First Impressions: November 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.

N’Durance Cristal

The clinical dentist is faced with choosing one or more restorative materials from among literally hundreds that are available. The most common day-to-day problems include high volumetric shrinkage, unpredictable and uneven translucency and opacity, and a comfortable viscosity. The longevity of the restoration can be greatly affected by microleakage, microcracking, and compromised aesthetics due to stain absorption. It makes sense to select a restorative material that solves some or all of these problems. Septodont has continued to develop its bis-GMA-free nanodimer technology and has introduced N’Durance Cristal, a highly translucent composite that is specifically designed for anterior restorations, but can also be used in posterior teeth for Class I and Class II preparations. Its natural translucency positions the Cristal A2 shade at the same light transmission levels as the enamel shades of competing composites. Cristal is a highly biocompatible, light-cure, nanodimer composite that exhibits very low volumetric shrinkage; this means that there is less stress at the tooth-restoration interface, reduced microleakage, and improved marginal integrity. The higher intraoral monomer conversion to long chains during polymerization optimizes physical and mechanical properties and results in less functional microcracking. The decreased presence of residual monomers makes it more biocompatible and less chemically irritating to the pulp. Cristal is hydrophobic for better long-term color stability. Continued manipulation makes it more pliable; this thixotropic property guarantees its “on-demand” viscosity that can please the most demanding practitioner. It is nonsticky, easy to place, position, and sculpt. N’Durance Cristal is radiopaque to allow for clear differentiation between the restoration, healthy and tooth structure and decay, and totally compatible with all bonding agents.
For more information, call (800) 872-8305 or visit

Brasseler USA

The placement of composite resins in the cavity preparation is always a stressful. It is typically better for long-term wear and function to use hybrid materials for posterior restorations; their downside is that they are rather viscous and may not manipulate well into all the nooks and crevices of the cavity. This maladaptation cannot be seen by the operator and risks bubbles, air spaces, and marginal gaps. The solution is most often to use a less viscous flowable resin in high-risk areas. The downside of this compromise approach is that most flowables are not as strong or wear-resistant as hybrids. Brasseler USA has introduced the ET3000 oscillating composite manipulation instrument (OCMI), the first vibrational device that can effectively overcome both the stickiness and the lack of flow of the more highly filled composite resins. It eliminates the stickiness and tug back of composites after they are placed into the cavity, allowing them to flow more efficiently into the less accessible recesses and for the development of anatomy. The instrument’s oscillations increase hybrid composite flow by 30%. The ET3000 OCMI is well balanced and lightweight, cordless, and very portable. The 14 different tip designs can accommodate every clinical requirement, from preventive pit and fissure procedures to Class I through V restorations, always reducing the occurrence of voids and air bubbles. The chucking system is quick and intuitive. The lithium ion battery can operate for many hours on a single charge. The ET3000 is also very useful in shaping and contouring the surface anatomy of any composite prior to polymerization, reducing the need and time for adjustment and polishing.
For more information, call (800) 841-4522 or visit

Dental GPS
Dental GPS

Dentists have been using various forms of software to preview, predict, and plan aesthetic procedures for more than 20 years. The earliest systems were very time intensive and required extensive specialized training. With time, many of these programs lapsed into obsolescence be­cause it took too long to develop a proper marketing or clinical guide. Dental GPS has introduced software, developed by Dr. Alain Meth­ot, that guides dental practitioners and laboratory technicians during the creation or transformation of a patient’s smile from the parameters described by digital facial photographs. The smile positioning software uses the patented M Ruler, an algorithm that analyzes the position of the maxillary teeth on a digital image. The program can be used for diagnosing, planning, and executing changes in the position, shape, dimension, and proportion of the teeth. The lead dentist, all associated specialists, and the laboratory technician are all able to access and share information regarding the treatment plan, ongoing procedural status, and the final results of the case. Should any midstream correction be necessary, it is relatively simple to inform and re­ceive consent from all involved. The process is simple: 1. Take a full-face image; 2. Enter width of centrals in millimeters; 3. Software guides digital face-bow and M Ruler; 4. Dentist sees proposed dental changes; 5. Patient views his/her new smile; 6. Simula­tion can be modified with patient and/or technician; 7. Provisionals sent to dentist to reproduce simulated smile; 8. Definitive restorations made at lab and inserted for patient. The GPS system can be leased or the dentist can opt to per case. GPS Cosmetic Dental Imaging offers a simple way to give patients the smiles that they have always wanted. Create a new smile—form a picture with Dental GPS.
For more information, call (877) 477-8977 or visit

KLOX Dental Specialties

In-office bleaching systems tend to be complicated: many components, many steps, and a long time for the patient in the chair. In addition, the during and post-treatment sensitivity associated with some in-office tooth whitening modalities makes them quite uncomfortable. KLOX Dental Specialties has introduced FAST&MILD, a novel multilight activated, advanced chairside tooth whitening treatment. The system is based on photodynamic technology, the combined use of chemical photo sensitizers with an enhancing gel and a nonproprietary activating light. The light energy stimulates photo sensitizers to produce oxygen molecules. The active bleaching agent consists of a 29% hydrogen peroxide solution. The tooth gel has been designed to change in color from bright orange to white once the action of the photo sensitizers has reached the optimal level and the peroxide has been activated. This signals the end of the destaining cycle and helps to prevent inadvertent overexposure to bleaching agents. Intraoral iso­lation can be accomplished in less than 5 minutes. Typ­ically, anywhere from 4 to 6 sessions of 2-minute active bleaching will provide a significant whitening of the teeth. Thus, the entire treatment is “fast,” requiring only 30 to 45 minutes, a significant chairside advantage. The photochemical process is a cold reaction; it produces negligible in­creases in tooth temperature, and is thus unlikely to cause thermal tooth sensitivity. The treatment is “mild,” with less sensitivity, less dehydration, and is nonabrasive. Any visible-light spectrum device (diode, halogen, plasma arc, or bleach-activator) can be used; there is no need to purchase another proprietary bleaching lamp. The kit also includes a take-home LifeSmile brightening pen con­taining 15% carbamide per­oxide for at-home use.
For more information, call (866) 653-KLOX (5569) or visit the Web site

Azenic DHP

The handpiece is the dentist’s most utilized tool. There are many handpiece applications in the practice: high-speed, low-speed, laboratory, im­plant, endodontics, and surgery, among others. Occasionally, a disposable handpiece is called for. Azenic has introduced their Azenic DHP, a strong, air-powered disposable handpiece. It is lightweight, weighing in at less than 20 g (0.6 oz), significantly less than standard and other disposable handpieces. The plastic handpiece is textured to minimize slipping and has an excellent ergonomic design for continued use without fatigue. The handpiece connects to a standard Mid­west style 5-hole supply line as well as most 4-hole supply lines. It attaches to dental units’ tubing without a coupler. The Azenic DHP is equipped with a single port water spray as well as a fiber-optic rod. Its peak power is 20W and it has a maximum no-load speed of 325 to 375,000 rpm. The chuck mechanism is friction grip; the bur is inserted into the chuck, and then pushed into place by pressing the end of the bur against the small concavity on the end of the plastic cap which is re­moved from the back of the handpiece before connecting to the unit. To remove the bur, simply hold it be­tween the fingers while pushing the metal rod (on the inside surface of the plastic cap) into the top hole in the head of the Azenic DHP. The disposable handpiece is very useful when infection control is an issue, as a backup, or for high workload situations (such as all-metal crown removal) when the additional wear on the more delicate operative handpieces is of concern. At $23 per unit, the Azenic DHP is a great investment.
For more information, call (888) 347-7576 or visit the Web site at

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, 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