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.
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Ceramir Crown & Bridge (Bioceramic Luting Cement) |
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Dental cements must be biocompatible, adhesive to tooth and restorative structures, aesthetic, predictable, clinically stable, and easy to use. In fact, the closer the cement is to natural tooth structure, the easier it is to fulfill the above parameters. Dental cements have progressed remarkably since the days of zinc phosphate, a luting agent. The past 2 decades have seen the rise of increasingly biomimetic permanent cements that make clinical practice better and easier. Ceramir Crown & Bridge (Bioceramic Luting Cement) from Doxa Dental is a cementing agent that belongs to the biomimetic nanostructurally integrating bioceramics materials group. This involves conventional glass ionomer technology interlaced with Ceramir technology, offering unique cement handling characteristics that are indicated for the permanent cementation of all conventional prosthetic restorations as well as alumina and zirconia frameworks. Ceramir technology is natural and biocompatible (5-year in vivo studies), and nonirritating to the pulp (histological studies). There is no postoperative sensitivity, and it creates an alkaline environment that resists acidity and bacterial decay. The cement has a film thickness of 15 μm, making an effective interface with tooth structures that is impermeable and stable throughout the long term. Ceramir encourages the buildup of nanocrystals and hydroxyapatite that integrate with the dentin and enamel. Its properties are very similar to natural dentin. The cement self-seals margins well, even under less than optimal placement conditions and it is chemically stable in the oral environment. No etching, priming, bonding, or conditioning is required. A 2-minute working time is followed by a 4- to 8-minute setting time. Excellent handling, cleanup times, retention, and clinical performance are the hallmarks of the innovative Ceramir Crown & Bridge cementation technology.|
GingiTrac MiniMix |
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One of my least favorite crown and bridge tasks is the packing of cord for gingival retraction. I know that many of my colleagues are of like mind. Packing cord is technique-sensitive and often time-intensive under very trying conditions. The placement of retraction cord can be rather uncomfortable for the patient during and after the procedure. Supragingival margins are preferable for ease of patient maintenance (and convenience and accuracy of clinical and laboratory processing) whenever aesthetically feasible. When, however, subgingival preparation and impressions are required, then gingival retraction must be made as easy, convenient, and comfortable as possible. Centrix developed the GingiTrac system; in effect, gingival retraction without the cord. The GingiTrac MiniMix is the latest addition to the armamentarium, eliminating waste and risks of cross-contamination, and saving chair time. The automixed GingiTrac material is syringed around the prepared tooth and into the sulcus. The compressing foam GingiCap allows the patient’s bite to press the retraction material into the sulcus where the mild, built-in astringent shrinks the gingival tissue and controls crevicular fluid and blood seepage. When the foam and the GingiTrac material are removed after 5 minutes or less, the patient’s soft tissues are ready for a routine impression. The GingiTrac MiniMix single dose requires less setup and cleanup and is easier to express from the 1:1 automix gun. The GingiTrac system requires no rinsing prior to impressions and no packing cord. It does not require the practitioner to be present during the passive retraction phase, thus freeing the dentist to perform a check or other short procedure while the soft tissue is made ready. The GingiTrac MiniMix provides fast, effective and pleasant gingival retraction.|
360° Cervical Matrix |
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The dental profession has been notably successful in encouraging patients to maintain their teeth for a lifetime. It is common to see the majority of patients in a practice fully or almost fully dentulous, even with advancing age. The retention of the natural dentition has led to a significant rise in the lesions found in the cervical third of teeth, more from abfraction than decay (treatment is similar in any case). The Class V restoration is arguably the most efficient procedure in the dental armamentarium. Current adhesive technology allows secure bonding to both enamel and dentin with little or no tooth surface preparation, and treatment can often be accomplished without anesthesia. Restoration is straightforward, but finishing can be problematic. The gingival margin is particularly difficult to polish as it is subgingival, located on vital, sensitive dentin, and offers limited visual access. The innovative 360° Cervical Matrix from Triodent provides a versatile system for simplified Class V composite placement, polymerization, and much quicker finishing. The matrix is a translucent molded plastic surface-former that does not adhere to composite. Once the tooth cavity is readied for restoration, a flowable composite is injected to slightly overfill the preparation, then the selected 360° Cervical Matrix is applied to the tooth such that all the cavity margins (including the gingival) are covered by the clear matrix. As it is held in position with the pin-tweezers, the resin is polymerized through the plastic. There are 3 color-coded sizes, and each is 360° rotatable to reach every tooth with ease. The margins are void-free, sealed, and require little or no finishing. The 360° Cervical Matrix imparts a mirrorlike surface to the restoration for faster, better Class Vs.
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Waterpik Sensonic Professional Toothbrush SR-1000 |
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The selection of the toothbrush is the most important oral health decision for the patient, and this choice is greatly influenced by the dental professional. Patients are naturally interested in maintaining an optimal level of oral health, and they look to their oral health providers for leadership in this area. In order to be able to provide reliable professional guidance, the dental team must be well informed about the different options available, the research data, and the devices that are most suitable for the patient’s home maintenance routine, and therefore most likely to be utilized on a regular basis. Virtually all the research studies have indicated conclusively that power brushing is far superior to manual brushing. Water Pik’s Sensonic Professional Toothbrush SR-1000 offers state-of-the-art sonic technology that delivers gentle yet very effective, clinically proven plaque removal. The patient (or the dentist) will notice the tremendous enhancement of tooth cleansing the very first time that the power brush is used. Its bristle speed is 25% faster than other sonic brushes, and a dual-speed control on the handle al-lows users to customize the brushing experience to their own personal preferences. The brush’s action naturally whitens teeth and stimulates the soft tissues, promoting healthier gingiva. Three advanced- design brush heads cover the full range of patient re-quirements. An ergonomic handle promotes regular and comfortable brushing through the recommended cleansing cycle, while a 30-second quadrant timer and a 2-minute brushing timer help to guide proper technique and encourage compliance. The charge indicator ensures that the Waterpik Sen-sonic Professional Toothbrush SR-1000 is always powered and ready for action.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 materials editor 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.
