First Impressions: June 2009

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.


Futar Scan
Kettenbach LP

One of the most difficult and technically sensitive steps in CAD/CAM dentistry is the even application of a white powder onto the prepared tooth (or teeth) that enables the scanner to take the optical impression. In most technologies, an additional optical impression of the opposing dentition is required in order to develop the 3-dimensional occlusal relationships on the restoration. Unfortunately, applying the white powder can be inconsistent and messy, as it can moisten and/or clump. In either case, the optical impression and the subsequent milled restoration will be inaccurate in those areas where the powder coating was not thin, even, and dry. Kettenbach LP has developed its innovative Futar Scan, which is an addition-curing polyvinyl siloxane bite registration material whose color and rigidity were specifically designed to be scannable by CAD/ CAM units. Since the bite registration material has been enhanced for optical registration, it can be used with most current CAD/CAM systems in dental offices and laboratories. Most importantly for the practitioner, high-quality scan results can be achieved without the intraoral use of any powders. Futar Scan sets with a final hardness of Shore D 35 and is very fast acting—the working time is 15 seconds, and the setting time is approximately 45 seconds. The polymerized bite registration can be readily trimmed with a scal-pel. It speeds the optical registration procedure for the CAD/CAM restoration by eliminating the very difficult and time-consuming step of powdering the prepared teeth and maintaining the area moisture-free and contamination-free throughout the entire scanning phase. Thus, Futar Scan plays a major role in making restorations and CAD/CAM systems less technique-sensitive and more time-efficient. For more information, call (877) 532-2123 or visit the company's Web site at kettenbach.com.

Bond-1 SF
Pentron Clinical Technologies

The adhesive layer is the foundation for the entire restoration; thus, it is essential that enamel and dentin bonding be predictable and effective. Today's parameters for a useful adhesive include minimal technique sensitivity, minimum number of clinical steps, and ease of use. Pentron Clinical Technologies' new Bond-1 SF is a single-coat, self-etch adhesive with some very unique features. The "SF" stands for solvent-free; therefore, no air-drying is required (no guessing of how dry is too dry). Excessive overdrying may lead to postoperative sensitivity by eliminating the adhesive from the dentinal tubules and leaving them open; under-drying may leave residual solvent in the resin. Residual solvents may weaken the adhesive in the long term or make it inconsistent, leading to bond interface degradation. Thus, the elimination of solvents from Bond-1 SF also eliminates the drying step and the concomitant concerns. The versatile adhesive can be used in conjunction with both light-cured and dual-cured materials. An easily applied single coat provides an even surface coating of adhesive and reduces treatment time (apply, agitate for 20 seconds, light-cure for 10 seconds). Bond-1 SF has very high bond strengths to both enamel and dentin that are virtually equal, thereby decreasing the possibility of stressing the weaker bond during clinical function. The adhesive also exhibits very low microleakage at the interface, providing good marginal integrity. Bond-1 SF is available in 2 innovative delivery modalities: (1) a syringe with a unique flocked needle for direct placement and agitation on the preparation, and (2) a free-standing single-dose container unit that offers the ultimate in infection and quality control. The single-dose capsule is supplied with its own applicator brush. Solvent-free is worry-free.For more information, call (800) 551-0283 or visit the Web site at pentron.com.

STA System
Milestone Scientific

The major factor that keeps half the population out of the dental office is the fear of pain. While many of the procedures historically associated with pain are gone from today's dental practice, the stigma and the fear remain. Local anesthetic for overcoming the fear factor has been available for more than 70 years but unfortunately has created another complaint; the discomfort of the injection process. The typical operative appointment has also changed. In the past, it was common to treat multiple teeth in a quadrant. Today, better home care and conservative dentistry have made single-tooth restorations more the norm. Milestone Scientific has introduced the Single Tooth Anesthesia (STA) System to provide the practitioner the means to selectively anaesthetize a single tooth for a limited amount of time. The STA System precisely administers an intraligamentary injection that anesthetizes a single tooth; onset takes only 1 to 2 minutes and typically lasts an hour. (A comparable mandibular block affects the entire quadrant, with an onset of 10 to 15 minutes, and lasts 2 to 3 hours.) The computer-controlled STA System offers real-time audio and visual feedback. Dynamic pressure sensing indicates the ideal intraligamentary pressure without requiring the operator visual contact with the unit. Compuflow technology controls painless anesthetic delivery by minimizing tissue pressure. The intraligamentary 30-gauge needle is virtually pain-free; simply insert the needle at the proper angulation until resistance is audibly indicated and quickly achieve anesthesia. The engineering of the STA System's handpiece provides an easier and more controlled anesthetic flow at higher volumes for precise, pain-free delivery to every tooth. The ergonomic handpiece is indicated for general, paedodontic, endodontic, periodontic, and cosmetic practices.For more information, call (800) 862-1125, or visit the company's Web sites at milestonescientific.com, or STAIS4U.com.

Kleer-Veneer
Pulpdent

We have been placing porcelain veneers for more than 25 years. The concept of improving smiles with veneers has become popular with our patients as well. This popularity is easy to understand as veneers are far less invasive than crowns and often minimally or totally noninvasive at all. Yet porcelain veneers radically change the shape, size, position, and spacing of the teeth that comprise the all-important smile. While tooth preparation and ceramic sciences have advanced tremendously, cementation technology has remained surprisingly static. The early veneers were often semi-translucent, and colored cements were used as shade-modifiers. The exercise of developing aesthetics through cementation became very frustrating for the practitioner because cements varied in thickness, varied in opacity, and a microns-thick layer often imparted little coloration. It is now more common to make all shade modifications within the ceramic veneer itself. The veneer cement is only visible at or near the margins. Most veneer cements are yellowish and/or opaque. Pulpdent's Kleer-Veneer is a unique veneer cement, totally translucent both before and after curing, providing the practitioner accurate shade and aesthetics visualization prior to polymerization. The "window pane" clear cement does not interfere with veneer coloration and does not change shade after curing. Kleer-Veneer is moisture-tolerant and self-adhesive, requiring neither bonding agents on enamel nor silane on the ceramic. Its ideal viscosity holds veneers in place without sagging or drifting prior to curing, and the 9-µm film thickness permits precise fitting and excellent marginal adaptation. The clinical technique is familiar: cleanse tooth surface, place Kleer-Veneer onto ceramic, seat, remove excess, tack, clean, polymerize, and polish. For color modification, 3 opaque shades are available: cream, pink, and white. Kleer-Veneer cement for excellent aesthetics! For more information, call (800) 343-4342 or visit pulpdent.com.

Sahara
Micrylium

Based upon the work of Professor Semmelweis in the Austro-Hungarian Empire more than a century ago, it has been widely accepted that dental and medical professionals must wash their hands effectively between patients. Considering the number of patients treated every day, this can become an irritating and sometimes painful task. Washing hands 100 or more times a day can cause skin dryness and eliminate surface oils. Moreover, many soaps are ineffective at removing bacteria that may hide in the nooks and crannies of human skin. (Few cleansers have actually been tested.) Most conventional soaps are simply inadequate for professional cleansing, while many of the professional soaps are too caustic. Sahara, Micrylium's cleansing product, is designed specifically for hand treatment. It has been tested scientifically, demonstrating that it significantly reduces a variety of common bacteria including Escherichia coli, Staphylococcus aureus, and Proteus mirabilis (representing gram-negative enteric rods, gram-positive cocci, and gram-positive motile rods common in the oral cavity) with a 30-second application to hand surfaces. Sahara has also been shown to significantly reduce Pseudomonas aeruginosa, an opportunistic gram-negative rod and the major component of oral biofilm. In addition to its antibacterial effect, Sahara reduces Candida albicans, which causes opportunistic yeast infections. Sahara is an ethanol gel product that meets the World Health Organization's 5 log10 reduction standards within 30 seconds (test method EN 1500), far more effectively than most other ethanol gel products. In addition to the universal use of gloves in the dental profession, it is still important to get and to keep hand surfaces clean. Sahara does the job effectively and predictably, and the results are confirmed by solid scientific evidence.For more information, call (800) 489-8868 or visit micrylium.com.

Dr. Freedman is past president of the American Academy of Cosmetic Dentistry, and materials editor and author of the monthly section "First Impressions" 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. Dr. Freedman is a visiting professor at the Università 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. He 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 materials, aesthetics, and technology with his popular program, "First Impressions to Time Tested: Better, Faster, Easier Clinical Dentistry." A graduate of McGill University in Montreal, he maintains a private practice limited to Esthetic Dentistry in Toronto, Canada. He can be reached at (905) 513-9191 or This e-mail address is being protected from spambots. You need JavaScript enabled to view it .
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