First Impressions: April 2007

Dentistry Today

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In First Impressions, George Freedman, DDS, gives readers a brief summary of products that have been introduced to dentistry, based on his clinical experience.

CADMaster Kits for Cerec
Shofu

1. Friction-Grip Kit

2. Contra-Angle Kit

3. Handpiece Kit

More and more dentists are delivering CAD/CAM restorations to their patients. This technology is available through in-office and in-lab systems; both offer excellent restorative dentistry options. Cerec CAD/CAMs can manufacture in-office crowns, veneers, onlays, and even multi-unit bridges. The ceramic blocks from which the Cerec restorations are milled are extremely strong and durable materials. This is excellent because the restorations are likely to last a very long time in the patient’s mouth, and they tend to be very resistant to fracture and wear. This same strength, however, makes the polishing and shaping of these ceramic materials rather difficult. Many of the currently available polishers make the process of adjusting and polishing CAD/CAM ceramics a very long and tedious process. Shofu has recently introduced the CADMaster series of kits, instruments that are designed to adjust, prepolish, and polish Cerec restorations in just 2 easy steps. In fact, the total polishing time involved in using CeraMaster Coarse and CeraMaster Regular polishers is a mere 60 seconds and achieves a surface gloss that is higher than most other products on the market. Ceramic block sprues are removed with Dura-Green stones (silicon carbide) and Dura-White stones (micro-grained aluminum oxide). The prepolish is developed with the Cera-Master Coarse (diamond-impregnated silicone), while the final polish, a super glaze finish, is achieved with the CeraMaster (very fine diamond- impregnated silicone). All polishing instruments are perfectly balanced on their stainless steel shanks for vibration-free adjustment. Three kits are available: chairside Friction-Grip, Contra-Angle, and straight lab Handpiece. Shofu CADMaster Kits for Cerec makes polishing Cerec restorations a snap; adjust, prepolish, and polish in 2 easy, fast, and predictable steps.
For more information, call (800) 827-4638 or visit shofu.com.


AZtec
Dentatus USA

Dentists have been successful in encouraging their patients to retain their dentition for a lifetime. Sometimes, however, endodontic intervention becomes necessary. Then, the tooth must be structurally rebuilt from the root up. The post, which is the foundation for the core and ultimately the crown, may be made of many different materials. Each material has its own mechanical advantages and clinical benefits. Dentatus USA has recently introduced the AZtec titanium post. It is a metal post specifically designed for small, thin teeth with slim roots where conventional preparation for a regularly sized post might compromise the remaining dentinal walls of the tooth. The AZtec post has a spiral thread in its midsection that is configured for passive insertion, yet it provides secure retention and a track for retrievability. The overall shape is that of a slim taper, fitting easily into even the smallest roots. The AZtec’s texturized post surface doubles composite adhesion in the canal, reducing microleakage. If the post must be retrieved or the endodontic canal reaccessed, a hollowed key can be used to unscrew the AZtec anchor in a counterclockwise direction; it unscrews through the composite luting material inside the canal. The post’s coronal T-form is flat and retentive, and it can be adjusted by finger pressure to the required angulation of the overlying core. Thus, if the angulation of the remaining root is not consistent with the required angulation of the crown, it is a simple matter to bend the T-form (once it is cemented into the root) until the required occlusal direction is achieved. AZtec posts offer the simplest technique and the most predictable result for thin roots of thin teeth.
For more information, call (800) 323-3136 or visit dentatus.com.


G-Coat Plus
GC America

We are often too caught up in the minutiae of preparing and restoring teeth to spend much time worrying about the performance of the materials that we use. How will the numerous composite, glass ionomer, and resin ionomer restorations that we place every day in our practices bear up under long-term wear? How can we protect the surfaces of the restorations in the oral cavity? And what about the restorative margins? The light-cured filling material is left at the mercy of the intraoral elements; acids, bases, wear, mastication, etc, all working to disrupt the carefully crafted surface of the restoration.
GC America has introduced its G-Coat Plus aesthetic sealer. It is a clear, light-cured protective coating that is formulated with adhesive monomers and nanofillers. A single coat serves to reduce staining and provides a high- gloss finish. Additionally, G-Coat Plus protects the restoration’s margins. The glossy surface that is achieved with composite resins, veneers, and provisionals is comparable to extensive polishing. G-Coat Plus also protects glass ionomer restorations against early water contamination and long-term surface wear. G-Coat’s proprietary adhesive monomer offers excellent adhesion to tooth structures as well as restorative materials. Its nanofillers are uniformly dispersed for balanced wear resistance and thus help to provide a smoother and longer-lasting surface finish. G-Coat Plus aesthetically revitalizes the mottled surfaces of older composites as it easily and quickly eliminates minor surface and marginal defects, extending the longevity of these restorations. Its translucence allows predictable and accurate shade mapping. G-Coat Plus can be light-cured with either LED (light-emitting diode) or halogen lamps. G-Coat Plus is the clear choice for protective sealing.
For more information, call (800) 323-7063 or visit gcamerica.com.


Googles
Kerr TotalCare

It is readily apparent in most dental practices that the message of eye protection has been delivered and accepted. Most practitioners and staff wear glasses or lenses of some sort to protect themselves from the possibility of direct impact by particles that are expelled from the teeth and the mouth during the use of high-and low-speed drills. Regular glasses, however, are not as protective as they need to be in the dental environment. Most of the glasses in current use offer only partial coverage; there is lots of space on the sides, underneath, and even above the eyes where particulate matter can enter directly or ricochet in, possibly damaging the eyes. Kerr TotalCare has introduced Googles eyewear, an OSHA-compliant product, designed to protect eyes much more completely. Googles offer a more extensive protective barrier; side shield extensions can be worn without glasses and over regular glasses, without interfering with  most dental masks. The disposable lenses are made of distortion-free, optical-grade plastic. The separate frames are light in weight and recyclable. They are available in a wide assortment of bright, patient-friendly colors. Cold sterilization of the frames is recommended. For specialized procedures, there are UV-tinted Googles and amber light-curing Googles, the treated plastic eliminating the glare from overhead lighting. Again, each plastic lens is disposable. The Googles full-face shield weighs less than 1.5 oz, eliminating potential operator discomfort and fatigue. It can be readily worn over prescription glasses. Since Googles are convenient, disposable, inexpensive, and available in attractive colors, protection and fashion can go together. Googles, saving eyes practically and comfortably.
For more information, contact your dental dealer, call (800) 878-3902 or visit kerrtotalcare.com.


HYDRIM L110W
SciCan

Sterilization is an absolute must in 21st century dentistry. However, instruments that are not effectively washed, rinsed, and dried cannot be properly sterilized! An automated instrument washer eliminates hand scrubbing, the risk of punctures, and saves time, providing consistent wash cycles with 99.9%+ protein removal. Automated washing offers the most predictable processing and the guarantee that the instruments are dry enough for sterilization. SciCan’s HYDRIM L110W washing system is easy to use: simply remove any large debris, composite, amalgam, or cement chairside, load the instruments into a cassette or basket, and press the start button. HYDRIM’s rapid washing cycles clean, rinse, and dry the instruments, preparing them for sterilization in the Statim or other autoclaves. The HYDRIM HIP cleaning solution protects instruments with a proprietary blend of surfactants that reduce the water’s surface tension, increasing its ability to lift debris from the dental instruments. Once the washing cycle is complete, the dried instruments (in the cassette or basket) are placed directly into the sterilizer. The HYDRIM L110W can process 100 instrument sets in a single day, making it suitable for larger practices. The floor-standing unit can be installed under the counter or left as a freestanding unit. Its observation window allows the operator to see the washing of the instruments. The HYDRIM’s rapid washing cycle keeps the instruments working in the mouth, where they can produce income, rather than in the sterilization area, where they cannot. Speed, durability, and software-controlled washing, combined with the HIP proprietary chemical liquid, make the HYDRIM a complete, effective, and easy-to-use washing system. HYDRIM L110W cleans and protects dental instruments all at the same time.
For more information, call (800) 572-1211 in the United States, (800) 667-7733 in Canada, or visit scican.com.


Inlay/Onlay Kit
SS White Burs

Tooth 1. Use a Piranha 379-018 fine grit diamond to adjust the occlusal surface of the ceramic restoration. This shape provides an ideal fit into the primary features of the anatomical surface.

Tooth 2. The 862-012 very fine diamond is ideal for trimming the cusp areas and removing excess resin and cement.

A dentist can only be as efficient as his or her armamentarium. Thus, it makes sense to employ instruments specifically designed for a procedure. The sequenced organization of focused tools makes the procedure more efficient and hence more productive. Bur kits target specific procedures, making the operative procedure faster and easier. The SS White Burs’ Inlay/Onlay Kit contains preparation carbides and diamonds that have been specifically selected for the Inlay/Onlay procedure. The kit includes instruments for preparation, occlusal adjustment, and marginal/interproximal finishing organized into a single, autoclavable bur block. The recommended Inlay/Onlay Technique describes the following steps: prepare the occlusal portion of the tooth (large or small 845 KR), always checking parallelism in the preparation to ensure the desired draw. (These burs are designed specifically to develop occlusally divergent axial walls, flat pulpal floors, and rounded internal line angles.) The proximal box is similarly prepared, creating divergent walls with an ideal 6° angle. Remember to eliminate all sharp internal line angles. Interproximal contact areas are best prepared using the very thin FG 1170L. The pulpal floor is smoothed with the end-cutting Piranha diamond. Once the onlay returns from the laboratory, the Piranha 379-018 develops the occlusal surface of the ceramic restoration and creates the desired interproximal contacts. This bur’s shape assists in the creation of the primary anatomical surface. The very fine 862-012 diamond is best suited for trimming the cusp areas and removing excess resin and cement after cementation, while the 859-014 is a very fine diamond designed to remove remaining cement in tight contact and interproximal areas. The SS White Burs’ Inlay/Onlay Kit guides clinical technique to predictably good inlays and onlays.
For more information, call (800) 535-2877 (or [732] 905-1100) or visit sswhiteburs.com.


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 epdot@rogers.com