Dentistry Today — November/December 2020

Inside this issue

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

1. Page 8

   Overcoming Challenges in Direct Posterior Restorations Robert Rosenfeld, DDS The use of composite resin for direct posterior restorations is often accompanied by technical difficulties, namely postoperative sensitivity, imperfect interproximal contact and contour, and the challenge of creating an aesthetic shade match. The following is a case report that addresses some of these challenges. Case Report A 28-year-old female came to my office seeking a second opinion. After a series of recent filings and the recommendation of numerous crowns by another dentist, the patient became disillusioned because some of her basic complaints were not being addressed. Despite being in active treatment,…

2. Page 9

   omniCHROMA One-Shade Universal Composite LONG TERM PERFORMANCE "I could not have been happier with this follow-up, as the restoration still looked incredible after more than a year and was continuing to generate the natural color of the surrounding tooth. I feel truly confident in OMNICHROMA's ability to match a surrounding tooth's color while also feeling at ease knowing that the pressure of choosing a perfect shade for a patient's restoration no longer rests on my shoulders..." Dr. James Chae, Diamond Bar, CA [Three clinical images shown:] Pre-Operative | Post-Operative | 16 Month Revisit [Award logo] DA 2020 AWARD WINNER DENTAL…

3. Page 10

   EDITOR'S PAGE A 2020 Prediction Proved True! As we entered into this year, the title of my January column was "Change and New Opportunities in 2020." Now I would never pretend to be able to predict what I will have for breakfast tomorrow, and especially not what will actually take place in our world in the future. Well, all it likely does if you want, but can certainly say that 2020 brought us a whole lot of that! And every day, out of the "fog of war" in our fight against the SARS-CoV-2 virus, opportunities are being born with the…

4. Page 12

   The Gatekeepers of Systemic Inflammation The COVID-19 crisis has dramatically changed our world and our profession. It stimulates respiratory distress interactions with the body's immune system and inflammatory responses. It has the potential to produce fatal outcomes for the immunocompromised and those with elevated levels of pre-existing systemic inflammation due to diabetes, respiratory disease, atherosclerosis, obesity, liver disease, kidney disease, autoimmune diseases, arthritis, sleep apnea, etc. Our whole society is very concerned about staying healthy in a viral world, both during the current worldwide pandemic and for the long-term future. Other than wearing PPE, social distancing, and increased sterilization precautions,…

5. Page 14

   VIEWPOINT continued from page 10 Diet, blood sugar and fat levels, and the periodontal response appear to be related. A diet high in refined sugars, grains, pastas, breads, cereals, and vegetable oils is associated with greater risk of developing metabolic syndrome, insulin resistance, high blood pressure, elevated cholesterol, and weight gain around the waist. This can lead to Type 2 diabetes. Diabetes has been compared to having shards of glass continuously scraping the walls of the arteries all day long, creating tremendous inflammation and destruction throughout the body. There is a strong correlation between a poor diet, blood sugar dysregulation,…

6. Page 16

   Dentistry During the Pandemic Roger P. Levin, DDS, centers a discussion on 4 ways to win in the COVID-19 recovery. COVID-19 has changed dentistry forever. Practices are experiencing changes in areas such as infection control, patient volume per day, staffing patterns, and insurance reimbursement. However, even in the midst of all this upheaval, the basic aspects of running an excellent business will still be the major factors that will contribute to achieving and maintaining success. Back to the Basics Legendary UCLA basketball coach John Wooden won 10 NCAA basketball championships, including 7 in a row, making him one of the…

7. Page 18

   Using the Penguin RFA Implant Stability Monitor Ara Nazarian, DDS When a patient presents to your dental practice with questionable and/or restorable teeth requiring extraction, the biggest concern is whether implants can be placed during the same surgical visit. There are several factors to consider when placing dental implants immediately into extraction sites. These include, but are not limited to, the quality and quantity of bone, the presence of infection, and the patient's health. Here is a case that demonstrates the use of the Penguin RFA Implant Stability Monitor (Integrated Diagnostics/Aseptico) to aid in the decision-making process. A patient presented…

8. Page 20

   Heated Composite in Everyday Practice INTRODUCTION Many clinicians have heard of the concept of heated composite since its introduction to dentistry in the early 1980s,1 yet a significant number of them still have many questions as to why heated composite may be advantageous and how is it that we can effectively heat composite for restorations. Before we can tackle the latter, we need to have an understanding of the benefits heated composite can provide. When composite is heated, the physical properties of the material are modified. Many of these modifications can help make it easier to handle the composite and…

9. Page 22

   Figure 1. Teflon tape was placed around the preparation prior to air abrasion. Figure 2. The cleaned restoration prior to placing the ceramic conditioner. Figure 3. Ceramic primer (Ceramic Primer Plus [Kuraray]) was applied to the overlay that had been placed in the Calsci Composite Warmer (AdDent). Figure 4. A 35% phosphoric acid gel (Ultra-Etch [Ultradent Products]) was placed for 15 seconds. Figure 5. The Calsci Composite Warmer, loaded with composite materials. Figure 6. Warmed composite was then loaded into the restoration. Figure 7. The restoration was seated, and direct pressure was applied, with excess composite flowing freely from the…

10. Page 23

    TECHNOLOGY 7): The dental assistant continued to apply pressure while excess composite was removed with the aid of microbrushes and floss to clean interproximal surfaces. Once satislingual margins, a silicone based, aluminum oxide-impregnated composite was removed with the aid of microbrushes and floss to clean the interproximal surfaces. Once satis- All of these benefits have been made available through the use of a composite warming unit. fied, the restoration was light cured from all angles for approximately 40 seconds per surface to ensure adequate polymerization. After removal of the isolation device (DryShield), the restoration was carefully adjusted using fine diamonds…

11. Page 24

    Drills Elevate Standard of Care for Patients THOUSAND OAKS, Calif.–Implant Direct's DLC Drills feature intuitive banding and Diamond like Carbon Coating. Used together with the Implant Direct Drill Stops, clinicians can elevate the standard of care they offer their patients. DLC Drills offer high contrast coating for greater visibility of drill depth markings, intuitive color coding makes identification and organization of drills easier than ever before. The Diamond like Carbon Coating comprises a bioinert material that enhances wear resistance while maintaining low friction during drilling. Internal testing has demonstrated that drill sharpness is maintained through osteotomies (with a 1.5x safety…

12. Page 25

    Microscope Provides Breakthrough Visualization Modes DUBLIN, Calif.–The medical technology business of ZEISS offers a comprehensive line of medical loupes and surgical microscopes for dentistry. Surgical microscope technology from ZEISS provides medical professionals with clear visibility of minute details and fine structures in regions that are otherwise difficult to view. The EXTARO 300 from ZEISS provides breakthrough visualization modes that introduce new applications to microdentistry. From more efficient caries detection to a simpler tooth restoration workflow, ZEISS EXTARO 300 is poised to revolutionize and differentiate your practice. The integrated HD camera of the EXTARO 300 records wirelessly to the ZEISS Connect…

13. Page 26

    Laser Reverses Moderate and Severe Periodontitis CERRITOS, Calif.–The PerioLase MVP-7 from Millennium Dental Technologies has the first and only scientifically proven FDA clearance for true bone regeneration with the LANAP Protocol, which reverses moderate and severe periodontitis. It can regenerate bone around failing implants via the LAPIP protocol. Maximize return on investment and patient satisfaction with a 6-month, money-back clinical results guarantee. The PerioLase performs more than 40 other procedures. The technology includes a built-in power meter and Joule counter for calculating clinical algorithms for safety and efficacy. For more information, call Millennium Dental Technologies at (888) 49-LASER (495-2737) or…

14. Page 27

    Shade-Matching Light Ensures Restorations Look Natural in Any Lighting DANBURY, Conn.—AdDent's new Rite Lite PRO Multispectral, HI-CRI Shade Matching Light offers (1) multi spectra HI-CRI LEDs, (2) three intensity levels, (3) a black light setting for matching restorations to the natural dentition fluorescence, (4) a rechargeable lithium-ion battery, and (5) more. Shades taken at the dental office or lab are frequently done using north white light (5,500 K). The problem arises when the patient goes home and looks in his or her mirror under incandescent or ambient lighting conditions. The shade may look a little off. The Rite Lite PRO…

15. Page 28

    Sensor Barrier Protects Patients and Clinicians From Viruses FERNANDINA BEACH, Fla.—Steri-Shield's Radiological Sensor (R.S.) Barrier protects your patients and you from viruses and diseases. It differs from plastic heat-sealed barriers in that it has no seams where microbes can be present, allowing it to thwart cross contamination. The elastic design snugly fits all popular radiological sensors and sizes while padding the sensor for maximum comfort. Each barrier is 100% integrity tested and is available in latex and non latex. For more information, visit Steri-Shield's website at steri-shield.com. FREEinfo, Shade-Matching System Delivers Quick, Repeatable Color Analyses ORMOND BEACH, Fla.—Denterprises Rayplicker Quickshade…

16. Page 29

    DENTISTRY TODAY 11th ANNUAL READERS' CHOICE Top 50 TECHNOLOGY PRODUCTS Dentistry Today's 11th Annual Readers Choice Top 50 Technology Products, selected on the basis of lead generation, represent some of the profession's most innovative technology products. The products appear in no particular order. Parkell Curing Light The Parkell Curing Light is just one more example of the quality design and workmanship that the company has been known for in the 70 years it has been in business. This sleek, new light features a low-profile head, so reaching into the posterior region of the mouth or sliding it into the buccal…

17. Page 30

    Top 50 Technology Products Sonendo Root Canal Therapy System The GentleWave System offers a novel approach to root canal treatment, using advanced fluid dynamics, broad-spectrum acoustic energy, and accelerated chemistry to deliver optimal cleaning and disinfection of the root canal system. The GentleWave System is backed by years of research, peer-reviewed clinical outcomes, and nearly 500,000 patients treated. The technology was designed to help save more teeth for more patients and to improve experiences for patients and practices everywhere. For more information, call (844) SONENDO (766-3636) or visit sonendo.com. FREEinfo, Glidewell Restorative System The glidewell.io In-Office Solution is a suite…

18. Page 32

    Top 50 Technology Products AG Neovo Handpieces The Dental Revolution series high-speed, air-driven handpieces are engineered for maximal durability and a smooth, vibration-free carving experience for all restorative treatments. These handpieces engage the spring-back chuck spindle mechanism that ensures greater retention force as the bur rotates. AG Neovo also has engineered a one-of-a-kind, dual-impeller-designed turbine that helps guarantee a smooth, stable, consistent, and powerful cutting procedure. Each handpiece comes with proprietary coating that ensures a positive tactile grip when prepping oral procedures. The Dental Revolution series includes the most popular handpieces and couplers that are currently available in the marketplace…

19. Page 34

    Top 50 Technology Products Millennium Dental Technologies Laser The PerioLase MVP-7 has the first and only scientifically proven FDA clearance for True Bone Regeneration with the LANAP Protocol, which reverses moderate and severe periodontitis. It can regenerate bone around failing implants via the LAPIP protocol. Maximize return on investment and patient satisfaction with a 6-month, money-back clinical results guarantee. The PerioLase performs more than 40 other procedures. The technology includes a built-in power meter and built-in counter for calculating clinical algorithms for safety and efficacy. For more information, call (888) 49-LASER (495-2737) or visit lanap.com. FREEinfo, ZEISS Microscope The EXTARO…

20. Page 36

    Top 50 Technology Products Orascoptic Loupes Specifically built as a platform for loupes, ErgoEdge is a lightweight sports frame designed to let the user achieve his or her personal balance of comfort and posture. One of Orascoptic's most customizable frames, its adjustable features include flexible temple arms. These allow the frame to conform comfortably to the user's head without affecting the alignment of the oculars. Its adjustable nose pad can be moved up and down, in addition to being spread or compressed, allowing the user to match it to his or her facial geometry for a precise, comfortable fit. Most…

21. Page 38

    Top 50 Technology Products Digital Doc Intraoral Camera IRIS X80's new liquid lens auto focus keeps things sharp and clear without buttons. An internal computer monitors the image and adjusts the focus automatically from micro to infinity. With plug-and-play ease, there is no installation; just plug it in, and start taking the high-definition 1080p images over a standard USB 2.0 protocol. Quality is built into every component, from a Sony sensor to the multi-element lens path and prism assembly. For more than 16 years, Digital Doc's innovation has been one of the leaders of the industry and provides one of…

22. Page 40

    Top 50 Technology Products Q-Optics Loupes Q-Optics' TTL (Through-the-Lens) loupes offer a better look, as well as a fit for everyone. With advanced materials and nose-relief design, Q-Optics features titanium frames and lightweight optics with a lifetime warranty. True-Fit Technology ensures ergonomic placement without impeding performance. The high-resolution loupes feature a dense optical system yet weigh, on average, 25 g less than standard systems, offering the company's clearest resolution yet. For more information, call (800) 858-2121 or visit q-optics.com. FREEinfo, BIOLASE Laser Waterlase Express is designed to provide clinically superior, patient-friendly results in more than 80 clinical indications, including a…

23. Page 42

    Top 50 Technology Products A-dec Sterilizer Achieve the best sterilization practices with the Lexa Sterilizer from W&H. Patented vacuum technology delivers bone-dry loads to help protect patients and mitigate risk. The large capacity makes it easy to combine loads and customize cycles, increasing efficiency. Closed-door vacuum drying keeps the door locked throughout the entire cycle. A single-use water system ensures water is never reused. The system sterilizes and dries loads in as little as 30 minutes. Its 11-in-diameter chamber holds up to 18 lbs of dental instruments. Six pre-programmed and 3 custom cycles enable the fastest cycle for any load…

24. Page 44

    Top 50 Technology Products DentiMax Digital Sensors The Dream Sensor works natively with virtually all software, including the DEXIS Imaging Suite, Patterson Eaglesoft, Gendex ViXWin, Dentrix Ascend, Instrumentarium CLINVIEW, Suni, and more. The sensor produces crystal-clear x-ray images that are among the best in the industry and has received numerous accolades, including the Editors' Choice Award from DENTAL ADVISOR. The sensor has rounded, beveled corners, which helps to provide superior comfort to patients. And, at just 5.41 mm, the Dream Sensor is the thinnest CMOS sensor on the market (data on file). All DentiMax sensors come with a 3-year, zero-deductible…

25. Page 45

    Sentodont Anesthesia Delivery System Performing the right injection is the first step toward a pain-free patient experience. Anesthesia is an essential step for most dental procedures. But dentists face a variety of issues when using a traditional syringe, such as (1) adhering to the recommended injection time (1 mL in 1 minute); (2) variations in pressure, which can cause discomfort to the patient; and (3) keeping the quality of injections consistent. With the Dentapen, these challenges are greatly reduced. The injection is monitored 50 times per second to ensure a constant flow at the right pace. This lets the dentist…

26. Page 46

    Top 50 Technology Products AdDent Oral Cancer Screening Device The Bio/Screen oral cancer screening device now offers a 40% increase in light output for improved lesion visibility. It can be used in full room light due to its exceptionally powerful shortwave LEDs. It is lightweight and ergonomically designed for maximum comfort and ease of use. Special optical filters improve contrast between healthy and abnormal tissue to enhance visualization of early stage lesions, when treatment is most successful. The Bio/Screen needs no fan and is completely quiet. It is cordless, rechargeable, and will operate continuously for more than 1.5 hours on…

27. Page 47

    Ritter Dental USA Dental Chair Upgrade your practice with the German-engineered Vanguard and the Vanguard Smart dental packages. The Vanguard combines the technology of electronics and the smooth movements of hydraulics in Ritter Dental's most popular dental unit. The left and right 360° unit can be very easily switched from right-hand use to left-hand use. The patient chair is synchronized and also offers a 30° swivel. This package comes standard with an upgraded LED operating light and all of the quality features that you have come to expect from Ritter Dental. The Vanguard and Vanguard Smart are hassle-free dental packages…

28. Page 48

    Top 50 Technology Products BrandMax Ultrasonic Cleaning Unit Tri-Clean Ultrasonic Cleaners deliver the next generation of cleaning power. Working in conjunction with the Tri-Clean Triple Enzymatic Cleaners, BrandMax ultrasonic cleaners can prolong instrument life, produce cleaner instruments, and improve infection prevention. Utilizing a consistent elevated temperature of 110°F can help produce cleaner instruments. All Tri-Clean Ultrasonic units feature a heating element at no extra charge. BrandMax provides industry-leading power and also includes the basket at no additional cost. The system's stainless steel construction and best-in-class product support are second to none. For more information, call (844) 874-2532 or visit brandmax.us.…

29. Page 50

    Top 50 Technology Products Ortek Therapeutics Caries Detection System The Ortek ECD was specifically designed to instantly detect occlusal cavitated lesions at the earliest possible stages. It helps solve a major diagnostic challenge for dental professionals by detecting these highly prevalent lesions that often go undetected by x-ray and visual methods. The ECD significantly improves patient outcomes by conserving tooth structure and creates a valuable new profit center with a return on investment in just days. In a published clinical study, it demonstrated 100% sensitivity and 93% specificity. Unlike other caries detection systems, the revolutionary ECD measures the conductivity of…

30. Page 51

    Technology Products Top 50 READERS' CHOICE Dentsply Sirona Digital Impression System Primescan makes digital impression taking easier than ever, faster than before, and more accurate than previously possible. With its completely new, patent-pending digital impressioning technology, it enables high-precision digital impressions to be taken of the entire jaw. These scans present numerous possibilities for users. Primescan was designed for various digital workflows with the laboratory directly in the practice, with CEREC, or in cooperation with external partners. Validated interfaces notably simplify the process, offering dentists the flexibility they desire. Primescan's optical impression system has been decisively developed. The scan of…

31. Page 52

    Top 50 Technology Products DEXIS Caries Detection Device With dental x-rays, what you see is not always an accurate snapshot of what is there. When watching a suspicious area that appears on a radiograph, such as hard-to-detect interproximal decay, it's possible to get a more in-depth view using CariVu—a compact, portable caries detection device that uses transillumination technology and no ionizing radiation to identify carious lesions and cracks. CariVu images read similarly to the familiar x-ray image. The tooth is bathed in safe, near-infrared light to make enamel appear transparent. Porous lesions, even those in the beginning stages, trap and…

32. Page 53

    Technology Products Top 50 READERS' CHOICE ContacEZ Interproximal Reduction System The IPR Strip System is an innovative interproximal reduction system that makes IPR safe and stress-free for dentists and patients alike. The compact and easy-to-use design of the IPR Strips prevent cuts to patients' lips and gums while the built-in flexibility of the strips preserves round, natural tooth contours and prevents the creation of sharp corners or flat contacts. Systematized for maximum efficiency, the IPR Strip system simplifies the process of breaking into tight contacts and accurately removing only the necessary amount of enamel. Each IPR Strip also includes its…

33. Page 54

    Top 50 Technology Products Planmeca Intraoral Scanner The Emerald S intraoral scanner combines superior accuracy and hyper-speed image capture in one lightweight, easy-to-use unit. Ideal for quadrant or full-arch scanning, this scanner has a large field of view so that one can easily see the patient's oral environment. Other features include Shade Assist technology, which removes the guesswork in shade matching; autofocus and red tips; and the flexibility to move the scanner between operatories due to its USB connection. Built on an open architecture system, Planmeca Emerald S can be fully integrated with your current equipment or software, allowing for…

34. Page 55

    EyeSpecial: Perfect Pictures Every Time! Figure 1. A look at the EyeSpecial Digital Dental Camera. Figure 2. There are 9 preset shooting modes, offering perfect pictures every time. Figure 3. Built-in gridlines provide consistent images. Icons correspond to the magnification range for easy selection. Figure 4. Mirror mode and standard mode are shown. Figure 5. Surgery mode, isolate shade mode, and tele-macro mode are displayed. Figure 6. Eyespecial's water/chemical resistant characteristics allow for disinfecting between patients to prevent cross contamination. Figure 7. A view of the 3.5 in LED/LCD touchscreen, which works with exam gloves. The EyeSpecial digital dental camera…

35. Page 56

    Printer Allows for Printing of Extremely Precise Models and Accurate Surgical Guides LOUISVILLE, Ky.–The VeriBuild LCD 3D Printer from Whip Mix offers features rarely seen in economically priced printers. Laboratories and dental practices can now print extremely precise models and accurate surgical guides with slice thicknesses between 25 and 100 μm. This open system printer is able to print 405 nm print resins using the proper file with its advanced software. Whether this is someone's first 3D printer or an add-on for increased production, he or she can count on consistently high print quality and high accuracy at an affordable…

36. Page 58

    Universal Resin Cement Works With Restorative Material Without Primers or Activators ENCINITAS, Calif—Tokuyama Dental America's EsteCem II is a single solution for all cementation needs. This dual-cure universal resin cement system is compatible with all restorative materials without the need for additional primers or activators, always following the same simple protocol. The main properties include superior bond strength, easy cleanup, and minimal water absorption for esthetic and long-lasting results. The EsteCem II kit includes one auto-mix resin cement syringe in the shade "Universal" and a full-sized Tokuyama Universal bond kit. Both are also sold separately. Clear, white-opaque, and brown shades…

37. Page 59

    Two-Component System Covers All Direct and Indirect Bonding Applications ST. PAUL, Minn.-3M's RelyX Universal Resin Cement and Scotchbond Universal Plus Adhesive offer 2 components that cover virtually every self adhesive and adhesive dual cure resin cement indication as well as all direct adhesive cases. When used alone, RelyX Universal Resin Cement works as a self-adhesive resin cement with outstanding bond strength, reliably solving routine cases with maximized efficiency. Scotchbond Universal Plus Adhesive is the first radiopaque, all-in one universal adhesive. It serves as a universal primer for all materials, including glass ceramics, and further boosts bond strength of RelyX Universal…

38. Page 61

    Sticker Accessories Allow Patients to Make Clear Aligners Unique SAN JOSE, Calif.—Align Technology's Invisalign Stickables are innovative sticker accessories designed exclusively for use with the patented SmartTrack material in Invisalign clear aligners. Available in an array of designs, colors, shapes, and themes, Invisalign Stickables are a cool, engaging, and fun way for patients to show their personal flair during Invisalign treatment. Starting with young patients, Invisalign Stickables are initially available in 10 fun themes, including (1) fantasy and gaming, (2) shapes and colors, (3) sports and activities, (4) travel and animals, (5) emojis and faces, (6) animals and nature, (7)…

39. Page 62

    Industry News Owandy Radiology Moves Its Headquarters Owandy Radiology has moved its US headquarters to Roslyn, NY, to better serve the North American dental market, according to the company. With a presence in the United States for more than 15 years, Owandy Radiology said it experienced exponential growth prior to the COVID-19 pandemic and expects to resume its upward trajectory in the fourth quarter of 2020 and beyond. "Fortunately, Owandy was able to build a very robust sales pipeline prior to the pandemic," said Boris Loyez, Owandy's vice president of sales and marketing for North America. "We are continuing many…

40. Page 63

    Magnesium Hydroxide Improves Bone Regeneration and Function Research at the University of Queensland School of Dentistry could stimulate bone formation, as 3-D printed bone scaffolds that use magnesium hydroxide could be used as substitutes for human bone grafts. "Using magnesium hydroxide with existing bone-forming materials improved bone regeneration and function in our study," said research fellow Dr. Abdalla Ali. "Magnesium hydroxide has the potential to accelerate bone formation inside the human body when combined with polycaprolactone (PCL), the most common biodegradable material used in bone tissue engineering," said Ali. "The combination of 3-D printed scaffolds with both magnesium hydroxide and…

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