Dentistry Today — September 2015

Inside this issue

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

1. Page 6

   Implants Today Section Debut This issue is the debut of Implants Today, led by our distinguished new implant editor, Dr. Michael Tischler. According to our observations and knowledge of the profession, major growth is occurring among the general practitioners, and our goal is to embrace and support this dynamic move. In this new section, I have directed our editorial team to take every advantage of Dentistry Today's high circulation and top readership ratings to aim squarely at GPs, providing relevant content for clinicians new to implants as well as those with more experience. Our goal is to share practical and…

2. Page 8

   Conflict of Interest Revisited: Law Versus Ethics In the past, Texas State Board of Dental Examiners members engaged in behavior that raised ethical concerns. In 2007, it was reported that a member of the State Board had appeared as an expert paid witness for the defense in a malpractice trial of a dentist who had also been the subject of complaints to the Board. At that time, it was legal for a member of the State Board to appear as an expert witness in a malpractice trial. However, some questioned whether such expert witness testimony created an appearance of impropriety.…

3. Page 10

   VIEWPOINT continued from page 8 honest mistake should result in loss of licensure. However, I also believe that a responsible professional organization can serve the long-term interests of the profession when it strongly supports the removal from practice of those dentists whose practice the greatest continuing threat to public safety and health. I applaud the efforts of Representatives Fletcher and Kolkhorst to make state law more supportive of good ethical practice. But more remains to be done. First, Texas should consider and adopt effective sanctions against general dentists who falsely claim expertise that the record of their professional education, training,…

4. Page 12

   This month on Technique of the Week Direct Composite Restoration Rolando Nunez, DDS, MSc Rolando Nunez, DDS, MSc, an aesthetic and restorative expert, presents a step-by-step technique for a Class I direct composite restoration using TheraCal LC as a liner. He demonstrates this procedure, using ALL-BOND UNIVERSAL dental adhesive to ensure a durable bond and long-lasting restoration. Watch as Dr. Nunez uses a light-cured restorative composite to fill the cavity and concludes by creating a durable restoration that polishes to a high-luster finish. This video can be seen on our homepage, . CEREC 30th Celebration Coverage From Las Vegas The…

5. Page 14

   FOCUS ON: New Zirconia Restorations Rella Christensen, PhD, discusses the newest in zirconia restorations and how zirconia is changing. Q: Why is zirconia a hot topic in 2015? A: This is the year translucent zirconia with new formulations, new molecular structures, and new physical properties became available. More translucent formulations open the option for zirconia use on anterior and posterior dentitions, and start an aggressive race among competing companies to win market dominance. Since all the companies are using similar raw product from Japan or China, their challenge is to develop unique characteristics that distinguish their product. BruxZir (Glidewell Laboratories)…

6. Page 16

   From the June 2015 Issue BIOACTIVE VARNISH Shofu Dental PRG Barrier Coat effectively treats dental hypersensitivity by providing immediate and long-lasting relief. A light-cured bioactive varnish with extended protection time of up to 6 months, it incorporates Shofu's proprietary 6NOMER technology, "Surface Pre-Reacted Glass," for high fluoride release and recharge, acid neutralization, and antiplaque benefits. For more information, call (800) 827-4638 or visit shofu.com. FREEinfo, BUR BLOCKS Brasseler USA Brasseler USA now offers aluminum bur blocks equipped with silicone inserts for optimal bur security and organization. The burs rest within the inserts inside the aluminum block, secured firmly in place.…

7. Page 18

   You've Got the Power Paul Feuerstein, DMD Most practitioners make their airturbine handpiece purchasing decisions based on the model they used in school or perhaps the ones that were used in a former or associated office. You step on the pedal and get to work. No matter how much technology a practitioner uses, there is one common instrument that everyone uses, and the majority of them use one with a 30-year-old design: the airturbine handpiece, a staple in the armamentarium of almost every office. Most practitioners make their purchasing decisions based on the model they used in school or perhaps…

8. Page 20

   Spotlight New Restorative Material Offers a Beautiful, Economical Option for Everyday Dentistry DUBLIN, Calif.—Introducing e.maxP posterior restorations for everyday dentistry, offered exclusively from MicroDental Laboratories. Now, with new e.maxP restorations, dentists no longer have to choose between performance and economics. More translucent than zirconia and PFM, e.maxP has proven e.max performance from the trusted Ivoclar brand, in partnership with the MicroDental network of authorized laboratories. With 360 MPa of flexural strength, e.maxP is monolithic and offers optimal strength that mimics that of natural teeth. MicroDental's proprietary, systematized production process generates exceptional value for dentists for everyday affordability. In addition to…

9. Page 22

   Spotlight Next-Generation Scanner Offers Faster, Easier Scanning, and Superior Accuracy Among the Device's Features: the Smallest Wand on the Market ST. PAUL, Minn—Offered by 3M Digital Oral Care, the next-generation 3M True Definition Scanner features a new wand with a profile so slim that it's the smallest on the market. The scanner is offered in tandem with 3M True Definition Scanner Software, which supports faster and easier scanning with superior accuracy. The 3M True Definition Scanner was built for fast scanning: once a field is prepared, an adept user can scan a diagnostic arch in as little as 60 seconds.…

10. Page 24

    Spotlight Composite Improves Overall Efficiency and Aesthetics When Placing Class I and II Restorations AMHERST, NY–Ivoclar Vivadent introduces Tetric EvoFlow Bulk Fill, a one-of-a-kind flowable composite that improves overall efficiency and aesthetics when placing Class I and II restorations. With 71% of North American dentists using a flowable composite to line/base their posterior restorations (data on file), Ivoclar Vivadent has developed a flowable composite that offers (1) self-adapting qualities to eliminate voids, (2) dentin-like opacity for a more natural appearance, (3) the ability to cure up to 4 mm increments with one to-second cure, and (4) radiopacity where it's most…

11. Page 26

    Direct-to-Drain System for Dental Offices Designed to Eliminate Condensate Tanks DAYTON, Ohio–Midmark Corp's new VistaCool direct-to-drain drainage system for the dental office is designed to reduce the temperature of sterilizer wastewater and eliminate the risk and need to manually empty messy condensate tanks. It protects staff, reduces sterilizer maintenance, guards drains, and prevents mold and mildew from collecting on cabinets caused by spills and exhaust from condensation systems. In addition, it helps reduce the number of used condensate bottles and tanks, and it can prevent plumbing issues that occur when wastewater is not sufficiently cooled before being poured down the…

12. Page 27

    Achieving Optimal Strength and Retention for Ceramic Crown Restorations The ever-growing world of all-ceramic restorations provides an impressive variety of aesthetic solutions for today's patients. At the same time, it presents a new challenge for clinicians: to choose the right combination of materials for the best result. It can be a dazzling task to pair a luting material with a specific type of ceramic because there are so many options to consider. The goal is to select the ideal substrate for the prosthesis and then cement with a compatible, retentive material. This concept is simple in theory, but in practice,…

13. Page 28

    Spotlight Sectional Matrix System's Optimized Ring, Band, and Wedge Technology Facilitates Contact Creation MILFORD, Del.–DENTSPLY Caulk's Palodent Plus sectional matrix system facilitates contact creation by utilizing optimized ring, band, and wedge technology. The Palodent Plus EZ Coat matrices make the system easier to use, utilizing 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 more information, call DENTSPLY Caulk at (800) 532-2855 or visit palodentplus.com. FREEinfo, New Universal Single-Bottle Adhesive's Versatility Cited INDIAN LAND, SC–VOCO's new Futurabond M+ universal single-bottle…

14. Page 30

    Improved Version of Time-Tested Resin Cement Now Offered Spotlight Screw-Retained Hybrid Dentures Include Lightweight Titanium Implant Bar for Superb Fit and Strength ORANGE, Calif.–Offered by OC Cosmetic Dental Laboratory, Screw-Retained Hybrid Dentures are fabricated using high-tech CAD/CAM technology that includes a lightweight titanium implant bar for superb fit and strength. The dentures are a proven replacement to removable dentures, and the titanium implant bar is designed and manufactured by OC Cosmetics' technicians using the most modern technology. To ensure a superb fit and strength, OC Cosmetics processes the dentures in a high-impact acrylic resin that is extremely resilient against breakage,…

15. Page 32

    Soft Chews' Nutrients Help Dry-Mouth Patients Maintain Oral Health ROSLYN HEIGHTS, NY-To combat reduced salivary flow, which can cause numerous oral care conditions, BasicBites soft chews contain a patented blend of vital, saliva-based nutrients that nourish enamel and produce healthy, alkali-generating bacteria on tooth surfaces. Featuring breakthrough technology developed at Stony Brook University School of Dentistry, BasicBites' saliva-mimicking AlkaGen technology consists of arginine bicarbonate and calcium carbonate. Base-generating bacteria in dental plaque favor arginine, and the breakdown of arginine facilitates sustained alkali production on tooth surfaces. In a healthy pH environment, calcium and carbonate/carbon-ate ions are available to coat and…

16. Page 34

    Implant Enhances Bone Preservation Spotlight Product Line Utilizes New, Practice-Friendly Branding Platform to Re-Emphasize Importance of Whitening LOMPOC, Calif.-DenMat announces new additions to the LumiSmile White Professional Whitening product line. Notably, the in office and take-home whitening solutions now utilize a new brand platform, "Whitening for every smile," to emphasize the importance of whitening in a practice and help dental professionals get more patients to say yes to whitening. The brand platform is designed to make patients feel that professional whitening can make any smile brighter. It includes DenMat's new Practice Building System featuring a bulk package with (1) fifty…

17. Page 35

    Brush Tip Designed Specifically for Application of Viscous Materials RACINE, Wis. Offered by Vista Dental Products, the Spira-Flo brush tip is designed specifically for application of viscous materials, offering controlled delivery of etchants, softer effect or pushing to motion for a stiffer effect. Among the tip's features are its curved cannula for optimal entry, internal spiral channels, and universal luer lock-style hub. For more information, call Vista Dental Products toll-free at (877) 418-4782 or visit vistadental.com. FREEinfo, Have A Better Look resins, and other viscous materials used in most restorative procedures. The length of the tip's brush fiber can be…

18. Page 36

    Primer's Bond-Enhancing Qualities Cited EDGEWOOD, NY—The perfect adjunct to any resin cement, Parkell's new EaZy-Primer is specifically formulated with an MDP monomer added to a MMA, which enhances the bond to the silica-free, polycrystalline structure of zirconia. It will also work well with lithium disilicate and porcelain in conjunction with adhesive resin cements. And with EaZy-Primer, users can eliminate the need for hydrofluoric acid and the risks that come with it, such as discomfort if it comes in contact with soft tissue. For more information, call Parkell at (800) 243-7446 or visit the website parkell.com. FREEinfo, Prophy Paste/Desensitizer Offered WEST…

19. Page 37

    Saliva Ejector's Locking Mechanism Eliminates Possibility of Tip Dislodging From Suction Line NEW YORK CITY–SecureTip is the only saliva ejector designed with a locking mechanism to eliminate the possibility of the tip dislodging from its suction line. This design allows it to screw securely into the valve, resulting in an ejector that functions like a single bonded piece. This prevents slips, drops, and the need to replace o-rings, which saves both time and money. SecureTip's ergonomics include a soft head to ensure patient comfort as well as an embedded copper wire that allows the tube to retain its shape upon…

20. Page 39

    Spotlight World's First All-in-One Forceps and Matrix Ring Introduced MEZZOVICO, Switzerland—Polydentia's MyClip is the world's first sectional matrix ring combined with forceps. Forget buying expensive forceps for every type of matrix system you have in your office and avoid sterlizing mountains of forceps every evening. Utilize this innovative and smart dental device to make your clinical life faster, easier, and less expensive. For more information, email marketing@polydentia.com. FREEinfo, Material Reproduces Reliable Impressions of Highest Detail THE VILLAGES, Fla-Bona-sil A+ VPS impression material has the optimal combination of physical and mechanical properties working together to reproduce reliable impressions of the highest…

21. Page 40

    NEWS/TRENDS Industry News Ultradent Products to Be Global Distributor of Uveneer Template System South Jordan, Utah-based Ultradent Products announced recently that it will be the global distributor (with the exception of Australia, Israel, and Norway) of the Uveneer Template System, the only direct composite veneer template system currently available in the dental market. For more information, call (800) 552-5512 or visit ultradent.com. Sure Business Logic Opens New Headquarters Sure Business Logic, a company specializing in developing sales programs creating branding awareness, announced recently the opening of its new headquarters in Port Washington, NY. According to Ed Matthews, Sure Business Logic's…

22. Page 42

    Emergency Room Visits... continued from page 40 despite an adequate supply of dentists. These findings suggest that even in states whose Medicaid programs offer expanded dental coverage, patients may have difficulty locating dentists who accept Medicaid. The rate of dentists who accept Medicaid has been reported to be as low as 11% in Missouri, 15% in Florida, and 20% in New York. "Faced with pressure to cut costs, some states have lowered Medicaid reimbursement rates for dental services, which reduces the incentive for dentists to participate in the program," the study noted. The recession that began in 2007 led to…

23. Page 43

    NEWS/TRENDS Researchers Turn to the Silkworm to Regenerate Salivary Gland Cells The silkworm, which produces the essential ingredient for fine silk fabric, now also plays a critical role in a new process designed to provide relief for millions of individuals with xerostomia (dry mouth). A research team led by Chih-Ko Yeh, BDS, PhD, from the University of Texas Health Science Center at San Antonio, is using silk fibers as a framework to grow stem cells into salivary gland cells, which are critical to good health and have little regenerative capability. Silk is a good choice for stem cell scaffolding because…

24. Page 46

    Test 189 dentalCEtoday.com A Review of E-Cigarettes and Related Health Issues This article discusses electronic nicotine delivery systems (ENDS), or "e-cigarettes," including related regulatory and oral/public health issues. Alison L. Glascoe, DDS, MS, is an associate professor in the department of preventive services at Howard University College of Dentistry in Washington, DC. She is a Diplomate of the American Board of Periodontology, and maintains a private periodontics practice in Baltimore. She can be reached at aglascoe@howard.edu. Tobacco usage remains a significant public health issue today. The inhalation of smoke from burning tobacco use remains the single largest preventable cause of…

25. Page 47

    human periodontal ligament (PDL) cells. Furthermore, with regard to cytokine modulation, Jabbour et al39 reported that nicotine differentially regulated IL-1 and IL-8 production by gingival keratinocytes. Wang et al40 reported the functional expression of a7nAChR in human PDL fibroblasts and rat periodontal tissues. Zhou et al41 reported that nicotine deteriorated the osteogenic differentiation of human PDL stem cells in a dose-dependent manner through activation of a7nAChR/NF-kB regulating the Wnt pathway, inducing an osteogenic differentiation deficiency. Furthermore, Breivik et al43 reported that nicotinic acetylcholine receptor activation enhances the susceptibility to periodontitis. Tinti and Sozz43 reported that the results of a human…

26. 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. PRG Barrier Coat Shofu Dental Dental hypersensitivity is one of the most common presenting complaints that dentists face every day. For the busy practitioner, it is also one of the most frustrating challenges. Tooth sensitivity can be caused by a variety of factors, some self-inflicted by diet, habits, wear, and trauma. Patients are typically looking for instant, long-term relief that is as noninvasive as possible. Shofu Dental's PRG Barrier Coat is the first glomer (rechargeable)…

27. Page 50

    ards Visit dentaladvisor.com for more information DIRECT RESTORATIVE TOP HANDPIECE — AIR-DRIVEN Statis ML +++++ SciCan | (800) 572-1211 | scican.com TOP HANDPIECE — ELECTRIC Ti-Max Z95L +++++ NSK Dental LLC | (888) 675-1675 | nskdental.us The Ti-Max Z95L is a high-speed (1.5 increasing) contra-angle attachment for e-type electric motors. The Ti-Max Z series of attachments are designed to offer improved visibility through the reduction of head and neck size. This product received a 98% clinical rating. • "This is a high-quality handpiece—quiet, vibration-free, and dependable." • "Gets into tight areas well." • "Small head." • "Curved angle improves access."…

28. Page 52

    ards Visit dentaladvisor.com for more information TOP BUR — DIAMOND/CARBIDE NeoDiamond +++++ Microcopy | (800) 235-1863 | neodiamond.com NeoDiamond is a disposable, individually packaged and sterilized diamond bur. It uses Triton bonding to fasten diamonds to a Swiss-made stainless steel shank that exposes 20% more diamond cutting surface. It is single-use diamond, it is available in extracoarse, coarse, medium, fine, and very fine grits in packs of 25. This product received a 96% clinical rating. • "Sterile packaging, good quality, wide variety of shapes." • "I liked the speed of reduction and lack of clogging." • "An excellent bur for…

29. Page 54

    ards Visit dentaladvisor.com for more information TOP 5TH GENERATION BONDING AGENT iBOND Total Etch ++++½ Heraeus Kulzer | (800) 431-1785 | heraeusdentalusa.com TOP 6TH GENERATION BONDING AGENT, TYPE 1 CLEARFIL SE PROTECT +++++ Kuraray America | (800) 879-1676 | kuraraydental.com TOP 6TH GENERATION BONDING AGENT, TYPE 2 ACE ALL-BOND SE +++++ BISCO Dental Products | (800) 247-3368 | bisco.com [Image showing ACE All-Bond SE product and applicator] ACE ALL-BOND SE is a self-etching (6th generation, Type II) bonding agent that combines etching, priming, and bonding in a dual-chamber cartridge dispensing system. It is a light-cured, ethanol/water-based, self-etching adhesive containing acidic…

30. Page 55

    ECTANT TheraCal LC ++++ BISCO Dental Products | (800) 247-3368 | bisco.com TheraCal LC is a light-cured, resin-modified calcium silicate material that performs as a barrier and protectant to the dental pulpal complex. It is indicated for direct and indirect pulp capping and as a protective base/liner under restorative materials, including composite, amalgam, and cements. The formulation consists of tricalcium silicate particles in a hydrophilic monomer that stimulates hydroxyapatite and secondary dentin bridge formation through calcium release and an alkaline pH. This product received a 96% clinical rating. • "I would switch; I love this product!" • "No mixing required,…

31. Page 56

    ards Visit dentaladvisor.com for more information posite is designed for use in anterior and posterior direct restorations. It may also be used for core buildups, splinting, and indirect restorations including inlays, onlays, and veneers. This product receiving a 92% clinical rating. • "Wide shade selection." • "The enamel shades give good depth for most anterior multilayer/shade restorations." • "Composite stays where placed and is easy to sculpt." • "Good color match and very nice surface finish." • "Color wheel is complex." • "Sticky and harder to handle than 3M ESPE Filtek Supreme Plus." • "Organize the shades in the kit."…

32. Page 57

    Use FREE Info Cards on pages 1 and 49 (superfine) polishing disks included in the original Super Snap polishing system. It is a 4-step disk system that includes black (coarse) and violet (medium) disks for contouring and finishing plus green and red disks for polishing composite restorations. The grit on the polishers contains aluminum oxide and there is no metal center on the disk. The Super-Snap X-treme red and green disks are thicker and stiffer in order to increase durability and tactile feel. These composite polishers contain a 98% clinical rating. "Produced a glass-like finish to composite restorations." "Distinct color…

33. Page 58

    ards Visit dentaladvisor.com for more information TOP SOFT-TISSUE LASER NV Microlaser +++++ DenMat Holdings, LLC | (800) 4DENMAT | denmat.com NV Microlaser is a cordless diode laser designed to deliver laser energy in either a continuous wave or pulsed mode. The laser features an LCD screen for selecting modes, preset procedures, aiming beam, and beeping volume. Each nonsterile, disposable fiber tip is individually wrapped and is prescored and prestripped. The unit contains a magnet, which snaps the tip into place and aligns the tip with the laser aperture. When the tip is connected, there is a visual verification indicating proper…

34. Page 60

    ards Visit dentaladvisor.com for more information TOP CEMENT — TEMPORARY, NONEUGENOL RelyX Temp NE Zinc Oxide Noneugenol Temporary Cement +++++ 3M ESPE | (800) 634-2249 | 3mespe.com RelyX Temp NE is a noneugenol, zinc oxide temporary cement formerly known as Provem. This 2-paste system is supplied in plastic tubes of catalyst (16 g) and base (36 g) pastes. Equal lengths are dispensed onto a pad and mixed to a uniform consistency. Working time is 3:30 and intraoral setting occurs in 3:30. This product received a 96% clinical rating. • "My assistants love the tubes; easy to use, not messy." •…

35. Page 62

    ards Visit dentaladvisor.com for more information TOP PROVISIONAL — LONG-TERM Protemp Plus Temporization Material ++++½ 3M ESPE | (800) 634-2249 | www.3mespe.com Protemp Plus Temporization Material is a 2-component composite with a new generation of fillers for fabrication of interim restorations. It is packaged in 50-mL automix cartridges and is available in 5 fluorescent shades: A1, A2, A3, B3, and Bleach. The introductory kit contains one cartridge of Protemp Plus Temporization Material, dispenser, mixing tips, RelyX Temp NE Temporary Cement, and 2-g syringe of Filtek Supreme Plus Flowable Restorative to be used when needed for repair of the temporary. This…

36. Page 63

    RMERS TOP LONG-TERM PERFORMER — COMPOSITE Tetric EvoCeram +++++ Ivoclar Vivadent | (800) 533-6825 | ivoclarvivadent.com Tetric EvoCeram is a universal, nanohybrid composite indicated for Class I, II, III, IV, and V restorations; veneering anterior teeth; splitting of mobile teeth; and repair of ceramic and composite veneers. It takes advantage of nanotechnology to allow for better polishing and lower shrinkage. It is packaged in pre-coded, unit-dose Cavifils and 3-g. color-coded syringes. Both the syringe and the unit-dose packages come with a custom shade guide. This product received a 96% clinical rating. • "I loved the way it blended with the…

37. Page 64

    ards Visit dentaladvisor.com for more information ly after cementation and was replaced. During the 2-year period, BruxZir has proven to be excellent restoration with respect to aesthetics, resistance to fracture/chipping, resistance to marginal discoloration, wear resistance, and retention. This product received a clinical rating of 98%. • "BruxZir restorations had a high rate of acceptance by patients." • "Great option for second molars because minimal occlusal reduction is required (0.5 to 1 mm)." • "The recalled BruxZir restorations looked great and had excellent anatomy and surface finish." • "The strength of this material makes it ideal for heavy bruxers." FREEinfo,…

38. Page 74

    Marrying Clinical Techniques and Teamwork Our editor-in-chief, Dr. Damon Adams, interviews Ross W. Nash, DDS, and Debra Engelhardt-Nash, AA, BFA, about their collaboration of clinical dentistry and practice management. Tell us a little about your beginnings. When and how did you become involved in dentistry? Ross: I graduated from North Carolina State University with a bachelor of science degree in textile technology and went to work for DuPont in a nylon yarn manufacturing plant as a process engineer. In this role, I was able to learn a lot about how polymers (plastics) work. In 1972, I accepted a job with…

39. Page 76

    Marrying Clinical Techniques and... continued from page 74 dentistry and me, personally. Light-cured composite resins came on the scene. There were no light-cured composites when I was in dental school. We had a few chemically cured materials that could be used for a few procedures. Class III composites could be placed after etching the enamel margins with 50% phosphoric acid for 60 seconds and rinsing and drying to achieve the frosty, micromechanically retentive surface that was readily bonded to with a resin bonding agent. Dentin bonding was not performed, so the enamel bond and mechanical undercuts were expected to hold…

40. Page 78

    Marrying Clinical Techniques and... continued from page 76 team members, there was now a blending of responsibilities and skills enhancing patient management. Cross-training was not optional—it was required. The auxiliary who could blend clinical experience with exceptional communication skills became the employee in demand. Intraoral cameras were first introduced in the late 1980s and were met with great hesitation in the dental practice. Hygienists were using them as coat racks and not as they were intended—as patient education tools. Auxiliaries were resentful of the additional time required to give patients a "tour" of their mouth. As this technology improved and…

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