First Impressions: November 2010

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.


Have you ever nicked the healthy adjacent tooth structure when preparing the interproximal area for a Class II or a crown? Of course not, but at least theoretically, it is possible. The problems are that the bur is rotating at 300,000-plus rpm, the patient may move slightly, and the operative area is truly miniscule. Triodent’s newly introduced WedgeGuard is unique problem solver, eliminating 2 major chairside headaches: protection of adjacent hard tissues and protection of adjacent soft tissues. The metal guards are manufactured into the top of the color-coded Triodent Wave-Wedges in several sizes. The WedgeGuard is inserted between the teeth interproximally prior to preparation, safeguarding the adjacent teeth by providing a physical barrier to prevent inadvertent bur nicks. The WedgeGuard also protects the papillae during preparation, eliminating post preparation bleeding that can contaminate the restorative materials. After the preparation of the Class II, Class III, veneer, crown, or tunnel prep, the WedgeGuard is removed from Triodent’s Wave-Wedge with pin tweezers, leaving the Wave-Wedge in place between the teeth and ready to accommodate the insertion of a standard matrix band. Decreased gingival trauma is particularly important during the preparation of indirect restorations where immediate polyvinyl impressions are planned; decreased (or eliminated) bleeding makes the taking of the final impression much easier, more accurate, and predictable. The intent is not use the WedgeGuard as a matrix. The WedgeGuard’s position is in the middle of the wedge, which may result in a large overhang or open contact after removal. The WedgeGuard increases operator visibility while increasing safety, making restorative dentistry better, easier, faster, and clinically risk-free.
For more information, call (800) 811-3949 in the United States, (866) 316-9007 in Canada, or visit the Web site

Bifix SE
VOCO America

Resin cements are so much more useful than the traditional zinc oxyphosphate or polycarboxylate ones that we used to use. They bond securely to the remaining enamel and dentin, composite core buildups, and most restorative materials. That is why they are so popular with the profession. The major problems with the earlier resin cements were that they required etching and/or conditioning of the prepared tooth structure, often causing extended post-cementation sensitivity in vital teeth, and their film thickness prevented the complete seating of restorations, requiring costly chair time for adjustment. VOCO has introduced Bifix SE, a self-adhesive, dual-curing, automixing resin cement that overcomes these concerns. Bifix SE’s innovative chemistry eliminates the need for time-consuming etching, conditioning, and bonding as separate steps. All the necessary components are contained within the mixture that is dispensed directly from the syringe (no trituration). Its neutral pH assures no patient sensitivity in vital teeth during or after the procedure. Bifix SE’s 10 μm film thickness ensures accurate fit, complete seating, and minimal post-cementation adjustment time. It is available in 3 shades: transparent (most commonly used), A2 (universal), and white-opaque (color block-out). Bifix SE is dual-cured; it photo polymerizes in the presence of light and self-cures in the absence of light. Thus, the practitioner is confident of curing all light-inaccessible areas between the abutment and the restoration. Indicated for crowns, bridges, inlays, onlays, and posts manufactured from ceramic, metal, and zirconium, Bifix SE is radiopaque for assured radiographic monitoring over the lifetime of the restoration. A practical 2-minute working time is followed by a 4-minute setting time. The gel-phase cleanup reduces finishing time. Bifix SE is quick, clean, and reliable.
For more information, call (888) 658-2584 or visit the company Web site

CarieScan PRO

How does one determine whether a tooth is carious or simply stained? If carious, how long will preventive procedures suffice, and when is it time to intervene and restore? And how to apply these treatment parameters guided by the evidence-based data? CarieScan has introduced the CarieScan PRO, a handheld device for the detection and monitoring of caries by the application and analysis of alternating current impedance spectroscopy (ACIST). The process is to pass a very small electric current through the tissues, one that is not at all felt by the patient and poses no danger whatsoever. ACIST has the highest proven accuracy of all the caries detection systems on the market, with the all important, minimal “false positive” indications. The CarieScan PRO permits dental professionals to evaluate decay in teeth and provides information about whether the tissue is healthy, in the early stages of decay or already significantly decayed. The diagnostic process is simple: place the grounding hook on the patient’s finger or lip, air-dry the tooth site, and hold the battery-operated sensor against the tooth to be examined. A very low current (undetectable to the patient) is passed through the tooth and encounters various levels of impedance in the tooth dependent upon its condition. The blue LED light flashes and is then followed by 4 audible beeps. The diagnostic results are displayed both on the LCD screen and the color LED display. The entire process takes 4 seconds. The clear numeric information is easily documented into the patient’s chart to monitor and assess disease status and progress (or improvement). Infection control is simplified by single-use, disposable sensors. CarieScan PRO offers clear, dependable, caries detection in seconds.
For more information, call (877) 580-7226, contact the exclusive distributor, Patterson Dental, at (800) 873-7683, or visit the company Web site


The restoration of the endodontically treated tooth should be a fairly straightforward process. The most common problems encountered by the practitioner include difficulties in placing, shaping, and containing the build-up resin, the polymerization shrinkage that can stress the remaining dentin, and “slips” during the preparation phase if the tooth and the composite do not offer the same resistance to the bur. BISCO has recently introduced CORE-FLO DC, a dual-cured, fluoride-containing, radiopaque core build-up resin that also cements the post into the prepared space and acts effectively as a dentin replacement. This material has excellent flowability and adaptation inside the post hole, and it concurrently offers excellent nonslumping handling for building up the core. Once cured, CORE-FLO DC prepares just like dentin. Its void-free flow when bonding the post and core provides a homogenous bond to tooth and restorative substrates and strong, durable cores. Its high flexural and compressive strengths and a significantly reduced water sorption/solubility profile ensure clinical confidence in the predictability and longevity of the restoration. CORE-FLO DC’s low shrinkage stress during polymerization minimizes the risks to the radicular dentin. Its compatibility with adhesives and its immediate hardness after polymerization allow for crown preparation of the core without dislodgement at the same appointment. The maximum working time is 2 minutes, while the maximum setting time is 7 minutes. CORE-FLO DC is available in 3 shades: Natural (or A1), Opaque White, and Contrasting Blue. (My preference is the Natural for aesthetic reasons.) The radiopacity is particularly important during follow-up recall examinations; there is a clear differentiation between the buildup and the remaining tooth structures, and any redecay or marginal breakdown is clearly evident.
For more information, call (800) BIS-DENT (247-3368) or visit the Web site

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 a visiting professor at the Universita di Firenze, Florence, Italy. 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 .