Dentistry Today — October 2013 cover

September 2013 · 148 pages

Dentistry Today — October 2013

Clinical articles, techniques, product news and continuing education for dentists. Read the full issue free in the digital edition.

Inside this issue

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

  1. Page 2

    Simplified State-of-the-Art Endodontics To achieve excellent outcomes in cleaning and shaping root canals, effective case selection is of primary importance to practitioners. The highest success results have been associated with selecting teeth that are vital, without periapical lesions, are accomplished in a single visit, have a short filling level, and are not retreatments. With the vast amount of endodontic canal shaping systems available to practitioners, evaluating which systems will consistently and effectively clean and shape canals while minimizing instrumentation protocols and file expense can involve a long and tedious process of trial and error. The clinician has a choice of…

  2. Page 8

    Halloween in New Orleans! The Dentistry Today team is looking forward to attending the ADA Annual Session in New Orleans, beginning October 31. The ADA is bringing out one of America's top celebrities to kick off to this event. The 2013 Distinguished Speaker this year will be none other than former President Bill Clinton. No matter where you fall in the political spectrum, all who attend will undoubtedly enjoy hearing what he has to say. A true president, he will surely bring his affable charm and down-home style to hear on the topics upon which he will discourse. (We remember…

  3. Page 12

    VIEWPOINT continued from page 10 the solutions appealed for by Dr. David Satcher in the 2000 Surgeon General's Report. These uniquely packaged instructional materials offer trailblazing promise for classroom-based educational opportunities. They could spearhead efforts toward drafting the staggering oral health crisis in America. Evidence-based research data has been compiled to validate the invaluable importance of oral health education in public schools. "Evaluations of Code Blue: The Oral Health Crisis in Your Classroom" highlight the potential impact that oral health education can have on student performance. Teachers recognize the critical need for dental care and are well equipped to supplement…

  4. Page 13

    VIEWPOINT it is imperative that an explanation of the carcinogenicity of certain foods and beverages is communicated, since tooth decay is directly proportional to one's dietary habits. Frequent in-between meal consumption of sugar laden snacks or drinks (eg, juice, formula, sodas), increases the risk of caries. These concepts should be reinforced throughout the K-12 experiences. Students should understand the role surrounding frequency of consumption, for food and beverages, and their consequences—not only on tooth structures, but also to overall health and well-being. These are core competencies that must be routinely communicated in classrooms, and earnestly incorporated into school curricula. Establishing…

  5. Page 14

    opt·in Dental Laboratory Cooperative SIMPLE JUST GOT EASIER Work with the Owner Every Time • Tell us about your practice • Tell us what you need & when you need it • Seat & Deliver in 10 minutes or less • No managers, no assistants, no excuses Dr. Dean Mersky launched OPT-In in 2012 to help small laboratory owners adapt to the specific needs of today's private practitioners. OPT-In owners are trained to learn about and serve each individual practice, regardless of budget and style. Instead of the needs of the laboratory, Read more about Dr. Mersky and OPT-In at…

  6. Page 16

    FOCUS ON: Lasers Robert H. Gregg II, DDS, discusses what to look for when buying a laser. Q: What is a "ray gun"? What do they do? A: A "ray gun" is one type of "directed energy weapon" (DEW) that include phasers, laser blasters, photon disruptors, and vaporizers. Most shoppers of DEWs know nothing of how a ray gun, a phaser, or a laser blaster does what it does, and they really don't. All anyone really wants to know is, "How do I operate it, and doesn't it work?" Indeed DEWs work. The evidence for their safety and effectiveness has…

  7. Page 18

    From the July 2013 Issue CURING LIGHT Kerr Demi Ultra is the first and only cordless curing light without a battery. By utilizing state-of-the-art ultracapacitor technology to store energy, it can be re-energized much more quickly—without the need to replace a battery. Ultracapacitors, long proven in the aerospace, automotive, and medical industries, are now compact enough for use in dentistry. For more information, call (877) 685-1484 or visit kerrental.com/demiultra. FREEinfo, SEALANT Shofu Dental BeautiSealant is a giomer, containing surface prereacted glass. The unique property of this filler material is that it has been clinically shown to recharge fluoride from highionic…

  8. Page 20

    CLINICAL REVIEWS A-dec LED +++++ A-dec | (800) 547-1883 | a-dec.com Consultants' Comments • "Great illumination." • "The one-side was extremely useful when doing multiple fillings on posterior teeth." • "Light stays in position; no drifting." • "Buttons can be accessed from either side of the chair." • "Love this light" Description The A-dec LED dental light features intensity settings of 15,000, 25,000, and 30,000 lux plus a cure-safe mode providing 25,000 lux of only yellow light. The 5000 K color temperature is a neutral, white light with a color rendering index of 90 out of 100. Eight white and…

  9. Page 22

    Spotlight New Adaptor Offers the Advantages of State-of-the-Art Dental Isolation SANTA BARBARA, Calif.—For practices and clinics that want the advantages of state-of-the-art dental isolation, Isolite Systems introduces Isovac, the most versatile and affordable clinical option to date. Debuting this month at the ADA Annual Session in New Orleans, Isovac modifies a standard HVE hose so that any Isolite Mouthpiece can be easily attached. Isovac provides the same suction control and safety advantages as Isolite Systems' award-winning Isolite and Isodry dental isolation systems, and its unique design makes it easy to clean and sterilize. It is an excellent addition for hygiene…

  10. Page 24

    Spotlight CAD/CAM Denture Solution Yields Dentures With Just Two Patient Visits LOS ANGELES-One of the biggest challenges in dentistry today involves the more than 40 million US adults who are partially or completely edentulous. To resolve this significant healthcare issue, DENTICA pioneered a revolutionary CAD/CAM denture solution to make denture cases not only possible with just 2 visits but also significantly better in terms of quality, performance, esthetics, convenience, and efficiency. Its Digital CAD/CAM Denture System starts with a patented tray system that allows the impression, VD, CR, and all other key measurements needed for denture accuracy to be captured…

  11. Page 26

    Spotlight Uniquely Designed by Dentists, New Sensor's Many Features Cited LOS ANGELES-XDR Radiology introduces the Anatomic Sensor. Uniquely designed by dentists, its maximized mesial imaging area helps you capture challenging proximal contacts, its rounded and beveled corners broaden the contact zone for increased patient comfort, its white face cases intraoral visibility, and the sleek button on its immissible shell is easy to clean. The sensor is direct USB with no interface box and has a durable yet replaceable Kevlar reinforced cord. In synergy with XDR Software, the high signal-to-noise ratio and 19-h pixel size mean you'll see both the subtlest…

  12. Page 29

    Device Utilizes Optical Illumination/Visualization System to Detect Oral Cancer MALVERN, Pa.—Now marketed under DentalEZ Group's San Dental brand, the idenafi oral cancer screening device detects biochemical and morphological changes in the cells of the mouth, throat, tongue, and tonsils that may potentially lead to oral cancer. Intended for use by dentists, hygienists, and oral surgeons, the cordless, handheld device utilizes a wavelength optical illumination and visualization system that allows users to identify oral mucosal abnormalities that may not be visible to the naked eye. White, violet, and green-amber wavelengths of light monitor biochemical changes with fluorescence, while morphological changes are…

  13. Page 30

    Imprint 4 VPS Impression Material From 3M ESPE Faster Impressions Than Ever Before Quickly capturing an accurate impression is something that we all strive to accomplish. Accuracy is not only vital to the fit of a final restoration, but it will also certainly keep the process as comfortable as possible for patients. Imprint 4 VPS Impression Material from 3M ESPE, its latest impression material, has characteristics that make it valuable on both fronts. Imprint 4 is available in a Super Quick Set-ting option that sets in just 75 seconds. Compared to other VPS materials that require 3 minutes or more…

  14. Page 32

    Spotlight Whitening Gel Features Innovative Tray Delivery That Improves Gel Coverage and Whitening Experience SOUTH JORDAN, Utah–Ultradent Products' new Opalescence Go take-home whitening gel comes in an innovative, ready-made UltraFit tray that adapts instantly and comfortably to the teeth for a better fit and improved whitening experience. It provides molar-to-molar coverage, ensuring that the gel comes into contact with more posterior teeth than ever before, and its superior adaptability ensures that the maximum amount of gel stays in contact with the teeth during whitening. Best of all, prefilled trays can be worn right out of the package. Opalescence Go 6%…

  15. Page 34

    Spotlight New VPS Impression Materials' Accuracy Cited, Minimizing the Need for Retakes AMHERST, NY–Ivoclar Vivadent's new Virtual XD advanced system of VPS impression materials features new "Xtra Definition" wash materials, resulting in more accurate and better-fitting restorations while minimizing the need for retakes. Virtual XD impression materials offer many of the benefits dentists have come to expect from the original Virtual system, including high tear strength and outstanding dimensional stability. New benefits include optimized flow characteristics for deeper penetration into sulcus and improved coverage of the preparation, advanced wetting ability for precise detail reproduction of both soft and hard tissue,…

  16. Page 35

    Online Emergency Medical Kit Offered MOUNTLAKE TERRACE, Wash.—Your emergency medical kit only works if you know how and when to use it. You may be prepared with the right medications, portable positive-pressure oxygen, and an AED, but if a patient has a biphasic anaphylactic reaction, would you know how much epinephrine 1:1000 to inject? In the heat of the moment, would you remember how to draw medication from a vial? A life may depend on it. To allay these concerns, HealthFirst now offers a training course online spanning less than one hour on how to use the medications and devices…

  17. Page 36

    Zirconia Implant Bridge Stands the Test of Time WOODSTOCK, NY—Tischler Dental Laboratory offers as its only product Zirkonzahn's Prettau Zirconia Bridge. While many labs offer copycat zirconia bridge products, the Prettau System, with more than 5 years of proven history, stands the test of time. Zirkonzahn's combination of specific milling machines, scanners, zirconia, stains, and sintering ovens makes this system stand apart. Hybrid bridges and bar overdentures are obsolete when you compare them to the Prettau Bridge option. Visit prettaubridge.com for additional information, including information on Tischler Dental Laboratory's Prettau Course. FREEinfo, Mixpac candy collection. Happy colors. Healthy patients. www.sulzer.com…

  18. Page 38

    Versatile Splinting Systems Offered MEZZOVICO, Switzerland–Offered in 2-mm and 4-mm sizes in a unique bottle delivery system, Polydentia's F Splint-Aid and F Splint-Aid Slim are fiberglass bands preimpregnated with bonding, ideal for all situations where dental splinting is required. The slim version, a DENTAL ADVISOR 2103 Preferred Product, provides the same strength as the wider band, even if used for the treatment of surfaces with reduced dimensions. Just a few steps are required for great results: cut to desired length, position on etched surface; immobilize with clips; then light cure. No anesthesia is needed, and tooth preparation is significantly reduced.…

  19. Page 39

    Fibers Strengthen and Reinforce All Composites and Denture Base Resins SANTA YNEZ, Calif.-PREAT Corp's Fiber and Mesh are indicated for strengthening and reinforcing all composites and denture base resins. The fibers are translucent, do not require any special tools, are very easy to handle, can be polished to a smooth finish, and bond to all denture base resins, composites, and enamel. They will increase the strength and toughness of resins up to 100 times compared to polyethylene, Kevlar, and orthodontic wire. Both Fiber and Mesh may be used for long-term reinforcement of new and existing full and partial dentures, TMJ…

  20. Page 40

    Sectional Matrix System Now Offered With Nonstick Finish MILFORD, Del.—DENTSPLY Caulk's Palonent Plus sectional matrix system facilitates contact creation by utilizing optimized ring, band, and wedge technology. And now it's even easier to use; Palodent Plus EZ Coat Matrices have a nonstick finish that makes matrix removal easier. Also, greater matrix curvature helps improve the anatomical accuracy of the restoration and avoid interference with the ring during placement. For additional information, contact DENTSPLY Caulk at (800) 532-3855 or visit the Web site located at palodent-plus.com. FREEinfo, New Desensitizer Offered NEW YORK CITY—When applied to dentin and/or enamel surface, Kuraray's TEETH…

  21. Page 42

    NEWS/TRENDS Industry News Argen Corp Hires New Senior VP of Domestic Sales The San Diego, Califbased Argen Corp, manufacturer of dental gold alloys and a leading innovator in digital dentistry solutions, announced recently that it has hired Michael B. Clark as senior vice president of domestic sales. Mr. Clark will direct a team of sales professionals to deliver an expanding suite of products and services to dental laboratories nationwide. Michael B. Clark AdDent Launches New Web Site AdDent announce recently the launch of its new, state-of-the-art Web site, addent.com. In addition to offering information on AdDent's standard products, which includes…

  22. Page 44

    "Fit to Bite..." continued from page 42 France during World War I, Frederic Giauque, DDS, left a successful private practice in New York City after 20 years to fulfill a long time dream—serving in the US Navy. "The new LCDR Frederic Giauque is dental department head, USS Essex. "I joined the Navy only three and a half years ago, and I have found an incredibly supportive and challenging environment," LCDR Giauque said. "I chose to be with the Marines for my first tour, and the experience I got was simply extraordinary, as I serving at 1st Dental Battalion at Camp…

  23. Page 48

    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. Panavia SA Cement Kuraray Dental The clinical standards for today's resin cement include self-adhesion and single-step delivery. Yesterday's products were multicomponent, multistep, tedious, and confusing. As cements must adhere to a majority of the indirect dental restorative materials in common use today, they must also have high bond strengths to resist marginal leakage and failure. Kuraray Dental's well-known Panavia cement line has long been a mainstay of many practices. The recently introduced single-step, self-adhesive Panavia…

  24. Page 50

    50 18th Annual FALL PRODUCT SHOWCASE NOTE: Dentistry Today's 2013 Fall Product Showcase highlights the latest products being offered to dental professionals at the fall meetings, including the ADA Annual Session, being held in New Orleans at the Ernest N. Morial Convention Center, and the Greater New York Dental Meeting at the Jacob K. Javits Convention Center. OBTURATION SYSTEM Obtura Spartan Endodontics The Obtura MaxPack, Obtura Spartan Endodontics' newest heat source, represents the latest technology for gutta percha compaction. This product has the ability to remove excess gutta percha during lateral condensation techniques, create an endodontic post space, or compact…

  25. Page 52

    FALL PRODUCT SHOWCASE DIGITAL RADIOGRAPHY SENSORS XDR Radiology XDR sensors provides superior comfort and image quality. Chosen by UCLA's School of Dentistry, it is dramatically easy to use. Advanced imaging filters go beyond film and the human eye, and patented distortion correction undoes the effects of projective distortions. Bidirectional scaling allows more accurate measurements in any direction. For more information, call (888) XDR-XRAY or visit xdrradiology.com. FREEinfo, ELECTRIC HANDPIECE NSK Dental Ti-Max Z45L is the world's first 45° electric attachment handpiece. It features a unique, 2-way spray mode. It possesses (1) a water jet spray option to help prevent subcutaneous…

  26. Page 54

    FALL PRODUCT SHOWCASE DIGITAL IMPRESSION SYSTEM 3Shape TRIOS is a powder-free, next-generation intraoral digital impression solution that scans natural colors to clearly distinguish between teeth and gingival and restorative materials. It enables clinicians to rapidly capture the complete intraoral situation, clinically validates the impression, and sends the 3-D model directly to the lab. The POD solution is an alternative to the cart and offers more mobility and flexibility. For more information, call (908) 867-0144 or visit 3shapedental.com. FREEinfo, AUTOCLAVE SciCan The STATIM G4 is the same renowned and trusted autoclave it has been for more than 20 years but now…

  27. Page 56

    FALL PRODUCT SHOWCASE UNIVERSAL ADHESIVE VOCO America Futurabond U is a dual cure universal adhesive that does not require primers or activators. It is the bond that does it all. It can be used with self-etch, selective-etch, and total-etch procedures. It is indicated for all direct or indirect materials, whether it is light-, dual-, or self-cured resins. It is available in VOCO's patented SingleDose delivery system, eliminating the solvent evaporation problem. For more information, call (888) 658-2584, visit vocoamerica.com, or e-mail infousa@voco.com. FREEinfo, ZIRCONIA CROWN Assured Dental Laboratory Zenostar is a 100% full-milled zirconia restoration with no porcelain overlay, resulting…

  28. Page 57

    Inseparable: Zirconia and PermaCem 2.0 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 Zirconium 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 you with the added…

  29. Page 58

    FALL PRODUCT SHOWCASE IMPLANT SYSTEM Ritter Dental USA The Ivory Dental Implant System is affordably priced yet designed to meet the standards of the most experienced implantologist. Made in Germany, the implant line features self-tapping threads and a nanosurface for quick osseointegration. Two models provide a complete solution for most surgical applications. The Ivory Implant System has excellent clinical success rates and is supported by Ritter's surgical instruments. For more information, call (855) 807-8111 or visit the Web site ritterdentalusa.com. FREEinfo, PRACTICE MANAGEMENT SOFTWARE Henry Schein Practice Solutions Henry Schein Easy Dental is the easiest, most affordable dental practice management…

  30. Page 60

    FALL PRODUCT SHOWCASE INTRAORAL RADIOGRAPHY SYSTEM Suni Medical Imaging SuniRay digital radiography system is the favorite among dental practitioners for when easily and quickly it captures and analyzes dental radiographs. This portable intraoral device displays crisp images even in the toughest areas with its ergonomic design, ensuring easy positioning and optimal patient comfort. Plus, its sensors provide easy-to-use software that allows for ingenious applications. For more information, call (800) 438-7864 or visit suni.com. FREEinfo, IMPLANT SYSTEM ZEST Anchors The LOCATOR Overdenture Implant System comprises narrow diameter implants designed to work perfectly with the LOCATOR attachment. Featuring a unique, 2-piece coronai…

  31. Page 62

    FALL PRODUCT SHOWCASE CERAMIC/COMPOSITE MATERIAL Vident VITA Enamic, the world's first hybrid dental ceramic with a dual network structure, combines the best properties of ceramic and composite materials. Its dourable ceramic network structure and its reinforcing polymer network structure are fully merged with one another, similar to the way steel reinforces concrete. With this dual ceramic polymer network, the material incorporates the benefits of ceramic and composite materials into one revolutionary, new product. For more information, call (800) 828-3839 or visit vident.com. FREEinfo, UNIVERSAL COMPOSITE Tokuyama Dental America Tokuyama Estelite Sigma Quick is a 100% spherically filled universal composite. Utilizing…

  32. Page 64

    FALL PRODUCT SHOWCASE DENTAL CART Velopex International The new Velopex SmartCart is an essential component for today's dental practice. It is contemporary, totally aseptic, and accessible from all 3 sides of the shelf. It comes with casters with front locking wheels and is strong, durable, and versatile. The shelves are interchangeable and can be adjusted to suit individual requirements, with an electrical box at the base plate. For more information, call (888) 835-6739 or visit velopexusa.com. FREEinfo, BITE GUARD Keller Laboratories The NTI-tss Plus Soft provides maximum patient comfort and significantly reduced chair time. It is a custom-fitted device that…

  33. Page 66

    FALL PRODUCT SHOWCASE ABUTMENTS KAT Implants Locator Abutments are provided in 2.5, 3.5, and 4.5 mm cuff lengths and are compatible with all implants of the KAT Implants System—from a long-term ion-KAT implant (2.5 and 3.1 mm diameter) to Really Wide Implants (6.5 and 8.0 mm diameters). KAT Implants Locator Abutments are attached with a simple taping action to engage the locking taper connection. For more information, call (603) 427-0084 or visit katimplants.com. FREEinfo, HYDRO-ABRASION DEVICE Danville Materials The Prepstart is the world's leader in air abrasion. The H2O Prepstart sprays a conical jet of water surrounding the abrasion stream,…

  34. Page 70

    FALL PRODUCT SHOWCASE DENTAL WEB SITE DESIGNER Sesame Communications It only takes 90 seconds for a patient to decide if he or she will contact the practice. The groundbreaking research study uncovered the 25 factors in a Web site that prospective patients consider when choosing a practice online. You can market your practice with an effective Sesame Patient Appeal Rated Web site so prospective patients choose you. For more information, call (866) 600-4979 or visit sesamecommunications.com. FREEinfo, APEX LOCATOR MedicNRG Designed to work with most handpieces, the ApexNRG Rider and the ApexNRG blue apex locators measure canal length in real…

  35. Page 72

    FALL PRODUCT SHOWCASE COSMETIC SIMULATION SOFTWARE SNAP Imaging Systems SNAP cosmetic simulation software is a must-have tool for generating interest in and increasing case acceptance of cosmetic treatments. You can produce natural-looking simulations in less than one minute, helping your patients to envision what they would look like after dental veneers, orthodontics, teeth whitening, bridges/implants, and more. The take-home photo is often shared with others who help motivate the patient to schedule treatment. For more information, call (866) 987-7627 or visit snapdental.com. FREEinfo, ENDODONTIC STORAGE SYSTEM Jordco The Endoring FileCaddy organizer provides a unique bulk storage solution for all endodontic…

  36. Page 73

    Purchase $250 of ANY EDS Products and Receive A $10 E-Certificate for goods at Big Cat Coffees! OR Purchase $750 and get A $50 E-Certificate! Visit www.edsdental.com for additional promotions and complete details ROOT CANAL POST Filhol Dental Endo-Express® & SafeSiders® FILPOST preserves healthy tooth structure and is stronger in use due to its unique, passive interlocking system that strengthens retention. It can be easily customized to suit the canal without risk of fracture, enabling easy insertion of multiple posts into converging canals. There is no drilling required during placement. For more information, call (855) 714-9286 or visit filhol.com FREEinfo,…

  37. Page 74

    FALL PRODUCT SHOWCASE CARBIDE BURS Coltène Alpen StenX is a presterilized carbide, individually packaged, providing an aseptic bar out of the box. Alpen StenX offers one of the largest one-piece carbide selections on the market. For more information, call (800) 221-3046 or visit alpenrotary.com. FREEinfo, ZIRCONIA RESTORATION Prudential Laboratories SuperZir is a full contour milled zirconia restoration. Anterior units have an overlay of porcelain on the facial to improve aesthetics. Prudential has developed a staining and glazing technique to achieve shade consistency. SuperZir, with its high strength and sheer/fracture resistance, is ideal for bruxers and grinders. It is indicated for…

  38. Page 76

    FALL PRODUCT SHOWCASE COMPOSITE-DISPENSING TIPS Vista Dental Products The patented Therma Flo Composite Applicator is uniquely engineered to utilize heat for optimal performance of any composite material. With easy motorized extrusion, it offers greater versatility to enhance composites, allowing clinicians to use highly filled composites in a wide variety of applications with the same clinical ease as flowables. This is done without sacrificing strength, hardness, or wear resistance. For more information, call (262) 635-3393 or visit vista-dental.com. FREEinfo, REVOLUTIONIZING COMPOSITE DELIVERY Therma-Flo Composite Applicator™ For motorized extrusion of heated composites! Benefits of HEAT: • Fewer voids, greater depth of cure,…

  39. Page 77

    Inman Aligner The Inman Aligner is an innovative solution for patients suffering with protruding or crowded anterior teeth. The aligner is great for ortho relapse and pre-alignment for cosmetic work. This revolutionary appliance is removable and highly discreet, and the average treatment time is only 6 to 16 weeks. Training for the Inman Aligner is available online or at any of the popular hands-on certification courses. For more information, call (800) 289-0118 or visit the Web site located at inmannaligner.com. FREEinfo, EXTRACTION INSTRUMENTS Golden Dental Solutions The innovative Beak & Bumper design of the Physics Forceps dental extraction instruments allows…

  40. Page 78

    FALL PRODUCT SHOWCASE FIBER POSTS Penton FiberKleer 4x Fiber Posts feature radioactivity of up to 400% of aluminum to help ensure they are instantaneously identified on a radiograph. This feature, combined with the excellent core retention and color coding, streamlines the post placement process, especially when used with Build It FR Core Material. For more information, call (800) 551-0283 or visit penton.com. FREEinfo, LOUPE/HEADLIGHT Orascoptic XV1 is the world's first wireless loupe and headlight combination. This innovation seamlessly combines Orascoptic's award-winning loupes and award-winning headlight—featuring a lightweight and completely cableless design. And by removing the heavy and bulky backpacks of…

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