Dentistry Today — October 2019

Inside this issue

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

1. Page 8

   Below is a Letter to the Editor that Dentistry Today received in response to the article, "Treating Peri-implantitis," by Edward R. Kusek, DDS, which ran in the August 2019 issue on pages 18 to 20. The original article can be found on . To the editor: We were intrigued by Dr. Edward R. Kusek's "Treating Peri-implantitis" case report in the August 2019 issue. We respectfully acknowledge the considerable skills necessary to attempt the rather complex, multi-step surgical approach outlined by Dr. Kusek. We wonder, though, how many clinicians would be willing to undertake the technique-sensitive treatment regimen outlined by the…

2. Page 10

   The Ethical Responsibilities of Dental Associations Dentistry comprises many specialized professional organizations. Each has its own mission and distinctive responsibilities to its members, the larger professional dental community, and society at large. Many dental associations have ethical guidelines outlined in their charters. The purpose of this article is to discuss whether or not dental associations are living up to their commitments to society that these codes of conduct are designed to ethics, dental associations generally share 2 special characteristics: 1. Making good on the professional community's claim and promise to offer unique knowledge and skills that the larger society recognizes…

3. Page 12

   VIEWPOINT continued from page 10 ethical obligations. This is because organizations are capable of evaluating possible actions and then choosing an action and arguing it out. These are the same characteristics we look for when we claim that an individual has ethical obligations. In other words, without exception, every dental professional organization has ethical obligations that have been enforced by society and responsibilities that have been assumed by the profession. But, since our culture places much emphasis on individual liberty, this can be easily overlooked. The most obvious organizational obligation is that, like the individual members of the dental profession,…

4. Page 14

   Stay Connected With Your Patients and Community Roger P. Levin, DDS, discusses the challenges and solutions for keeping patients in touch with your practice. According to the Levin Group Data Center, most people only see their dentists every 6 months for a hygiene check that lasts approximately 5 minutes. And while dentists feel good that their patients are staying on top of their dental hygiene, it's difficult to truly connect with them when they don't see them that often. Connecting with patients is critical to maintaining your patient base, so you must be creative when it comes to staying in…

5. Page 16

   Bio Gregory Belok, DDS, MPH, received his DDS degree from the New York University (NYU) College of Dentistry (1971) and his Master of Public Health degree from Yale University (1974) and completed his Dental Public Health residency at the University of Connecticut Health Center (1974 to 1975). He was on the full-time faculty of the Fairleigh Dickinson University School of Dentistry in the Department of Community Dentistry and is now the owner of a multi-specialty group practice in New York City, New Jersey, and Connecticut and formerly in London, England. Presently, he also practices evidence-based restorative and implant dentistry for…

6. Page 18

   CLINICAL REVIEWS DENTAL ADVISOR 3M Filtek Universal Restorative +++++ (96%) 3M | (800) 634-2249 | 3m.com/dental Evaluators' Comments • "Very aesthetic and easy to match to the VITA shade guide." • "Nine shades make shade selection easier and require less inventory." • "I liked the ease of control at the margins for occlusal and interproximal restorations." • "The pink opaquer blocks out dark stains perfectly." • "I would like to see a flowable Filtek Universal for deep restorations and proximal boxes." Unique Features • Patented nanoparticles that include nanoclusters for wear resistance and aesthetics. • High strength, making it suitable…

7. Page 20

   COMPANY PROFILE A-dec was Founded on an Invention and a Dream The book American Dreamers by A-dec cofounder Ken Austin tells the humbling tale of how he and co-founder/wife Joan created the company on an invention and a dream more than 50 years ago. Their mission has to better the world of dentistry. Today, A-dec is one of the largest dental equipment manufacturers in the world. Even though its reach extends to more than 100 countries, the company still operates on the ethical philosophies and principles that were founded in its beginning. PRODUCTS A-dec empowers dentists to do their best…

8. Page 22

   Take a Look Around Paul Fuerstein, DMD The bottom line is, if you are considering a 3-D printer, know what you can actually make efficiently in your office and how much you will actually use it. Last month, the annual meetings of the ADA and the FDI (World Dental Federation) were combined and held in San Francisco as the ADA FDI World Dental Congress 2019. For those not familiar, FDI represents more than a million dentists worldwide. As usual, as many new products debuted in a large array of manufacturer displays. There were only 5 days full of continuing education…

9. Page 24

   Spotlight Set of Drivers Services Virtually All Types of Implant Cases SANTA MARIA, Calif.–Preat introduces its newest innovative product, the Implant Buddy and Omega Torque Wrench. This all-in-one set of drivers will service 99% of implant cases. Unique features of the Implant Buddy include (1) its small and compact size that does not interfere with limited space chairside, its color coded base, and its drivers for easy visibility; (2) a magnetic base for stability on the surgical tray; (3) tapered drivers for a stronger connection; and more. Easily sterilize the individual drivers or the entire Buddy. Prophetic inclusions include straight,…

10. Page 25

    New Implant's Collar Brings Junction of Implant, Abutment Above Crest of Bone ALBUQUERQUE–OCO Biomedical added a groundbreaking new dental implant, the Engage Plus, within its Engage bone level implant system product line. The new implant leverages a one-mm, machine-finished collar, which brings the junction of the implant and abutment above the crest of bone. This prevents bone loss and improves soft-tissue preservation. The implant's proprietary auger tip, mini-cortico threads, and unique thread pattern lock directly into the bone, providing instant fixation. Other key features include (1) a platform-switching design on the 5.0- and 6.0-mm Engage Plus implants that aids in…

11. Page 26

    Spotlight Handpiece Maintenance System Supports Continuous Workflow NEWBERG, Ore.—A dce is introducing a more efficient approach to handpiece maintenance: the Assistina Twin. Its unique, dual-chamber system lubricates, cleans, and purges each dental handpiece in just 10 seconds. Designed to eliminate frustrating wait times, the Assistina Twin features 2 independently operating chambers. Assistants can access and load one chamber oil while the other is processing, supporting a continuous workflow. A high performance injector applies a precise amount of fine lubricant to protect remote gear components. An active suction system includes a special HEPA filter to prevent emissions and odors. The complete…

12. Page 27

    System Shows Occlusal Masticatory Distribution Data on iPad App NASHUA, NH - Occlusense, a new system developed by Bausch, combines the traditional and digital registration of the pressure distribution of the occlusal surfaces. Occlusense handles all data with a battery-powered device that uses a local wireless network to transfer the recorded data to the OccluSense iPad app. The inductive charger provides a wireless power transfer. Fully charged batteries allow the usage of the device for up to 4 hours. The 80-μm OccluSense Electronic Pressure Sensor is used just like traditional occlusion test materials. The technologically advanced pressure sensors allow for…

13. Page 28

    Spotlight Disposable Prophy Angle Produces Significant Reduction in Splatter SOUTH JORDAN, Utah—Ultradent Products unveiled its latest innovation in disposable prophy angles, the Ultrapo Tx Sweep DPA. Splatter is a near constant concern for dental hygienists during polishing with 80% reporting at least 3 moderate amount while using their current prophy angle. After switching to the Ultrapo Tx Sweep DPA's, 5 out of 6 hygienists experienced a significant reduction in splatter, and 95% said he or she encountered little to no splatter compared to the former angle. Ultrapo Tx Sweep DPA's performance upgrades come from the unique brush guard attached near…

14. Page 29

    Spotlight Calcium Silicate Performs as Barrier, Protectant of Dental Pulpal Complex SCHAUMBURG, Ill—BISCO Dental Products' TheraCal PT is a biocompatible, dual-cured, resin-modified calcium silicate designed for pulpotomy treatment. It maintains tooth vitality by performing as a barrier and protectant of the dental pulp complex. TheraCal PT's chemical formulation consists of synthetic Portland cement calcium silicate particles in a unique hydrophilic matrix that facilitates calcium release. It is radiopaque, allowing for easy identification and differentiation from recurrent decay and other restorative materials. TheraCal PT's physical properties resist breakdown and degradation, leading to a durable seal. It is also indicated for direct…

15. Page 30

    Impression Material Offers Convenient Working Time, Improves Patient Comfort INDIAN LAND, SC-VOCO's V-Posil, the VPS impression material with optimal timing and maximal precision, provides this high level of precision while offering a convenient working time and a short intraoral setting time. It provides high hydrophilicity and dimensional accuracy plus a high degree of tear strength and elasticity. The putty viscosity of this product line has been extended and now includes the putty material in a large, 380 mL cartridge. V-Posil Putty Fast is used as a tray material for the following techniques: (1) putty and wash technique (2 step), (2)…

16. Page 31

    Self-Sealing Pouches Enable Sterilization of Dental Instruments ORANGE, Calif.–KaVo Kerr's PeelVue PRO Sterilization Pouches are a new line of self-sealing pouches for the sterilization of dental instruments. With 12 sizes available, PeelVue PRO pouches are a great answer to dental sterilization needs, whether for the sterilization or maintenance of sterility of dental instruments. PelVue PRO features a triple seal for increased strength against tears and fall-through, dotted perforation for an easy visual guide when sealing the pouch, as well as a notch to assist with opening the pouch after sterilization. Validated for steam and ethylene oxide sterilization, PeelVue PRO has…

17. Page 32

    Spotlight Desensitizer Showcases Impressive Antimicrobial Inhibition Zones LAKE ORION, Mich.–Advantage Dental's HS&C has rated the best overall desensitizer in a study of 9 products because of its antimicrobial action (4% chlorhexidine with HEMA), increase of bond strength, and nonirritancy compatibility with soft tissue. Recently published research demonstrates antimicrobial inhibition zones nearly twice that of glutaraldehyde-based products. It can also be used in dentin lesions at a fraction of the price of the glutaraldehyde products. It is available in a bulk bottle and unit-dose delivery. When combined with self-etch or total-etch adhesives, it provides no-excuse performance. For more information, call Advantage…

18. Page 33

    Composite Showcases Absolute Shade Stability SAN MARCOS, Calif.–Due to a unique filler technology, Shofu Dental's Beautifil II LS provides high abrasion resistance, antagonist-friendly surface hardness, and optimal compressive strength. This firm but easy handling, stackable, nonsticky micro-hybrid composite is ideal for anterior and posterior restorations, Classes I to V. It's a premium restorative material with absolute shade stability that can be quickly and easily polished to a sustainable high gloss finish. Beautifil II LS minimizes polymerization shrinkage and resultant shrinkage stress, which helps to prevent micro leakage and marginal discoloration for durable, long lasting aesthetic restorations. It features Shofu's proprietary…

19. Page 34

    Treatment of Pit and Fissure Caries With a New Flowable Composite Figure 1. Preoperative view of a mandibular premolar. Figure 2. Preparation. Figure 3. Etching gel in place. Figure 4. The bonding agent (Tokuyama Universal Bond [Tokuyama Dental America]) was applied. Figure 5. Universal flowable composite (Estelite Universal Flow [Tokuyama Dental America]) was applied. Ross W. Nash, DDS INTRODUCTION I started using flowable composites in the late 1980s, when they were first developed. Since then, many uses for them have been found in dental procedures, including as bases for composite restorations, filling margins of temporary restorations, sealing margins of temporary…

20. Page 36

    Industry News Dental Partnership Raises $1.8 Million for Children's Charities Ultradent Products and the Crown Council teamed up to raise more than $1.8 million through Smiles for Life between March 1 and August 1, 2019. Smiles for Life, the charitable arm of the Crown Council, has raised almost $44 million benefitting more than a thousand children's charities in North America since 1998. "I have personally participated in 2 humanitarian trips with Crown Council and have observed firsthand their members' commitment and hard work in this effort," said Karen Phillips, vice president of sales and marketing at Ultradent Products. Crown Council…

21. Page 38

    Industry News continued from page 36 Oral Cancer... continued from page 36 Laboratory Technologist and Master Certified Dental Technician in Implants, Crown & Bridge, Ceramics, Complete Dentures, Partial Denture, and Orthodontics. Most recently, Larson was national sales manager of GC America's Lab Division. He has been a dental technician and has worked in sales and marketing for Dental Arts Laboratories and as vice president of Ameridose Dental Labs. Larson holds a BS in communications and marketing from Southern Illinois University at Chicago (SIUC) as well as a dental technology degree from SIUC and an MBA from the University of Illinois…

22. Page 42

    DENTISTRY TODAY 24th Annual FALL PRODUCT SHOWCASE Dentistry Today's 2019 Fall Product Showcase highlights the latest products being offered to dental professionals at the fall meetings, including the ADA Annual Session, which was held in San Francisco at the George R. Moscone Convention Center, and the Greater New York Dental Meeting at the Jacob K. Javits Convention Center. VOCO America COMPOSITE Admira Fusion Xtra is a single-shade, omnichromatic bulk-fill restorative composite with a 4-mm depth of cure. Due to the extremely small nanoparticulate fillers, light does not refract or diffract from the restoration, creating a "chameleon effect" that matches the…

23. Page 44

    DenMat DIODE LASER The NV PRO3 Microlaser is one of the lightest weight soft-tissue diode lasers on the market, weighing in at less than a standard drill. It has a plug-and-play system with 12 preset procedures for all of your periodontal, restorative, and orthodontic needs. With 30 minutes of continuous operation at 1.2 W of power, you have enough power for more than 15 procedures before changing batteries. For more information, call (800) 433-5628 or visit denmat.com. FREEinfo, Bien-Air HANDPIECE SYSTEM The iOptma INT enables you to perform all of your dental operations, such as endodontics (including WaveOne), restoration, oral…

24. Page 46

    Planmeca CBCT SYSTEM ProMax 3D Mid is an all-in-one CBCT imaging system offering 2-D, 3-D, panoramic, cephalometric, multiplanar, and 3-D photo imaging, as well as the new Planmeca 4D Jaw Motion technology. Proprietary Planmeca Ultra Low Dose imaging protocol provides crystal-clear images giving you incredible clarity at the lowest diagnostically achievable dose. For more information, visit planmeca.com/imaging/uld/. FREEinfo, Align Technology TEETH STRAIGHTENING PRODUCT Invisalign Go treatment is a new teeth straightening product completely reimagined with general dentists in mind. Invisalign Go clear aligners feature (1) simplified digital workflow for easy integration in your practice; (2) instant case assessment to help…

25. Page 48

    DiaDent OBURATION SYSTEM Dia-Duo is a complete obturation system that comprises the Duo-Pen vertical compaction device and Duo-Gun backfill obturation device. Duo-Pen softens, spreads, cuts, compacts guttapercha, and seals all canals, including lateral canals. Duo-Gun backfills and can reach 200°C within 15 seconds. Its design is ergonomic and lightweight. Duo-Pen and Duo-Gun can be purchased separately. For more information, call (877) 342-3368 or visit diadent.com. FREEinfo, Convergent Dental LASER Solea provides breakthrough technology that delivers a completely different experience than anything before. It is the first all-tissue laser that can cut hard tissue—all classes of cavity preps—quickly, smoothly, and reliably…

26. Page 49

    Filhol Dental PIN FILPIN is the perfect product for all pin requirements, providing maximal advantages without compromising safety, dentin integrity, or retention. It is made of 99.8% pure titanium. The selfthreading, self-aligning FILPIN speeds and eases placement for self-shearing the first time, every time once optimal depth is reached. Where minimal tooth structure is present, pins are recommended to enhance the chemical bonding provided by adhesives. For more information, call (800) 330-0850 or visit filhol.com. FREEinfo, Vista Dental Products FERRIC SULFATE LIQUID Quick-Stat Liquid is a 15.5% ferric sulfate liquid. It is used to soak retraction cords to achieve hemostasis…

27. Page 50

    Velopex International AIR-ABRASION SYSTEM With total control of powder, pressure, and solution, AquaCare allows the clinician to decontaminate within adhesive dentistry, as well as desensitizing, and use within endodontics, hygiene, implant, laboratories, MI, orthodontics, pediatrics, periodontics, restorative dentistry, stain removal, veneers, and more. For more information, call (888) 835-6739 or visit the website airtherapicsystem@aquacarewin. FREEinfo, TruAbutment ABUTMENT The pioneering concept of the Angulated Screw Channel (ASC) Ti-bases has allowed users to deal with challenges by providing a restoration that is aesthetic and convenient. TruAbut ment ASC integrates the ASC into the current custom abutment solutions. This allows the users to…

28. Page 51

    PROVEN PERFORMANCE ◆ AWARD-WINNING QUALITY DMP Composites DENTISTRY TODAY TOP Innovative Products 2019 DMP Dental NANOHYBRID COMPOSITE NANOCERAM-BRIGHT: Universal and Flowable With more than 30 years of experience, DMP has developed an innovative manufacturing process that integrates a unique blend of micro and nanofillers into the resin, creating an easy-to-apply nanohybrid composite for class I to IV restorations. NANOCERAM-BRIGHT outperforms the competition, achieving superior physical and aesthetic results. Excellent color matching, high polishability, and lifelike translucency allow the restoration to blend into the natural tooth structure and surrounding area for a chameleon effect. For more information, visit dmpdentalus.or email info@dmpdentalus.…

29. Page 52

    FALL PRODUCT SHOWCASE COLTENE APEX LOCATOR The CanallPro Apex Locator with rechargeable battery has a brilliant, colored, 3-D panel noted for its accuracy of measurement with audio feedback, volume control, built-in self-test, and auto-off. The user is notified when an endodontic file reaches the apical foramen by the Virtual Apex function. The apex locator has a 2-year warranty. For more information, call toll-free at (800) 221-3046 or visit coltene.com. FREEinfo, KaVo Kerr PERIODONTIC HANDPIECE The Perio Tip provides a daily prophylaxis treatment that's easier, quicker, more thorough, and even enjoyable. It offers exceptional cleaning and enhanced visibility. It has less…

30. Page 54

    Curve Dental ONLINE FORMS Now a feature of its practice management software, Curve Dental's online forms provide dentists with the ability to create any form that can be accessed by any device, with all data written automatically to the patient's record. The company hails the forms as being the easiest way to collect, process, and manage patient information and states that the level of information it has created will significantly reduce the time a practice spends entering and updating patient information. For more information, call (888) 910-4376 FREEinfo, Fairfax Dental DENTAL PIN The Stablok Pin is designed to achieve 2…

31. Page 55

    Preat OVERDENTURE ATTACHMENT SYSTEM The industry standard overdenture solution is now even better with the new LOCATOR RTx removable attachment system. It provides angle correction up to 30° per implant, with easier seating that eliminates the need for angled abutments. The housings have more aggressive grooves and flats to improve retention in acrylic and are anodized pink for aesthetics and patient confidence where acrylic may be thin. For more information, call (800) 232-7732 or visit preat.com. FREEinfo, Dentsply Sirona CHAIRSIDE CAD/CAM CEREC AC with Omnicam is a chairside solution designed to execute anything from single-visit restorations to digital hybridics and…

32. Page 56

    Trends in All-Ceramic Material Options Kenneth A. Malment, DDS, MScD, discusses his professional expertise and candid perspectives related to all-ceramic dental material options. Dr. Malment, in addition to your position as a clinical instructor at Tufts University School of Dental Medicine (TUSDM) and even more importantly to our GP readers, you are a busy clinician. How does being a practicing Board Certified Prosthodontist and postgraduate continuing education provider shape your view of dentistry? Dr. Malment: I have been a clinical professor in the Department of Postgraduate Prosthodontics at TUSDM for more than 25 years and teach a course each week…

33. Page 58

    Trends in All-Ceramic Material... continued from page 56 quickly and with improving precision. Digital impressions are accurate, and the data has the potential to create a restoration that will fit more precisely than restorations made with any of the different impression materials, stone dies, investment materials, and casting techniques. As always, proper tooth preparations and any required tissue retraction must be acceptable. With each passing year, CAD/CAM technology is improving with the introduction of more precise milling machines that can self-calibrate and replace worn bits automatically. CAD/CAM restorations can be milled today in blocks or in discs where many restorations…

34. Page 60

    Figure 10. Maxillary full-coverage tooth preparations. Figure 11. A digital pantograph (Cadiaix) was used to record the patient's posterior determinants and to set a fully adjustable articulator. The registration allowed a visualization of the canine movements and timing. Figure 12. After the new VDO had been determined and captured in the full-mouth provisional restoration, the dimension was maintained using a leaf gauge. The guided centric relation (CR) was recorded. Figure 13. A full white wax-up can either be made by hand or digitally fabricated. This is tried in to examine tooth position, shape, length, and occlusal planes. Most important is…

35. Page 61

    INTERVIEW 61 In my dental career, nothing has shaped me more than continuing education. the expected growth in minimally invasive dentistry, despite the fact that quite a few modern composite and ceramic materials allow for more thoughtful prep design that saves tooth structure. Knowing that, along with placing a fairly high number of partial-coverage lithium silicate restorations, what are your comments and recommendations to the majority of clinicians who seem to find it easier or "safer" to deliver full-crown restorations instead of more minimally invasive partial-coverage restorations? Dr. Malament: Minimally invasive dentistry has been around a very long time. For…

36. Page 64

    Management of Retrograde Peri-implantitis The Minimally Invasive Tunnel Approach Jonathan Waasdorp, DMD, MS INTRODUCTION Retrograde peri-implantitis, also referred to as an implant peri-apical lesion, can be described as a radiolucent lesion around the apical portion of a dental implant that typically develops within the first few months after insertion.¹ This lesion, which was first described by McAllister et al,² is a rare reported prevalence. Reiser and Nevins³ reported foci among 3,800 implants placed (0.26%), while Quirynen et al⁴ found cases among 539 implants placed (1.6% of maxillary implants and 2.7% of mandibular implants). This lesion can be radiative or active,…

37. Page 66

    Management of Retrograde... continued from page 64 8, along with a horizontal crown fracture (Figure 3). A vertical root fracture was diagnosed, and the tooth was treatment planned for extraction and immediate implant placement. A cone beam computed tomography (CBCT) scan was taken, and impressions were made for an interim partial denture. Immediate provisioning would not be done in this case because the patient thought he would have difficulty in complying with the functional restrictions. In addition, he had no concerns with wearing a removable prosthesis while the implant integrated. Clinical Protocol One hour before surgery, the patient was premedicated…

38. Page 70

    Improving Implant Survival by... continued from page 68 be educated on how to clean their specific prostheses and oral tissues. Patients who are not committed and/or motivated to maintain proper oral hygiene should educated, and their treatment should be suspended until an improvement in behavior and attitude is noticed (Figure 2).21 The entire dental team, including the dental hygienist, dental assistant, and the restorative dentist, should participate in educating the patient on the oral hygiene regimen. Choosing Devices and Clinical Care Guidelines to Optimize Oral Hygiene It is critical to incorporate the most effective oral hygiene devices into each patient's…

39. Page 74

    Electric Handpieces George Freedman, DDS The familiar handpiece is the dentist's basic clinical tool. It is used for tooth preparation, restoration adjustment, surgery, endodontics, and a myriad of other procedures. The variety of tasks assigned to handpieces requires both standardized platforms and specialized accessories. Some handpieces are generic, designed for handling most routine dental office tasks, while others are focused on specific procedures (such as surgical, endodontic, and implant placement). Handpiece technology improvements have occurred at a rapid pace in recent years, enhancing the patient and dentist experience. Electric handpieces were developed in Europe, where it was difficult to connect…

40. Page 76

    ELECTRIC HANDPIECES continued from page 74 Bien-Air Dental Equipped with patented COOLTOUCH+ heat-arresting technology and featuring a ceramic push button, the EVO.15 is the only contra-angle proven never to exceed human body temperature. After years of research and development, it is geared to protect both the patient and the clinician during some of the profession's most frequently performed procedures. Additionally, EVO.15 features a considerably smaller and lighter shockproof, stainless steel head and premier technological innovations ranging from a new spray illumination system to an improved bur locking system. For more information, call (800) 433-BIEN or visit bienair.com. FREEinfo, Brasseler USA…

And 18 more pages — read the whole issue.