First Impressions: July 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.




ICON No-Drilling Caries Treatment
DMG America

The dental profession has been treating dental disease in the traditional surgical mode for several centuries. The process is simple: amputate and replace. The medical profession, on the other hand, has changed its focus to preventive and reparative measures. This paradigm shift in medicine occurred decades ago. Now, DMG America has introduced ICON (Infiltration Concept), an innovative treatment approach for caries that involves no drilling or pain, and it avoids the inadvertent loss of hard dental tissues. At the earliest stages, incipient carious lesions can be treated with fluoride. As the lesion progresses deeper into the tooth, however, restorations are re­quired. Most interproximal lesions tend to develop at the contact area where food and bacteria are readily trapped. Even when these lesions are at their earliest stages, the restorative process is particularly destructive interproximally at the marginal ridge, where healthy enamel and dentin often must be sacrificed in order to gain operative access. ICON provides proximal caries treatment that is gentle to the tooth surface. Once diagnosed, the early decay is routinely etched and dried. Then, ICON infiltration is accomplished using an approximal tip (an ultrathin film held between 2 plastic prongs) that simplifies interproximal insertion and positioning between slightly wedged teeth. Once the aproximal tip is in place, a slight pressure on the syringe will extrude enough infiltrant to coat the affected area and arrest the caries by creating a localized remineralizing environment. ICON combines early caries treatment with white spot elimination in a single sitting. This is particularly well suited for orthodontic patients after bracket removal and individuals with demineralized spots on their teeth. 
For more information, call (800) 662-6383 or visit the Web sites and

CoMax Composite Dispenser

By now, many dentists are familiar with the concept that composite resin, heated to slightly above body temperature, is easier to manipulate and has better restorative characteristics than the same material at room temperature. (Lab technicians have been aware of this for years.) Several studies over the past decade have completely repudiated the old canard of keeping composite in the re-frigerator until im-mediately prior to use. Given the unanimity of the science, the practical issue is how to conveniently heat the composites to the re-quired ideal temperatures and then to maintain them at that point until use. AdDent has been a leader in the concept and the technology of composite heating. Most recently, it has developed the heated CoMax Composite Dispenser. The compule gun is very ergonomic. It is very comfortable to hold, and the control trigger is readily accessible. The levered handle minimizes the dispensing force that is required to express heavily filled composites, a very important feature for practitioners and assistants who have small hands. The CoMax Composite Dispenser is manufactured from high-tech plastic and stainless steel, and it is completely autoclavable. Unlike many other dispensers, it is easy to load and unload, even with one hand. This frees up the other hand for any other necessary tasks. The dispenser accepts all brands of compules. The entire composite dispenser, including the inserted compule, fits into the Calset Composite Warmer. The preselected restorative material is heating in the loaded dispenser, ready for use. The entire dispenser assembly can be brought immediately to the tooth cavity prepared for the restoration. The Co-Max Composite Dispenser is a better way to manage your composites. 
For more information, call (203) 778-0200 or visit AdDent’s Web site at


The entire dental team—including both the dentist and laboratory technician—is always on the lookout for newer and better methods to make indirect restorations that function more effectively and look more natural. There are a number of material options available to the practitioner: ceramic and composite, and each has its advantages. Shofu’s Ceramage zirconium silicate indirect restorative provides excellent aesthetic results for both anterior and posterior restorations. It is indicated for implants, inlays, onlays, crowns, and bridges. For extended restorations where multiple segments are involved, this allows the technician to use the same material throughout without compromising function or aesthetics. Ceramage’s organic polymer matrix is filled more than 73% with progressive fine structure (PFS) filling, a microstructure that resists plaque accumulation. Its composition offers the material excellent flexural strength, elasticity, and polishability. Ceramage also provides excellent abrasion resistance and color stability. It replicates the appearance and light-diffusing properties of both dentin and enamel, and the PFS filter makes it possible to match light transmission properties of the natural tooth structure without firing. The natural light transmission and fluorescence of Ceramage pastes cause restorations to exhibit a dazzling and distinctly vital appearance in the patient’s mouth. The Gum Color Set allows the lab technician to reestablish a realistic natural anatomy towards the gingival, particularly important in implant-related treatment planning and telescopic restorations. Using Ceramage to build up metal-free inlays and onlays is simple and fast, allowing controlled application and modeling, even for very fine anatomical details. To fuel the ceramic-composite controversy, Ceramage cases include durable posterior restorations, resilient and more elastic than conventional ce-ramic. Ceramage indirect restorations provide pure aesthetics. 
 For more information, call (800) 827-4638 or visit the Web site located at

Clinical photos courtesy of Dr. Lou Graham

Canon Rebel XSi






When selecting a dental photo system, the practitioner has 2 options: (1) assemble a functional system and locate the various components, pre-ferably at competitive prices. Once everything arrives (usually not at the same time), attach the components and troubleshoot; or (2) purchase a tried-and-tested system from one of the dental photo dealers. My choice is the second option. CliniPix (with more than 40 years of experience in dental photography) has built a dedicated system around the 12.2-megapixel Canon Rebel XSi, the latest and the smallest of the Rebels. This single-lens reflex camera (what you see is what you get; live-action viewing) provides a high-resolution, color-accurate image and auto sensor cleansing. The Rebel XSi’s high-resolution (4,272 X 2,848 pixels) offers 35-mm quality in a digital format and uses secure digital memory cards. The practitioner can use the giant 3-in LCD live-action rear screen or the traditional view-finder. It is powered by using a lithium-ion battery with a 90-minute external re-charger. The F2.8 105-mm macro lens is bright and powerful and focuses infinity to 2 times life-size ratio in either manual or autofocus modes. The focal length allows for a comfortable working distance to the patient even when taking 1:1 life-size views of the posterior region and provides distortion-free, full-face/profile images. The standardized series of views printed on the lens is a ready reference comparable to traditional 35-mm dental views. The dedicated through-the- lens ring light provides excellent color and lighting everywhere, from intraoral to full-face views. The Canon Rebel XSi is fully tested and shipped with all functions preset and relevant dental instructions. Most important of all, CliniPix offers unlimited toll-free telephone support (which I have used many, and it has been a lifesaver). 
 For more information, call (866) 254-6749 or visit

Team Vista Dental Waterline Cleaner

The issue of biofilms and various other contaminants in dental waterlines has been making an ever-increasing appearance in the dental literature and as a concern for dental office safety. When waterlines are not regularly cleaned or maintained, bacteria biofilm develops on the inner surfaces of the tubing and system components. This clogs waterlines, causes corrosion, and creates health hazards for both staff and patients. A 2-step maintenance and cleaning process is required to achieve the recommendations that have been set forward by the CDC and ADA. Many practices have, in fact, been cleaning their dental waterlines in one fashion or another for a number of years. The objective is to have an effective yet efficient and economical method for keeping waterlines both safe and clean. Hu-Friedy has introduced the Team Vista Dental Waterline Cleaner, an easy-to-use system that quickly controls microbial contamination in dental waterlines and has both an approved organic irrigant and a registered antimicrobial cleaner for enhanced patient care. VistaClean is a daily irrigant solution derived from organic citrus botanicals and is totally safe for patients. The solution assists in the protection of waterlines and equipment from the deposits and scale by emulsifying organic and inorganic contaminants that tend to build up in waterlines. The environmentally friendly VistaClean has no taste or odor, is completely nontoxic and noncorrosive, and has been shown not to have any negative affect on adhesive bond strengths. VistaTab antimicrobial tablets dissolve quickly in water to create a noncorrosive solution that is 7 times more effective than bleach. This is used to periodically clean and maintain dental unit waterlines. Team Vista is the dental waterline microbe terminator. 
For more information, call (800) HU-Friedy (483-7433) or visit the Web site at

"Total Veneer Experience" DVD series
Alan R. Grodin, DDS

Dental education is a very personal journey. It is, however, an essential part of the successful dental practice. If we fail to continue learning, we risk being unable to grasp new techniques, technologies, and procedures, and we remain forever tied to the concepts and materials of the past. Since porcelain veneers were first introduced 25 years ago, they have had a major impact on the general population as well as the dental profession. Prior to veneers, aesthetics did not exist as part of the restorative vocabulary. With veneers and composites and other innovations came the ability to change patients’ smiles—and their lives—for the better. This, in turn, has motivated many patients to seek dental treatment both for specific procedures such as porcelain veneers and generally for long-term maintenance of oral health. When new techniques are adopted into the practice (or existing ones reviewed), it is beneficial to share the experiences of colleagues who have experienced success. "The Total Veneer Experience" DVD series by Alan R. Grodin, DDS, provides practitioners with an opportunity to expand their dental practices by learning (or relearning) the porcelain veneer procedure. Dr. Grodin’s 5-disc DVD set provides both marketing and clinical elements that assist in developing a successful veneer practice. Topics include (1) clinical aspects of the veneer procedure, including supplies and materials, (2) laboratory aspects; (3) harnessing both internal and external marketing; (4) importance of the Internet; and (5) the 30-minute cosmetic consultation, from tactics to financing. This DVD series is viewed at the practitioner’s own pace, in the office or home, and can be reviewed at any time as often as necessary. "The Total Veneer Experience" DVD series offers strategies for success.
For more information or to purchase, call Dr. Grodin directly at (248) 288-1110, or visit the Web sites or

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 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 .