First Impressions: December 2008

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. 

FenderWedge Interproximal Tooth Shields
Garrison Dental Solutions




















It goes without saying that I have never, ever, accidentally nicked the proximal adjacent tooth when preparing an interproximal restoration or a crown. All those little surface scratches and pits must have come from another practitioner. Interproximal nicking is known to occur all too often, given the confines, access, and visibility in these areas, and is virtually impossible to avoid unless a protective material is placed between the teeth. Garrison Dental Solutions has introduced FenderWedge Interproximal Tooth Shields, designed to protect adjacent teeth from inadvertent and iatrogenic nicking. The FenderWedge has a plastic wedge portion that fits tightly in the interproximal space at the level of the papilla. As a side benefit, it provides a preseparation force, opening the contact for better access and a tighter contact upon restoration. The FenderWedge fits tightly and will not dislodge when contact is broken during preparation. It is a great tool for conservative dentistry, allowing better access to interproximal areas, better visibility, and protection from inadvertent interproximal nicks. The FenderWedge conserves tooth tissue, both on the prepared and adjacent teeth. Once the preparation is completed, the FenderWedge can be removed as easily as it was inserted, and the procedure, whether direct or indirect restorative, can continue. The FenderWedge is an easy-to-use, easy-to-place, conservative tool that should be a part of every crown- and-bridge procedure. It can be reinserted after the placement of the restoration for a few moments in order to assist in the finishing and polishing process, facilitating access for smoothing and refining interproximal margins toward the buccal and the lingual surfaces of the restoration. For more information, call (888) 437-0032 or visit the Web site garrisondental.com.

 


Go!
SDI North America

The concept of adhesion in dentistry is more than 50 years old. Practical and clinically effective adhesion to both enamel and dentin is entering its third decade. The evolution of dental adhesives has been in specific positive directions. These products have become better, faster, and less technique-sensitive. Today, the practitioner has access to a very large selection of effective and predictable adhesive products in composite dentistry. It is important to select the product that best suits the practice and the clinical techniques of the practitioner. SDI recently introduced Go! adhesive, a single-component, light-cured, self-etching, fluoride-releasing, dentin and enamel bonding system. It is a seventh-generation single-step adhesive with innovative chemical features. First and foremost, Go! exhibits high bond strengths to both enamel and dentin and is easy to apply; a single application saturating the tooth surfaces is all that is necessary. No tooth surface agitation is required. A moist dentin and enamel surface is recommended, but a dry surface is acceptable. Once Go! is thoroughly air-dried, it leaves a glossy surface that forms a low 10-µ film thickness after curing. The adhesive is 7% filled with specially treated ultrafine nanofillers that change from hydrophilic to hydrophobic after polymerization; thus, there is no moisture or water found at the restorative interface after polymerization. Go! is dark yellow in color when applied but is changed to clear during curing. Thus, the completion of the polymerization procedure is readily evident. Overetching and overdrying are not possible with Go!, and therefore postoperative sensitivity simply does not occur. The adhesive is ready to use right out of the bottle (no shaking required). For more information, call (800) 228-5166 or visit sdi.com.au.

Enamel Pro Varnish
Premier Dental Products

The art and science of fluoride varnish has been making a major comeback in recent months. Fluoride varnishes, once strictly reserved for application on children, are now becoming part of the dentist’s adult armamentarium as well. The aging baby boomer population is increasingly interested in materials that protect and strengthen enamel and dentin, and fluoride and other products that can be released from varnishes have proven to be practical and effective. Premier’s new Enamel Pro Varnish is a fluoride varnish that contains ACP (amorphous calcium phosphate), an effective desensitization and mineralizing compound. Enamel Pro’s 5% sodium fluoride white varnish is applied directly to the teeth using the enclosed brush. The brush is then used to thin out the gel on the tooth surfaces until the varnish is dry. The varnish should be applied to dry tooth surfaces, but it will cover even moist teeth with a protective film. Enamel Pro Varnish hardens on contact with saliva, allowing the patient to leave the practice immediately after application. Enamel Pro has a high level of fluoride available to exposed tooth surfaces; it also deposits calcium and phosphate from the ACP into the dentition. The gel is a fluoride-containing preparation indicated for the treatment of dentinal hypersensitivity and the reduction of postoperative sensitivity. It is recommended for the treatment of sensitive root surfaces and under provisional restorations and cements to seal dentinal tubules. For the dental practitioner, the typical hypersensitivity treatment process involves 2 applications with several days in between. Enamel Pro is available in two flavors, (1) strawberry-and-cream and (2) bubble gum, for the discriminating patient. For more information, call (888) 670-6100 or visit the Web site premusa.com.


SporeCheck
Hu-Friedy

The dental profession places a tremendous emphasis on the clean working environment of the clinical practice. The basic tool for most practices is the steam sterilizing unit. Since there is so much reliance on this single instrument, and since it is visually impossible to determine whether the sterilizer is actually functioning properly, it is essential for patient, dentist, and staff safety to verify its operation regularly. Routine testing (at least weekly and with every implant load), is recommended for spores lodged in the system. Hu-Friedy has introduced the easy-to-use SporeCheck 24-hour in-office test. Its underlying concept is that 2 biological indicator (BI) vials from the same lot are processed simultaneously. One, the control, is not put through the sterilizer; the other is run through the normal sterilization procedure. Both BI vials are labeled, and the test vial is placed into the sterilizer with a normal instrument load. The sterilized BI vial (browned chemical indicator) is allowed 10 minutes to cool. Then both BI vials are activated by crushing the inner glass media using the provided crusher. The spore strip is mixed into the growth media. Both processed and control BI vials are incubated at 60ºC for 24 hours. The control vial should indicate spore growth (medium has changed from purple to yellow), a positive result. In the processed BI vial, proper sterilization is indicated by no color change from purple. A yellow result in the processed vial indicates spore growth and a sterilizer problem. All results should be recorded; a positive result should take the sterilizer out of service until the issue is resolved. SporeCheck offers full confidence with every sterilization load. For more information, call (800) HU-FRIEDY (483-7433) or visit the Web site hufriedy.com.

Protemp Plus Temporization Material
3M ESPE

As the patient population’s interest in maintaining a healthy dentition for an entire lifetime has increased, the demand for indirect restorations, crowns, and bridges has grown tremendously. While good intentions may abound, patients’ lack of care and/or attention has often damaged the dentition. Eventually, direct restorations cannot adequately re-store the teeth to form and function, and crowns/bridges are required. 3M/ESPE has introduced Protemp Plus Temporization Material (replacing Protemp 3 Garant). Its major innovative feature is a nanotechnology-based bisacryl material that includes a new generation of sophisticated fillers. These provide a stronger provisional restoration with a longer durability, reducing unplanned visits by patients who have fractured their temporaries. The automix material is easy to handle. Protemp Plus has excellent compressive strength and mechanical toughness under stress (and can be used for long-term provisionals). Protemp Plus’s strength is complemented by a glossy surface requiring little or no polishing or glazing, facilitating plaque removal and supporting gingival health during the provisionalization phase. The 5 available shades match the Filtex Supreme Plus flowable restorative materials and provide a wide range of aesthetic solutions for the finicky patient. The shades include bleach shade, an ultrawhite color that is found among our aesthetically motivated pa-tients. Protemp Plus also tends to retain the originally developed shade over extended periods, particularly beneficial when used as a long-term provisional. In most cases, polishing requires simply cleaning the temporary with alcohol. Protemp Plus has a built-in fluorescence that makes the provisional look natural under various lighting conditions, even ultraviolet. Protemp Plus is in-dicated for crowns, bridges, inlays, onlays, veneers, and very specifically for long-term temporization. For more information, call (800) 634-2249 or visit 3mespe.com.

QuikGlaze
All Dental Prodx

One of the more time-consuming segments of the crown and bridge procedure is the fabrication of the provisional. With current materials, the actual fabrication of the provisional is relatively fast: 2 to 3 minutes of chairside time. Assuming an accurate template, marginal adaptation, anatomical form, and occlusion should take no more than an additional 1 to 2 minutes. The most labor-intensive part of the provisional restoration is the polishing and surface-glazing of the restoration. Historically, a sequence of ever- finer cups and disks were used to develop a surface luster for the provisional restoration that was compatible with function, aesthetics and patient comfort; the chairside time cost was 10 to 15 minutes (or even longer) for a restoration that was destined to stay in the mouth for no more than a week or 2. All Dental Prodx has introduced its QuikGlaze Universal Light-Cured Material, offering an excellent provisional surface glaze in seconds. The major advantage over the original Quik-Glaze is that the current product is compatible with all curing lights: halogen, LED, Pac, or UV. Simply paint QuikGlaze onto the provisional’s external surfaces and light-cure. The provisional is ready for insertion into the mouth. QuikGlaze is indicated for all short- and long-term provisionals, including composites, acrylics, and everything in between as well as custom trays and orthodontic appliances. QuikGlaze bonds to prefabricated polycarbonate or polyacetate teeth. It can also be used as a bonding agent for voids and marginal repair. Its low viscosity and nonyellowing stability are highly desirable in the aesthetic practice. QuikGlaze eliminates 10 expensive chairside polishing minutes, maximizing provisional efficiency, and improving the practice’s bottom line. For more information, call (877) 64-PRODX (647-7639) or visit alldentalprodx.com or prodxspa.com.

Dr. Freedman is past president of the American Academy of Cosmetic Dentistry and is the materials editor for Dentistry Today. He is the author or co-author of 11 textbooks, more than 400 dental articles, and numerous CDs, video, and audiotapes and is a team member of REALITY. He is a visiting professor at the Universita di Firenze, Florence, Italy. He is a past director of CE Programs in Esthetic 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. He is a co-founder of the Canadian Academy for Esthetic Dentistry, and a Diplomate of the American Board of Aesthetic Dentistry. He 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 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