First Impressions: December 2007

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





 




All-Bond SE
BISCO

The seventh-generation, single-component bonding agents have become the standards in dental adhesion. While some of the seventh-generation bonding strengths may be lower than certain fourth-generation products, the former have many advantages over other bonding agents.  Since they do not have to be mixed from multiple components, these materials exhibit virtually no technique sensitivity. Postoperative sensitivity is virtually unknown with this category of bonding agents. The placement technique is simple, predictable, and proven, and they are easily placed into the cavity (usually a single application of a single adhesive) and cured. Most seventh-generation adhesives bond well to light-cured composites only; they are not suitable for self- and dual-cured restorative materials. BISCO’s All-Bond SE is an innovative, self-etching, light-cured adhesive that combines etching, priming, and bonding in a single application. It is an ethanol and water-based adhesive that bonds well to dentin and cut enamel. (Roughen or etch uncut enamel to make it bondable as well.) Unlike many other self-etch adhesives, All-Bond SE is compatible with light-cure, self-cure, and dual-cure composite materials, without requiring any additional activators, steps, or chemistry. All-Bond SE virtually eliminates postoperative sensitivity as it maintains a secure seal to prevent microleakage, and it can be used with All-Bond SE Liner, a filled, radiopaque resin that adds strength and support to the adhesive interface, particularly important in larger restorations. It also provides an additional barrier to surface permeability at the bond interface and a visible landmark for the adhesive radiographically. All-Bond SE is a self-etching, seventh-generation adhesive that provides a very reliable bond to enamel, dentin, and all categories of composite materials.
For more information, call (800) 247-3368 or visit bisco.com.


iBond Self Etch
Heraeus Kulzer

Dental adhesion has become much more effective, much more predict-able, and much less technique-sensitive with time. Ideally, a bonding agent should work the first time, every time, and under practically all intraoral conditions, with little or no technique sensitivity. Heraeus Kul-zer pioneered seventh-generation adhesive techniques in 2001 and has maintained its leading position ever since. They have introduced iBond Self Etch, an innovative adhesive that is applied in a single coat. Its  lack of technique sensitivity is due to its high monomer content and low water content. The monomers precipitate proteins that close the dentinal tubules internally (similar to Gluma Desensitizers). Proper use of the iBond Self Etch technique has been shown to eliminate adhesive layer staining. Its acetone solvent quickly carries the monomers deep into the tooth surface, improving the bond by developing the hybrid layer. The iBond Self Etch adhesive has improved upon iBond Gluma’s bond strength, marginal sealing, and minimal postoperative sensitivity, with a faster and more convenient clinical application. It should only be used with light-cured materials—self-cure and dual-cure materials may have their curing properties inhibited—and should not be applied to uncut enamel. (Roughen or etch uncut enamel to achieve excellent bond strength.) Sclerotic dentin should be acid-etched. The iBond Self Etch adhesive itself can be stored at room temperature but must be vigorously shaken prior to use to combine all the components homogeneously. It exhibits high bond strengths compared to other self-etch adhesives and is in the multistep adhesive range (measured 24 hours after application in water storage). It maintains Heraeus Kulzer’s ongoing innovation in developing excellent adhesive materials for bonding to enamel and dentin.
For more information, call (800) 431-1785 or visit the Web site at heraeus-kulzer-us.com.


CariFree
Oral Biotech

Co-authored by Dr. Fay Goldstep

In trying to fight dental caries, the dental team’s first duty is to identify patients who are more prone to the decay process among those who are less so. This permits better treatment targeting for each group. The conventional approach, providing the same preventive treatment to all patients with respect to caries susceptibility, is wasteful and misdirected. The question remains, though, how to identify those patients who will most benefit from an active anticaries battery of treatments. Oral Biotech has recently introduced its innovative CariFree system. The CariScreen testing meter provides a 1-minute test that measures the ATP that is present in localized biofilm. A higher reading is correlated with higher caries susceptibility. CariFree Treatment Rinse is a 2-part mouthwash that elevates local pH to kill the cariogenic bacteria in plaque biofilm. A 2-week at-home treatment typically tips the balance of the patient’s oral pH in favor of the “good” oral microflora (versus the “bad” cariogenic variety). Remeasuring the caries susceptibility at this stage usually yields a lower level of ATP. In order to sustain the positive oral effects for the long term, the patient can continue to maintain his or her improved oral environment using CariFree Maintenance Rinse and CariFree Boost mouth spray. A series of topical patient brochures and displays offers an excellent marketing tool to educate patients and to increase their interest level. Com-prehensive CariFree training is typically accomplished live, online, by expert facilitators who take the whole dental team through the entire process step by step. The training is an excellent format for effective information transfer and improves the familiarity and confidence level of the entire dental team in the CariFree system.
For more information, call (866) 928-4445 or visit carifree.com.


AdheSE One VivaPen
Ivoclar Vivadent

Dispensing adhesive materials into a well (with or without mixing) has always been a technique-sensitive step. The all-in-one adhesives make this process more predictable, since the technique does not require dispensing (hopefully) equal amounts of components nor does it involve hand mixing (trapping air bubbles). An additional problem is the time lag between dispensing into the well (chemical reaction begins) and cavity application—too much time and the adhesive’s chemistry is no longer effective. Ivoclar Vivadent’s introduction of AdheSE One VivaPen solves this long-standing problem. This self-etching, light-curing, all-in-one adhesive is packaged in the unique VivaPen, an innovative delivery system that allows the adhesive to be applied directly into the cavity preparation in the patient’s mouth, saving chemistry, time, and money. The supplied brush cannulas make cavities anywhere in the mouth easy to reach. The VivaPen is an ergonomic, pen-shaped instrument that is easy to operate and is equipped with a thumb-click mechanism to dispense adhesive through the cannula. The cannula has been specifically designed with a minimal depth volume space to minimize waste. The brush cannulas are disposable, allowing the VivaPen to be reused. The Pen is disinfected with a spray or wipes in between uses. The VivaPen dispenses only the actual required amount of adhesive directly at the operative site. AdheSE One should be dispersed with a strong air stream until no minidroplets of adhesive are moving across the surface. It can then be light-polymerized for 10 seconds prior to applying the restorative material. AdheSE One VivaPen can be stored at room temperature and should not be used with self-cure and dual-cure composites.
For more information, call (800) 533-6825 in the United States, (800) 263-8182 in Canada, or visit the Web site ivoclarvivadent.us.


Polidont Diamond Polishers
Microdont

Disc polishers have long been an integral part of both aesthetic and prosthodontic procedures. They are used to quickly and evenly remove portions of the tooth or restoration surface that are too large or too prominent. Polishers are designed to leave a surface that can be characterized (for aesthetic enhancement) and relatively quickly polished to a high gloss. Typically, a flexible rubber cup with diamond paste is required to achieve the final shine. Common problems that the clinician encounters with polishing discs include a jutting metal or plastic mandrel cover in the center of the disc that allows only the edges of the polisher to be used, a backing that is not strong enough to resist the forces required during intraoral use, and an abrasion rate that is far too slow for effective utilization. Microdont’s new Polidont Diamond Polisher disc system solves all these common problems, and more. First and foremost, the disc backing is made of thin, semirigid Mylar that effectively maintains its shape throughout an entire procedure of effective polishing. Instead of alumina abrasives, Polidont discs are coated with diamond particles of various grits for  quick and easy polishing and finishing. In fact, using the 3 grits of the Polidont system consecutively not only quickly completes composite finishing but also achieves polishing to a gloss in 3 easy steps. The discs have no jutting metal or plastic center, so the entire surface of the instrument is clinically usable. Polidont discs are available in 3 grits, standard and micro sizes, and both external and internal polishing surfaces. Polidont Diamond Polishers are very fast and very easy, offering a very aesthetic finish.
For more information, call (760) 268-1108, or visit the Web site at microdont.com.br.


Disposable Cheek Retractor and Mouth Prop
Affordable Dental Products

A variety of cheek retractors are available to the dental practitioner. These instruments are useful for displacing soft tissues for dental photo and videography and  for protecting cheeks and lips during bleaching and similar aesthetic cases. Retractors may require 2-handed use (staff or patient holding a retractor on each side), single-handed use, or no-handed use (self-activating and most convenient). Cheek retractors move the cheeks and lips out of the way so a dentist can see or work unimpeded on the anterior teeth. Some cheek retractors are effective in pulling and keeping the soft tissues out of the way; others, often with too-small flanges, let the tissues slip around, obscuring the working area and making the task more difficult. The sterilization or disinfection of the cheek retractors is also rather problematic: how, with what solutions, and for how long? An innovative cheek retractor has been designed by Affordable Dental Products to offer several major advantages. Affordable’s Disposable Cheek Retractor eliminates sterilization and disinfection concerns, features a swivel retractor connection mechanism that makes intraoral placement easy for anyone on the dental team, and is comfortable for the patient. The cheek retractors are made from soft, yet firm, clear rubber that allows total visibility through and around the appliance. In addition, the cheek retractors can be removed and used individually as bite blocks. The extraoral spring connector is quite flexible, preventing excessive stress on the cheeks being retracted and providing the patient comfort through extended periods of wear. The Disposable Cheek Retractor and Mouth Prop is easy to place, is easy to wear, and is useful for photography, bleaching, and anterior aesthetic restorative procedures.

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 orm  This e-mail address is being protected from spambots. You need JavaScript enabled to view it


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