First Impressions: December 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.

Piranha (Single-Patient-Use Diamonds) and Piranha 2X (Turbo-Double-Action Diamonds)
SS White Burs

Dentists use burs every day. The efficiency and the effectiveness of our operative burs have a major impact not only on the practice’s bottom line but also on the dentist’s stomach lining. It can be very frustrating to prepare a cavity or a crown with burs that are dull or inefficient and not up to the task. Cross-contamination between patients is a persistent concern, since it is rather difficult to clean diamond burs. The Piranha line of single-patient- use diamonds has been available for some time. Now, SS White Burs has introduced the Piranha 2X, a patented, double-helix design, dual cross-channel disposable diamond bur that actively flushes debris as it cuts, reducing clogging for cooler, faster, and, of course, more efficient tooth preparation. Both water and air flow around the Piranha 2X burs, thus eliminating cutting heat. Cooler cutting is more comfortable for the patient, causing less postoperative sensitivity. Since the Piranha 2X are single-use diamonds, the teeth are prepared with a fresh bur every time. There is never a risk of a dull bur or any possibility of cross-contamination from one patient to another. The easy-to-dispense packaging is designed to prevent contamination as well. Piranha 2X bulk reduction is excellent for crown preparation, since the medium-grit diamonds require little or no polishing prior to the impression. The original Piranha offered the broadest selection of single-use diamonds, including short shanks and shorter-than-short shanks for those hard-to-reach tight spots in the posterior occlusal or buccal areas. The Piranha 2Xs are available in a variety of preparation-friendly shapes. Cut fast, cut Piranha.

For more information, call (800) 535-2877 or visit

SILGIMIX (Alginate Replacement Impression Material)
Sultan Healthcare

There are many uses for alginate-like materials in dentistry, and practitioners have been using them for decades. Unfortunately, many of the traditional materials in this category have a number of drawbacks. They tend to be messy during 2 particular segments of the mixing stage: the dispensing of the alginate powder and the incorporation of the powder into the water. Powder ends up everywhere…on the counter, clothing, the face, and hair. Alginate-like materials tend to be slow setting; even the faster ones usually take a long time, and the impressions can be poured accurately only once. SILGIMIX from Sultan Healthcare is an alginate replacement material conveniently packaged in an automix delivery system that eliminates the clinical mess of conventional alginate materials. It is an intermediate impression material, partly alginate and partly vinyl polysiloxane. There is no mess in dispensing and no mess in mixing. Since neither the dentist nor the auxiliary is ever exposed to dust during dispensing or mixing, irritations or dust allergies are avoided. SILGIMIX is available in premeasured automatic mixing machine inserts or 1:1 ratio cartridges for conventional impression handguns. The VPS chemistry ensures a more accurate impression and provides a more practical setting time of just more than 2 minutes, eliminating the wasted chair time of the older, traditional alginate products. SILGIMIX remains dimensionally stable for extended periods and can be poured several times without losing accuracy or changing dimension. These impressions are readily disinfected, thus eliminating the possibility of transmitting con-taminated impressions from the patient’s mouth to the dental lab technician. SILGIMIX is an excellent, dust-free alternative to alginate materials.

For more information, call (800) 637-8582 or visit


Interproximal wedging has 2 seemingly incompatible objectives: (1) separating the teeth to allow for a functional contact area once the matrix band is removed (particularly difficult with composite restorations that require a stiff, strong wedge); and (2) adapting the matrix gingivally to create anatomical marginal contours (requiring a softer, more flexible wedge). Flat, conventional wedges typically contact the matrix at a single spot and may pierce the gingiva. They tend to be extruded by the tissues and teeth and can easily fall into the patient’s mouth. The Wave-Wedge from TrioDent offers solutions to these concerns. It is shaped like a wave. Its 2 elements include stiff separators for the embrasure and interproximal areas, ensuring good multifocal adaptation of the matrix, and apical to the contact point, a softer, more flexible component that allows the wedge to conform to the contours of the gingival margins of the preparation. The thin, malleable plastic flanges of the wedge enter the interproximal sulcular areas rather easily, gently repositioning the tissues away from the teeth. The Wave-Wedge’s curved profile offers ease of placement and convenient manipulation with positive gripping tweezers that ensure that as it is inserted interproximally, it points incisally, away from the gingiva, decreasing trauma and bleeding. Its shape self-guides it into the infracontact interproximal area. The open, V form of the apical side of the Wave-Wedge is hollow to provide space for gingival tissues, decreasing contusion and bleeding. To prevent accidental loss in the patient’s mouth, each Wave-Wedge is equipped with a small grommet hole that readily accepts anchoring floss thread. The Wave-Wedge is a simple, yet effective interproximal solution.

For more information, call (800) 811-3949 or visit the Web site.

HemCon Dental Dressing
HemCon Medical Technologies

Hemostasis can be a major concern for dentists. Routine dental treatment involves creating wounds all day, every day. In most cases, these wounds close almost instantaneously, bleeding stops, and there are no problems. Increasingly, patients are taking anticoagulants, which decrease the blood’s clotting ability. The introduction of HemCon Dental Dressing from HemCon Medical Technologies is an innovative approach to controlling oral bleeding. The dental dressing is fabricated from naturally occurring, biocompatible saccharides (chitosan, isolated from shrimp shells). HemCon Dental Dressing’s positively charged surface attracts the red blood cells’ negative charge. Its positive-negative reaction precipitates the dental dressing’s aggressive adhesiveness to both mucosa and blood. It is easy to use. Simply place the HemCon Dental Dressing in the area of the oral wound. The material flattens and turns very slick within 20 seconds. The patient can leave the office immediately. HemCon dissolves within approximately 2 days (may take a week). After a week, the patient or dentist should irrigate the wound area to remove any residual dressing material. HemCon Dental Dressing is indicated for use in extraction sites and oral wounds, and in clinical trials it has been shown effective for patients on anticoagulants without altering their regimen. (Current practice is to reduce anticoagulant therapy prior to oral surgery.) The dental dressing provides a protective barrier to oral mucosal tissues and pain relief. It is safe, effective, FDAcleared (generally recognized as safe category), and has no known side effects or reactions. HemCon Dental Dressings are packaged in foil pouches of 1 to 4 dressings. Once a 4-pack is opened for one patient, it should not be used for anyone else.

For more information and distributors, call (503) 245-0459, visit, or call distributor JL Bosser at (800) 200-3594.

ProMax 3D CBVT X-Ray

It can be readily argued that diagnosis is the critical element in dental treatment. Tools that enhance accuracy and comprehensive diagnostics (and therefore encourage minimally invasive treatment) are developing rapidly. The ProMax 3D Cone Beam Volumetric Tomography (CBVT) X-Ray unit from PLANMECA is about to usher in a very exciting new era in dental technology. It is an x-ray system but so much more. It offers digital panoramic imaging, digital panoramic bite-wings, and digital cephalometrics through one single x-ray head. Most interesting of all, it introduces 3-D imaging. The unit has a relatively small footprint, advantageous in the cramped dental operatory. The ProMax 3D CBVT’s effective and comfortable exposure time is only 7 seconds. Flat-panel semiconductor sensors offer high sensitivity, excellent image resolution, and life-size ratio images. This data is extremely useful for implant surgery, planning for orthodontics, TMJ analysis, and general treatment planning. From a patient’s perspective, the radiation dose for a full-volume data set is the equivalent of a full-mouth (FMX) series. The ProMax 3D CBVT X-Ray is available as an upgrade to existing CBVT x-rays or as a new unit. The ProMax software allows simultaneous viewing of 16 different images while maintaining up to 512 open images at the same time. For implant site location, the dental reformat module views a prepared implant site with a life-size 1:1 ratio that replicates the patient’s 3-D anatomy, including soft tissues, in both color and gray scale. The single- button selection 3-D tool provides instant axial, coronal, and sagittal views (gray scale or color renderings) for any interesting region. The ProMax 3D CBVT X-Ray is a new way to look at dentistry.

For more information, call (630) 529-2300 or visit the Web site

Cook-Waite Zorcaine (Articaine Hydrochloride 4% With Epinephrine 1:100,000 Injection)
KODAK Dental Systems

Local anesthetic revolutionized dental treatment and made it electively accessible to most
people. The discomfort of dental treatment and the fears of this discomfort are ubiquitous, tending to keep patients away from dental practices. In fact, given the choice of dental treatment without anesthetic or no dental treatment at all, most patients opt for the latter. The introduction of local anesthetic to mainstream dental practice half a century ago made it easier for more people to get more dental treatment in a relatively comfortable fashion. The objectives of an anesthetic are comfortable injection, quick establishment of pain-blocking effects, and then, rapid return of the patient’s tissues to normal. Since most dental treatments last 60 to 90 minutes, an ideal anesthetic offers rapid onset and an active duration that encompasses the average dental appointment. Cook-Waite (well-known for dental anesthetics for more than 60 years) has introduced a brand of articaine hydrochloride called Cook-Waite Zorcaine (articaine hydrochloride 4% with epinephrine 1:100,000 injection). Articaine is not new on the market; it has been available in many parts of the world for more than 2 decades. In fact, articaine has been my anesthetic of choice for more than 20 years. Articaine fulfills the above parameters; in most infiltration situations, it takes less than 5 minutes to establish profound anesthesia, and it dissipates within an hour or so. Patients are more comfortable and less likely to bite their cheeks and lips. I have also used articaine routinely for mandibular blocks and have seen no literature references to any actual problems with this technique. In those jurisdictions where articaine has been available to the dental profession, it has quickly become the local anesthetic of choice.

For more information, call (800) 933-8031 or visit

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