First Impressions: February 2011

Dentistry Today

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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.

SS White EndoGuide Burs Kit
SS White Burs

The exploration of the decayed tooth to find the endodontic canals is always a contentious procedure: the patient is often uncomfortable, the dentist is under pressure to locate the canals accurately and quickly, and the dental anatomy is subject to great variability. Visibility is typically limited, and in addition, the hardness of the decayed dentin may be confusing. All in all, access and exploration are very stressful procedures for both the practitioner and the auxiliaries. SS White Burs has introduced the SS White EndoGuide Burs kit for canal access and exploration in nonsurgical root canal treatment. There are 2 dedicated EndoGuide kits available: one for molars and another for anteriors and bicuspids. Burs are also sold separately from the kits. Each kit is designed to assist in the exploration for the canals to facilitate the access once they are located and to reduce the clinical reliance on expensive ultrasonic equipment. The patented, conically shaped microdiameter tips act as self-centering guides for straight-line access to canals, preventing incorrect angulation that can lead to excess removal of tooth structure and perforations. This is particularly important when there are multiple canals that originate close together in the pulp chamber before diverging into the roots. Conservative access also maximizes clinical efficiency and helps to preserve healthy peri-cervical dentin. EndoGuide Burs provide the practitioner with an increased tactile sense in differentiating between healthy dentin and calcified canals. They leave a polished dentinal surface that facilitates the visual identification (preferably with magnification) of hidden canals and other endodontic anomalies. EndoGuide Burs make endodontic access and exploration faster, more predictable, and less stressful.
For more information, call (800) 535-2877 or visit sswhiteburs.com.

DOE Oral Exam System
DentLight

The scientific training of the dental practitioner is focused on diagnostic skill. While the clinical procedures that we perform are highly technical and often demanding, it is the detection of disease and the decision-making that precedes treatment that is truly the hallmark of the profession. Thus, the techniques and devices that assist us in becoming better diagnosticians are always welcome. DentLight has introduced the DOE Oral Exam System that helps dentists and hygienists to identify abnormal tissues that may otherwise escape detection. The dental team is tasked with performing regular cancer screenings for patients, and the DOE makes the potentially life-saving examination pleasant and fast. The small, cordless DOE utilizes high-powered LED illumination with a contrast-switching filter that enhances routine visualization. It looks and feels like a portable curing light, only much more versatile. The unit’s easily interchangeable heads allow for a multiple wavelength intraoral examination with violet and white lights that provide an excellent opportunity for early detection. DOE’s unique collimation provides a uniform beam for superior illumination and excitation of fluorescence. The DOE is compatible with digital cameras to allow a permanent visual record that can assist in monitoring oral changes over the short and long term. The smart, nonmemory, rechargeable battery maintains constant power and has enough charge for 20 patients or more. The DOE uses convenient, integrated loupe filters that can be customized for all major magnification brands. The DOE is a modular light source; it converts instantly to transillumination and curing (with an upgrade) with just a simple head replacement. The DOE is all about early detection and prevention.
For more information, call (800) 763-6901 or visit the company Web site dentlight.com.


RelyX Unicem 2 Automix Self-Adhesive Resin Cement
3M ESPE

The keys to successful cementation include ease of mix, ease of insertion, ease of cleanup, and long-term wear and color stability. It also helps when the coloration of the cement is well suited to the intended restorative materials and a good selection is available to serve the range of natural tooth shade variability. 3M ESPE has recently introduced RelyX UniCem 2 Automix self-adhesive resin cement. This product builds upon the pre-existing RelyX Unicem technology with improvements in dentin bond, flexural strength, color stability, and lower wear in function. It also exhibits an improved bond to Lava restorations. RelyX UniCem 2 Automix is strong and moisture tolerant and is indicated for crowns, inlays and onlays (all-ceramic, composite, PFM, all-metal), bridges (all-ceramic, composite, PFM, all-metal), posts, 3-unit inlay/onlay bridges, and all-ceramic, composite, or metal restorations to implant abutments. The capability of multitask utilization makes the dentist’s decision-making process much easier; one cement fits all. In all applications the method is the same: a convenient automix. The ease of insertion is that no etching, priming, or bonding of the tooth or restoration surfaces is required. The excess cement is removed easily at the tack stage or 3 minutes

Dentistry courtesy of Dr. Gunnar Reich, Germany.

after mixing, and there is virtually no operative sensitivity reported during or after cementation. There are 3 shades available—translucent, A2 Universal, and A3 Opaque—which should cover most clinical needs. The RelyX UniCem 2 Automix syringes conveniently extrude the mixed cement through regular, postendodontic, and inlay/onlay tips for optimal bubble and void-free application. The cement’s proven long-term color stability ensures that aesthetic restorations remain aesthetic.
For more information, call (800) 634-2249 or visit the company Web site 3MESPE.com.


Brush & Sculpt
Cosmedent

One of the most irritating aspects of composite placement is the restorative material’s tendency to avoid staying put. The familiar problem of “pull-back” occurs when the carrying or placement instrument is used to smooth the surface; the composite layer tends to curl towards the instrument, pulling away from the margin and the underlying layer. Left uncorrected, pull-back will cause microleakage, marginal and restorative failure. Another common problem is surface smoothing. It makes sense for the practitioner to develop a polished surface prior to polymerization, thereby reducing polishing time significantly. Unfortunately, composite is unlike amalgam; burnishing is not possible. The options for this technique are very limited. Coating the instrument with alcohol provides a short-term smoothness but disrupts surface polymerization, and in the longer term, allows a pitted, irregular surface
that discolors and attracts plaque.
The use of resin adhesive to coat the smoothing instrument also achieves an acceptable short-term result, but most of these materials have a yellowish tinge, staining the restoration with a discoloration that deepens over time. These adhesives also absorb food stains more readily than microhybrid or nanohybrid composites. Cosmedent has introduced Brush & Sculpt, a 36% filled colorless liquid resin that is indicated for smoothing composite during placement. Brush & Sculpt prevents pull-back by lubricating the interface between the instrument and the unpolymerized composite; there is no formation of marginal or interlayer gaps. It also fills in surface micro-porosities. The liquid resin’s fill ratio creates a smooth, insoluble surface that does not stain, pit, or discolor over time. Brush & Sculpt is HEMA-free for long-term color stability. Brush & Sculpt minimizes polishing time and effort.
For more information, call (800) 621-6729 or visit the company Web site cosemedent.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.