DDSGadget

SLActive a new standard in implant dentistry?

2006-08-15T17:18:16Z

Last week Straumann provided a research update on its third-generation dental implant surface technology, SLActive. According to Straumann, as the first chemically-active dental implant surface, SLActive accelerates the osseointegration process, enhances predictability in every indication, and reduces healing times, from 6 weeks to 3 weeks.

]]> Studies you ask? The company commented in their latest press release:
"In all, more than 14 studies on SLActive have been initiated, with particular focus on the initial healing processes. These add to the existing body of scientific data on SLA that supports the new surface.

The development program and distinct clinical benefits of SLActive were also reviewed at the AO. The new surface has shown outstanding clinical results and predictability. For example, in the multicenter clinical trial initiated in 2004 and involving 19 centers worldwide, more than 400 SLActive dental implants have been placed with a survival rate of 98%. This is remarkable in view of the extremely challenging treatment protocols involving immediate function/loading (211 dental implants) or early loading (190 dental implants).

To add further to the body of peer-reviewed published scientific evidence supporting SLActive, the results of a significant preclinical trial are in the process of being accepted for publication in a leading peer-reviewed journal. The findings demonstrate that osseointegration occurred up to twice as fast with the SLActive surface by comparison with the current gold-standard SLA surface. "

These are pretty hefty claims. Does anybody have any experiences to share with SLActive to shed some light on these results? Is this new dental implant surface technology truly going to set a new standard in implant dentistry?

Pulp Capping

2006-07-17T13:45:52Z

Dr. Lustman asks us:
I have heard many pro´s and con's for pulp capping. I understand that the mainstream consensus is not pulp cap carious exposures but rather to start endo.

]]> Small mechanical exposures that can be isolated and disinfected can be pulp capped. The most common materials used for pulp capping are Dycal, Vitrebond, MTA and bonded resins. What are other people doing with pulp capping? What is your failure or success rate? Any advice?

Dental Bonding Agents

2006-07-11T13:26:14Z

Dr. Morris asks us:
According to my sales rep, I only need one bonding agent that will do everything I need. Of course my sales rep knows which one that is and the recommendation seems seems to change every year.

]]> How many bonding systems do you have in your practice? Which ones and what do they do? Does anyone out there have only one bonding system and is that suitable for all your needs?

BloodStop: An Ideal Tool for Extractions or Perio Surgery?

2006-06-05T18:01:18Z

Dr. Leach asks us: I have heard about this new hemostatic BloodStop. It is supposed to be the fastest acting hemostatic agent. Just insert it into the socket and the bleeding stops.

]]> I have many patients on coumadin, aspirin or other anticoagulants. I was thinking of doing more extractions and maybe
some perio surgery if this product is as good as is claimed. In the past I have used other anticoagulants, but I have to sit there and hold gauze over the socket and apply pressure for some time. Has anybody used BloodStop on patients who are on anticoagulants? What are your thoughts?

A New Level of Function for Posterior Composites?

2006-05-16T15:31:34Z

Recently, Garrison Dental has introduced a new sectional matrix retainer, the Composi-Tight® Silver Plus (TM) . Garrison claims that, "The combination of new G-Rings and the matrix band selection available in the new Composi-Tight Silver Plus Kit will provide clinicians tight; predictable contacts on posterior Class II composites with minimum effort."

]]> Furthermore, the company explains that, " Major advancements in the manufacturing techniques of the new G-Ring® have resulted in a ring with nearly twice the amount of tooth separating force as Garrison"s original G-Ring while preventing ring deformation from repeated use. Color-coding of the rings allows instant identification for selecting either the standard G-Ring or the long-tined G-Ring. The tips of the G-Rings are the smallest available allowing for easier placement and less flash. They retain Garrison"s patented burnished tip that prevents accidental ring spring-off. The matrix band selection for Composi-Tight Silver Plus is made up of the most popular sizes from both their Original and Gold kits. "

We would note, however, that there are several of these type of sectional matrix retainers already on the market, including BiTine, Palodent and TriClip to name just a few. There are also a number of contact tightening gadgets to help with posterior composites. What are the pros and cons of these devices and what are your experiences? Does the new Composi-Tight® Silver Plus (TM) really offer a new level of form and function to your posterior composites?

Case Study: Orthodontic Analysis with Cone Beam CT

2006-05-08T19:56:37Z

In this first installment of DDSGadget.com's and Conebeam.com's complex dental case discussions, we cover the case of a patient with bilaterally impacted canines. We encourage you to provide your own opinions on this case, including any different decisions you may have made.

]]> Case History:
The patient has bilaterally impacted canines. It was difficult to assess the precise position of the impacted teeth vis-a-vis the other teeth and thus the likelihood of success of trying to move it into position. The orthodontist ordered a cone-beam CT.

Photo Description:

The panoramic & 3D reconstructions seen below, shows both impacted teeth, #'s 6 & 11. The cross-sections below show #11 to be lying above the other developing teeth, with its long axis directed bucco-lingually, and its crown pointing towards the buccal.

Clinical Decisions:

The orthodontists decided in this case to extract the impacted cuspids.

What is your opinion on this case? Would you have done the same thing or perhaps done something different? Please leave your thoughts below.

Photos:

Credits:

Scan: Harvard School of Dental Medicine (http://www.hsdm.harvard.edu/asp-html/)

3D Reconstructions: 3D Diagnostix Inc.

Images Courtesy of: www.Conebeam.com

An Alternative to Periotomes?

2006-05-08T17:23:41Z

There are a number of pricey gadgets on the market, including the Easy X-TRAC® System pictured here, for atraumatically extracting teeth which claim to offer advantages over traditional or periotome extractions.

]]> The goal is to destroy or remove as little bone as possible to preserve the extraction site for a dental implant. These newer dental instruments utilize sort of a cork-screw mechanism to pull the tooth out of the socket, leaving much of the cortical plates intact.

For example the sales material for Easy X-Trac claims: "The Easy X-TRAC® technique allows you to execute an absolute atraumatic extraction with no rotary movements, zero bone loss, and no post-traumatic swelling. It also gives you the ability to perform an efficient extraction that minimizes patient discomfort and provides you the opportunity to successfully place immediate implants."

Has anybody used any of these new gadgets or techniques? Do they really work that much better that traditional or periotome extractions?

Calcium Sulfate to Revolutionize Bone Augmentation?

2006-04-25T16:06:51Z

Does anyone have any thoughts on BoneGen, a new product being marketed by Bio-Lock for bone augmentation? Given the recent concerns surrounding other regeneration materials, do you think BoneGen will make a strong impact on the market? According to the company, BoneGen is new clinically safe, nano-composite, time release calcium sulfate product for bone augmentation.

]]>
Bruce L. Hollander, BioLok's President & Chief Executive Officer, "BoneGen-TR is a nano-composite material that
fully resorbs into the body, leaving nothing but newly formed bone, which has significant advantages over many of the other products in the market. Existing natural products used in the bone augmentation and regeneration industry have for the past several months been negatively impacted by a myriad of health concerns. Among natural material sources, freeze dried bone has come under government investigation for unsafe procurement methods, while bovine-based products suggest exposure to the possibility of mad cow disease. Many ceramic substances do not fully resorb and are still questionable in their ability to grow new bone. With this backdrop, BoneGen-TR, a synthetic, should receive rapid adoption by dental professionals." Based on medical grade calcium sulfate, a product proven safe for over 100 years, BioLok's BoneGen-TR has increased the time for resorbsion of calcium sulfate from 4 weeks to 18 weeks, allowing time for full and safe bone growth in large voids.

What do you make of these claims?

Ozone Therapy for Cavities?

2006-04-25T15:43:05Z

Can ozone be used to treat caries (cavities) without the need for drilling and filling? We recently attended a lecture on the uses of ozone in dentistry. It seems that in most of the world, other than the US, ozone is already being used to disinfect cavities by killing bacteria on direct contact. All you do is expose the carious enamel and dentin to ozone. Ozone can also be used to disinfect root canals.

]]> Ozone therapy in dentistry is being marketed by a company called CuroZone (www.curozone.com), under the product name, HealOzone. The company explains on the front page of its website:
"Up to now, dentistry was convinced: Caries can only be eliminated by removing the dental substance thru drilling and filling. A painful and inaccurate treatment method: Residual caries is present in 80% of the cases. But now there is a new therapy that treats caries using ozone. This therapy is highly effective in the painless removal of caries. Hence, you can tell your patients: "No, there are alternatives"."

Clearly, Ozone Therapy will appeal to a large patient target group from young to old throughout all generations, because most people are afraid of the pain involved with caries (cavity) treatment. But the caries (cavity) treatment with ozone puts an end to all this!

This device is not being used in the US yet and is awaiting FDA approval. Have any of you dentists outside of the US been using ozone and what can you tell us about your experiences?

3-D Digital Imaging to Revolutionize Impression Taking

2006-04-18T18:07:54Z

According to Eric Paley, CEO of Brontes Technologies, an estimated 50% of the roughly 50 million dental impressions taken each year in the U.S. are substandard, and require a second one or lots of finish work by the dentist to get them to fit properly. "Patients and doctors hate them," stated Paley. Is the new 3-D Imaging technology out of Brontes the solution to our impression problems?

]]> The Wall Street Journal profiled Brontes Technologies this week and explained: "Dentists, who are usually sole practitioners, typically average several impressions each day. And dental labs, which create the dental appliances, often find that a wax or plaster-like cast may not be adequate to create a proper denture, and may request a second impression be taken. Another potential pitfall is that the impression, which is usually shipped to the lab, could get damaged or lost in shipping, Mr. Paley said."

Paley explainted that, "The Brontes technology aims to provide a consistently accurate image for the fabricator in order to assure proper fit and comfort of dental appliances. A dentist using the Brontes system scans a wand, about the size and shape of an electric toothbrush, over each arch of a patient's teeth while it captures their images via a camera.

The process, which is painless and conducted in the dentist's office, creates a digital video image that is transmitted to a flat-screen panel. It presents a detailed, life-size image that can be moved and spun for viewing at different angles by simply touching the image on screen. The digital image is forwarded to a dental lab so it can produce a permanent denture or crown.

The dentist can also save the image to access when ready to apply the crown, in order to preview the work when the new item comes in. The dentist can also maintain permanent images of the patient's mouth to track changes in patients' dental health over time, to prevent and diagnose problems. A traditional X-ray is still necessary to determine if there is decay underneath the surface of teeth or gums."

As regards to the technology the Journal qouted two different viewpoints:

"As for Brontes's technology, Mr. Freedman, director of marketing of the Dental Trade Alliance, said that in the short term, dentists using it may find it difficult to find laboratories that use digital images to fabricate appliances. "I think it's still a relatively small universe."

But Dell Dine, vice president of research and development at National Dentex Corp., one of the largest operators of dental laboratories in the U.S., said it is just a matter of time before a support technology is developed for labs."

What are your thoughts? Will this be a standard technology in a few years time?

Source: FRANK BYRT, Wall Street Journal

Intraoral Cameras

2006-04-10T15:56:44Z

Dr. Feuerstein asks: Are Intraoral cameras still useful? With the advent of high resolution, low cost digital cameras, many practitioners feel that they do not need intraoral cameras.

]]> These units cost between $1,500 and $8,000 and give lower resolution images than the digital cameras. You can surely take a photo of a full arch and zoom in on a specific tooth close enough to see fractures or other conditions. Why are manufacturers still designing and marketing intraoral cameras? Which models are useful? Have there been any new advances?

DDSGadget.com Welcomes Dental Technology Guru, Paul Feuerstein, DMD

2006-04-05T11:45:37Z

DDSGadget.com is excited to welcome dental technology guru, Paul Feuerstein, DMD to our editorial board.

]]> Paul Feuerstein received his undergraduate degree at SUNY Stony Brook where he majored in Chemistry, engineering and music and learned how to program computers. He received his dental degree at UNJMD in 1972 and has a General Practice in North Billerica, MA. He installed one of dentistry's first "in-office computers" in 1978 and has been teaching dental professionals how to use computers since the late 70’s. He is currently the Technology Editor of Dental Economics Magazine and the High Tech writer for the Journal of the Mass Dental Society as well as contributing author to several national dental journals. He is now one of the ADA technology lecturers, speaking at the annual sessions, has been speaking at Yankee for over 20 years as well as several state and local dental association meetings.

Over the past years he has made an extensive study of the high tech products available to the dental profession and has used many of them in his general practice. He has also been in the forefront of using the internet at both office and home, and has brought many of his colleagues online.

Find out more about Dr. Feuerstein at: www.computersindentistry.com

Electronic Apex Locator

2006-04-03T22:28:01Z

I have tried a bunch of electronic apex locators, like Foramatron, Root-ZX, Apex NRG, etc.

]]> I can get them to work some of the time but I cannot depend on them. I still am taking measurement radiographs for every case which wastes a lot of time. I would really like to get settled with a reliable apex locator. What apex locators are you using and what are your recommendations?

Dental Materials: Anchor: Core Build Up / Luting Cement

2006-03-28T14:24:00Z

Has anybody tried the new cement and core material called Anchor?

]]> It was developed by John Kanca and is compatible with his Simplicity bonding system. It really sounds like a great material. It can be used to cement a post and then build up the core. It can also be used to cement crowns and bridges.

At the company´s website, Apex Dental the material is described as follows:

"Independent research along with your feedback suggests a perfect core material would combine the following characteristics:
* Ease of placement
* Bonds to tooth structure
* Ability to be contoured and prepared immediately
* High strength and rigidity
* Cutting resistance like tooth structure, carves like dentin
* Tooth shade under ceramic crowns
* Compatible with bonding agents
* Fluoride release
* High radiopacity (*)

A material that couples these features with the proper viscosity and delivery system would not only qualify as the best core material on the market today but also a top luting cement. Working hard to simplify your practice and ensure your clinical success, Apex has created a highly versatile product to function as both your core build up and luting cement."

Any thoughts or comments?

Burs for High Speed Dental Handpieces

2006-03-21T17:33:01Z

I have tried several of those new aggressive friction grip burs in my air driven high speed dental handpiece. I tried Samuarai, Razor, Great White, etc.

]]> In my hands I found that these burs cut a little better than plain old carbide burs. I am wondering if these aggressive burs cut better when they are used in higher torque electric handpieces. Has anybody found a carbide that
really cuts fast and aggressively like the advertisements, and that can also be used in an air driven dental handpiece?