First Impressions: September 2011

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.


Gingival bleeding during impression taking or crown cementation is a deal breaker. If the restorative process cannot be accomplished in a moisture-controlled environment, it will fail. The same situation arises during the restoration of deep Class IIs and Class Vs. In addition to the problem of hemorrhage, the continual flow of crevicular fluid also tends to disrupt dental procedures. Gingival hemostasis has long utilized various sulphur compounds, despite the complication that even trace amounts of this additive can interrupt the polymerization of the commonly used vinyl siloxane impression materials. Septodont has recently introduced Racegel, a thermally dynamic hemostatic agent that features faster control of bleeding, precise placement, and rapid cleanup. It also absorbs crevicular fluid, guaranteeing a dry peridental operating field. Racegel's active ingredient is 25% aluminum chloride, a proven astringent that has no effect on impression materials. Its thermodynamic properties make it a liquid at room temperatures that applies easily to gingival surfaces; oral temperatures of 35°C increase its viscosity so that it stays in place until the impression sets. The thermal effect is completely reversed by rinsing with room temperature water. Racegel's convenient prebent tip syringe makes it easy to dispense precisely and its bright orange color ensures that it is completely rinsed away prior to taking the impression without tissue discoloration or irritation. Racegel can be used in combination with a retraction cord, directly applied to both the single- and double-cord techniques, to make margins visible and readily accessible. It facilitates crown and bridge impressions and cementations, deep direct restorations, as well as periodontal scaling. Racegel makes hemostasis and crevicular fluid management much easier and far more predictable.
For more information, call (800) 872-8305 or visit the company Web site at

Gen II
Dental Vibe

Since the introduction of the revolutionary DentalVibe, this system has alleviated the associated discomfort and eliminated apprehensions and fear with dental injections; many dentists, and far more patients, love these comfortable injections. Now the new DentalVibe Gen II is featuring many advances over the "old" model, scarcely one year later. Twice the power: The increase in power generates an increase of twice the amplitude at the vibrating tip, leading to greater sensory nerve stimulation enhancing the pain blocking effect. Proprietary VibraPulse technology stimulates the sensory nerves at the injection site—effectively closing the neural path gate, thereby blocking the pain of injections. New white tip: This color change increases visibility within the oral cavity as does the super-bright LED illumination that provides optimal illumination. More microfilaments on the underside of the tip: The addition of many microfilaments further stimulates the oral mucosa, offering a greater vibrational stimulation. Voltage regulated power supply: A technical addition to the motherboard provides an increase in voltage, increasing the power output, as the tip is retracting the lip or cheek. This increase in voltage helps to maintain a high amplitude of vibration at the tip even under the load of retraction, leading to a smooth, consistent operation of the device. Tear-away tip upon removal: A newly designed feature to prevent any risk of patient cross-contamination. The unit is designed to shut off if excessive force is applied. The DentalVibe Gen II unit is cordless and handheld, with strategically placed finger grips. It is readily portable, weighing less than 3 ounces, and delivers soothing, pulsed percussive micro-oscillations to the injection site. Try it. Your patients will love it even more!
For more information, call (877) 503-VIBE (8423) or visit the Web site at

Sheer White!

There are any number of tooth whitening products available to the patient and the practitioner. Dentists generally prefer those that are distributed exclusively through professionals; this not only offers more clinical supervision for the patient, but it also is advantageous to the practice bottom line. At-home tooth whitening has evolved tremendously from the days of custom fabricated, labor-intensive trays, when the bleaching gel seeped into the mouth within minutes and was diluted and eliminated by the saliva. The Cao Group has recently introduced Sheer White!, a trayless film whitening system that works effectively and predictably for the patient (and the dentist) outside of the dental office. It is also an excellent complement to in-office whitening, maintaining and improving tooth coloration after (and in between) chairside sessions. The active ingredient is 20% carbamide peroxide gel, well tolerated by the hard and soft tissues, and chemically equivalent to a 7% hydrogen peroxide solution. The Sheer White! gel is very viscous, and thus the thin moldable film adapts to the dental anatomy, fitting very tightly, sealing to the teeth and keeping gel against the dentition instead of running down the throat. The strip stays in place. Patients can talk normally while wearing the strip and can even take a drink without lisping or drooling. The suggested wear time is one hour. Patients who are more comfortable tend to exhibit greater compliance. A longer wear time (such as overnight) means faster whitening. The gel remains active for as long as 6 hours. Sheer White! can be used as a touch-up whitening agent as well. No trays, no chair time, no sensitivity, just sheer whitening.
For more information, call (877) 236-4495 or visit the company Web site at

Directa Dental

Tooth restoration is the most common procedure in dentistry. As such, it provides the "bread and butter" for most practitioners. The process is relatively straightforward when it is guided by existing dental anatomical landmarks (Class I, Class II, and Class III), but becomes far more complicated when these physical guidelines are absent (Class IV and incisal edges). The restoration of a fractured or decayed incisal edge or proximo-incisal corner often involves 3-dimensional guessing of what the tooth form was in its natural state, in a process that is complicated by restorative, functional, and aesthetic parameters. Directa's CoForm matrix system is an innovative kit of preformed celluloid plastic transparent matrixes specifically designed to restore realistic shape and form to composite restorations that replace incisal edges and fractured teeth. The preformed anatomical matrices are available in 4 sizes that accommodate most clinical situations: anteriors, cuspids, and first molars. The handy clinical dispenser simplifies size and shape selection. These matrices conform readily to the patient's dentition, creating a template for the restorative composite that guides the fabrication of a natural-looking restoration. The CoForm is applied over the missing area after the tooth surface is cleansed, etched, and bonded. A slight movement eliminates air bubbles. Excess composite is removed, and the material light cured through the transparent matrix. The celluloid does not adhere to composite, and can be removed without any drag on the restoration. CoForm pressures composite material into undercuts and microdefects. The restoration is full size and full contour, approximating the ideal incisal or Class IV dental shape. This anatomy must be verified for premature occlusal and protrusive contacts, and adjusted as necessary.
For more information, call (800) 284-3368 or visit

DirectCrown Natural 1
DirectCrown Products

Teeth break down even when times are tough. The dentist is often faced with the dilemma of the patient who needs a crown, and who would certainly have had one made under better financial circumstances, but simply cannot afford one right away. With the best intentions, a dentist simply cannot afford too many pro bono procedures before the practice begins to suffer. DirectCrown Products has introduced the DirectCrown Natural 1, long-term provisional. It offers the clinical benefits of a single appointment, chairside nanohybrid composite crown. The DirectCrown is a high-impact flexible polymer preformed shell that is filled with the DirectCrown resin and molded over the prepared tooth. The lined shell forms an extremely hard and wear-resistant temporary crown with excellent margins and contacts. The recommended DirectCrown resin liner material adheres to the shell, polymerizing to form a single bonded unit that is strong, durable, and comfortable for the patient. A patented mesial/distal "window" in the shell guarantees the creation of tight-fitting contacts. The DirectCrown long-term provisional is fabricated chairside in less than 5 minutes. The process is an easy and stress-free fabrication and installation technique for the dentist and/or the dental auxiliary (depending on jurisdiction). It eliminates the need for impressions and is very versatile, usable in wet or hemorrhagic environments. DirectCrown's excellent margins and tight contacts minimize remakes and prevent the shifting of adjacent teeth until the definitive crown can be installed. The DirectCrown kit is indicated for 16 molars and premolars, small, medium, and large, organized as a total of 48 crowns. The crowns are highly aesthetic and resistant to discoloration, providing excellent patient satisfaction. DirectCrowns are economical alternative treatments for routine in-office provisionals and long-term provisionals for low-income, senior, and noninsured patients.
For more information, call (888) 910-4490 or (541) 344-5876, or visit

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 .