First Impressions: August 2007

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.



MD Gold Handpiece

The utility of any instrument in the dental practice depends on how easily it can be put to use, how well it works, and most importantly, how comfortable and effective it is for patient treatment. As dental lasers have become more and more important in the dental practice, the cumbersome and clunky early handpieces have given way to sleek, efficient, and ergonomic new designs. Cutting precision, cutting speed, and the all-important operational “sweet spot” are the major considerations in selecting a dental laser handpiece and its associated cutting tips. BIOLASE has recently introduced the MD Gold Handpiece for the Waterlase MD. The new handpiece has in-creased cutting precision; this allows the practitioner to provide more highly focused, less invasive techniques that result in an increased conservation of tooth structure. Increased cutting speed and efficiency make both the patient and the dentist happier. Faster and more effective tooth preparation reduces the chair time per patient, allowing for more procedures per day per chair and laser unit. The sweet spot, that all-important, high-efficiency cutting focus of the laser tip (usually located a few mm beyond the actual tip), has been enhanced. The enhanced focal depth allows greater latitude in everyday use; since the targeting does not have to be quite as precise, it allows more efficiency. The greater focal depth also permits easier tooth preparation and less clinician fatigue. The BIOLASE ZipTips are specially designed for the MD Gold Handpiece. While each is an improvement on the previously available technologies, when used together they truly transform the laser procedure. MD Gold is the new standard in laser handpiece technology.

For more information, call (888) 424-6527 or visit

NX3 Nexus Third Generation Universal Adhesive Resin Cement

The minimal requirements for dental cements today include an acceptable aesthetic restorative material that fulfills the patient’s appearance-related demands, a long-term function as a nondissolvable luting agent, and a predictable adhesion to a variety of diverse materials. There is an absolute need for dental resin cements to bond to all dental substrates, including enamel, dentin, ceramic, resin, metal, and CAD/CAM blocks. Over the past 2 to 3 years, the process of mixing cements and delivering them into the crown or bridge has been radically simplified by automix dual-syringe systems and direct application tips. Kerr has recently introduced NX3 Nexus Third Generation Universal Adhesive Resin Cement. This new cement offers automixing convenience, simplified delivery, and total compatibility with both total-etch and self-etch bonding systems. Five shade selections are available, including bleach. Kerr’s amine-free initiator system provides a superior color stability that encourages the use of NX3 Nexus as a dual-cure cement for anterior aesthetic restorations. (Traditional dual-cure cements have a phosphene initiator that tends to yellow with time.) NX3 Nexus is supplied with a set of shade-corrected try-in gels that provide a true color match for both patient and dentist to evaluate prior to final cementation. The automixed NX3 Nexus is dispensed directly into the indirect restoration and then simply seated onto the abutment(s). The excess cement can be readily removed during the gel state, minimizing the post set cleanup of the final restoration. NX3 Nexus is indicated for all indirect applications, including veneers. If a longer working time is desired, a separate light-cure cement for seating multiple units is available.

For more information, call (800) KERR-123 or visit

VITA Bleachedguide 3D-MASTER

A glance at any group of people clearly indicates that a significant part of the adult population of North America has chosen to whiten its teeth. And the rest of the patients in our practices are likely to do so in the near future. Unfortunately, this throws shade matching, as we know it, on its ear. With the major shift of tooth coloration to the brighter and whiter, B1 is now the new A2. Most of the existing shade guides, developed decades ago, have not kept pace with this patientled aesthetic revolution. The VITA shade guide has been the industry standard for assessing tooth coloration for more than 50 years, including the innovative and user-friendly 3D-MASTER Shade Guide that was introduced just a decade ago. Now Vident, the leading shade guide manufacturer in North America, has introduced the VITA Bleachedguide 3D-MASTER. It differs from the traditional VITA Classical Shade Guide System by offering shade tabs that are specifically arranged for measuring the bleaching process. Thus, both the patient and the dentist can plan, as well as monitor, the tooth-whitening treatment. The practitioner benefits from the precise shade reproduction that is a hallmark of the 3D-MASTER System and can use the Bleachedguide 3D-MASTER to educate and inform the patient, helping to market in-office and at-home bleaching treatment. The 15 shades in the guide represent a good range, from natural dentition to the bleached (and even ultrableached) shades that can be seen in typical general dental populations. The VITA Bleachedguide 3D-MASTER is an ideal marketing and monitoring tool for the bleaching practice.
For more information, call (800) 828-3839 or visit


Pre-etching Post-etching

Dentists have been etching tooth surfaces prior to restorative procedures for more than 50 years. While the role of etching is well-established in dentistry, the precise clinical procedure is somewhat technique-sensitive, and the adhesive quality of the etched surface may be difficult to evaluate. To complicate matters further in the world of dental materials, an increasing number of adhesive systems that utilize self-etching mechanisms have been developed. An additional caveat is that—even with the newest sixth- and seventh-generation adhesives—etching the enamel is well-known to increase the enamel surface bond strength significantly. The EtchMaster, manufactured by Gro-man, is a tooth surface etching device that was developed as a variation on the inexpensive PrepMaster, (the budget answer to dental microabrasion). The EtchMaster kit includes the handpiece adapter as well as single-use disposable tips. The tips are prefilled with a variety of abrasive powders: hard, mild, or soft. In addition, each powder type is available in 2 particle sizes of aluminum oxide: 27 µm or 50 µm. The EtchMaster microabrader prepares all exposed tooth surfaces to an ideal adhesive roughness, predictably and effectively, in seconds. The tiny, controlled stream of abrasive particles quickly and painlessly etches where even the smallest bur cannot penetrate. It is indicated for use prior to sealants, anterior and posterior adhesive direct restorations, as well as indirect treatments. The innovative etching tip is tightly focused, eliminating overspray. The EtchMaster tip is sealed until the nozzle is pulled forward, immediately prior to use, activating the instrument. When liquid or gel etching is not possible or practical, the EtchMaster microabrader does the job.
For more information, call (800) 906-9298 or visit the Web site located at

Endo Safe End Instrument Series
SS White Burs

The angulation and the location of the endodontic access orifices can be problematic at times, particularly when working in teeth restored with crowns, bridges, or large direct fillings. It is always important to achieve straight-line access to these orifices, and even more so if mechanical instrumentation is to be used. Without adequate access, both instruments and obturation materials are difficult to position, handle, and manipulate effectively within the canals. An additional overriding concern in the practitioner’s mind is, of course, the conservation of the remaining tooth structure. Initial access through the enamel or restored crown is typically achieved with a larger round bur. Once inside the pulp chamber, it can be tricky to develop the necessary lateral extension that is needed to create straight-line access to all canals. The Endo Safe End Instrument series from SS White Burs has been designed to cut only laterally and not apically. This allows confidence in lateral extension without the risk of penetrating the floor of the pulp chamber. The tip of the Endo Safe End bur is totally rounded and thus will not develop a ledge. (Other “safe end” burs, which have a step to the safe end portion, can cause ledging, an internal step that is difficult to smooth after obturation.) Endo Safe End instruments are available in 2 sizes, 1.4 and 1.8 mm in diameter, with the 9-mm head length offering easy access to the pulpal floor. The taper permits proper visualization of the working area. The 8-bladed, friction-grip, tungsten carbide burs provide rapid and controlled removal of tooth structure. The Endo Safe End burs go as far and as fast as you need within the pulpal chamber, but no farther.
For more information, call (800) 535-2877 or visit

SMILE-NOW Instant Dental Templates
VIP Smiles

Do you ever wish you could clearly describe to patients what they will look like after the set of veneers you are proposing? Drawings or previous patients’ pictures help, but they are not personal. A quick resin mock-up done directly in the patient’s mouth is very informative but both time-consuming and technique-sensitive. (After all, the main arguments for porcelain veneers include that they usually look better and tend to last longer than resin veneers.) Lab-fabricated intraoral diagnostic mock-up inserts can be very expensive and require 2 appointments at least. The innovative SMILE-NOW Instant Dental Templates offer the dentist and the patient an immediate new smile—within a minute—that helps to visualize the after-treatment smile. Virtually no learning curve is involved. Simply measure the approximate space available and key it into one of the 3 SMILE-NOW templates sizes. Insert the selected template onto the teeth with the clear adhesive provided and have the patient take a look. The patient is very likely to be amazed at the change that can be created. The improved image of his or her dentition in his or her own mouth is worth far more than a thousand words. SMILE-NOW eliminates the need for digital imaging or complicated Photoshop sessions. There is no lab fee or expensive in-office chair time to build intraoral mock-ups. In fact, SMILE-NOW can be a task delegated to the dental team. In-the-mouth imaging is easy to do and predictable. SMILE-NOW increases pa-tient comprehension, interest, and case acceptance significantly. Try SMILE-NOW on your own teeth. I did. See what a difference just one minute can make.
For more information, call (866) 478-6398 or visit the Web site (featuring a live video demonstration).

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 .