First Impressions: October 2008

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.




Retract Gingival Retractors
Danville Materials

Years ago, practitioners occasionally saw class V cavities. They would then restore these lesions with amalgam or, preferably, gold foil. At that time, gingival decay was most often due to lack of brushing. Clinically, we have observed that as patients are retaining their teeth for a lifetime, more and more abfractions seem to occur. These gingival cavities, usually on the buccal, develop as a result of the vertical forces that are placed upon the teeth. They begin as a disruption of the weaker irregular enamel rods that are found in the gingival area. Left alone, however, they can enlarge with time and become decayed. Ultimately, they can cause abscesses and tooth loss. In restoring abfracted teeth, one of the major problems is keeping the gingiva out of harmís way and untouched by either dental burs or instruments. If the gingiva is touched inadvertently, it often bleeds, complicating the restorative process. Danville Materials has introduced the Retract Gingival Retractors, which were specifically designed for gingival positioning during class V preparation and restoration. Retract instruments can also be used for gingival retraction during veneer placement. There are 2 sizes available, and the instruments have nonslip grips that are comfortable as they are held in position for extended periods of time. The blades, which are used in the gingival area, are contoured to better fit the rounded root surface. The blades are also sharpened to allow composite shaping. Retract offers left- and right-handed blades with blunted points to prevent gingival injury. The large Retract instrument is excellent for retracting and shielding the soft tissues during air abrasion procedures as well. For more information, call (800) 827-7940 or visit the Web site at


Composite restorations are the restorations of choice for most dental practitioners today. These materials have largely replaced amalgams. They are being used for the majority of posterior restorations as well as virtually all anterior restorations. It goes without saying, of course, that an ultimate high-gloss and functionally smooth surface are an absolute requirement for all tooth-colored restorations. Typically, the final polishing of a composite restoration involves 3 separate steps utilizing a succession of fine, extrafine, and ultra-fine finishing instruments. This process can be rather time-consuming, adding expensive chairside minutes to every restorative procedure. (For example, a dental practitioner billing $350 an hour has a chairside cost of $6 a minute.) KOMET USA has recently introduced its line of Q-Finishers, a series of specifically designed crosscut carbide composite finishing burs. The crosscut finishing on the Q-Finisher burs provides both rapid bulk reduction (shaping) and surface smoothing in a single pass. This eliminates one of the polishing steps, offering the fine and the extrafine procedures in a single instrument. Thus, the finishing and polishing segment of the composite restoration procedure can now be reduced to just 2 steps; the Q-Finisher for the first step, and an ultrafine instrument for the second. The Q-Finisher actually provides a much better restoration surface than the traditional first 2 steps combined. Thus, the overall polishing procedure is more efficient and effective and less time- consuming. The Q-Finisher instruments are tapered and are equipped with a noncutting tip. This ensures gentle and smooth finishing of the composite (no ledge) and minimizes gingival damage. Q-Finishers offer a better finishing result in less chair time. For more information, call (888) KOMET-USA (566-3887) or visit

Flor-Opal Varnish White
Ultradent Products

It has long been established that flouride varnishes are very good for the teeth, excellent for kids, and very good for adults. The problem was, of course, their striking yellow tint. Patients did not want to walk out of the dental office with their teeth looking fluorescent yellow, a rather negative attention grabber. Fortunately, in recent years, many scientific and manufacturing strides have been made in this area. These developments allow for a more effective as well as a more aesthetic use of fluoride varnishes. Ultradent Products has recently introduced its Flor-Opal Varnish White, a 5% sodium fluoride varnish that is both flavored and xylitol-sweetened. It has all the benefits of the original Ultradent fluoride varnish without the stigma of the striking yellow color. Flor-Opal White is mixed fresh chairside, using a syringe-to-syringe process that provides a consistent dose of fluoride in each and every application. The 0.5-mL unit dose is delivered quickly and efficiently through the one-handed application using the FX Flex tip, a tufted tip that allows delivery of the varnish directly to the tooth surface and spreads it out evenly in a single motion. This saves time by eliminating the repetitive, time-consuming, back-and- forth motion of traditional fluoride application instruments. The tufted tip can be bent up to 90° for more convenient application intraorally. It also prevents premature setting of the varnish by saliva on the brush. Flor-Opal White has been designed for enhanced retention on the tooth surface, prolonging the dentitionís exposure to the varnish for a greater fluoride uptake. Flor-Opal Varnish White is available in 2 flavors, mint and bubble gum. For more information, call (800) 552-5512 or visit

RapidCore MiniMix

Dental professionals have been eminently successful in educating their patients about keeping their teeth, preferably for a lifetime. Dental caries and fractures are still quite prevalent in large segments of the population, however. Fortunately, endodontic treatment can save many of the remaining root structures for long-term functional, aesthetic, and effective use. What happens after the endodontic treatment of the tooth is completed? Typically, a post-and-core procedure is followed by a crown, either a ceramic or pfm. After more than a century of cast metal fabrication, the science and art of post-and-core materials have evolved rapidly over the past decade. Centrix's innovative RapidCore MiniMix is the latest of many clinical improvements. It is the first automix, unit-dose core material that incorporates fluoride to strengthen the remaining tooth structure. RapidCore is a self-cure composite resin. There is absolutely no risk of incomplete curing of the material; polymerization will proceed to completion without direct or indirect light activation even in the depths of the post space within 2 minutes, much faster than earlier products. It has a thixotropic formula that allows it to flow smoothly through the mixing needle. RapidCore is stiff enough, however, so that there is little or no need to use matrices or core forms once the material is placed on the tooth and post. The convenient unit-dose system virtually eliminates any waste of core material. It also prevents the possibility of cross-contamination that can occur from using a multidose automixer/dispenser with several patients. RapidCore MiniMix is a one-step, fast, and effective core material. For more information, call (800) 235-5862, or

D-h2o Water Purification and Demineralization System

The clinical imperative for water purification and water filtration has hit the dental industry like a perfect storm. Increasingly, instrument sterilization and clinical procedures (implant placement and oral surgery) involve the use of purified and/or demineralized water. As more and more procedures and equipment require this specialized liquid commodity, there is a greater demand for purified water in the dental practice. There are a number of systems that are available that purify small amounts of water daily; the practical concern, however, is that utilization and consumption has increased dramatically. The D-h2o Water Purification and Demineralization System is an easy-to-use, 5-stage water purification system. (Prefiltration removes larger particulates, carbon filtration reduces chlorine taste, reverse osmosis eliminates contaminants, granular activated carbon clarifies, and the last filter deionizes.) Volume requirements are not a problem; a typical D-h2o unit provides purified water on demand, 50 gallons per day or more, depending on the requirements of individual practices. A point-of-use faucet supplies demineralized water on demand. Purified water protects autoclaves and sterilization equipment, prevents staining and corrosion of surgical tools during ultrasonic cleaning, and eliminates monthly distilled water purchase and delivery costs. The D-h2o is very convenient; it not only eliminates the purchase and delivery of bottled water, but it is also great for the environmentóno empty plastic jugs to dispose or recycle. The filtration and reverse osmosis mechanism has no mechanical moving parts. (The filter should be changed yearly.) Many practices use D-h2o to provide exceptional drinking water to patients and staff. The filtration unit can be connected directly to the water system or cooler, eliminating the purchasing, carrying, lifting, or delivering of cumbersome water jugs. For more information, call (973) 794-3175 or visit

Dr. Freedman is past president of the American Academy of Cosmetic Dentistry and is the Materials Editor for Dentistry Today. He is the Chairman of the Clinical Innovations Conference (London, UK) as well as the Dental Innovations Forum (Singapore). He is the author or co-author of 11 textbooks, more than 400 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. He is a co-founder of the Canadian Academy for Esthetic Dentistry and a Diplomat of the American Board of Aesthetic Dentistry. He lectures internationally on dental aesthetics, 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 This e-mail address is being protected from spambots. You need JavaScript enabled to view it .