First Impressions: October 2009

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.




One of the major clinical challenges of indirect placement is the handling and control of the restoration during bonding, cement loading, and the accurate placement of the restoration in the tooth cavity. Most inlays, onlays, and crowns are very small and particularly difficult to grasp with gloved fingers once the surfaces are bonded. The relatively rapid set of dual-curing cements makes it essential that indirect restorations be inserted quickly to their fully seated position and that excess resin cement be rapidly removed as the restoration is held in place while the cement is curing. Triodent's innovative Griptab system was designed as a universal system for manually managing all indirect restorations from prebonding through cementation and polymerization. The system uses plastic tab retainers (3 shapes available) adhered to the res-toration with a temporary but retentive adhesive. The Griptab is light-cured to a nonretentive surface of the restoration within seconds, allowing the restoration to be held with Pin-Tweezers. This provides a secure grip without the risk of marring the surface or damaging the high shine that is the hallmark of these restorations while allowing totally free movement for the practitioner and un­paralleled visibility around the res­toration, particularly at the margins. The Gribtab securely maintains the practitioner's hold on the restoration through the adhesive, cementation, and insertion steps, and it maintains positive pressure throughout the polymerization process. Excess marginal cement is readily cleaned around the Grip­tab, and once cementation is complete the Pin-Tweezers are released. The Griptab adhesive is easily removed by peeling it off the restoration with a flat-bladed metal instrument such as a wax carver. Griptab provides total clinical control during cementation. For more information call (800) 811-3949 or visit the company Web site located at at

Close-up of Griptab on rod.

Griptab easily held with hemostat or Pin-Tweezers.
Blob of adhesive added to Griptab. Applied to crown and light-cured, the adhesive changes color when cured.
Griptab peels off easily without marking.  

SafeGuaze Green

Gauze is one of the most commonly used consumable products in the dental practice. It is also one of the least known and understood. Dental gauze is one of those products that we have used regularly in our practice since school days without much thought. We utilize gauze in the dental practice as a matter of course; it is available in a variety of sizes and formats for everything from oral hygiene to oral surgery. Where does it come from? What materials comprise it? What trace chemicals are still in it? And how effective is it? Of course, gauze does not cost very much, and thus its financial implications on the practice are somewhat minimal. But then we do tend to go through a lot of gauze, so it is important to know how efficient it is and how effectively it works compared to other similar products on the market. Furthermore, what is the environmental impact of the gauze that we use in such large quantities? Medicom has recently introduced SafeGauze Green, which is manufactured from 2 natural, organically grown fibers, cotton and lyosil, a material that is derived from wood pulp. Both of these ingredients come from plants and trees that are grown in America. SafeGuaze Green is very soft for patient comfort and highly absorbent for clinical effectiveness. The gauze is manufactured in the United States, is designed to be nonlinting, and consists of 100% natural fibers that are totally chlorine-free. SafeGuaze Green nonwoven sponges are perfect for the environment-friendly practice.For more information, call (800) 361-2862, or visit the Web site at

Tokuyama America

Composite materials are very much a part of our everyday practice. Dentists use these materials for a wide variety of procedures in all phases of dentistry. What differentiates one composite from another? There are a number of factors, including their ease of clinical use, their speed of curing, the facility of their shade-matching system, and the speed and ease of polishing the restoration once it has been placed. Tokuyama America recently introduced ESTELITE SIGMA QUICK, an innovative universal composite which is 100% spherically filled. The 82% (by weight) fill ratio provides a highly polishable and wear-resistant surface that offers excellent mechanical strength and is less wearing to opposing dentition. SIGMA QUICK's inorganic fillers are all spherical submicron particles ranging from 0.1 µm to 0.3 µm, averaging out at 0.2 µm. The size and the shape of the filler particles provide the restoration with a long-lasting polish and the assurance of retaining the surface gloss for extended periods. SIGMA QUICK utilizes Radical Amplified Photo­polymerization technology to provide both a reduced curing time and an excellent shading system. Its chameleon effect is consistent over the 20 available shades in 3 opacities and allows the restoration to blend in with existing tooth coloration. Most restorations require only 1 or 2 shades to establish an excellent match. SIGMA QUICK's nonstick composition makes insertion straightforward. Its very low polymerization shrinkage (approximately 1.5%) guarantees margins that stay intact and free of microleakage over extended periods of functional use. SIGMA QUICK composite is indicated for both posterior and anterior restorations. Spherical submicron filler particle technology is now available in ESTELITE SIGMA QUICK.For more information call (877) ESTELIT(E) [378-3548] or visit the Web site at


Have you ever had a problem releasing an impression? Today's accurately adaptive impression materials can make removing an impression a scary task even when the pontics and severe undercuts have been blocked out. Eventually, the tray and impression will release, but there is always a concern that teeth (or parts thereof) or existing restorations might come with it. Another common annoyance is the cement (or other dental material) that stick to the lips or onto the face. These materials wedge into the micropores on restorations or on the skin and are rather difficult to remove. Patients are never pleased when the dentist or assistant irritates their skin trying to wipe particles off their face or lips. Pulpdent's newest addition, Wink, is a water-soluble lubricant and release agent with a myriad of uses in the dental practice. Simply place it on the nonprepared teeth and surrounding tissues intra- and extraorally prior to an impression for incredibly easy impression release from the patient's mouth. Wink is also excellent for orthodontic impressions. A thin coat on the tooth surfaces, kept away from the prepared teeth, works wonders. The most accurate impressions slide off easily after the application of Wink to the teeth and soft tissues around the preparations. Wink is oil-free and will not interfere with adhesive procedures. It is excellent for lubricating prepared and adjacent teeth during provisional fabrication, and when used on the external surfaces of indirect restorations, it facilitates post-cementation excess removal. It lubricates rubber dams to ensure tear-free placement. Wink is also a hand and glove lubricant used prior to handling sticky materials. Eliminate stress when working with tenacious and sticky materials in the oral cavity: let it slide with Wink!For more information call (800) 343-4342 or visit


What is a practitioner to do for pain relief when the oral mucosa is affected by minor irritations, minor inflammations, or the pain associated with canker sores, ill-fitting dentures, or orthodontic appliances? These seemingly minor problems can often cause the patient to forego or to interrupt a dental appointment because it is simply too uncomfortable to proceed. This re-sults in loss of time for the patient and loss of clinical time (and production) for the dentist, but fortunately is totally avoidable. Septodont recently introduced ProJel-20, a 20% benzocaine topical anesthetic gel that is used effectively for temporary pain relief of the oral mucosa. It is fast and effective and is delivered to the mouth in a viscous gel formula. Clinically, this consistency means that ProJel-20 tends to stay where it is placed, often a problem on the slippery surfaces of the oral cavity. It is available in 4 flavors: cherry, pina colada, bubble gum, and mint. Some flavoring agents can discolor restorations; ProJel-20's dye-free flavoring avoids aesthetic complications. Its chemistry is specifically formulated to avoid a bitter aftertaste. It is offered in mess-free jars containing 60 g of topical anesthetic. It is also available in convenient smaller tubes, which can be distributed to each treatment room or given to patients for directed home use when a postoperative pain problem is foreseen. The disposable small tubes each contain 12 g of anesthetic. Mess-free, bitter taste-free, and dye-free, ProJel-20 is worry-free.For more information call (800) 872-8305 or visit the company Web site at

EndoSequence BC Sealer
Brasseler USA

Sealers are the last—but very significant—components of endodontic therapy. Some are difficult to mix, others are difficult to insert into the canal. How viscous is the sealer and how does it respond to the intraoral moisture? How to mix, how to use, and most importantly, is it radiopaque? Brasseler USA's new EndoSequence BC Sealer is a revolutionary root canal sealer with a new bioceramic technology. The sealer is premixed and directly injectable, has excellent sealing and handling characteristics, and is safe and effective in the sealing of canals. The elimination of the mixing step saves time, saves the mess, and provides a consistent and homogeneous sealer at every application. EndoSequence BC Sealer injects directly from the syringe into the canal using disposable provided intracanal tips. Its excellent viscosity and extremely small particle size allow it to flow readily into the dental tubules and to accommodate the gutta-percha, filling lateral canals and webs. It provides a seamless, gap-free interface between the gutta-percha, sealer, and dentin. It exhibits absolutely no shrinkage; thus, the original seal is not lost during setting or over time. Unlike traditional hydrophobic materials, EndoSequence BC Sealer uses the moisture present in the dentinal tubules to initiate and complete the setting reaction. Moisture inside the canal is not a concern; it is actually a part of the solution, not part of the problem. EndoSequence BC Sealer is antibacterial during setting because it is highly alkaline and yet, after setting, it is highly biocompatible. Its formula is highly radiopaque and thus it is radiographically visible post-treatment. EndoSequence BC Sealer brings bioceramics to endodontic treatment.For more information call (800) 841-4522 or visit the company 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 the materials editor and author of the monthly section "First Impressions" 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