First Impressions: January 2013

George Freedman, DDS

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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.

Integrity Multi•Cure
DENTSPLY Caulk

Provisional restorations are invariably annoying; they are typically fabricated toward the end of a crown-and-bridge procedure when the practitioner is running late and eager to be done. Provisionals are, however, very important for the maintenance of proximal and occlusal dimensions, tissue protection, and with vital teeth, the decrease of postoperative sensitivity. It is essential that the provisional restorations be easy to fabricate, to polish, and to cement. They must be strong enough to resist normal function for a period of several weeks to several months. DENTSPLY Caulk’s Integrity Multi•Cure is a dual-cure extension to the well-established Integrity brand, containing both autocure and photocure initiators. It is an automixed, high-quality 10:1 bis-acryl material that exhibits an improved flexural strength and a 30% faster procedure time, and the dentist has the option of utilizing light-curing to finalize the polymerization. It repairs easily with light-cure restorative materials and is polished quickly to a high gloss. The technique is familiar: up to 15 seconds to dispense the uncured provisional material into the preliminary impression, the next 30 seconds to insert the template into the mouth, which can be removed within 60 to 90 seconds and light-cured. Alternatively, the provisional can be allowed to self-cure within 5 minutes, at which time the oxygen-inhibited layer is eliminated with alcohol. Then the provisional is refitted and checked, polished, and cemented. It is available in 5 shades: A1, A2, A3.5, B1, and BW. Integrity Multi•Cure is a self-cure, light-cure material, and its multifunctional methacryl esters allow it to be used for short- and long-term provisional situations.
For additional information, call (800) 532-2855, or visit dentsply.com or integritymulticure.com.


Hemostyp Hemostatic Gauze 
SINC Ventures

One of the major problems associated with dental surgery is hemostasis, the effective control of bleeding from a cut or wound such that natural healing can take place. While there are numerous hemostatic agents available to the dental practitioner, most of them are difficult to place, difficult to keep in position, and difficult to remove without disturbing the clotted surface, thereby reinitiating the bleeding. This situation is particularly problematic in areas that are being prepared for dental implants (sockets of freshly extracted teeth and areas of bone grafting). SINC Ventures has recently introduced Hemostyp Hemostatic Gauze. This specifically formulated gauze produces hemostasis almost instantly when positioned on a cut or wound. It contains no potentially harmful chemicals such as thrombin, collagen, or animal byproducts, is hypoallergenic, and works more quickly than other hemostatic agents. The hemostatic gel eventually degrades into glucose and saline. Once it has completed its task, it is readily dissolved by saline solution or water for easy removal that neither disturbs the clotted surface nor encourages re-bleeding. Hemostyp contains natural regenerated cellulose and absorbs blood to expand to 3 to 4 times its original size as it converts to a gel, creating direct local pressure on the wound site, which results in hemostasis. In most situations, one to 2 layers of gauze are placed over the entire bleeding surface and held under slight pressure until the gauze is saturated. A clean dressing is then applied over the gauze to protect the wound from trauma and infection. Gauze pads of sterile Hemostyp (2 x 3.5 cm) are blister- packaged for ease of use and are easy to cut if a smaller size is desired.
For more information, call (855) 255-7462 or visit sincventures.com or hemostypdental.com.


TMJ Quick Splint 
Migratherapy

Many dental patients present with parafunctional stresses during mastication, clenching, and sleep. The practitioner often suspects that a splint appliance may be helpful for the condition, but the patient, for reasons financial or otherwise, is reluctant to proceed with an extended-use, lab-fabricated device. Other patients may be in severe discomfort and would prefer immediate relief while awaiting their lab-fabricated occlusal guard. Migratherapy’s TMJ QuickSplint is an anterior bite plate appliance that covers the upper or lower teeth from bicuspid to bicuspid. The device has 2 components: a rigid plastic shell and a pliant liner that customizes each appliance to the supporting dictation. It inhibits the extensive forces that are generated during parafunctional tooth clenching and allows the supporting musculature to relax, often reducing the pain associated with bruxism headaches and TMD dysfunction. The patient feels the benefits almost immediately and can better appreciate a comprehensive treatment plan, whether using the QuickSplint alone or in combination with other modalities. It is designed for overnight wear, although limited daytime wear can be prescribed. The process is very simple: ensure that the aperture between the maxillary and mandibular dentition is 25 to 60 mm; fill the rigid frame with bite registration material; align the TMJ QuickSplint on the teeth and support it as a patient bites down to level the bite registration; remove the splint once set; and trim the excess material with scalpel. The patient takes the appliance home in the provided container. For patients in pain and for bruxers, a 2- to 4-week wearing period enhances diagnosis and determines the efficacy of oral appliance therapy. TMJ QuickSplint is cost effective, efficient, diagnostic, and immediate.
For more information, call 800-760-0526 or visit the Web site at tmjquicksplint.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 a visiting professor at the Universita di Firenze, Florence, Italy. He is the materials editor for Dentistry Today. He is the author or co-author of 11 textbooks, including his most recent textbook Contemporary Esthetic Dentistry (Elsevier), more than 700 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 epdot@rogers.com.