First Impressions: September 2010

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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.


Smartburs II
SS White Burs

Despite extensive education, prevention, and regular care efforts, dentists still see deeply carious cavities. In fact, higher-speed radiographic films and improperly inserted pit and fissure sealants have seen the rise of “hidden caries”; the decay remain undiagnosed until the unsupported occlusal surface fractures to reveal extensive and deep carious lesions. These situations present the dentist with the dilemma of differentiating healthy from unhealthy dentin. These decisions are complicated by the sensitivity in the area, very close to the pulp, where just a touch of a diamond or carbide bur risks exposure. SS White Burs has introduced the new Smartburs II for conservative decay removal. The original has been reformulated to address endpoint durability and clinical efficiency, therefore the Smartburs II is a polymer bur specifically designed to remove infected dentin, and some affected dentin, without removing any healthy dentin. It is indicated for decay removal in both adults and children and is particularly useful for patients who prefer not to have anesthesia or cannot tolerate it. Establish cavity access using carbide burs and expose the deeper carious lesion. Then, the single-use Smartburs II, in a slow-speed handpiece (5,000 to 10,000 rpm), removes the decayed dentin. (A lower rpm extends bur life.) The polymer bur reduces pain reception and the need for local anesthesia by not disturbing the odontoblastic processes within the dentin tubules. Deep, soft decay is removed with a circular light-brush stroke. As the Smartburs II contacts healthy dentin, it transmits increased vibration to the operator. The instrument cannot cut healthy dental tissues; contact with enamel or restorations can rapidly wear the Smartburs II, thus deforming its polymer edges. The Smartburs II offers enhanced diagnostics at the tip of the handpiece.
For more information, call (800) 535-2877 or visit the company’s Web site at sswhiteburs.com.

Peak SE Adhesive System
Ultradent Products

The clinical concerns with self-etch adhesive systems include compatible enamel-dentin bonding (to prevent subrestoration stresses) and chemical degradation of the adhesive over time. Researchers have observed that self-etch systems may bond well to dentin or enamel but don’t always bond well to both. Complex adhesive chemistries, combined into a single container at the factory, may begin to degrade, reducing bond strength over time. Further, there is evidence that adhesive layers can hybridize over time. Ultradent Products’s Peak SE is a versatile adhesive system that offers clinical options for both self-etch and total-etch techniques, both with excellent bond strengths. The ethyl alcohol carrier of the Peak SE Primer provides a consistent surface coat and penetration, reliable bond strengths, reduced postoperative sensitivity, and increased working time. The SE Primer eliminates the post-manufacturing degradation problem by its unique delivery system; a thin film separates the 2 distinct components that are activated only when the plunger is depressed. Once the components are mixed together, they remain fresh for approximately a month. It has been designed to work specifically with the syringe-delivered, light-cured Peak LC Bond Resin Adhesive. The LC Bond Resin is 7.5% nanofilled, penetrating tubules effectively and reinforcing and strengthening the hybrid layer. The LC Bond Resin can be used either with the SE Primer self-etch technique or the Ultra Etch total-etch technique. Its excellent viscosity provides consistent application and clinical control during delivery. The technique for applying the Peak SE formula is very straightforward: the SE Primer is applied to the moist dental surface and agitated for approximately 20 seconds. Virtually all post-op sensitivity is eliminated. Suction can be used to dry the primer, then the LC Bond Resin is applied.
For more information, call (800) 552-5512 or visit the company’s Web site at ultradent.com.

Vintage ZR Press Over
Shofu Dental

The difficulty with aesthetic indirect restorations lies in the alignment of clinical aesthetics with strength. All too often, strength is sacrificed for beauty, or vice versa. In multilayered restorations, a strong substructure with an aesthetic veneering material, the interface can be problematic, both during fabrication and with long-term wear where the veneer fractures away from the substructure. Shofu Dental has introduced its Vintage ZR Press Over material, which offers the excellent aesthetics of porcelain coupled with the high strength of a zirconia oxide substructure. Vintage ZR Press Over is formulated to press to full contour on all 100% zirconia oxide materials. The ZR pellets contain a blend of dentin and Opal incisal that creates a very aesthetic restoration that is readily characterized with Vintage Art stains. The pressing technique’s substructure advantages include marginal integrity, consistency, and economy. The margins do not “lift” and are easy to finish. The material can also be further characterized with Ceramage, light-curing indirect composite restorative materials that naturally bond to the Vintage ZR Press Over with light-curing, making the 2 materials virtually indistinguishable. It is a very versatile restorative material and can also be used for highly aesthetic veneers, inlays, and onlays. Vintage ZR Press Over is a pure leucite-reinforced, feldspar-based ceramic that has been specifically engineered for zirconia frameworks. It contains high-fusing micro-fine particles that create a very dense and homogeneous material that en-hances durability and fracture resistance and mimics the opalescent enamel for the optics required for matching natural teeth. It is a high-strength ma-terial that does not develop glass-modified porcelain fractures. Biocom-patibility, conventional cementation, and easy-to-polish margins all serve to make Vintage ZR Press Over very dentist-friendly!
For more information, call (800) 827-4638 or visit the company’s Web site at shofu.com.


EOS Micro 3-W LED Headlight
High Q Dental

Magnification has rapidly become the standard of dental practice. Few clinicians are prepared to perform exacting clinical procedures without the benefit of magnification loupes that assist in visualizing the operative area, both tooth structure and restorative materials. As the practitioner utilizes magnification, it becomes evident that the traditional overhead dental light does not provide enough illumination in the operative or diagnostic area. Effective magnification ushers in illumination. The first headlights were cumbersome, hot, and heavy and had a battery charge that inevitably gave out in the middle of a procedure. High Q Dental has introduced its newest headlight system, the EOS Micro 3-W LED Headlight. First and foremost, it provides a variable intensity of up to 4,500-foot candles of white light into the operating field. The light weighs only 0.4 oz. Available clips can be used with most loupes, eyewear, or headbands. The lightweight lithium battery pack offers a full day’s clinical use after a single 3-hour charge. The compact universal power charger is provided with the system. The EOS Micro 3-W LED white light has such high intensity that it can cause composite to polymerize prematurely as it is being placed or positioned in the cavity. The convenient flip-down filter, however, allows the dentist to alter the white light to an orange wavelength that prevents polymerization yet provides plenty of illumination in the operative field. The removable cap on the filter handle used by the practitioner to reposition it is autoclaveable, preventing cross contamination between patients. The EOS Micro 3-W LED headlight literally sheds light on your clinical future.
For more information, call (800) 775-3433, e-mail sales@highq-dental.com, or visit the company’s Web site at highqdental.com.

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 special advisor of First Impressions and Buyers’ Guides 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 epdot@rogers.com.