Dentistry Today — May 2023

Inside this issue

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1. Page 6

   My Old School The first dental school that accepted me was the University of Detroit. I applied because my college roommate, Steve Ratner (fondly called Rat), had been accepted there and we to join him. But I decided to go to Jersey City, NJ, to the school now known as Rutgers. Years ago, I met Dr. Ira Nazarian, who practices in the Detroit area and is one of our great educators. He knew that I was not a fan of oral surgery and invited me to one of his courses where I could extract about 100 teeth over a weekend…

2. Page 8

   Are You Using AI in Your Dental Marketing? Unless you've been living under a rock or spending an excessive amount of time binge-watching Netflix, you know that artificial intelligence (AI) is everywhere. It's being used to read your digital x-rays, create your patient's clear aligners, and even diagnose your treatment plans for you. It kind of makes you wonder why you spent all that time in dental school. But there's one place you might not have considered using artificial intelligence: in your dental marketing. We live in a world of content—websites, blogs, social media posts, email marketing, and more. That's…

3. Page 10

   VIEWPOINT continued from page 8 Flossing helps remove food particles and plaque that can get stuck between your teeth, which brushing alone cannot reach. This can help prevent tooth decay, cavities, and gum disease. Gum disease, also known as periodontal disease, is a severe condition that can lead to tooth loss and even increase the risk of heart disease and stroke. Flossing also promotes healthy gums. When you floss regularly, you help to stimulate the gums and increase blood flow to the area. This can help prevent inflammation and swelling, which can lead to gum disease. Furthermore, flossing can help…

4. Page 11

   Foil Offers Numerous Possibilities TrollDental's TrollFoil and New TrollFoil 4.5 articulating Foil, a brand acquired by Directa AB, is well known as a product of choice for occlusion worldwide. TrollFoil can be used under a variety of clinical situations, including wet or dry teeth, limited opening, limited vestibular space, gaggers, and metal and non-metallic restorations. Ronni Brown, DDS, a public health dentist in Santa Rosa Calif, gave TrollFoil a test run last year as part of an evaluation. She and her dental assistant were so impressed, they needed to get their hands on more. Ronni Brown, DDS Dr. Brown quickly…

5. Page 12

   Trauma-Informed Care in Dentistry Michelle Strange, MSDH, RDH, discusses how implementing trauma-informed care (TIC) practices in our clinics can have a marked effect on the patient experience, potentially improving treatment adherence and health outcomes and the overall wellness and health of staff and practitioners. Q: What is the correlation between a patient's exposure to adverse childhood experiences (ACEs) and his or her long-term health, including dental health? A: Exposure to traumatic events or ACEs is proven to increase a person's overall risk of severe long-term health issues and at-risk behaviors.¹ Acknowledging these experiences can improve patient clinician engagement and increase…

6. Page 14

   Q & A AI-Powered, One-Shot 3D Face Scanner Revolutionizes Dentistry Nazariy Mykhaylyuk, DMD Dr. Nazariy Mykhaylyuk is a highly accomplished prosthodontist from Kyiv, Ukraine, where he operates 2 dental offices and a dental laboratory. He has gained international recognition for his expertise and is a sought-after speaker in his field. As an experienced practitioner, Dr. Mykhaylyuk has been utilizing Ray's RAYFace technology, and we are thrilled to share his invaluable insights with you. This interview represents the second part of a 2-part series with Dr. Mykhaylyuk, where he shares his experiences and opinions on RAYFace. Q: What is full-mouth reconstruction,…

7. Page 16

   KometaBio Dentin Grinder Offers Fast Regeneration of New Bone FORT LEE, NJ–The innovative, next generation Smart Dentin Grinder – GENESIS is now able to convert any extracted tooth into autologous gold standard graft within 7 minutes from extraction. In a simple to use process, the device pulverizes the teeth within seconds and then controls particulate size. A cleaner is applied to render the output graft completely bacteria free and safe. It is a must have device for anyone who is extracting teeth and cares about the prognosis of the socket. Autologous dentin graft has been proven to actively regenerate bone…

8. Page 18

   Shofu Dental Digital Dental Camera Produces Perfect Pictures SAN MARCOS, Calif.—The Eye Special digital dental camera is made exclusively for dentistry. This unique and innovative camera allows the entire dental team to take perfect pictures every time— no photography skills are needed. Easily take stress free, high quality images for case documentation, lab collaboration, and patient communication by merely pressing one of the preset dental shooting modes. In addition, the EyeSpecial can prevent cross contamination by simply wiping the camera with a disinfecting wipe between patients, which is essential for infection control in the office, and the large LCD touch…

9. Page 19

   PreXion CBCT System Provides High-Quality Image Clarity SAN JOSE, Calif.—The 3D Excelsior PRO CBCT offers an ideal solution for improving diagnostic capability and growing practice revenue. It provides high-quality image clarity with its 0.3-mm focal spot, which is the smallest focal spot available on the market. 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 uses, including, but not limited to, implant placement, bone quality studies, pathology, periodontics and endodontics. An optional 15 x 13 cm FOV is available for diagnostics…

10. Page 21

    SprintRay 3D Printing Ecosystem Suited for Definitive Ceramic Crown Restorations SprintRay, an industry leader in digital dentistry and 3D printing solutions, offers the world's first solution for same-day, chairside delivery of ceramic dental restorations. According to SprintRay CEO and co-founder Amir Mansouri, PhD: "The SprintRay Ceramic Crown 3D Printing Ecosystem enables lab production, definitive chairside crown fabrication in less than 45 minutes, delivering tangible financial and time-saving benefits to patients and providers." A New Era in Hybrid Ceramic Resin The ecosystem includes SprintRay Ceramic Crown, a new, ceramic, dominant resin 510(k) Class II cleared by the US FDA for 3D…

11. Page 22

    Service With (and for) a Smile: Q & A with Julie Frantsve-Hawley Julie Frantsve-Hawley, PhD, CAE, Executive Director of the TAG Oral Care Center for Excellence, speaks to how the Oral Care Center restores smiles and confidence to Illinois residents who need it most while training the next generation of dental practitioners. Q: TAG (The Aspen Group) opened the doors of its Oral Care Center for Excellence less than a year ago—can you give us an overview of this center's purpose? A: In July 2022, TAG launched the first-of-its-kind Oral Care Center for Excellence (OCC) at its former corporate headquarters…

12. Page 24

    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. Wolf Cam wired HD intraoral camera Dental Savings Club Not all intraoral cameras are alike. The keys to a great chairside tool are image clarity, ease of use, and software integration, and price, of course. All dental professionals recognize the value of instant visualization in patient education and marketing—nothing sells a new restoration like seeing just how broken down that old molar restoration is. This is where image quality comes in. WolfCam delivers a 1,280…

13. Page 25

    Glidewell Surgical Guides Help Predictably Reduce Bone NEWPORT BEACH, Calif.–Glidewell's Digital Treatment Planning department is now offering multi-level surgical guides to help clinicians more efficiently provide full-arch implant treatment and immediate provisionalization. With these new surgical guides, clinicians will be able to predictably reduce bone; place full-arch implants; and deliver an immediate, fixed, screw retained provisional for fully edentulous patients in just one streamlined visit. Dentists who desire a fully guided surgical procedure for their full-arch cases can digitally upload their scans via Glidewell's DTP portal. The DTP team then develops a treatment plan that is reviewed and approved by…

14. Page 26

    Air2Zed Device Gets Rid of Clutter in Dental Spaces SCHAUMBURG, Ill.-Air2Zed is a groundbreaking new technology that is poised to revolutionize one's imaging workflow. This patent pending innovation is designed to streamline operations by converting USB infrared x-ray sensors to wireless. The Air2Zed technology eliminates the need for cumbersome wires and cables, streamlining the x-ray process and freeing up valuable space in the treatment room. This wireless capability also means that practices can save money in the long term on repair and replacement costs for their sensors, which become damaged or worn out over time. One of the most significant…

15. Page 27

    Commander In Teeth Dental Lab Laboratory Introduces New Rewards Program BALTIMORE—Commander In Teeth Dental Lab is committed to providing top quality services that meet the unique needs of every dentist. From PFM and all ceramic restorations full and partial removable dentures to dental appliances, the lab offers a wide range of services to help provide exceptional care to patients. This includes accepting 3D scans from all scanning providers. With Commander In Teeth's rewards program, the lab is making it easier than ever to earn amazing prizes simply by choosing it for all dental lab needs. The new rewards program is…

16. Page 28

    Steri-Shield Sensor Holders Offer Patient Comfort, Dependable Image Capture FERNANDINA BEACH, Fla.— Wingers digital sensor holders were introduced in 1993 as the first dedicated 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. Wing ers 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 offices offer a high standard of care at an affordable price.…

17. Page 29

    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. Borea Rayplicker Cobra Video Dental Concepts You have a scanner to acquire the digital impression, all the necessary software to design the restoration, and to enable a 3D printer to manufacture it (or send it out from a block). So, what's missing to complete your comprehensive digital workflow? The answer is a reliable and accurate, as well as a totally system-integrable tooth shade analyzer. Patients understand ably have this esthetic expectations, and it is crucial…

18. Page 30

    Celebrating 20 Years of the Shatkin F.I.R.S.T. Technique Yes, you can replace a tooth permanently in one visit! Todd E. Shatkin, DDS One of Shatkin F.I.R.S.T.'s facilities. In 1999, when Todd E. Shatkin, DDS, was introduced to mini dental implants, he saw the potential to change implant dentistry. With the conventional dental implant, he was only able to convert 1 or 2 out of 10 patients. The main reason was cost. Mini dental implants were the answer. The acceptance of the treatment plan by his patients rose to 7, 8, or 9 out of 10. Mini implants are 5 times…

19. Page 32

    In-Office CAD/CAM Systems Glidewell With the glidewell.io In-Office Solution, one can deliver fully sintered BruxZir NOW crowns and bridges while eliminating the need for oven time and significantly reducing the lab bill. Combining (1) AI-powered, one click designs; (2) reliable training and support directly from Glidewell; and (3) the flexibility to pair with the intraoral scanner of one's choice, the glidewell.io In-Office Solution makes digital dentistry easy, accessible, and affordable. For more information, call (844) 949-7184, visit the website glidewell.io, or send an email to robert.brenner@glidewell.com. AD/CAM is open, affordable, efficient, and consistent. Unlike closed systems, OneVisit lets one delve…

20. Page 33

    IN-OFFICE CAD/CAM SYSTEMS 33 Align Technology The iTero Element 5D Plus imaging system is a powerhouse of cutting-edge dentistry designed to improve the practice and patient experience with state-of-the-art computing power, an elegant design, and ergonomics. Powerful computing advancements enable a smoother and more intuitive scanning experience. The iTero near infrared imaging technology aids in the diagnosis and monitoring of interproximal carious lesions above the gingiva. For more information, call (800) 577-8767 or visit itero.com. Use FREE info card, makes same-day dentistry simple for you and your patients. It is engineered to fit milling needs for same-day restorations thanks to…

21. Page 34

    The New Open Sensor by DentiMax Q: What is the Open Sensor? A: The Open Sensor is the newest sensor released by DentiMax earlier this year. It's one of the thinnest sensors on the market and is available in a size 1 for kids or a size 2 for adults. It features a durable and comfortable housing with a large active image area and a direct USB connection. Q: Why do you call it the Open Sensor? A: One of the best features of Open Sensor is its ability to integrate directly with virtually all imaging software. This means that…

22. Page 36

    Industry News MouthWatch Now Offers Comfort Soft by Armor Dental MouthWatch, LLC, is now offering the Comfort Soft under a new agreement with Armor Dental, the manufacturer of patented, soft-retraction dental instruments. Comfort Soft is a dual-purpose soft-tissue retractor designed to provide a clearer view of the patient's mouth while delivering a more comfortable chairside patient experience. The product also offers patients easier access, visibility, and focus when brushing at home to help improve hygiene between visits. "We couldn't be more excited to collaborate with MouthWatch to strengthen the care connection between clinicians, caregivers, and patients," said Cherie Le Penske,…

23. Page 37

    Inflammation More Likely With Soft Gums We know the gingiva plays a crucial role in maintaining healthy teeth. It contains gingival fibers that connect the tooth to the gingiva and fibroblasts, which contribute to the formation of connective tissue. Recently, a team of researchers from Tohoku University found that gingiva stiffness influences the make up of gingival fibroblasts, which in turn affects the likelihood of inflammation and the formation of gingival fibers. This is the first recorded instance of gingival stiffness being attributed to biological factors. Individuals with thick or stiff gingiva are known to be less susceptible to gingival…

24. Page 38

    Miramar Beach to Host the Gulf Coast Dental Conference The Gulf Coast Dental Conference will take place from July 12 through July 16 at the Hilton Sandestin Beach Golf Resort and Spa in Miramar, Fla. Attendees can take part in various lectures that will amount to more than 75 hours of incredible continuing education. There is a full schedule of events planned, including several events fit for the whole family. There'll also be plenty of networking opportunities with a 2-day exhibit show featuring commercial exhibitions. For more information, visit gulfcoastdentalconference.org. AADOM Conference Scheduled for September in Orlando The American Association…

25. Page 40

    DENTISTRY TODAY 11th ANNUAL Top 25 Aesthetic/Restorative Products Dentistry Today's Readers' Choice Top 25 Aesthetic/Restorative Products, selected on the basis of lead generation, represent some of the profession's most innovative aesthetic/restorative products. The products appear in no particular order. Tokuyama Dental America OMNICHROMA is the first universal composite that matches all patients' tooth shades, from A1 to D4, with a single shade. Rather than relying on dyes or pigments, this unique composite utilizes Smart Chromatic Technology and structural color. OMNICHROMA's 260nm supra-nano spherical fillers are the precise shape and size necessary to generate a red-to-yellow color. As ambient light reflects…

26. Page 42

    Top 25 Aesthetic/Restorative Products Oxford Scientific SpheriChrome is a color-free, light-cured, shade-adaptive composite that is based on the natural universal structural coloration principle that occurs in nature. This new product has been adapted for all classes of dental restorations and dental uses. Its innovative, high-tech constructed composite continuously absorbs the color spectrum of a patient's dentition, matching it exactly. This is accomplished through the composition shape and distribution of the spherical fillers inside the material. Ambient light is reflected from the patient's dentition color spectrum, providing a virtual match. For more information, visit oxfordscientifica.com. VALO Grand curing light uses a…

27. Page 44

    Top 25 Aesthetic/Restorative Products Assured Dental Laboratory Z'Brux is a 100% full-filled, high translucency zirconia restorative with no porcelain overlay, resulting in no porcelain fractures. Its benefits include (1) being less than half the price of gold crowns, (2) offering an aesthetic alternative to gold restoration and PFM, (3) 1,250 MPa flexural strength, (4) conventional chamber prep and cement, (5) working well with limited occlusal clearance, and (6) excellent marginal fit. Its indications include single units in full mouths/houses for frames and full contour. For more information, call (877) 283-5351 or visit the website assureddentallab.com. a truly universal, self-adhesive resin…

28. Page 46

    Top 25 Aesthetic/Restorative Products SprintRay SprintRay is revolutionizing restorative dentistry with a complete solution for 3D-printing definitive crowns intraorally. The Ceramic Crown solution combines 3 industry-first products: automated AI design, a new class of ceramic dominant resin, and new production hardware. Powered by artificial intelligence and available 24/7, AI Crown Design can deliver a crown design in 5 minutes or less from a single cloud platform. Ceramic Crown resin is a breakthrough material composed of greater than 50% ceramic, and is FDA-cleared for 3D printing definitive full crowns, partial crowns, and veneers. Because Ceramic Crown is more than 50% ceramic…

29. Page 47

    Top 25 Aesthetic/Restorative Products ClearCorrect Engineered for precision, comfort, and aesthetics, ClearCorrect aligners are the ultimate orthodontic tool for one's practice. Born from decades of material science, research, and innovation, these aligners combine proprietary ClearQuartz tri-layer material, high and flat trimlines, and scientifically proven features to help achieve one's orthodontic goals. Industry-leading hybrid material provides greater orthodontic control by combining 2 layers of resilient polymers with an elastomeric inner layer, resulting in gentle, consistent application of force. But the aligner material is just the beginning. ClearCorrect's high and flat trimline, scientifically proven clinical features, and custom manufacturing technology and processes…

30. Page 48

    Advances in Processing Implant-Retained Prostheses Timothy F. Kosinski, DDS Techniques and technology for our modern dental implants are expanding to extremely predictable levels. The days of placing implants in available hard tissue to support function without major concern for the final aesthetic result are long gone. Today, our patients are requesting, and even demanding, not only restorative stability and a long term positive prognosis but also smile design duplicating natural dentition. The challenge we face as providers is meeting the patient's high expectations prior to any surgical intervention. This is initially accomplished through CAD/CAM design and digital imaging, allowing both…

31. Page 50

    Fully Digital Full Arch? Continued Advancements in Full-Arch Implant Restorations INTRODUCTION Full-arch, implant supported reconstruction continues to provide viable solutions to restore and improve function, enhance aesthetics, and change the quality of life for our patients. All-on-X implant reconstruction has benefited from new advancements and technical innovations. In this current edition, the authors continue the journey, navigating through new developments in full arch analog and digital workflows. Our previous articles introduced several elements to aid the clinician in both the surgical and restorative phases of full arch replacement, including the use of CBCT guided surgical applications¹ and how they have…

32. Page 52

    Figure 1. Rubber bands, splinted wire frames, or applying composite directly to the tissue (Abelian sigma curve) aids intraoral scanners in acquiring accurate data. Figure 2. Photogrammetry (PG) uses an extraoral light source with manufacturer-specific scan abutments (Cam4D [Imetric]) to capture data for the PG software. Fully Digital Full Arch? Continued... continued from page 50 nology generates a fully digital workflow. There is little need for an analog model for production or verification purposes. While these impressive devices are extremely accurate, the initial purchase costs and availability of sensitive components materials have been an issue of concern. To obviate the…

33. Page 54

    Figure 6. Three methods of attaching zirconia restorations to implants are illustrated here: via conventional MUA, Ti-bar, or Ti-base. Figure 7. The dimensions of standard MUA screwheads and available zirconia, which can lead to fracture. Figure 8. (a) Illustration of angled vs straight screw channels and variation in access hole positions for improved strength and aesthetics. (b) Using an angled screw channel can result in up to a 25° change in angulation. Fully Digital Full Arch? Continued... continued from page 52 over fixed, cementable prostheses has been debated for some time.11 As restorative components have evolved and CAM software/hardware manufacturing…

34. Page 55

    IMPLANTS 55 using an MUA with an increased degree of angulation. When an MUA is secured to the implant and the scan data has been captured, altering the screw access channel would then affect the angulation of the MUA, which would need to be replaced. This becomes problematic when prior restorations have already been designed and a new desired positional tooth change is requested. Often, these changes can leave access holes in aesthetic or potentially vulnerable areas (Figure 8). Additionally, there are angular limitations of the MUAs, which vary with each component manufacturer. Rather than changing the MUA and dealing…

35. Page 56

    IMPLANTS (Figure 11a) The maxilla was in similar condition with deteriorating, painfully mobile teeth, as well as extensive caries. While the bone loss was significant in the mandible, the vertical dimension allowed for both arches to be treated with an FPt (fixed prosthetic i Misch classification 24) manor. Diagnostic records were collected, including intraoral digital impressions (i700w [Medit] [Figures 11b and 11c]), large FOV 3D CBCT imaging (CS 9000 [Carestream Dental]), full-mouth digital scans (Figure 11d), RVG 6200 [Carestream Dental]), and intraoral and extraoral photographs (Figure 11e). Based on the assessment of the acquired data, several treatment plans were developed…

36. Page 57

    IMPLANTS 57 Figure 16. (a) Panoramic radiograph showing printed restorations secured with La Vis Grammerty screws. (b) The retracted, intraoral view. Figure 17. (a) Final panoramic radiograph confirming seating of monolithic zirconia restorations. (b) The intraoral, retracted view. (c) The final patient smile, showing excellent aesthetics and a happy patient. digital articulation (Occluesense) (Figure 16b). The patient was extremely satisfied with the printed try-in. Since no adjustments were required, the patient was allowed to leave with the printed try-in as a try-in provisional als made from extra strong resin. The new provisionals were utilized for 10 days to confirm form…

37. Page 58

    Full-Mouth Reconstruction Workflow in a Hopeless Situation INTRODUCTION In today's society, we are seeing more and more patients presenting with teeth that are severely broken down, either from decay, wear, or periodontal disease. Our goal as dental providers is to treat the various dental problems these patients present with to maintain an oral environment that is healthy, functional, and aesthetic. However, there comes a time when all the various dental treatments are exhausted, and tooth removal is necessary. This article describes a patient who was referred to me by a colleague for full-mouth dental implant reconstruction because all her previous…

38. Page 60

    Figure 1. Preoperative smile view. Figure 2. Pre-op retracted bite view. Figure 3. Pre-op retracted open bite view. Figure 4. CS 8100 (Carestream Dental) 3D view. Figure 5. Treatment planning of dental implants. Figure 6. Surgical guides and provisional restorations. Figure 7. Extractions using GoldenForce Forceps (GoldenDent). Figure 8. Reflecting tissue with a Reflector instrument (GoldenDent). Full-Mouth Reconstruction... continued from page 58 (7) available bone in the edentulous sites, and (8) implant design.1 Since the patient's bone was somewhat compromised in the areas of the apicoectomies, it was decided to place additional dental implants in those regions to ensure a…

39. Page 61

    PROSTHODONTICS forces coolant through the guide to ensure that the irrigation reaches the bone, preventing overheat-ing. Once the sequential drilling was completed, the dental implants (Touareg OS) were inserted with fixed implant drivers through the sleeves of the surgical guide (Figure 12). The dental operator may use either a hand-oper-ated ratchet or a handpiece adapter to insert the dental implant at a recommended All risks, benefits, and alternatives... were reviewed with the patient. torque of 50 Ncm. To ensure the correct orientation of the internal hex component, an occlusal view of the placed implants was inspected (Figure 13), followed by…

40. Page 62

    Figure 9. Bone leveling with a surgical handpiece. Figure 10. A surgical implant guide (Pittman Dental Lab/ITX Pros). Figure 11. Adinwide (Adin Dental Implants). Figure 12. Implant insertion drivers. Figure 13. Occlusal view of transmucosal abutments. Figure 14. Maxillary PMMA provisional restoration. Figure 15. Mandibular bone foundation guide. Figure 16. Surgical implant guide. Figure 17. Insertion of Touareg OS dental implants (Adin Dental Implants). Figure 18. Mandibular PMMA provisional restoration. Figure 19. Panorex view of immediate provisional on dental implants. Figure 20. Duralay verification jigs. ened, followed by their removal via the Physics Forceps (Directa Dental). Once the teeth were…

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