First Impressions: March 2007

In First Impressions, Dr. George Freedman, DDS, gives readers a brief summary of products that have been introduced to dentistry, based on his clinical experience.










Estelite (Sigma)
Tokuyama Dental

The science and technology of composite resin materials has been advancing at a rapid pace for more than 2 decades. Since tooth-colored restorative materials have become the worldwide standard for direct dental restorative treatment, an increasing number of manufacturers have be-come involved in the research and development of new materials. This is very good for the dental profession. Newer and better restorative materials are introduced on a regular basis, and most of these new products address specific clinical concerns that dentists face in everyday practice. The most common practitioner requirements include good aesthetics, easy handling, polishability, high strength, low wear, low shrinkage, and a range of shades. Tokuyama Dental has re-cently introduced Estelite ∑ (Sigma), a light-cured, submicron filler composite resin. The high fill ratio (82% by weight) provides a polishable, highly wear-resistant restorative material that exhibits excellent mechanical strength. Estelite∑’s inorganic fillers range in size from 0.1 µm to 0.3 µm (average size 0.2 µm) and are all spherical submicron particles. The spherical shape of the fillers allows the dentist to rapidly develop an excellent polish and maintains long-term gloss retention in function. Its nonstick handling makes for a relatively problem-free insertion. Estelite ∑’s very low polymerization shrinkage is just more than 1.5%, ensuring that margins stay intact and free of microleakage. It is indicated for both anterior and posterior restorations. Estelite∑ is available in 18 shades with excellent translucency, and the filler technology creates a “chameleon” effect that blends in readily with the existing tooth coloration. It exhibits a minimal color variation during and after curing. Estelite : submicron filler particle technology has arrived.
For more information, call (877) 378-3548 or visit tokuyama-us.com.

LolliCaine (20% Benzocaine)
Centrix



Topical anesthetics should be given prior to any injection. The patient’s comfort is immeasurably increased by a simple, 30-second soft-tissue application. In addition, topical anesthetics are an excellent adjunct prior to periodontal procedures that do not require the more extensive effect of a local or block anesthetic. The major worry with these chairside procedures is the common practice of in-serting a cotton swab into the topical anesthetic jar or container. Even under the best of conditions, cross-in-fection is a concern, and sanitary operatory guidelines are difficult to maintain. The recent introduction of LolliCaine (20% Benzocaine) by Centrix eliminates these hygiene issues and anxieties. LolliCaine is a 20% benzocaine gel topical anesthetic, a product that is familiar to most dentists. It is packaged, however, in an innovative, single-use LolliPack container. Each unit contains a single dose of LolliCaine gel and 1 clean swab applicator. The dentist or auxiliary simply peels back the cover of the LolliPack, dips the sterile swab into the topical anesthetic, and then applies the anesthetic directly into the patient’s mouth. The LolliCaine application package eliminates cross-contaminating jars and the dangers of cross-infection between patients. The 20% benzocaine gel is a fast-acting topical anesthetic that is available in 3 popular flavors and accommodates patients’ preferences. LolliCaine LolliPacks are single-use products, thus simplifying inventory *control. Since the LolliCaine contains everything that is needed for topical anesthesia in a single package, it can be readily given to patients as a take- home treatment adjunct when postoperative pain or sensitivity is foreseen. Self-contained, single-use topical anesthetic is an idea whose time has come.
For more information, call (800) 235-5862 or visit centrixdental.com.

ET Illustra
Brasseler USA


Pre-Polish High-Gloss Shine
After Trimming and finishing and final polishing with ET Illustra. Proper technique with ET Illustra preserves more of your detail surface anatomy and texture for a truly natural, aesthetic result.
ET Illustra on tooth.

There is polishing and there is polishing for aesthetics. The 2 procedures are not at all similar. Polishing results in a smooth surface that is functional and comfortable to the pa-tient’s soft tissues. Aesthetic polishing provides the wet-look shine of natural teeth that patients demand with the current elevated awareness of aesthetics. Not all polishers are the same; in fact, not all polishing instruments were designed for today’s much harder hybrid and microhybrid composite materials. Brasseler USA’s ET Illustra polishers have a proprietary filler shape technology that incorporates abrasive particles that do not have acute angles. This means that during normal rotary polishing, the angle of attack is higher, leaving a smoother surface. (Conventional polisher particles abrade with acute cutting angles, resulting in a microscratching effect of the composite surface. With conventional polisher abrasives, the finer anatomical details are often erased along with the development of the high shine.) ET Illustra’s non-acute cutting angles achieve an excellent, high-gloss shine while more readily retaining anatomical details. ET Illustra seems to have a burnishing or micromilling effect on the composite restoration. The ET Illustra composite polishers have been developed (and in fact are priced) for single use, eliminating cross-contamination and the chore of running these instruments through presterilization and autoclaving. The system involves 2 grits: one for prepolishing and the other for a high-gloss shine. Each grit is available in 3 shapes: cup, disk, and point. Brassler USA’s tradition of concentric metal mandrels eliminates the wobble that can complicate polishing. (Nonconcentric polishing paths are far too aggressive.) The wobble is a major contributor to handpiece turbine degradation and failure.
For more information, call (800) 841-4522 or visit brasselerusa.com. (In Canada, call [800] 363-3838.)


Excel Bond LC
J. Morita USA


1. Before restoration. 2. One drop of Agent A.
3. One drop of Agent B. 4. Mix A and B for 5 seconds.
5. Apply Excel Bond LC. 6. Light-cure for 10 seconds.
7. Place resin. 8. Completed restoration.
(Photos courtesy of Dr. Ian Shuman.)

The sheer number of currently available dental bonding products is mind-boggling. For the practitioner, it is imperative that the materials are simple to use and effective. For the patient, a bonding agent must function long-term to ensure adhesion to the enamel, dentin, and the overlying restorative materials. For the auxiliary, the adhesive must be easy to prepare or mix. Excel Bond LC, recently introduced by J. Morita USA, is a self-etch bonding system characterized by its simplified application and excellent bond strength. Since it is self-etching to tooth structure, it can be used with any light-curing system and composite restorative material. Designed as an alternative to multi-step bonding systems, Excel Bond LC has 2 components that are easily mixed together and applied in a single step. The process is not technique- sensitive. A 10-second light-cure provides strong bonding to both enamel and dentin, offering an effective marginal seal that protects against microleakage and results in long-lasting restorations. Water is always necessary in bonding systems to develop a low pH for enamel and dentin de-mineralization. Water, however, may also contribute to the hydrolysis of resin or dentin hybrid layers that are a must for adhesion. Excel Bond LC is packaged in 2 separate bottles, segregating the water from the acidic res-ins, resulting in a stable product with a longer shelf life. The technique is very straightforward: dispense one drop each of agents A and B into a mixing well. Mix for at least 5 seconds. Apply the bonding agent onto slightly wet enamel/dentin for 20 seconds while agitating. Air-dry for 5 seconds. Light-cure for 10 seconds. The preparation is now ready for the restorative material of choice.
For more information, call (888) 566-7482 or visit jmoritausa.com.


Flor-Opal and UltraEz Tray Delivery System
Ultradent Products


Tooth sensitivity is a very irritating problem for the average practice. It is difficult to diagnose accurately in all cases and even more difficult to pinpoint precisely for treatment. Thus, it is difficult to predictably eliminate this recurrent patient complaint. Post-treatment sensitivity is fairly common in certain operative procedures, tooth bleaching, and particularly in-office bleaching. Patients are likely to complain about these post-treatment problems, and it is important to have the tools to readily eliminate these complaints comprehensively and completely. A number of topical desensitizing materials have been available: Flor-Opal (1.1% neutral sodium fluoride) and UltraEz (3% potassium nitrate-0.11% fluoride ion) have long been used for desensitizing in bleaching and generalized sensitivity cases. In-office application was generally required. Recently, Ultradent Products has introduced an improved delivery system; its popular TresWhite bleaching tray system is now available loaded with these desensitizing materials. The disposable TresWhite tray fits any arch. Its design incorporates an outer delivery tray with a preloaded disposable adaptive tray on the inside that holds the selected desensitizing material in close apposition to the tooth surfaces for maximum patient benefit. The inner tray is thin, clear, and pliable, and can be worn to treat sensitivity at any time of the day without interfering with talking or smiling. The UltraEz formulation is used to eliminate sensitivity from abrasion, chemical injuries, tooth whitening, and root exposure quite rapidly. The Flor-Opal formulation desensitizes somewhat more slowly, but its effects last longer. These trays are to be worn for a limited amount of time, typically not overnight. In fact, the maximum release time for these desensitizing materials is approximately 90 minutes.
For more information, call (800) 552-5512 or visit ultradent.com.


CollarDam Premier Protect
CollarDam Plc


I really have not thought much about bibs since dental school. In typical fashion, we just ordered the standard ones. They were all more or less the same size, shape consistency, and cost. The bib was a commodity, with little effort made at product differentiation. Most traditional bibs are squares that fit partially over patients’ chests while leaving the neck area rather exposed. Fairly often, water or other dental materials accidentally fell on to these unprotected areas, a “sorry” muttered, and I considered the matter closed. The patients, however, felt wet, cold, and uncomfortable at not being able to dry their neck, and wondered about what sort of materials had just touched their skin. During longer appointments, the likelihood of neck wetting is increased. CollarDam Plc has recently introduced the CollarDam Premier Protect, a super bib that creates a new standard in patient protection. The CollarDam Premier Protect is anatomically designed to protect the patient completely from any intrusive materials. It is available in one comfortable and relaxing fits-all size. Easy to custom apply for each patient, it eliminates unsanitary daisy chains and other disposable around-the-neck retainers. An innovative breakthrough in crystal fiber technology offers a super-absorbent bib that changes color when it is thoroughly soaked and needs to be replaced. (We have never reached that point in practice yet.) It is efficient, effective, and affordable. Dentists specifically designed the CollarDam Premier Protect for dental use, to protect patients from discomfort and wetness and their clothes from chemical and water damage. All CollarDam products are disposable and comply with the latest cross-infection control criteria. The CollarDam Premier Protect eliminates that wet pain in the neck.
For more information, call (877) 265-5274 or visit the Web site collardam.com. (Outside the United States, call +44 845 310 4286).


Dr. Freedman is past president of the American Academy of Cosmetic Dentistry and a founder of the Canadian Academy for Esthetic Dentistry. He is the Chairman of the Clinical Innovations Conference (London, United Kingdom) as well as the Dental Innovations Forum (Singapore). Dr. Freedman is the author or co-author of 9 textbooks, more than 220 dental articles, and numerous CDs, video and audiotapes, and is a Team Member of REALITY. He is a past director of CE programs in aesthetic dentistry at the Universities of California at San Francisco, Florida, UMKC, Minnesota, Baylor College, and Case Western Reserve, and was the founding Associate Director of the Esthetic Dentistry Education Center at the State University of New York at Buffalo. Dr Freedman is a Diplomate of the American Board of Aesthetic Dentistry and lectures internationally on dental aesthetics, dental technology, and photography. A graduate of McGill University in Montreal, Dr. Freedman maintains a private practice limited to aesthetic dentistry in Toronto, Canada, and can be reached at (905) 513-9191 or This e-mail address is being protected from spambots. You need JavaScript enabled to view it