Study Results May Apply to Common Inflammatory Bone Diseases A scientist's long-term research focus on a rare genetic condition has led to discoveries that apply to more common diseases. Supported by the National Institute of Dental and Craniofacial Research (NIDCR), Yasuyoshi Ueki, MD, PhD, an associate professor at the University of Missouri-Kansas City School of Dentistry, studies the functions of SH3BP2 (Src homology 3 binding protein 2) gene. In 2001, Dr. Ueki revealed that mutations in the SH3BP2 gene were the cause of cherubism, a rare inflammatory bone condition of the jaw. Since that time, he and his research…

27. Page 55

    The Brain and Dental Pain Relief Although local anesthesia has made dental patients more comfortable since 1884, little is known about the mechanisms related to dental pain relief. At the 64st General Session and Exhibition of the International Association for Dental Research (IADR), research Michael Meier, Center for Dental Medicine, University of Zurich, Switzerland, presented a placebo-controlled and age matched functional magnetic resonance imaging study aimed to investigate task-related brain activity and functional connectivity patterns following onset of a regional anesthetic nerve block during continuous postdental stimulation. The study involved a total of 28 male subjects with a mean age…

28. Page 56

    Test 185 dentalCEtoday.com The Circumferential Splint Reinvented This article discusses the circumferential splint as a long-term treatment for periodontally compromised anterior teeth. The clinical procedure is described, and 2 case reports are presented. [PHOTO: Headshot of Dr. Wank, an older man with white hair wearing a blue tie and smiling] Dr. Wank is a clinical professor and former postgraduate director of periodontics and implantology at NYU College of Dentistry and is in private practice in periodontics and implant dentistry in New York. He is a diplomate of the American College of Dentists, International College of Dentists, Academy of Dentistry International,…

29. Page 57

    of maloocclusions that would transmit excessive forces to the relatively healthy abutments when splinted is an essential part of pretreatment diagnosis, particularly when a circumferential splint will support a pontic.³ As such, thorough occlusal evaluation and establishment of a mutually protective occlusion are a necessity. CLINICAL PROCEDURE The circumferential groove preparation resembles a horizontal slice of an ideal PFM preparation, with facial 1.5 mm reduction to allow composite thickness for aesthetic blockout of the ligature, and up to one mm on all other surfaces, just enough to incorporate and cover the ligature without changing the tooth contour. The circumferential groove…

30. Page 58

    Top 25 Endodontic Products . 1 Kerr Endodontics The TF Adaptive file system is designed to work with the Elements motor, featuring adaptive motion technology—a patented algorithm allowing the file to self-adjust to intracanal torsional forces. The TF Adaptive file system leverages the proven Twisted File R-Phase technology, improving file durability and flexibility. Its intuitive, color-coded system is easy to learn and use. For more information, call (800) 346-3636 or visit kerrendodontics.com. FREEinfo, Charles B. Schwed C Files are ideal for negotiating calcified, torturous, or severely curved canals. The files are available in 21- and 25-mm lengths and size Nos.…

31. Page 60

    Top 25 Endodontic Products . 1 Medidenta With only 3 Ni-Ti instruments, REVO-S files simplify initial endodontic treatment and optimize cleaning. The rectangular cross section of the files facilitates penetration with a "snakelike" movement and offers root canal shaping that is adapted to biological and ergonomic imperatives. The file sequence has a cutting debris elimination and cleaning cycle that optimizes root canal cleaning by improving the upward removal of the generated dentin debris. For more information call (800) 221-0750 or visit medidenta.com. FREEinfo, DenMat Core-Post is ideal for core buildups in single-tooth restorations. Flexing like natural tooth structure, it dramatically…

32. Page 62

    Top 25 Endodontic Products Aseptico The AEU-7000E-70V provides the ultimate return on investment. A unique handpiece calibration system automatically detects the internal properties of individual reduction handpieces at the time of treatment, ensuring highly accurate speed and torque results. Existing handpieces can be used, resulting in additional cost saving. Compatible handpiece ratios include 4:1 through 16:1 for endo, 1:5 and 12:2 increasing for surgical applications, 1:1 for polishing or adjustments, and 16:1 through 32:1 reduction for implants. Custom display names and settings can also be added to the programmable preset buttons for enhanced customization. Upgradeable software means longevity of the…

33. Page 64

    64 . 1 READERS' CHOICE Top 25 Endodontic Products ACTEON North America The NEWTRON Booster piezoelectric ultrasonic unit provides superior power and capability for all your endodontic needs in a compact, tabletop device. The exclusive Cruise Control System adapts the ultrasonic power depending on the resistance encountered by the tip in real time. This generates unmatched power for the clinician to perform broken instrument removal, canal access preparation, and apical surgery quickly and easily. The refined curves of the NEWTRON SLIM handpiece enhance its handling and accessibility in any patient's mouth. ACTEON provides a large selection of endodontic tips, including…

34. Page 66

    66 . 1 READERS' CHOICE Top 25 Endodontic Products JS Dental Manufacturing Xtreme Endodontic Instruments are extremely flexible and follow the canal with virtually no transportation, ledging, or perforation. The development of a controlled memory material has led to the ability to make files that follow the canal like nothing else on the market and are also 300% less likely to separate. These files follow the path of least resistance, resulting in a perfectly enlarged canal, preserved tooth structure, and easier obturation. They also return to their original shape during autoclaving. The Xtreme Instruments are available in hand K-File and…

35. Page 68

    68 . 1 READERS' CHOICE Top 25 Endodontic Products B&L Biotech USA The Super Beta Cordless Obturation device is designed for warm gutta-percha techniques, such as backfilling a canal with warm vertical obturation or with a complete fill technique (injecting from the apex up). Perfectly complementing B&L's Alpha heat source, the Beta unit provides simplicity, operator ease and comfort, and durability into this cordless injectable obturation gun. Equipped with a durable rechargeable battery and mounting easily in a charge cradle, the Beta will provide more than 4 hours of continuous use on a single charge. Unique design features include a…

36. Page 70

    70 . 1 READERS' CHOICE Top 25 Endodontic Products Video Dental Concepts The QuickRay dental x-ray sensor gives you the highest digital x-ray resolution and pristine image clarity while connecting directly to your Mac or PC USB port. There is no special inter-face box needed. It offers rounded corners and smooth edges to optimize patient comfort while receiving a dental x-ray. QuickRay is also one of the fastest intraoral dental sensors on the market. QuickRay Mac works with MacPractice, EndoTrack, RadioVision, and all major Windows imaging software, including Apteryx XrayVision, Carestream, DEXIS, Eaglesoft, QuickImage, and many more. The sensors are…

37. Page 72

    72 . 1 READERS' CHOICE Top 25 Endodontic Products BISCO Dental Products D.T. LIGHT-POST ILLUSION X-RO is one of the most advanced and aesthetically pleasing quartz fiber posts on the market, with the added benefit of color-on-command technology. When the post is placed, the intrinsic color of the post disappears, allowing it to blend into the natural dentition. If retreatment or removal is ever required, the color of the post will reappear on command by simply using cold water. The color-changing post optimizes aesthetics and eliminates the risk of shadowing within the aesthetic core material. The D.T. LIGHT-POST ILLUSION X-RO…

38. Page 73

    Endodontic Products TOP 25 READERS' CHOICE Angelus MTA-Angelus is an endodontic reparative cement, containing mineral trioxide aggregate (MTA). It is indicated for the treatment of lateral and furcation perforations, perforation, internal resorption, pulpotomy, pulp capping, and apexogenesis. MTA is the only cement capable of stimulating cells to the point of fully regenerating infection-compromised tissues. Also, unlike other substances with identical indications, MTA can be inserted in moist areas, drastically facilitating the work of the dentist. The Calcium Ions Release feature promotes the formation of a dentin bridge when used for pulp capping and enables biological healing and unbeatable sealing in…

39. Page 74

    74 . 1 READERS' CHOICE Top 25 Endodontic Products MedicNRG Designed to work with most handpieces, the ApexNRG-Rider and the ApexNRG-Blue apex locators measure canal length in real time with a precision of 0.1 mm, allowing for quicker canal preparation without frequent manual verification stops. While other aggressive files increase the possibility of apex perforation, MedicNRG's devices use Digital Signal Processing to enable optimal preparation of the canal all the way to the apical constriction. This can be done without fear of perforation caused by the lag time of reading the file location, which can cause penetration of the periapical…

40. Page 75

    Endodontic Products Top 25 Jordco The e-Dx represents the next generation in endodontic diagnostic instruments. This unique instrument can easily cold-test and fracture-test teeth. Using a special open cell foam insert, the e-Dx stores dental coolants longer, enabling a doctor to easily cold test multiple teeth. The detachable contra-angled pliers are designed to securely hold the foam insert and reach posterior teeth to provide improved visibility during cold testing. The built-in Frac-Tester can be placed onto a tooth cup or other suspected areas to help detect fractures. For more information, call toll-free at (800) 752-2812 or visit Jordco.com. FREEinfo, Micro-Mega…

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