First Impressions: November 2008

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.

bluephase G2
Ivoclar Vivadent

Much like the high-speed handpiece, the curing light is an indispensable operative tool for the dental practitioner. Early composites were cured with ultraviolet lights (which can possibly damage unshielded eyes). Composite technology quickly evolved to visible (halogen) light-curing units, which are safer, faster, and easier. Effective new polymerization initiators cured composites quickly. (It’s easy to forget that in the early composite days, the dentist held the restorative in place with a matrix, relatively motionless and moisture-free, for 4 minutes or longer to attain a successful self-cure polymerization). In time, xenon-powered PAC lights, ultrapowerful halogen lights, and argon curing lasers competed with the standard curing unit. None, though, made as immediate an impact as LED (lightemitting diode) units, which have largely replaced halogen in dental practices. The early LED units had a narrow curing spectrum that did not cover all the common initiators, leaving many flowables, provisionals, and sealants unpolymerized. Ivoclar Vivadent’s new bluephase G2 LED curing light has polywave LED technology (380 to 550 nm) that cures all dental restorative materials. The lithium polymer battery permits both cordless and connected functions, allowing continuous operation, should the charge become exhausted. The internally vented cooling fan allows for extended periods of operation without shutting down. The bluephase G2 produces a continuous 1,200 mW/cm² through a 10-mm wand that covers even large posterior restorations. Its probe-tip focusing technology offers excellent residual light intensity, even as the distance from the tooth increases. Both composites and adhesives can be cured in just 10 seconds, regardless of shade. The bright, built-in LED screen provides an informative display that fully informs both the practitioner and the assistant of the operational status at any given time. For more information, call (800) 533-6825 or visit ivoclarvivadent.us.com.


LuxaPost
Zenith Dental

Today, the post-and-core procedure is one of the most commonly performed restorative treatments around the country. As more and more patients are electing to keep their teeth (versus extraction), the post-endodontic restoration is an increasingly important part of the dental armamentarium. The function of the post is to provide an anchor within the canal system of the endodontically treated tooth, thereby anchoring the core that retains the restorative crown after preparation. For more than a decade, LuxaCore has been the dental profession standard for tooth restoration after endodontics and before the crown. Now, Zenith Dental DMG has introduced the LuxaPost, a root post that combines the highest manufacturing quality with a distinctive ease of use. It must be considered that the post is basically designed as a dentin replacement material and thus should act as one. This means high flexural strength, dentinal coloration, and excellent adhesion to both tooth and core materials. LuxaPost has high flexural strength, allowing it to bend with the dentin rather than fracturing due to functional stress, and it has a high transparency that provides a superior aesthetic result. LuxaPost combines with the popular LuxaCore to form a mono-bloc that effectively prepares the post-endodontic dentition for crown-and-bridge procedures. Retention grooves in the coronal segment of the post provide additional physical retention for the core material. Luxa-Post is tapered to minimize internal preparation of the root system, is supplied in 3 sizes that are readily distinguishable through a color-coded application system, and is easy to trim with high-speed instruments. LuxaPost creates a reliable retention of the core build-up material where there is insufficient coronal structure remaining after endodontics. For more information, call (800) 662-6383 or visit zenithdental.com.


Venus Temp C&B
Heraeus Kulzer

Temporary restorations place the dental practitioner on the horns of a dilemma: the temporary restorative material should be functional, aesthetic, strong, resistant, resilient, and comfortable. Yet, it should also be easy to fabricate chairside, cement, and remove. Early provisional materials were powder-and-liquid methyl-methacrylates that were difficult to manipulate, difficult to fabricate, smelled bad, tasted horrible, and looked worse. Over the past 25 years, provisional technology has evolved from methyl-methacrylates to composites. Temporary restorations are increasingly easy to fabricate chairside and within minutes. The technique utilizes a template made of the patient’s natural or restored dentition prior to tooth preparation. Heraeus Kulzer has introduced its Venus Temp C&B as part of its Venus flagship restorative brand, a group of high-quality products that marry direct composite and indirect porcelain solutions into one single restorative family. Venus Temp C&B is a 2-component, self-cure dental provisional restorative material comprised of multifunctional methacrylate esters. Very importantly, however, it is free of methyl-methacrylate. Therefore, Venus Temp C&B has no bad smell or taste and no horrendous shrinkage during polymerization. It protects prepared teeth from external chemicals and maintains the occlusal relationships from tooth preparation to cementation, simplifying final cementation and reducing the need for chairside adjustments, a fact greatly appreciated by both the practitioner and the patient. Venus Temp C&B has excellent aesthetics, allowing the patient with the provisional restoration in place to enjoy the final restoration’s aesthetics while functioning effectively with the product’s unique combination of strength and beauty. As with all innovative products, while Venus Temp C&B’s enhanced properties can be readily understood, they must be seen and used intraorally to be really appreciated. For more information, call (800) 431-1785 or visit the Web site heraeus-kulzer-us.com.


Spee-Dee Build-Up
Pulpdent

Core build-up materials have undergone a major evolution. Once, amalgam was the ideal build-up choice prior to crown preparation; amalgam, however, bonds to neither dentin nor enamel and often leaves a “tattoo” on adjacent hard or soft structures. Strong compressively, amalgam has virtually no shear strength whatsoever. Resin-based core materials appeared in the mid-1980s; unfortunately, neither the bonding agents available nor the resin materials were up to the task. Today’s resin core materials, and their associated adhesives, have excellent properties that make them very useful in both the long and short term—relatively easy to place and functional for patients. Pulpdent’s Spee-Dee Build-Up is a dual-cure, multipurpose core and tooth build-up resin that releases fluoride for both antibacterial and dentinal-strengthening purposes. It is radiopaque on post-treatment radiographs (not mistaken for tooth structure or decay). Once initiated, dual-cure Spee-Dee polymerizes even in the absence of light, and it is self-etching and self-adhesive to dentin. Etching and bonding agents are optional, eliminating several time-consuming and clinically sensitive steps from the build-up procedure. Most importantly, Spee-Dee’s resin chemistry is moisture-tolerant in an area that often has moisture control issues. Spee-Dee cuts like dentin; rotary instruments do not shatter while creating the ideal crown preparation. The automix cartridge’s angled tips offer controlled and comfortable dispensing. Spee-Dee can also be used for vital tooth buildups, recementing post-and-cores, as a permanent luting cement, base or liner, or to repair lost restorations and broken splints. Patching broken cusps and porcelain is a snap. Spee-Dee Build-Up is a one-step post-and-core build-up material that ensures a homogenous polymerized internal structure, creating the monobloc that is so highly desirable with direct restorative procedures. For more information, call (800) 343-4342 or visit the Web site pulpdent.com.


Fiber Lite
AdDent

The science and art of illuminating the operative site have been advancing rapidly in recent years. Dentists, like medical surgeons, have decided that maximizing visual acuity in the work site is not only important, it is essential. Suitable lighting provides much-improved diagnosis, greatly enhanced treatment capabilities, and thus better treatment outcomes. Fiber-optic light handpieces have been the standard of care for several decades, and most dentists will not consider high-speed tooth preparation without targeted illumination of the target site. Diagnostics is more old-fashioned; the mouth mirror is positioned to catch the overhead light’s best rays in order to reflect in the mouth for better visualization. The multipurpose Microlux has had many roles in the illumination and transillumination of the oral cavity and associated structures. Now, AdDent has introduced its Fiber Lite plug-in accessory. The Fiber Lite is a disposable, 1-mm light guide developed for endodontic and periodontal procedures. The Fiber Lite is thin enough to assist in the illumination of the root canal system during endodontic treatment. By placing the light guide in the gingival sulcus, tooth and root fractures can be readily identified by transillumination.
The enhanced sulcular illumination clearly locates previously invisible deep calculus and tartar, both for the dentist and hygienist. The Fiber Lite can also be used for transillumination interproximally to aid in the detection of early proximal caries in posterior teeth. The narrow width of the Fiber Lite allows it to be used in surgical procedures (among others) where bright, pinpoint illumination is required. A problem that can be visualized can be treated. The Fiber Lite makes that visual access a reality. For more information, call (203) 778-0200 or visit the Web site addent.com.


Ray 3-W LED Headlight
High Q Dental

Yesteryear’s overhead dental lights were adequate for an amalgam age. Today’s resin materials, microcomponents, and aging dental providers require more light at the surgical site. Ideally, the light moves with the practitioner’s head rather than originating in a remote overhead source. Headlights have been a part of the dental armamentarium for years; unfortunately, the weight of the light and batteries became rather uncomfortable as the practice day progressed. The rapidly increasing use of magnifying loupes exacerbated the problem—how to get both magnification and lighting into the same small over-the-eye space without weight and without discomfort. High Q Dental, long a provider of excellent lighting solutions, has introduced Ray, a 3-W LED headlight that proves that function and affordability are not mutually exclusive parameters. Ray’s lightweight optics deliver high light intensity into the surgical field; a flip-down orange filter protects light-sensitive materials when necessary. Ray’s rechargeable lithium battery pack delivers 8 hours of clinical use from the tiny, lightweight belt-clip battery pack, where it is virtually unnoticeable. The bulb is a 3-W, 50,000-hour LED unit that is likely to outlast most dentists’ practices. Its intensity is variable between 2,200 and 3,200 foot-candles. Ray weighs 0.7 oz, negligible when placed on the forehead with a headband or clipped to magnifying loupes. (Adaptors to most major bands are provided). The headband is fully adjustable using top and rear knobs. Installation could not be simpler: charge the lithium battery, connect to the light, and clip it on. Turn on as necessary. Ray is usable worldwide (110V to 240V), but outlet adaptors may be needed). Ray 3-Wt LED Headlight is the bright idea for the illuminated dental practice. For more information, call (800) 775-3433 or visit the Web site highqdental.com.

Dr. Freedman is past president of the American Academy of Cosmetic Dentistry and is the Materials Editor for Dentistry Today. He is the Chairman of the Clinical Innovations Conference (London, UK) as well as the Dental Innovations Forum (Singapore). He is the author or co-author of 11 textbooks, more than 400 dental articles, and numerous CDs, video and audiotapes, and is a Team Member of REALITY. He is a past director of CE programs in aesthetic dentistry at the Universities of California at San Francisco, Florida, UMKC, Minnesota, Baylor College, and Case Western Reserve and was the founding associate director of the Esthetic Dentistry Education Center at the State University of New York at Buffalo. He is a co-founder of the Canadian Academy for Esthetic Dentistry and a Diplomat of the American Board of Aesthetic Dentistry. He lectures internationally on dental aesthetics, technology, and photography. A graduate of McGill University in Montreal, Dr. Freedman maintains a private practice limited to aesthetic dentistry in Toronto, Canada, and can be reached at (905) 513-9191 or epdot@rogers.com.