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OPT-In Clinical Updates for October, 2013

• Capturing Margin Details in Impressions...Prevent Remakes

• Announcing Low Cost Lab Alternatives

• A New Category of Permanent Cement, Evidence-based

• OPT-In Laboratory Members Near You

by

Dean Mersky, DDS

Creating Excellence, Partnering in Growth

Who are We and Why are You Receiving This?

In October, 2012, Dr. Dean Mersky formed

A national cooperative of small dental laboratory owners

Dedicated to the growth and viability of Private Practice Dental Offices.

A part of our support is providing doctors with evidence-based

information about materials and techniques key to patient care.

Look for the Logo in Choosing your Laboratory Partner

How We Decide Which Materials and Manufacturer to Feature

Products and services we feature must have benefits supported by independent research and be offered by companies dedicated to education in best practices, or, provide services that support care at the highest levels.

Capturing Margin Details in Impressions

 Increasing Predictability

Decrease Remakes

The Challenges We Face

The traditional procedure for enlarging the space between the gum and the base of the tooth necessary for an accurate C&B impression is tedious, time consuming, and too often painful for the patient. Not exactly a great practice builder! Also, in the event the space between the tooth and the gum is tight or very small, it can become even more difficult to place the cord without injury, raising the danger of accidentally forcing the cord beyond the physiologic tissue limits which can cause periodontal complications. Most of us don't enjoy packing cord, sometimes passing it off to others, which can lead to questionable results.

Alternatives

One way to retract and control bleeding, if the sulcus is large enough, is to place cord and then pack cotton. We might also soak the cord and cotton with Hemodent (Premier) to help control bleeding. Unfortunately, the extra cotton only spreads the sulcus, might not stay in place, and risks tearing the free gingiva. Recently, there have been two products offered  to clinicians to help with these challenges, one uses only a high viscosity gel to control bleeding, the other Traxodent, from Premier, combines a more flowable gel-paste with an optional pressure pad to stabilize the site.

Traxodent, which is formulated as a clay-based version of Hemodent, has the most advantages in this category of products. Traxodent combines distilled water, Aluminum Chloride Hexahydrate (15% by volume), Potasium Sorbate (a salt of sorbic acid that is a preservative and anti bacterial), and Potassium Nitrate (a salt and preservative that is an oxidizer and anti inflammatory). It is the combination of these components that differentiates and makes Traxodent so effective.

To view a live video recording of Traxodent Retraction Technique

http://www.youtube.com/watch?v=7rHUv4zDWKY

To view a live video recording of Traxodent Retraction Cap Technique

http://www.youtube.com/watch?v=bWWJudRfn5c

The Chemistry behind How it Works

Astringents are the substances that precipitate proteins, but do not penetrate cells, thus affecting the superficial layer of mucosa only. Astringents, such as Aluminum Chloride, exert their action topically on the abraded mucosal surface, whereas the hemostatic effect of vasoconstrictors is accomplished through a direct vascular action. Aluminum Chloride has been found to be least irritating and may be left in the sulcus for up to 15 minutes without causing permanent damage. In contrast, Ferric Sulfate acts as a clotting agent, and often, when the string is removed, the clot is pulled out with it, causing hemorrhaging. Additionally, Ferric Sulfate doesn't help with tissue shrinkage as do the components of Traxodent.

Traxodent contains a special clay formula that has been designed to flow into the sulcus, unlike other, high viscosity gels, that need to be injected into the sulcus. Similar  in viscosity to light body impression materials, Traxodent retracts tissue by combining an astringent with physical displacement and chemical absorption that serves as a drying agent. This results in an open, dry sulcus with minimal trauma that has also undergone shrinkage.

Clinical Guidelines

Because the viscosity of Traxodent is comparatively low, the delivery cannula (18-22 ga) is small and doesn't require sub gingival placement. Additionally, the small diameter cannula can be bent to more easily manage its use and make tight areas more accessible.

Traxodent can be allowed to stand for between 2 and 5 minutes, depending upon the amount of gingival crevicular fluid. Immediately prior to the impression:

1. Gently rinse the retraction material away
2. Dry the area around the tooth or teeth
3. Take the impression

Occasionally, obtaining effective retraction will require additional pressure due to inflammation or redundant tissue. The additional step of adding pressure with a specially designed cap placed over the tooth or teeth and gingival sulcus may be used.  The biting pressure of the patient holding the soft cap in close proximity will aid in the retraction of the gingival sulcus. Another variation that can be helpful is a combination technique of packing an initial small cord followed by Traxodent.

Summary

We have been packing cords for decades. It is a process that most of us would rather avoid but, we endure anyway. We know that often the tissue won't cooperate or that, in our efforts, we might make things worse. Scientific innovation has provided us with a worthwhile alternative. Relying on a very familiar and popular product that many of us have used, Hemodent, Premier Dental has combined other components that have the capacity to make our lives easier and our patients more comfortable. The Traxodent system can in part or entirely replace one of the most distasteful parts of C&B, cord packing. It is formulated to displace tissue with ease, control bleeding, dry the area, and, help shrink the tissue by reducing inflammation. If this can make everyone's life easier, at the very least, it is worth trying and evaluating personally.

For more information on the Traxodent System from Premier Dental

visit http://www.premusa.com/dental/restorative.asp#traxodent

Traxodent is available nationally through distributors

Please submit questions or find the right laboratory for your practice

by contacting us at:

info@optindentallab.com

855-321-OPTN (6786)

or visit our website at:

http://www.optindentallab.com/

Announcing New Laboratory Category:

OPT-In Insurance: The Answer to Fee Restrictions

OPT-In laboratories with fees & products

Matched to the needs of insurance budgets

It Should be Easier to

Find the Right Dental Laboratory

OPT-In Dental Laboratory Specialties

OPT-In Laboratories are grouped by their specific expertise

To simplify finding...

The Right Laboratory for your Needs

With Owners Eager to Help

Learn More about OPT-In Laboratory Specialty & Expertise

Visit

http://www.optindentallab.com/dentists/services/choose-a-laboratory-specialities/

BEGO Sponsored CE

Mike Dominguez, CDT/TE & Dr. Alfonso Pineyro

Implant Dentistry: A Team Approach

Saturday, November 9th, 9 a.m. until noon, Pacific

The event will be a live streaming webinar hosted at the Seattle Central Library Microsoft Auditorium, and include everyday implant situations from the perspectives of Prosthodontist and Certified Dental Technician. Presenting together live and live-streamed to different locations, the pair will discuss common complications and solutions for both screw-retained and cementable restorations, as well as, materials, products, and team communication in case planning.

The event is being supported by additional members of OPT-in Dental Laboratory Cooperative who will host live video feeds at their locations throughout the nation. They include, Youngs Dental Lab (Philadlephia, PA), 4 Points Dental (St. Petersburg, FL), Quality Dental (Virginia Beach, VA), King Dental Arts (Bristol, TN), and… Clinicians and technicians will be able to participate in the presentation live through a proctor and live-chat.   

To learn more and purchase tickets

http://dentalimplants.brownpapertickets.com/

Dr. Piñeyro, trained in prosthodontics at the University of Rochester Eastman Dental Center, is an affiliate instructor in the Department of Restorative Dentistry at the University of Washington, past president of the Washington State Society of Prosthodontists, and a founding member of the New Millennium Study Club  A national and international lecturer on implant prosthodonics, he is published in the Journal of Prosthetic Dentistry, International Journal of Oral Maxillofacial Implants, Journal of Esthetic and Restorative Dentistry, and Dentistry Today. 

Michael Dominguez, CDT/TE, graduated from The University of Texas Health Science Center at San Antonio with a Bachelor of Science in Dental Laboratory Sciences, summa cum laude. He founded Kymata Dental Arts, a boutique lab in Seattle, WA, in 2009, and has served on the board of directors for the Washington State Dental Laboratory Association, where he will serve as President in 2014. Michael, a national lecturer on laboratory materials and techniques, has been published and is relied upon by several manufacturers for his expertise in laboratory research and education.

info@optindentallab.com

http://www.optindentallab.com/

A New Category of Permanent Cement

All the Benefits, None of the Drawbacks

The Science Behind Biocactive Ceramir C&B

This Clinical Update is Presented by Your

OPT-In Dental Laboratory Cooperative Partner

http://www.optindentallab.com/dentists/

Experience the Difference an OPT-In Laboratory Owner can Make

To Find the Right Dental Laboratory Partner for Your Practice

Contact Us

info@optindentallab.com

855-321-OPTN (6786)

Next month we will discuss restorative materials & more.

Proud OPT-In Members

Creating Excellence, Partnering in Growth

OPT-In Dental Laboratories...Always Aware of the Clinical Challenges You Face

Call Today and Experience the Difference

Ask for the OPT-In Laboratory Specialty You Need Most

All OPT-In Members own small Dental Laboratories

Dedicated to the successes of the dentists they serve,

The unique needs of each practice, and

Tailored to the individual needs of each patient.

About the Author

Dr. Dean Mersky practiced general dentistry 26 years in Manhattan Beach, CA before spending 7     years    as  director of clinical communication for the Captek Company. Dr Mersky has been a dental lab implant coordinator, a national speaker, authored over a dozen published articles, is a regular on DentalTown.com. He launched OPT-In Management, LLC, in 2012, to help owners of small dental laboratories better understand dentists and the many clinical and business pressures facing today's private practice clinicians.

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