Dentistry Today — September 2012

Inside this issue

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

1. Page 4

   Now, combine the best live TV with your custom messaging. Introducing DIRECTV® Message Board. Only DIRECTV's industry-leading technology combines the best TV lineup with a powerful new marketing tool. Our revolutionary Message Board lets you overlay your messaging onto live TV so you can communicate with your customers in a way they can't ignore. This web-based system is simple to use and makes it easy for anyone to create or update messages within minutes across one or more locations, from anywhere at any time. You don't need expensive media players, special software, content, licenses or extra hardware. FREEinfo, on card…

2. Page 12

   Striking a Balance This month, we focus our issue on the implementation and impact of technology in dentistry. Not a year goes by without our witnessing a plethora of innovations, advances, and various improvements on the products and equipment used to deliver patient care throughout our ever-shrinking world. Despite advances in technology that allow the dental team to do some incredible things, the clinician must still properly develop and apply a patient centered philosophy of care in order to enjoy meaningful success. A given technology alone, no matter how advanced, is simply not enough to ensure success in every situation.…

3. Page 14

   How to Get Social Media Results in Your Practice The Internet seems like an obvious place for anyone with a unique product or strategy to sell to the general consumer. The success of companies like eBay and Amazon are obvious examples of that statement. However, service businesses (like dentistry) do not seem to have it that easy. Making a sale online is extremely difficult for a service business because of the constantly changing variables that affect each sale. Some of these variables include the facts that the viewer might not be seeing your information during normal business hours or may…

4. Page 16

   VIEWPOINT continued from page 14 consumers seek health related information as well as how they choose their healthcare providers. According to a recent survey by Pew Research Center's Internet and American Life Project, 61% of Americans turn to the Web for online medical advice and information. When done correctly, social media presence for your dental practice will give you the ability to instantly connect with the public and distribute your practice message. However, many practices that engage in a social media campaign do so by either dipping their toe in the water or jumping in with gusto before they have…

5. Page 18

   Global Dental Solutions, LLC is a full service dental laboratory dedicated to your success since 2001. Our consistently low remake rate and competitive pricing make us the laboratory capable of handling all of your needs. We offer free round-trip shipping, via FedEx preprinted labels or local courier. And, our owners are on site, five days a week. Just a sampling of our products CROWN & BRIDGE Full Contour Zirconia Cadent IPS Authorized Laboratory IMPLANTS Atlantis Custom Milled Abutments Titanium, Gold/due Ti, Zirconia Round-house implant supported bridges with gingival shaded porcelain CEREC Registered laboratory REMOVABLES Lightweight Cr-Co Partial Frames Custom Overdenture…

6. Page 21

   Make it e.max! Everyday Dentistry, Everyday IPS e.max! BY DR. AMANDA SEAY Every day, we dentists encounter different patients with unique restorative treatment needs, yet time and again we may tend to reach for the "everyday" solution that served us well since dental school—the PFM. It seems that regard less of tooth structure, spacing issues, mobility, or periodontal health, the PFM is a go-to everyday solution, especially for the posterior. Today, the use of IPS e.max is growing in popularity among everyday dentists for several reasons. First, we can seat IPS e.max restorations using either conventional cementation or adhesive bonding…

7. Page 22

   Dentistry Today.com Providing you with news and information from the industry leader in clinical content. Visit Our Site Today! Technique of the Week Single Implant Placement Brady Frank, DDS Dr. Brady Frank, of Ashland, Ore, presents a preparation of the implant abutment in this high-definition video. Dr. Frank describes the exact steps prior to entering the mouth and then proceeds on a fresh extraction area. The 3.8 mm drill used for the "mini envelope incision" will allow the space to fit a small-diameter implant system securely in the mouth. Dr. Frank demonstrates how this is a quick procedure that is…

8. Page 23

   FOCUS ON: Lasers Scott D. Benjamin, DDS, reviews dental laser basics. Q: What does a laser do? How do lasers work? A: Today, more than 30 indications for use of lasers have been cleared from the US FDA for oral procedures. However, it is important to understand that dental lasers use light based technology function in 2 ways: (1) to vaporize tissue, and (2) to stimulate a response from the target that is absorbing the light energy. This may seem very simplistic, but it is extremely accurate in the way a laser performs. Lasers ablate tissue, meaning the removal of…

9. Page 24

   From the June 2012 Issue MATRIX BAND Garrison Dental Solutions The revolutionary Blue View VariStrip solves the clinical problems associated with the highand low-speed polishing definition after a restoration is in place. It is a precontoured anterior matrix that has been manufactured with an optimal curvature to facilitate composite placement with maximal adaptation to the rounded margins of the preparation. For more information, call (888) 437-0032 or visit garrisondental.com. FREEinfo, TORQUE WRENCH 3M ESPE The Graduated Torque Wrench gives dentists a torque and ratchet feature in one simple tool. With easy-to-read custom torque markings that provide a continuous readout, it…

10. Page 26

    NEW PRODUCTS GINGIVAL RETRACTION PRODUCT 3M ESPE Designed with an extrafine tip that can be inserted right into the sulcus, the 3M ESPE Gingival Capsule is the first gingival retraction product that delivers astringent retraction paste using a common composite dispenser. Compared to retraction cords, it can cut up to half the time from the gingival retraction procedure, and it is 30% faster than the leading retraction paste. For more information, call (800) 634-2249. FREEinfo, SENSOR SLEEVES Flow Dental Comfee's Deluxe Sensor Sleeves are made from soft, textured vinyl material that reduces surface resistance so sensors slide in effortlessly, and…

11. Page 28

    Spotlight New Intraoral Camera Provides Unique Color Capture of Images While Offering Powder-Free Operation CHARLOTTE, NC–Sirona Dental Systems' new CEREC Omnicam intraoral camera features a completely new, ergonomic handpiece and special optics to guarantee unsurpassed intraoral access, and its new ColorStreaming allows continuous capture of the oral cavity as well as display of 3-D data in full color—an industry first. Additionally, operator convenience has been improved by making the CEREC Omnicam system completely powder free while retaining Sirona's high standards of precision. Other new features and benefits of the camera include the following: (1) it records 2-D and 3-D data…

12. Page 29

    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…

13. Page 30

    Spotlight Popular Dental Chair and Delivery Unit Introduced to North American Market CHARLOTTE, NC-Cefla Dental Group introduces the Stern Weber S250 dental chair and delivery unit to the North American market. A bestseller in Europe and the Middle East, it combines stunning Italian design and brilliantly integrated details for precision performance and patient comfort. From memory foam upholstery to integrated high-speed handpieces, digital radiography, and top-of-the-line hygiene solutions, the unit conveys the ultimate in luxury and innovation. Dentists can choose between continental and international delivery units and customize both doctor's and assistant's trays. Dynamic instrument parameters and electronically controlled pneumatics…

14. Page 32

    Spotlight Software Simplifies Administrative Tasks, Improving Practice Productivity ATLANTA Carestream Dental CS SoftDent v15.0, the latest version of the popular practice management software, features the Scheduler (shown), the most advanced scheduling software in the oral health industry, designed to give practice administrators a better handle on the interrupting environment of the front desk. It is intuitive and easy to use, delivering multilingual capabilities so users can easily resume partially completed tasks. And users can add and schedule patients in one simple step with the advanced drag and drop functionality. Further simplifying the scheduling process, CS SoftDent automatically checks for duplicate…

15. Page 33

    MINIMALLY INVASIVE DENTISTRY "Do No Harm" John J. Graeber, DMD The ADA clearly states in its Code of Ethics that in relation to patient care, a dentist must "do no harm." Most practitioners think of these words and feel they indicate some gross injury that might inflict on a patient. However, more often, the harm done to tooth structure is in the form of microfracturing during routine restorative procedures. It has been well understood that the high-speed handpiece causes microfractures in the tooth structure. These microfractures are primarily caused by the electricity of rotary instruments operating within the "high-speed range."…

16. Page 34

    To assist practitioners in their selection of essential dental products, Dentistry Today presents items reviewed by THE DENTAL ADVISOR'S staff of editors and consultants. Established in 1984, THE DENTAL ADVISOR, based in Ann Arbor, Mich, has provided dental professionals worldwide with objective, accurate information using in vivo and in vitro results on the performance of materials and equipment based on clinical and laboratory research. For more information, visit dentaladvisor.com or call (800) 347-1330. Quick Up +++++ VOCO | (888) 658-2584 | voco.com/us Consultants' Comments • "Very complete kit." • "Makes placing connectors much easier." • "Quick Up LC prevents locking…

17. Page 36

    36 . 1 INNOVATIONS Spotlight New Self-Adhesive Cement Engineered to Bond to Zirconia ENGLEWOOD, NJ–DMG America's new PermaCem 2.0 permanent cement provides one of the strongest bonds to zircorum restorations compared to other leading self-adhesive cements. Utilizing both chemical and mechanical adhesion, its dual-curing properties offer an exceptional bond across all substrates, including zirconia. Formulated for easy cleanup, PermaCem 2.0's optimized viscosity and no-drip formulation provide for the fastest and easiest removal of excess of all self-adhesive cements, resulting in less stress and chair time for the clinician. Plus, as a single-step cement, it provides clinicians with the added benefit…

18. Page 38

    Spotlight Post Procedure Kit Features Matched Materials Used From Cementation to Final Core Buildup BRIARCLIFF MANOR, NY- VOCO America's Post Procedure Kit features matched materials used from post cementation to final core buildup, including 3 sizes of Rebilda Posts—dentinlike, flexible glass-fiber posts with high radiopacity, high translucency, and excellent light conductivity—with matching tapered drills. The kit has been developed with the input of dentists, whose recommendations led to the inclusion of many procedure-oriented features. Application aids such as special brushes, tips, and tweezers. All materials match each other and take the guesswork out of the procedure, leading to faster, more…

19. Page 40

    Spotlight Rigidity and Accuracy the Hallmarks of New Anterior Dual-Arch Impression Tray SOUTH JORDAN, Utah--Rigidity and accuracy are synonymous with Trident's new reusable Trioarch Anterior Dual-Arch Impression Tray. Made from polished stainless steel, the uniquely designed tray will fit the naturally convex jaw profile and fully covers the upper and lower teeth, giving maximum support to the impression material. The tray's concavity produces a uniform impression material thickness on the labial side and ensures that the upper and lower impressions "lock in" without the need for adhesive. Also unique is the insert hedonic design, which directs impression material toward the…

20. Page 41

    Second Generation of Clinically Successful Resin-Modified Glass Ionomer Cement Introduced ALSIP, Ill–GC America introduces GC FujiCEM 2, its second generation, resin-modified glass ionomer luting cement. Following 10 years of clinical success with GC FujiCEM, GC FujiCEM 2, powered by F2 Flex Fuse Technology, incorporates high-elastic cross-linking monomers with a modified filler surface treatment to increase strength properties all around. Indicated for a broad array of indirect restorations—including all types of metal, resin, alumina, and zirconia-based inlays, onlays, crowns, and bridges—GC FujiCEM 2 delivers superior bond strength while allowing you to do more restorations in less time. With its F2 Flex…

21. Page 42

    Spotlight Flowable Composite Enhanced With Addition of New Shades, Improved Delivery Design AMHERST, NY–Ivoclar Vi-vadent has made its Tetric EvoFlow composite even better, enhancing the material by introducing additional shades and new translucencies, adding an extra fine application tip, and improving the delivery to a more ergonomic design. Tetric EvoFlow is indicated for all flowable indications. Its viscosity is "flowable when desired and stable as required," meaning it can be used effectively as a liner but is also nonsagging in Class III and Class V restorations. Doctor Vivadent has expanded Tetric EvoFlow's shade range, now offering 3 levels of translucency.…

22. Page 46

    NEWS/TRENDS Industry News Air Techniques Appointments John Scott President Melville, NY based Air Techniques has announced the appointment of John Scott as its president. Mr. Scott recently joined Air Techniques as vice president of sales and marketing and has more than 7 years of experience in the dental industry. He is an active member and committee chairman of the Dental Trade Alliance, a member of the ADA's Exhibit Advisory Committee, and a member of the corporate council for the American Dental Education Association. When asked to discuss his goals for Air Techniques, Mr. Scott responded, "It is important to maintain…

23. Page 48

    ADA Honors Dr. John S. Greenspan for His Landmark AIDS Research The ADA announced recently that it has named John S. Greenspan, PhD, as the recipient of the 2002 ADA Gold Medal for Excellence in Dental Research in recognition of his landmark AIDS research. Dr. Greenspan is (1) a distinguished professor of oral biology and pathology and associate dean for global health at the University of California, San Francisco School of Dentistry and (2) a distinguished professor of pathology and director emeritus, AIDS Research Institute, at the UCSF School of Medicine. "This award acknowledges Dr. Greenspan's groundbreaking research in the…

24. Page 50

    Coronectomy Versus Total Removal for Third Molar Extraction A systematic review by H. Long et al compared the outcomes between coronectomy and total removal for third molar extractions with high risk of nerve injury, with the goal of helping practitioners make prudent decisions on whether and how third molars should be removed. PubMed, Embase, Web of Science, CENTRAL, and SIGLE were searched from January 1990 to October 2012 for randomized or nonrandomized controlled trials. Four studies met the inclusion criteria. The pooled risk ratio (coronectomy versus total removal) was 0.11 (95% confidence interval [CI] = 0.03 to 0.36; I 03…

25. Page 52

    In First Impressions, George Freedman, DDS, gives readers a brief summary of products that have recently been introduced to dentistry, based on his clinical experience. Scotchbond Universal Adhesive 3M ESPE The profusion of adhesive materials can boggle the clinical mind. There are more than 200 adhesive products available to practitioners today, leading to many questions: Which one to use? Under what conditions? For which indications? Is it better to stock a different bonding agent for every major indication and procedure? 3M ESPE has introduced Scotchbond Universal Adhesive, a single bottle solution for all dental surfaces that can be used predictably…

26. Page 54

    Hygiene Update Fluoride Toothpastes for Preschool Children A systematic review and meta-analysis assessed the effects of fluoride (Fl) toothpastes on the prevention of dental caries in the primary dentition of preschool children. The review searched for randomized or quasi-randomized clinical trials, without idiom restraints, in 6 electronic databases, registers of ongoing trials, meeting abstracts, dentistry journals, and reference lists of potentially eligible studies. The search found 1,932 records and 159 full text articles; 2 examiners independently read these documents. Data regarding characteristics of participants, interventions, outcomes, length of follow-up, and potential of bias were independently extracted by 2 examiners on…

27. Page 55

    An Oxygenating Agent and Chlorhexidine-Induced Extrinsic Tooth Staining Chlorhexidine digluconate (CHX) mouthwash is effective for reducing plaque and gingivitis, but one of its side effects is extrinsic tooth staining. Oxygenating agents may reduce this staining. A review systematically searched the literature for data concerning the inhibiting effect of an oxygenating agent (OA) on CHX-induced tooth staining. Electronic databases were searched for articles including randomized controlled trials or controlled clinical trials conducted with healthy subjects aged 16 years that compared the effects of CHX mouthrinse combined with an OA with the effects of CHX alone. An independent screening of 1,183 titles…

28. Page 56

    Saving Lives: Toothbrushes Trump Seat Belts INTRODUCTION Yes, you read the title correctly. As important as seat belts are as a preventive measure, toothbrushes have a far greater impact on the health and longevity of the American public. According to the National Highway Traffic Safety Administration (NHTSA), seat belts save about 13,000 lives a year, nationwide. That is no small number: more than 3,000 Americans each month owe their lives to the 3 seconds it took them to "buckle up." NHTSA points out that seatbelts reduce a person's chances of dying in a crash by 45 percent, and being injured…

29. Page 57

    lack of exercise, not genetics; and no, it is not periodontal disease. Rather it is a combination of these, and other risk factors that add layer upon layer of increased risk of suffering a heart attack. Modern science has come to understand that many chronic diseases such as CVD and cancer are multifactorial in nature, and anything that we can do to eliminate risk factors can go a long way to lengthening our lives. In the past 2 decades there have been hundreds of studies published in the peerreviewed medical journals that show periodontal disease is a risk factor for…

30. Page 58

    DENTAL HYGIENE TODAY fibrinogen, both of which are directly linked to heart attacks. Microbes may also stimulate various tissue factors, which can activate blood coagulation. During the process of coagulation, platelets become trapped in the growing clot (or thrombus). Thrombus formation is one of the key factors in the development of atherosclerotic plaques. As atherosclerotic plaques enlarge, the lumen of the coronary blood vessels narrows and the blood supply to the heart muscle becomes reduced. A heart attack, or myocardial infarction, results when a larger part of the coronary artery lumen becomes occluded. Failing to receive enough blood, the heart…

31. Page 59

    argument against good oral health. It helps us in avoiding painful cavities, saving teeth, and eliminating bad breath and, at no extra cost, it may even save your life. References: 1. US Department of Health and Human Services. National Institute of Health, Periodontal (Gum) Disease: Causes, Symptoms, and Treatments. Bethesda, MD: National Institute of Dental and Craniofacial Research. [Accessed March 2010]. Available at: http://www.nidcr.nih.gov/NR/rdonlyres/4E054CB8076-2052E88F92/0/PeriodontalGum.pdf. Accessed March 2012. 2. US Department of Health and Human Services. Oral Health in America: A Report of the Surgeon General. Washington, DC: U.S. Dept. of Health and Human Services, National Institute of Dental and Craniofacial…

32. Page 60

    Product Focus FLUORIDE VARNISHES GC America MI Varnish is a 5% sodium fluoride varnish with RECALDENT (CPP-ACP). It is unique compared to all the other fluoride varnishes because it brings bioavailable calcium, phosphate, and fluoride to the tooth surface, releasing high levels of fluoride, and it is well known that fluoride is an important tool in the fight against caries. Working in concert with the sodium fluoride in the MI Varnish is a wiser clinical choice for you and your patients. It is indicated for the treatment of hypersensitive teeth. For more information, call (800) 323-7063 or visit gcamerica.com. FREEinfo,…

33. Page 61

    Colgate PredDent 5% Sodium Fluoride Varnish has a strong desensitizing action, treating hypersensitivity quickly and easily. This ready-to-use unit dose product sets rapidly on contact with saliva and dries to a natural enamel color your patients will love. It's available in 2 great tasting flavors, raspberry and mint. You can use it chairside and complement PreDent 5000 liquid gel toothpaste at home for use as a dental caries preventative in adults and pediatric patients. For more information, call (800) 962-2345 or visit colgateprofessional.com. FREEinfo, Sultan Healthcare DuraShield is a professional strength 5% sodium fluoride varnish featuring a hygienically sealed unit-dose…

34. Page 62

    Impacted Maxillary Canines: Diagnosis and Management An impacted maxillary canine is usually diagnosed during a routine dental examination. Disturbance in the eruption of permanent maxillary canines can cause problems in the dental arch and adjacent teeth, which require special care and attention. Therefore, clinicians should be capable of dealing with this clinical situation in order to deliver optimal treatment. Clinicians have various definitions of "impaction." Canine impaction can be defined as an unerupted tooth after its root development is complete, or a tooth still unerupted when the corresponding tooth on the other side of the arch has been erupted for…

35. Page 64

    Impacted Maxillary Canines... continued from page 62 presence of an alveolar cleft, a cystic lesion or neoplasm; ankylosis; dilacerations of the root; an iatrogenic origin; and an idiopathic condition for no apparent reason.1-5 Systemic conditions such as endocrine deficiencies, malnutrition, febrile disease, or irradiation can also account for impacted canines.1-5 Currently, there are a major theories that have been used to explain the cause of maxillary canine impaction: the guidance theory and the genetic theory. The guidance theory states that excess space in the canine area during dental development and eruption owing to an absent or malformed lateral incisor root…

36. Page 65

    ORTHODONTICS 65 exact position and shape of impacted canines possible, which is crucial in treatment planning. Furthermore, it is very helpful in evaluating damage to adjacent teeth and the amount of surrounding bone.31 The major disadvantage of CBCT is the increased amount of radiation exposure, which is at least 4 times higher than with ordinary panoramic radiographs.32,33,34 Therefore, orthodontists should consider cost-benefit outcomes before ordering this radiograph. PREDICTION OF MAXILLARY IMPACTION There are many predictive values and measurements proposed in the literature to help determine the chance of an eventual impacted canine. Ericson and Kurol35 proposed predicting canine impaction using…

37. Page 68

    Test 153 Expiration date of this CE article is September 1, 2015. To submit Continuing Education (CE) answers, use the answer sheet on page 69. Circle the letter corresponding to the answer you believe is correct, detach the answer sheet from the magazine, and mail to the Dentistry Today Department of Continuing Education. Or, use our easy online option at dentaltoday.com. This article is available for 2 hours of CE credit. The following 16 questions were derived from the article Impacted Maxillary Canines: Diagnosis and Management by Jae Hyun Park, DMD, MSD, MS, PhD et al on pages 62 to…

38. Page 70

    Technology: Today, Tomorrow, and Beyond! In an interview conducted by Dentistry Today's editor-in-chief, Dr. Damon Adams, Gordon Christensen, DDS, MSD, PhD, candidly expresses his thoughts on current topics affecting the profession. Dr. Christensen is founder and director of Practical Clinical Courses and CEO of CLINICIANS REPORT, Provo, Utah. What new technology will have the greatest impact on the future of dentistry? Dr. Christensen: I have personally been involved with most of the so-called new technologies in dentistry as they have come onto the dental market. Some of them fit my needs, and I incorporate them into practice, while others are…

39. Page 72

    Technology: Today, Tomorrow, and... continued from page 70 ment. I see the time in the near future when cone beam radiographs will become standard of care for those placing implants. Are there improvements coming in dental radiographic sensors? Dr. Christensen: Yes, but don't hold your breath. There is so much research and development money into the current generation of radiograph sensors that development of new concepts for sensors has been slow. At this time, phosphor plate images made with this, flexible sensors are easier to make and far less traumatic to the patients than charge coupled device (CCD) and complementary…

40. Page 74

    Technology: Today, Tomorrow, and... continued from page 72 devices are now available on the market. Among them are the following: for detection of interproximal caries, Logicon (Carestream Dental); for occlusal caries detection, Spectra (Air Techniques), SoproLife (ACTEON North America), and CariesScan, a 3D Diagnostic Imaging Company. It is anticipated that numerous new devices will come to market soon to attempt to fill this significant void in detection of initial dental caries. With the decrease in costs of lasers, will they become mainstream and be accepted by the ADA and the American Academy of Periodontologists (AAP)? Dr. Christensen: Lasers have been…

And 35 more pages — read the whole issue.