First Impressions: November 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.


 

 


 

 

ProDrive Handpiece
ProDrive Systems

The basic design of dental handpieces has remained almost unchanged for more than a century, consisting of an air- or electrically-powered turbine that rotates a bur held in place by friction. While this mechanism is relatively effective in high-speed handpieces, the friction grip nature of the relationship between the handpiece and the bur can lead to a slippage of the bur, particularly in situations where additional torque is required. This causes the turbine to rotate more quickly than the bur, decreasing operative speed while concurrently wearing the inside of the turbine. The ProDrive Handpiece system from ProDrive Systems has been designed to upgrade handpieces through a turbine-and-bur-locking mechanism that can improve the performance of the currently-used handpieces. It is fully compatible with many of today’s most popular handpieces, providing an improved clinical performance. The ProDrive Handpiece utilizes a proprietary triangular bur shank design that physically locks the bur to into the turbine. This provides positive bur retention, greatly increasing torque transfer, and hence improved cutting. Other benefits include smoother handpiece operation and greater rotational concentricity during use. The significantly enhanced Pro-Drive grip on the bur improves cutting speeds and decreasing stresses on the tooth as well as on the practitioner. This reduces vibration and chatter during preparation, permitting a more predictable cutting definition that offers a superior margin in both direct and indirect restorations. There are more than 550 bur types available for the ProDrive Handpiece system. A unique bur-lengthening feature permits a totally safe 3 mm bur extension; the ProDrive chuck engages horizontal bur grooves to eliminate any risk of losing the bur during operation. The ProDrive Handpiece system is an innovative, upgraded approach to tooth preparation. For more information, call (866) 937-8882 or visit the Web site at prodrivesystems.com.

Mojo Veneer Cement
Pentron Clinical

The prospect of veneers shifting shades after cementation can cause trepidation in a practitioner. Porcelain veneers are extensive and expensive procedures, and patients expect longevity. Light-cure resins tend to color-shift far less than self-cure or dual-cure resin cements. But which light-cure resin cements will remain aesthetic over time? Pentron Clinical’s Mojo Veneer Cement has been designed to have an undetectable shade shift. The color of the restoration stays visually constant from the day of cementation. The various available shades (light, clear, dark, and movie star white) can brighten or warm restorations, and shades can be mixed for extensive shade customization. Most practitioners find the clear or translucent shade to be the most useful. Mojo Veneer Cement is light-cured and does not require hand mixing. It is compatible with halogen and LED curing lights. The shade-matched Mojo try-in gels are optimized to match the cured resin cement. No refrigeration is required for the cement or try-in gels. Mojo expresses easily, yet its viscosity has been designed for veneer cementation, not too flowable and not too tacky; a slight pressure on the veneer extrudes the excess cement for removal. After 1 to 2 seconds of tacking polymerization, the excess is easily removed and polymerization completed. Mojo has excellent flexural modulus and strength. It is twice as radiopaque as the alumina industry standard. Its very low water solubility and water absorption maintain the stability of intact margins. The Mojo Veneer Cement kit includes everything that is required for cementation: 4 cements, shade-matched try-ins, primer adhesive, the acid-etch gel for preparing the enamel, silane, and elephant tips for application onto the veneer. Mojo Veneer Cement keeps the color consistent. For more information, call (800) 551-0283 or visit pentron.com.

VITA Easyshade Compact
Vident

If you liked the VITA Easyshade, you’re going to love Vident’s VITA Easyshade Compact. Electronic shade matching has replaced guesswork estimation and approximation in shade determination, for both indirect and direct restorations. Many practitioners limit electronic shade-taking to indirect restorations. These very same units can, and should, be used for every aesthetically critical anterior or posterior restoration, whether ceramic or composite. The Easyshade Compact is a spectrophotometer shade-matching device that assists the practitioner or auxiliary in evaluating the shade for indirect or direct restorations very quickly and effectively. The Easyshade Compact can also verify the shade of lab work, before the patient is brought in for cementation. The Easyshade Compact is cordless and portable, lightweight enough for everyone. The technique is easily taught or learned. The Easyshade Compact is based on the shade guides for the VITA 3D-Master and the VITAPAN Classical. The Easyshade Compact illuminates the target area, making the results independent of lighting conditions, operatory colors, clothing, facial tones, etc. The unit can store up to 25 shades at a time. Transferring the shade information to the technician is easy; the LabRX software prints out all the collected data, eliminating human transfer error. VITA Easyshade Compact’s convenient LED technology offers extended use. The unit features very easy instructions and displays the tooth shade results within seconds: Simply press the handpiece switch to turn the unit on, calibrate right on the unit prior to each use, place the measuring probe on the tooth (make certain that the probe is flat on the tooth), and press the switch. Look on the bottom of the unit and read the shade. Perfect shades every time, and anyone can do it! For more information, call (800) 828-3839 or visit vident.com.

SureFil SDR flow
DENTSPLY Caulk

The underlying quandary of composite restorations is that the monomer components shrink as they cure. As this shrinkage occurs, it causes stresses at the tooth structure and intra-restorative interfaces. Layered composite placement and curing have been the dental standard for more than 2 decades and the technique offers predictably thorough curing of resins, while concurrently decreasing the polymerization stress on the remaining tooth structures. The difficulty with this method, however, is that each layer takes valuable clinical chairside time. Dental research has recently developed composites that exhibit less shrinkage. DENTSPLY Caulk’s SureFil SDR flow (with Stress Decreasing Resin technology) offers significantly lower stress during and after polymerization. Its chemistry incorporates a polymerization moderator that controls matrix formation, creating a more relaxed network than earlier light-cured materials. This technology can reduce polymerization stress by up to 60% without increasing curing times. A lowered shrinkage stress means that less stress is transmitted to the tooth during and after polymerization. SureFil SDR flow is indicated for use as a posterior bulk fill base, and up to 4 mm can be layered and cured at a time with a 20-second cure. This base is chemically compatible with all methylmethacrylate-based adhesives and composites. Its fluoride is readily released and available for uptake by adjacent dental surfaces. Clearly radiopaque (x-ray appearance similar to enamel) and easily distinguishable on radiographs, SureFil SDR flow quickly indicates any recurring problems that might be developing at the tooth-restorative interface at the earliest stages. Its fracture toughness denotes resistance to interproximal marginal break down. During placement into the cavity its self-leveling offers excellent, and simplified, cavity adaptation. The SDR optimizes SureFil flow technology by reducing polymerization stresses. For more information, call (800) 532-2855 or visit the company Web site at surefilsdrflow.com.

KALORE
GC America

The composite restoration is the foundation of the aesthetic practice; the practitioner’s day-to-day success with this material will largely determine the success of the practice. The major concerns in selecting a composite restorative are its immediate aesthetics, handling during placement, and (very importantly for the patient and the practice) long-term durability. GC America has introduced KALORE, a universal light-cured nanocomposite restorative material that incorporates innovative monomer chemistry from DuPont; 2 flexible arms flank the monomer’s long rigid core. The recently developed high-density radiopaque prepolymerized filler particles, combined with proprietary interfaces between the filler and the matrix, make for a truly unique composite material. The stiff core of the monomer makes the composite putty-like; it does not slump, allowing easy sculpting and shaping. KALORE’s prepolymerized fillers make it nonsticky during placement. The monomer’s long chain and low shrinkage stress minimize the risk of fillers popping out of the matrix, offering excellent initial gloss, rapid polishability, and a sustained luster. During polymerization, the resin matrix typically experiences volume reduction, while the filler particles tend to maintain their prepolymerization volume. This can stress the resin-filler interface, eventually leading to loss of luster, staining, surface roughness, wear, and restorative breakdown. KALORE’s uniquely low shrinkage develops less stress around the fillers and improves restoration longevity. The optimized refractive index of the filler and the monomer matrix provide a color-adaptive chameleon effect; in most situations, a single universal shade will be sufficient. For additional color characterization, translucent and 3 opaque shades are available. The extended range of tooth coloration can be created using the total aesthetic control recipe system, blending universal, opaque, and translucent shades. For more information, call (800) 323-7063 or visit gcamerica.com.

EZ-Fill and EZ-Fill Xpress
Essential Dental Systems














The obturation of root canals (and their lateral canal systems) is one of those trust situations where the practitioner cannot see or even feel what is happening during the procedure. Gutta-percha has been traditionally used to occlude canals, but requires firm packing both laterally and apically. Coating the canal completely with cement is difficult without overfilling. Success is typically measured radiographically or in long-term clinical comfort. Essential Dental Systems’ innovative EZ-Fill and EZ-Fill Xpress (automix) deliver a noneugenol epoxy resin cement with a bidirectional spiral for a predictable obturation. Bonding both physically and chemically with both dentin and gutta-percha, EZ-Fill coats the walls of the canals (and lateral canals) without significant cement being forced apically. As it sets, the EZ-Fill exhibits no shrinkage; in fact, there is a mild expansion that ensures an intimate fit with the tooth structures. The reverse apical spirals rotate in reverse, unwinding out of the canal to eliminate the possibility of binding. This coronal exit path for the excess cement prevents compaction and extrusion at the apex. The EZ-Fill technique involves a single gutta-percha point and cement, working synergistically to ensure a complete seal. Lateral and vertical condensations are typically not required. EZ-Fill is a root temperature obturation material (not thermoplastic), flowing effectively into lateral canals and avoiding shrinkage upon cooling. The system does not require any thermoplastic hardware. EZ-Fill is very radiopaque for easy x-ray identification. It is hydrophobic and highly resistant to water degradation. It is easily removed from the canals for post-hole preparation and is compatible with all bonding agents and composites. Restorations, including composites, may be placed immediately. For more information, call (800) 22-FLEXI [3-5394] or visit the company Web site at edsdental.com.

Dr. Freedman is a founder and past president of the American Academy of Cosmetic Dentistry, a co-founder of the Canadian Academy for Esthetic Dentistry, and a Diplomate of the American Board of Aesthetic Dentistry. He is the Special Advisor of First Impressions and Buyers’ Guides for Dentistry Today. He is the author or co-author of 11 textbooks, more than 600 dental articles, and numerous Webinars and CDs, and is a Team Member of REALITY. He lectures internationally on dental aesthetics, adhesion, desensitization, composites, impression materials, and porcelain veneers. A graduate of McGill University in Montreal, Dr. Freedman maintains a private practice limited to aesthetic dentistry in Toronto. 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 .