First Impressions: November 2006

Dentistry Today


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. 

Embrace WetBond Pit and Fissure Sealant Unit Dose “Sealettes” – Pulpdent

1. Preoperative.

2. Apply Etch-Rite for 15 seconds.

3. Rinse and light dry. Leave tooth surface slightly moist.

4. Apply Embrace WetBond Pit & Fissure Sealant to the slightly moist tooth.

5. Light cure: cures with all lights.

6. After curing, the margin is undetectable with an explorer.

Pit and fissure sealants are easy to place but hard to finish. They flow easily into the occlusal grooves and fissures (preferably once the unseen bacteria are completely eliminated to prevent anaerobic demineralization and hidden caries) and are easily light-cured. Finishing the margin of the sealant to the tooth, however, particularly on a squirmy, uncooperative, ankle biter can be exasperating. Pulpdentís Embrace technology Wet-Bond Pit and Fissure Sealant has eliminated these problems. Since Embrace bonds chemically and micromechanically to slightly moist teeth, it can be used with children where drying the teeth can be impractical or difficult to achieve. Embrace WetBond Sealant is formulated with an advanced hydrophilic Resin Acid Integrating Network (RAIN) technology that allows the sealant to bond in a slightly moist field to both unetched and unbonded tooth structures. The RAIN technology provides margin-free tooth integration, creating an exceptional seal against microleakage. Thus, there is no margin to polish, no ridge to finish. No marginal ledge gives bacteria no foothold on the tooth surface where to begin their demineralizing activities. The benefit of not having to smooth out the sealant margins is self-evident with young children and saves time with teens and adults as well. Moist-bonding Embrace Wet-Bond P&F Sealant is self-adhesive to both dentin and enamel. Now, to offer always-perfect chemistry and to avoid cross-contamination, Embrace WetBond P&F Sealant is packaged in Sealettes, unit-dose pipettes that can be used for one or more teeth. The micro Sealette also avoids the appearance of a syringe-like dispenser that might scare children. Sealing with Embrace WetBond P&F Sealettes is a snapóone easy step to predictable tooth protection.

For more information, call (800) 343-4342 or visit


Lorin Library Interactive Smile Style Guide (iSSG) by Drs. Lorin Berland and David L. Traub – Digident

The patient in the chair has accepted the proposed aesthetic makeover. The funds (or the financing) for the makeover are available. Now what? Here comes the tricky part. How to design the smile? How long to make the teeth? What shade to assign to each tooth? Which teeth are most critical to the smile? These options (and the resulting confusion) can stress both the patient and the dentist. In fact, if there are too many questions, the patient is likely to delay treatment until these issues can be more definitively resolved. The Lorin Library Smile Style Guide has been available for a number of years. The format of developing a smile was fairly simple: step 1, select cuspid shape; step 2, select the incisor shape; and step 3, select the relative length of the incisors. The new Lorin Library Interactive Smile Style Guide (iSSG), by Drs. Berland and Traub is the digital companion to the Lorin Library. (Digident developed, produced, and distributes the iSSG.)  The steps are the same, but the format is entirely novel, decreasing the required chair time for the dentist. The new edition includes hundreds of portraits, both male and female, that will assist the patient in developing his or her dream smile. Since there are more smile samples, the final choices are easier to make, improving accuracy and patient satisfaction. The selected smiles can be previewed with just a few clicks. When the patient is able to choose an ideal smile prior to treatment, this information helps the dentist to develop and provide focused treatment more easily and become the patientís dental make-over artist. The iSSG increases the smile selection confidence for both the patient and the dentist.

For more information, call (800) 741-7966 or visit


AFFINIS Precious – Coltene/Whaledent


What do we ask of an impression material? Not much really… It has to mix easily, extremely quickly, and efficiently. It should be immediately usable when we need it, set immediately after insertion, and set hard, fast, and accurate. The im-pression must be easily readable by both technician and dentist, and, of course, the impression must work in the wet environment of the human mouth. AFFINIS Precious is Colténe/Whaledentís latest entry into the impression category, its best yet. AFFINIS Precious colors are metallic silver and gold, developing a dramatically visible difference between the light body and tray materials. The light body is stark silver; the heavy body is gleaming gold, designed to provide an excellent contrast. Fillers in the impression material reduce light scattering, making the margins easier to read. AFFINIS Precious is specifically geared to work in the oral cavity and spreads easily onto wet dentin. The self-leveling light body flows easily and directly into the sulcus, eliminating voids. It does not drip, a very useful property when taking impressions of gravity-prone prepared teeth in the maxillary arch. The total time for the impression material depends on the number of preparations that are to be impressed. Its thermal reactive setting is designed for a predictable snap set (120 seconds for the tray material) once the material is placed in the oral cavity. The wash working time is more variable and can extend to approximately 5 seconds per prepared tooth. AFFINIS Precious has a maximum working time of 60 seconds, allowing it to be used for multiple abutment or even extensive roundhouse impressions. Best of all, lab technicians love the excellent AFFINIS Precious marginal readability.

For more information, call (800) 221-3046 or visit

Opalescence PF – Ultradent Products

The days when patients were ready to accept either tooth sensitivity or possible risks to their enamel or dentin or both for the sake of a whiter smile are gone. Today, there is a basic requirement that the bleach will not harm any tooth or restorative structures; furthermore, there is a general expectation that specifically included additives will actually improve the strength and surface hardness of the dental structures. Patient acceptance of bleaching-associated sensitivity has also decreased significantly; the development of techniques and materials that eliminate these uncomfortable side effects has been an important factor in the rapid growth of the demand for destaining teeth. Ultradent Productsí introduction of Opalescence PF provides yet another breakthrough in tooth whitening. The enamel-enhancing additives in Opalescence PF make all the difference. The PF is shorthand for potassium nitrate fluoride. The carbamide peroxide gel contains both potassium nitrate and 1,100 ppm fluoride ion. Recent studies reported at the IADR indicate that combining potassium nitrate and   fluoride in bleaching gel reduces patientsí susceptibility to caries. Opalescence PF was also shown to increase the mineral content of the enamel for greater tooth surface strength. Thus, the profession now has the ability both to reduce tooth decay and to strengthen teeth while whitening them. Opalescence PF minimizes sensitivity as it increases enamel micro hardness. It is available in 10%, 15%, and 20% carbamide peroxides, and the sustained-release gel provides the well-established effectiveness of at-home bleaching. (My favorite for combining speed and comfort is still the 10%.) Opalescence PF is also available in the convenient TresWhite PF format. Give your patients a whiter, healthier, and stronger smile.

For more information, call (800) 552-5512 or visit




QwikStrip – Axis Dental

Over the years, the interproximal use of metal-backed finishing strips has always been a lot of “fun.” Not only are most strips typically too long for the oral cavity and incorrectly angulated, but they also tend to have sharp edges and pointy corners, which wreak havoc with the gingiva, cheeks, and gloves. When the finishing strip inflicts damage to an anesthetized portion of the gingiva, lips, or cheeks, there is little or no patient response. However, once the anesthesia is gone, the patient will certainly become aware of the cut, likely resulting in an after-hours telephone complaint, or even more inconveniently, an additional chairside session. Axis Dentalís QwikStrip eliminates at least some of these major problems. The integrated plastic handle makes the QwikStrip easy to grip, easy to manipulate, and easy to use. The back ridge allows the practitioner to apply occluso-gingival pressure during interproximal insertion without ripping the glove or the hand, and a handle for convenient manipulation. Finger rests on either end of the QwikStrip handle allow for convenient buccal and lingual movement without risking the integrity of the gloves, and offer excellent control for  limited local abrasion in the interproximal region. The ridge also has tether holes for floss just in case the instrument is inadvertently dropped. QwikStrips are available in 4 abrasive grits: coarse, medium, fine, and superfine. They are color-coded for easy identification. The same abrasive grits are available in a serrated edge format for “tooth discing” (used in orthodontic procedures such as Orthoclear or Invisalign). Qwik-Strip’s single-handed utilization is ergonomic and offers better tactile control as well as easier access to the posterior teeth.

For more information, call (800) 355-5063 or visit

Single-handed design for better tactile control, easy access to tight anterior or posterior spaces, and avoids soft-tissue irritation.

The floss “tether” holes enhance patient safety.

QwikStrip Serrated Strips White

QwikStrip Superfine Yellow

QwikStrip Medium Blue

QwikStrip Fine Red

QwikStrip Coarse Green


TheraGum – OMNI Preventive Care (A 3M ESPE Company)

Fact: Our patients have bacteria in their mouths. Fact: Our patients chew gum. Fact: Patients who chew sugar-sweetened gum provide nutrition to their oral bacteria, helping to eventually destroy their gingiva and their teeth. For many years, dentists could only stand by and encourage frequent brushing, sugarless chewing gums, and regular flossing. Patients did not always heed this excellent yet unpopular advice. Enter xylitol; discovered more than 100 years ago, it is a substance found naturally in fruits. Xylitolís major chemical advantage is that it has 5 carbon atoms, while sugars and sugar substitutes have 6 carbon atoms. Thus, it is nonfermentable by bacteria (which cannot digest it). Xylitol, a diabetic sweetener, has been shown to reduce the risk of caries, reduce plaque, increase saliva flow, promote a natural pH, reduce fermentable carbohydrates in the mouth, and increase available calcium and phosphate availability for remineralization. OMNI Preventive Careís innovative TheraGum is a 100% xylitol gum. Research has indicated that xylitol gums carry a 50% lower risk of decay than sorbitol-sweetened gums. In fact, TheraGum seems to be advantageous for patients who donít normally chew gum, exhibiting a 70% lower caries risk than no gum at all. It is indicated for patients with high caries risk, individuals with high sugar or starch diets, pregnant and lactating women, diabetic patients, as well as those with xerostomia. For our patients who chew, TheraGum is an ideal, risk-free, sweetened gum choice. With xylitol as its only sweetener, Thera-Gum has no other fermentable sweeteners to produce oral acids. The resulting neutral pH encourages the uptake of calcium and phosphate for remineralization and an overall healthier dentition.

For more information in the United States, contact OMNI Preventive Care at (800) 445-3386 or visit For more information in Canada, contact Canadian distributor Oral Science at (450) 442-7070.

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