First Impressions: August 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.





Diamonds With Depth Markings

One of the most persistent difficulties with inlay and onlay preparations is the task of accurately gauging the depth of tissue removal. For crowns, the process is rather intuitive; simply eliminate adequate tooth tissue buccally, lingually, interproximally, and then occlusally to make room for the crown. When preparing for inlays, however, the practitioner is caught between a rock and a hard place: conserving as much healthy, natural tooth structure as possible on the one hand and providing adequate restoration thickness and clearance (for long-term success) on the other. KOMET USA’s inlay/partial crown preparation diamonds incorporate depth markings on the cutting surface of the bur that facilitate safe and rapid tooth reduction during preparation. The markings indicate 2 and 4 mm depths, useful in developing the clearance for ceramic restorations. All of the burs in the Diamonds with Depth Mark-ings kit have rounded tips that develop a smooth transition between the floor and wall surfaces of the preparation. Eliminating sharp edges decreases the chances of post-treatment tooth fracture. The burs’ built-in taper of 6° to 10° delivers an ideal insertion path for the restoration once it is completed. The 3 instruments have different widths, allowing the practitioner to select the minimal amount of bucco­lingual preparation required for a successful restoration. Furthermore, the burs create a 90º angle at the cavo-surface margin for easier cementation and an enhanced functional distribution of forces on the occlusal surface. Inlays and onlays are made far more predictable when they are prepared to a proper depth and with the proper angulations that respect the strengths of both the remaining tooth structure and the ceramic restorative material. For more information, call (888) 566-3887 or visit the company Web site at

Enamel Pro Gel With Amorphous Calcium Phosphate Technology
Premier Dental Products

We have grown up with the fluoride tray philosophy. Children were treated with fluoride trays at least twice a year until adulthood for protecting teeth, making dental surfaces stronger and encouraging fluoride ion uptake into both the enamel and the dentin. While this technology is proven, it has not always been the children’s favorite dental experience (particularly when fluoride gel was inadvertently swallowed). Acidulated gels tended to etch teeth (necessary for effective fluoride uptake) and may have left their mark on the enamel. Premier Dental Products has introduced Enamel Pro Gel with Amorphous Calcium Phosphate (ACP) technology. Its innovations include that it is the only fluoride gel that delivers ACP and 1.23% nonacidulated fluoride topical gel. ACP remineralizes both enamel and dentin, and its reactive and soluble calcium compound acts as an ion reservoir in the saliva. When ACP forms near enamel or dentinal tubules, it rapidly releases calcium and phosphate ions that can convert to apatite, remineralizing tooth surfaces. The nonacidulated fluoride gel (pH 7 to 8) provides the same fluoride uptake as the acidulated fluoride-phosphate gels (when combined with ACP) without the risk of etching the enamel. Enamel Pro Gel with ACP offers the same benefits as neutral pH gels and is totally safe for patients with porcelains, composites, and sealants; the gel will not dull or etch these restorations. Younger children are more readily tolerant of the nonacid-ulated fluoride since they do not feel the taste or discomfort of a tart acid in their mouths. Thus, the gel stays in the mouth longer and with greater beneficial effect. Nonacidulated fluoride topical gel aids in the prevention of dental caries.For more information, call (888) 670-6100 or visit the company Web site at

OpalDam Green
Ultradent Products

Moisture control is a key element in a successful dental procedure. Whether it is required to isolate a specific area for restoration with composite resin or to segregate teeth that are to be bleached, isolation is often just as important in keeping caustic materials away from the gingiva as it is for keeping moisture away from the tooth surfaces. Arch or quadrant rubber dam application is not always necessary and may in fact be far too extensive for localized procedures or anterior bleaching. In these instances, a custom localized gingival resin barrier is indicated. Ultradent Products’ OpalDam Green gingival resin barrier is a unique, light-reflective, and passively adhesive light-cured resin. It creates a barrier between the soft and hard tissues, preventing migration of irritants towards the gingiva and moisture towards the teeth. While OpalDam Green is methacrylate-based, it has adequate strength to maintain a barrier. Once the procedure is completed, it is easily re­moved from embrasures and undercuts. Its green color contrasts well with red gingival tissues and yellowish-white teeth, clearly identifying its position and extent, allowing more effective and less extensive coverage. OpalDam Green is readily syringed directly into the target gingival and embrasure areas. Whether for restorative or bleaching procedures, it should extend somewhat beyond the actual treatment area and provide adequate clearance for the practitioner to readily access all the necessary tissues. A 20-second cure hardens the resin barrier without generating exothermic heat that can irritate or damage the underlying gingiva or teeth. After treatment, OpalDam Green is removed with an explorer, scaler, or floss, and the tissues underneath are rinsed with water.For more information, call (888) 230-1420 or visit the company Web site at

Fusio Liquid Dentin
Pentron Clinical Technologies

1. Caries detected on tooth No. 19. 2. Caries removed. Enamel roughened slightly past each groove.
3. Fusio B1 is applied, agitated, contoured with an explorer, and light-cured. 4. Final restoration.
There are many and varied uses for flowable resin in today’s clinical practice. Any innovation that makes it easier to place these restorative materials certainly deserves the practitioner’s attention. Pentron Clinical Tech­nologies has recently introduced Fusio Liquid Dentin. Fusio is acidic and hydrophilic. When it contacts the tooth surface, the negatively charged carboxylic acid groups bond to the mineral ions of the tooth structure. As the monomers polymerize, they are incorporated into the tooth surface, enhancing both dentin bonding and the sealing of the dentinal tubules. Fusio is a self-adhering flowable composite that bonds to both dentin and enamel without acid etching or an adhesive. Thus, it combines the benefits of adhesive and restorative technologies in a single product. Fusio is a 4-META flowable composite with nano-sized amorphous silica and glass fillers. It conditions, bonds, and seals, all without etchants or adhesives; it is simply syringed into the preparation, agitated on site, and light-cured. Fusio can be used as a stand-alone restorative system or with bonded composites. It seals dentin effectively, reducing the incidence of postoperative sensitivity, and it is radiopaque, clearly visible on radiographs, thus providing a ready differential diagnosis of redecay. When Fusio is used as a base material, it can be routinely etched, bonded, and restored with composite materials. It is indicated for pits and fissures, and the restoration of small occlusal cavities. It can also be used as a self-adhesive liner under higher viscosity restorative materials. It is available in 4 Vita shades: A1, A2, A3, and B1. Fusio Liquid Dentin is a flowable for every practice. For more information, call (800) 551-0283 or visit the company Web site at

The SensAble Dental Lab System
SensAble Technologies

Largely unnoticed by the practitioner, the lab environment has been changing rapidly. Technological and clinical innovations have transformed the dental laboratory dramatically over the past 2 to 3 decades. Most of these advances have been designed to provide the technician with result-oriented control at every step of the prosthetic design and fabrication procedure. The key elements of new technology for the dental technician are user-friendliness and intuitive use. The SensAble Dental Lab System from SensAble Technologies provides a comprehensive integrated solution for scanning, design, and output to 3-dimensional (3-D) printing for the production of partial frameworks, crowns, and bridge substructures. It is based on 3-D virtual proprioception. Technicians design and create the prosthetic restoration working entirely digitally while keeping the manual proprioception to which they are accustomed. One of the unique features of the SensAble System is the PHANTOM Desktop, an intuitive interface with a 3-D virtual touch stylus that allows technicians to use their design wax-up skills and to combine these with the advantages of working digitally. The system is easy to learn and to adapt to different design techniques. It can be used both by experienced and novice technicians. As the technician is designing, the contour of the tooth or framework can be felt through the PHANTOM; the software determines the margins, but adjustments are possible. Pontics and connectors are placed automatically, but also are adjustable with the 3-D proprioceptive technology. For removable partial frameworks, once the digital design is complete, a single button automatically waxes mesh patterns, clasps, and major connectors. The system’s integrated database and distributed architecture facilitate multiple configurations. One system produces multiple types of restorations, all fitting accurately. The SensAble Dental Lab System brings a new dimension to digital restorations.For more information, call (781) 939-7493 visit the Web site located at

Revitin Oral Therapy Paste
CS Bioscience

Today’s patients are increasingly aware of their oral health and those products that can provide a balanced oral environment that naturally resists tooth decay, gum disease, and bad breath. For many years, the dental profession has used predominantly chemically derived products to achieve the health results desired by both professionals and patients. A growing segment of society today prefers to utilize natural rather than chemical products, vitamins rather than detergents, and nutritional co-factors rather than antimicrobials, and the dentist should offer products that fall within these preference parameters whenever possible. CS Bioscience’s Revitin Oral Therapy Paste is formulated with NuPath Bio-actives which—when incorporated into dental products—assist in nourishing the oral biofilm such that it is stabilized as a clear, thin, and odorless layer of helpful and friendly bacteria. The NuPath Bioactives also make it difficult for this healthy ecosystem to become unhealthy. NuPath Bioactives are a precise combination of readily absorbable vitamins, herbs, and micro­nized minerals that have been developed in an all-natural formula. Clinical research has de-monstrated that Revitin has a positive effect on patients who have gingivitis in spite of regular oral hygiene. In addition, patients who suffer from xerostomia, canker sores, or burning mouth syndrome feel relief when using this dentifrice. Individuals who are undergoing radiation or chemo­therapy tend to have a lot of oral discomfort. These patients are at a tremendous risk if they don’t brush their teeth effectively, however. Revitin helps them to do so comfortably, leaving their teeth cleaner and healthier. Revitin Oral Therapy Paste’s citrus flavor is the first to go on the market, while other flavors will be introduced later in the year.For more information, call (877) 346-2700 or visit the Web site at

Dr. Freedman is a founder and 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, videos, audiotapes, and Webinars, 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 the post-graduate 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 aesthetic 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 .