First Impressions: April 2011

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.

Biodentine Septodont

Dentin can be damaged in the crown (caries, exposure) or in the root (perforation, internal or external resorption, pulpotomy, and apical surgery). A wide variety of materials are used to treat these conditions; the practitioner must, in turn, have all these materials readily available in the practice. Septodont’s Biodentine is the first bioactive material that can fully replace dentin, both coronally and radicularly. This dentin substitute, totally biocompatible with pulp tissues, is indicated for permanent dentin restorations, deep cavities, pulp capping, pulpotomy, temporary enamel restorations, root perforations, pulpal floor perforations, internal and external resorptions, apexification, and apical surgery supplanting mineral trioxide aggregate, glass ionomers, intermediate restorative material, and calcium hydroxide. Its bioactivity has been designed to promote the remineralization of dentine, pulpal healing, and to preserve pulp vitality. Ten years of research and development, including 4,000 clinical case studies, have been devoted to the creation of Biodentine, a high purity, 100% synthetic mineral, tricalcium silicate-water chemistry, patented, premium grade mineral microaggregate. It forms reactionary dentin and dentin bridges to promote pulp healing after exposure, reversible pulpitis, and iatrogenic exposure. Biodentine’s alkaline (pH = 12) prevents the recurrence of caries. Its easy handling assures optimal clinical utility and ivory shade is compatible with tooth coloration. A 6-minute working time and further 6-minute mouth-setting time permit accurate positioning of the material on the appropriate tooth surfaces. The high radiopacity (350% aluminum) allows the clear differentiation of the restorative material from surrounding tooth structures. Biodentine’s resin free formula, and hence absence of polymerization shrinkage, provides high-dimensional strength and makes the restorations resistant to microleakage. Wherever dentin is damaged, use Biodentine. For more information, call (800) 872-8305 or visit the company Web site at septodontusa.com.

Gluma Desensitizer PowerGel Heraeus Kulzer

When patients are sensitive, they want relief, immediate relief! In the absence of previous or current restorative procedures, most hypersensitivity is reported in noncarious cervical areas of the teeth. In fact, the patient’s tooth sensitivity is often their first encounter with the practitioner. The dentist’s ability to manage the discomfort determines whether the patient stays with the practice or does not. Gluma Desensitizer was originally introduced more than 20 years ago and has been used effectively in more than 50 million cases worldwide. Heraeus Kulzer’s new Gluma Desensitizer PowerGel is an innovative one-step gel desensitizer that has the same efficacy for rapid, long-term desensitization and is the next generation in this category. Its unique gel formula offers greater clinical control and accuracy during placement. This nondrip formulation reduces inadvertent contact with soft tissues. Gluma Desensitizer PowerGel can be applied in one-single step; no agitation is required. Its green coloration makes it readily visible, both during placement and during rinsing. Once completely washed, the process is complete; no light-curing is necessary. Gluma Desensitizer PowerGel is indicated for the reduction or the elimination of pain associated with hypersensitivity, whether in exposed cervical areas or as a result of restorative or crown-and-bridge preparation. Hygienists can also use this prior to the scaling and prophylaxis of patients who have significant gingival recession. For those who forego regular dental examinations and cleanings due to fear of post appointment sensitivity, Gluma Desensitizer PowerGel offers renewed comfort and confidence. Given the documented relationship between gingival disease and heart conditions, this can offer a significant benefit for the patient’s general and dental health. For more information, call (800) 431-1785 or visit the company Web site at heraeus.com.

GC Fuji TEMP LT GC America

Provisional cement must be strong enough to last until the definitive restoration returns from the laboratory; it must be weak enough to allow the provisional restoration to be removed without any risk of damaging the abutment. It must attach securely to the remaining tooth structures or restorative materials yet are readily and completely removable for final cementation. It must set quickly yet clean up easily. GC Fuji TEMP LT from GC America is a new provisional cement indicated for all-ceramic, resin, and metal-based crowns and bridges as well as implant restorations. It is designed to work in the moist environment of the mouth and exhibits excellent handling. It is not runny, thus facilitating cleanup. It is a biocompatible and does not irritate hard and soft tissues, of particular concern in the prevention of peri-implantitis. Its tooth-like coefficient of thermal expansion assists in maintaining a patent marginal seal. GC Fuji TEMP LT acts as an insulant, helping to prevent thermal sensitivity in vital structures. The provisional’s low film thickness (6 µm) minimizes residual effects on the prepared teeth. Its built-in ability to continuously recharge fluoride from oral fluids and rinses allows it to release higher concentrations into the mouth once the hypertonic conditions are removed. The released fluoride protects the remaining tooth structures against bacterial plaque, even during extended provisional wear. It exhibits ionic bonding to tooth structures and metals, a mechanical property that makes for high-bond strength and continued retention. GC Fuji TEMP LT is radiopaque (290% aluminum), so that interproximal overhangs can be spotted easily. For more information, call (800) 323-3386 or visit the company Web site at gcamerica.com.

Snap-On Smile Non-Invasive Cosmetic Removable Arch DenMat

Many patients, and potential patients, are unhappy with the appearance of their smiles. Some have the enthusiasm and the financial ability to improve their smiles through orthodontics, veneers, and crowns; far more cannot afford extended, expensive treatment. Most significantly, patients are interested in relatively instant gratification, where appearance is improved in day or weeks, not months or years. DenMat has refocused the Snap-On Smile Non-Invasive Cosmetic Removable Arch that expands its indications, improves its aesthetics, and simplifies the in-office process. The Snap-On Smile is a comfortable, removable dental appliance that requires no preparation of existing tooth structures; there is no need for injections, cements, or adhesives. The innovative acetyl resin, more durable and stain resistant than acrylic, is very strong, yet flexible and functional. It can be fabricated as thin as 0.5 mm without compromising its strength and aesthetics. The nontoxic material is also used in heart valve replacements and other minor applications in dentistry. The Snap-On Smile is completely tooth-borne and expands over the teeth to adapt tightly so the patient can eat and speak without the appliance disengaging or shifting position. The appliance does not impinge on the gingiva or cover the palate. It is very strong and polishes to an aesthetic luster. In the longer term, Snap-On Smile is durable, resists stains from cigarettes, wine, and coffee, and allows patients to eat while wearing it. The Snap-On Smile is a completely reversible, totally noninvasive treatment procedure, and the patient can easily remove it. Thus, it should be targeted to patients seeking a noninvasive, reversible, affordable approach to permanent restorative and cosmetic dentistry who want to quickly feel better, look better, and function better. For more information, call (800) 445-0345 or visit the company Web site at denmat.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.