First Impressions: November 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.







 


MI Paste Plus
GC America


Tooth structure remineralization is one of today’s dental buzzwords. For the first time, dentists can look beyond invasive surgical approaches to actually restoring unhealthy tooth structures to full health and function. While fluoride was first used commercially in dentistry in 1955, 2 of the most effective materials in remineralization science today are casein phosphopeptide (CPP) and amorphous calcium phosphate (ACP). CPP maintains calcium and phosphate ions in a stable form in close proximity to the tooth, and ACP delivers the ions into the tooth structure. GC America introduced MI Paste with Recaldent (CPP-ACP) in 2003. Developed at the University of Melbourne, Australia, Recaldent has a long history of effective use for remineralization following extensive pretesting. Long a leader in remineralization research, GC America now offers MI Paste Plus with added fluoride to the CPP-ACP complex (900 ppm fluoride ions as 0.2% NaF). This changes the CPP-ACP complex to CPP-ACP-F, increasing fluoride uptake into plaque and subsurface enamel, driving remineralization, and decreasing demineralization. MI Paste Plus delivers a physiologically ideal ratio (5:3:1) of calcium, phosphate, and fluoride, resulting in better tooth infusion to strengthen enamel. MI Paste Plus is easy to apply: 3 minutes in a custom tray or swabbed on tooth surfaces with a finger or brush (the tongue spreads the material around the mouth). Home treatment involves the application of a small amount of the MI Paste Plus to both upper and lower teeth with a dry finger or cotton tip (3 minutes). For high-risk patients, nighttime application after toothbrushing may be indicated. MI Paste Plus is helping dentists to move from the historical surgical model of treating dental disease to the medically oriented prevention model, emphasizing pre-emptive care to eliminate dental disease before it can become established.
For more information, call (800) 323-7063 or visit the Web site located at gcamerica.com.


TECO (Total Etch Control)
Zenith Dental/DMG


From the practitioner’s perspective, the keys to the bonding procedure are predictability, adhesive strength, and ease of use. Any procedure that is complicated runs the risk of mistakes, missteps, stress, and, ultimately, a failed adhesive interface. Zenith Dental/DMG’s new TECO bonding agent is a total-etch adhesive delivered in an innovative, single-dose dispensing system. TECO’s “SilvR” single-dose dispensing system contains all the components for the bonding process within an integrated applicator. Depressing the bubble (finger pressure) expresses the material into the well, and stirring the bonding agent with the applicator readies the liquid for direct application to tooth surfaces. The applicator is cylindrical in shape, making for easier application to flat cavity walls. The base of the “SilvR” dose integrated system dispenser is flat and stable, designed such that it remains upright on the tray or counter. TECO’s excellent tensile bond strength provides predictable adhesion to both enamel and dentin. The nonacetone formulation polymerizes with all types of curing lights (halogen, PAC, and LED), and is suitable for use with all light-cured materials. TECO’s unique single-dose applicator offers reliable bonding with push-button convenience. The application process is one step, one hand, clean and easy. Apply TECO adhesive after routine etching of both the enamel and dentin (total etch) and rinsing. The tooth surfaces are left moist. Rub the adhesive onto the tooth surfaces and leave undisturbed on the tooth for 20 seconds prior to air-drying. A 10-second light-cure completes the adhesion process. TECO offers an easy and predictable single-step method for applying light-cure compatible adhesion to all dental surfaces.
For more information, call (800) 662-6383 or visit zenithdental.com.


Jazz Polisher System
SS White


Polishing composites is a fairly routine procedure that is familiar to dental professionals and readily accomplished by existing methods and materials. Composite polishing is a procedure that is taught in dental school and offers routinely predictable results as long as all the appropriate steps are followed in proper sequence. This reflects the hidden problem of the polishing process: given the high cost of chairside time, every minute is prohibitively costly to the practitioner. Thus, as long as the final quality of the polish is not diminished, it is desirable to decrease polishing time. SS White has recently introduced the Jazz Polisher System, a highly efficient, full-range aesthetic polishing system of techniques and materials that is designed for intraoral use with both composites and ceramics. The Jazz Supreme Polisher is a single-step, diamond-infused composite polisher designed to create an ultrahigh-gloss polish on all types of composites including hybrids, microhybrids, microfills, and nanofills, as well as flowable materials. The development of a reflective gloss on the composite surface is possible in one easy step. This feature reduces the costly chair time associated with the use of the more cumbersome 2- and 3-step polishing techniques that are currently standard. The effect of the Jazz Supreme Polisher, a proprietary combination of a unique synthetic rubber matrix infused with diamond particles, is variable, based upon the rotation speed and the application pressure. To shape and prepolish, simply increase the pressure or speed (or both) of the polisher; to create an ultrahigh-gloss shine, decrease the speed and/or the pressure. The recommended speed of polishing is 5,000 rpm (maximum 15,000 rpm).
For more information, call (800) 535-2877 or visit the Web site located at sswhiteburs.com.


Freealgin
Zhermack


The alginate impression has been an important part of the dental armamentarium for many decades. Designated for impressions where 100% accuracy is not critical, it is a fast process, relatively inexpensive, relatively accurate, and most often delegated to the auxiliary. Unfortunate-ly, traditional alginates employ a powder and liquid mixing process. Accurate dosing of the components is critical to the impression quality, and yet, precision is often overlooked at this stage. The powder is often inconvenient to dispense and messy, the mixing process is technique-sensitive, and the set impressions are very time-limited in terms of their functional utility. Zhermack has recently introduced an innovative clinical alginate impression material called Freealgin. The major advantage of Freealgin is that it is automatically mixed (cartridge or machine) directly into the impression tray: no mess or fuss with the powder, no dosing needed, no instruments required, and no bowl or spatulas to clean. The material is provided in universal 50-mL dispenser cartridges that fit standard guns, and in bulk format (380 mL) canisters that are suitable for every automixing machine. Freealgin is a thixotropic, fast-setting silicone that has a constant consistency with every mix and will not run, either in the tray or in the mouth. It has a high tear resistance, preventing separation, even in thin areas, and provides a high degree of anatomical accuracy. Freealgin has excellent long-term dimensional stability, thus there is no time limit for pouring the impression. In fact, multiple pours (from one impression) are possible. A pleasant tropical flavor (for the patient) and safe disinfection (for the lab) both round out its properties. Freealgin is an excellent, hassle-free, next-generation alginate replacement.
For more information, call (877) 819-6206 or visit the Web site located at zhermack.com.


ThermaGrip
Alesar


We have all had the embarrassing experience of the smooth-surfaced inlay, onlay, crown, or veneer slipping out of our moist, gloved fingers and skittering across the floor. They are hard to pick up and harder yet to hold. Even more difficult is the manipulation of the restoration, with cement, correctly oriented, into the prepared cavity without salivary contamination. The ThermaGrip is an innovative solution to this problem. It is a battery-powered heating unit that forms a temporary thermoplastic attachment between the restoration and a disposable handle. The activated ThermaGrip generates heat. Ready in 5 seconds, the heated tip is used to contact an adhesive plastic pellet in the cassette or on a pad, melting it. Once the pellet is liquefied onto the handle tip, it is applied to the occlusal or buccal (nonadhesive) side of the restoration; within a second or so the cooling plastic pellet hardens and attaches to surface irregularities. Now the restoration can be lifted and the intaglio surface may be silanated, etched, bonded, and cemented as required. The restoration is then placed, directly and securely, into/onto the preparation. To release the Therma-Grip pellet, maintain finger pressure on the restoration as the handle is pulled away or rotated slightly to release the mechanical attachment. Once the cement is cured, any additional remaining pellet material is readily identified by its green coloration and scaled away. The Therma-Grip process simplifies the precise positioning and placement of bonded, cemented restorations into relatively inaccessible prepared cavities, eliminating the stress often associated with this phase of treatment, and assists in avoiding salivary contamination. The ThermGrip eliminates the fear factor in manipulating small restorations with gloved fingers.
For more information, call (866) 387-8259 or visit the Web site jonathanmacarthurdds.com/thermagrip.htm.


Esthetic Dentistry/Smile Design-The International Version
EC Dental Solutions


Clear communication between the patient and the dentist is the most effective tool for effective diagnosis and treatment planning. Dentists understand the process and the purpose of developing a healthy, functional, beautiful smile; patients often have the very same objectives. The problem lies in communicating and correlating these desires. Dental professionals tend to speak “dentaleze,” incomprehensible to patients, who tend to communicate more easily through pictures and concepts. The Esthetic Dentistry/Smile Design book offers an innovative bimodal approach to treatment planning: the patient identifies the desired smile, providing the dentist a technical guide to the anatomic form. This text is actually 2 books in one. Its 100 pages include what the dentist can do, what the patient may want, and the relationship between the two. Using this unique, 2-sided book, the dentist simply flips from the Patient’s Guide to the (correlated) Dentist’s Guide to develop the selected smile. This correlation provides a logical and sequential mechanism (for the dentist and the technician) to achieve the patient’s desired smile objective (if clinically attainable). This popular book was first published a number of years ago in English and has now been translated into 6 languages:  Spanish, German, French, Italian, Romanian, and Portuguese. Thus, patients who would like to change their smile but are not adept in the English language are still able to communicate with their dentists pictorially and conceptually. Even where language barriers exist, this multilingual co-treatment resource ensures that the patient and the dental team are on the same track before treatment has even begun. Language differences are no longer barriers to effective treatment planning and aesthetic communication!
For more information, call (877) 662-2374 or visit the Web site ecdentalsolutions.com.


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