First Impressions: May 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 experienc

Picasso Diode Laser

Lasers have been filtering into the dental profession for decades. In recent years, the area of greatest interest has been the diode laser, the small, soft tissue-specific instruments that trough, debride gingival tissues, and eliminate bacteria in deep pockets. For the practitioner, the major drawback of lasers (including the diode) has been the cost of implementation. Lasers are typically expensive to buy; some units also involve relatively high sundry costs for every single patient’s use. AMD Lasers’ introduction of its revolutionary Picasso diode laser with breakthrough technology has allowed a breakthrough in affordability as well. The cost has come down to a level where it is reasonable to consider incorporating the technology not just into every practice but also into every operatory within the practice. The Picasso offers 0.1 to 7.0 W in continuous or pulse modes and the always desirable customizable presets. The laser features an adjustable aiming beam and an easy-to-use touchscreen interface. A basic online seminar is available to meet certification and office laser needs. (In-office training is also available.) Hygiene applications, perio laser curettage, as well as billing and marketing, are available with continuing education credits. Hygienists can use Picasso in approximately half of North American jurisdictions. It comes ready to use out of the box in a transportation case with one fiber, one handpiece, 3 pairs of goggles, a training DVD, and a foot control as well as a fiber stripper. I recommend the accessory package of 2 fibers and one additional handpiece. Picasso is very easy to incorporate into the practice, very easy to use, and extends the practice’s range of services. Finally, laser dentistry at an affordable cost.For more information, call (866) 999-2635 or visit

EndoSequence Fiber Post System
Brasseler USA

As patients have learned the importance of maintaining their teeth for a lifetime, endodontics has enjoyed tremendous growth. From a restorative perspective, the postendodontic treatment should be rather straight-forward, but it is often complicated by the incompatibility of canal shape and post design. In fact, postcanal preparation can cause thinning of the dentinal walls and inadvertent perforation. Brasseler USA has introduced EndoSequence, the first fully synchronized prefabricated fiber post system designed to match the rotary instrumentation used to shape the canal. The entire process of post placement is drill-free! EndoSequence posts are shape-and-size synchronized to match EndoSequence rotary files. The space developed by the last EndoSequence file is the post space. Simply burn out the excess gutta-percha, and the ideal channel is already there. This alone is a tremendous time and stress saver. The EndoSequence process is minimally invasive; there is no requirement to remove additional tooth structure for post-space creation. The posts are made of glass fibers and epoxy resin, offering both strength and flexibility. The design absorbs and dissipates some of the masticatory stresses that are placed upon the teeth during chewing and parafunction. The EndoSequence posts have a modulus of elasticity that is similar to that of dentin, allowing them to move with the dentin rather than against it. The posts are white and translucent, making them ideally suited under aesthetic restorations, including somewhat translucent core and crown coverage. The unique zirconia-enriched fiber post composition provides a very clear radiopaque image. The posts are factory-presilanated, eliminating yet another chairside step, and they are color-coded for easy identification.
For more information, call (800) 841-4522 or visit the Web site

Plak-Vac Oral Biofilm Remover
Vista Dental Products

As dentists, we habitually ignore the tongue, yet as we all know, it has been implicated in a variety of oral and dental problems, including plaque retention, halitosis, root caries, and a variety of other health issues. Although tongue cleaning is a common practice in some parts of the world, most dentists do not, as of yet, recommend tongue cleaning to their patients. At-home tongue cleansing includes “tongue scraping”—a flexible but relatively hard surface or edge removes surface plaque from the tongue without, of course, cutting it. Vista Dental Products’ new Plak-Vac, a very effective and professional oral biofilm remover that can be used in-office with existing equipment. It has been specifically designed to remove biofilm from the patient’s tongue while simultaneously disposing of the buildup through the chairside high volume suction. Plak-Vac is easy to use, taking only about 30 seconds during a scheduled appointment. The Plak-Vac is inserted into the high volume suction adapter. It is then pulled back to front on the tongue with a sweeping motion until the entire surface has been cleansed. This improves the patient’s breath and taste immediately. Used after dental appointments, the technique reduces bacteria that could potentially complicate postsurgical healing and removes both (1) particles that may have become lodged in the irregular surface of the dorsum of the tongue and (2) the taste of dental materials that have been used during the procedure. The Plak-Vac is very user-friendly and reliable, and it fits all high-volume suction de-vices. Patients respond very positively to the concept of tongue cleaning. The Plak-Vac is convenient, efficient, and cost-effective and may assist in significantly reducing operative and postoperative infections.
For more information, call (877) 418-4782 or visit

seT Self-Etching, Self-Adhesive Resin Cement
SDI (North America)

Despite any fluctuations that may affect the world’s economy, the demand for dental restorations is always there. A decayed or broken tooth is a very clear and present problem that requires relatively im-mediate attention, no matter where in the world it occurs. Thus, the demand for indirect restorations, crowns, and bridges, has not decreased significantly and is not likely to do so in the foreseeable future. Once preparation, impression, fabrication, and try-in are complete, the final clinical step for every indirect restoration is the process of cementation. It is very important to have a reliable and easy-to-use cement that is indicated for most types of indirect procedures. The dual-cure resin cement seT from SDI (North Amer-ica) is self-etching, self-adhesive, and fluoride-releasing, and it is indicated for cementation of indirect ceramic or composite inlays, onlays, crowns, bridges, and posts. The cement requires refrigeration prior to use. SeT comes in kit packages of 50 capsules. The unit-dose capsules are triturated and applied using a gun dispenser. There is a generous 2-minute working time, and complete set should be achieved within 5 minutes. After seating the restoration, a quick tack-cure of the margins (while the crown is subject to finger or instrument pressure) is recommended. The immediate removal of excess marginal and interproximal cement at this rubbery stage facilitates cleanup after polymerization. SeT adapts well to both tooth and restoration, and its viscosity is well suited to a variety of cementation procedures. The fluoride-releasing feature is a definite benefit, particularly at the restorative interface areas where teeth are susceptible to demineralization and redecay. 
For more information, call (800) 228-5166 or visit

Renamel NANO

Composite materials have taken a major leadership role in the dental industry. Most of our restorations, direct and indirect, involve the use of composite resin in one form or another. With the great variety in clinical applications, dentists often find they have a multitude of composite materials in their practices, clogging up drawers, counters, and storage spaces. Whenever possible, universal materials, products that are useful in a variety of clinical applications, are desirable. This is, of course, assuming that they can perform in a superior fashion in all these functions. COSMEDENT’s new Renamel NANO has improved hand-ling and excellent wear resistance as well as superior aesthetics. Easy to apply and to manipulate on the tooth surface, it increases both practitioner satisfaction and chair-side productivity. It is a universal composite that provides excellent results in composite applications from class I to class V restorations. Clinically, Renamel NANO exhibits absolutely no slumping; it stays where it is placed, unless of course, it is moved somewhere else. The completed restoration polishes quickly and easily to a high shine. It can also be used in combination with microfills and other composites in order to achieve the highest level of aesthetics. The material has a built-in translucency that mimics both enam-el and dentin, and it has proved to be more stain- and plaque-resistant than many earlier composites. The translucency allows the creation of aesthetic margins even in full view. Renamel NANO is brushable and sculptable for function, contact, and aesthetics. Renamel NANO is provided in basic starter syringe kits as well as in compules.
For more information, call (800) 621-6729 or visit
Case 1 before NANO. Case 1 after NANO
Case 2 before NANO. Case 2 after NANO

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 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. 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 aesthetics, dental technology, and photography. 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