200 Hundred fans and Growing!

Thanks to our Facebook Fans for helping break the 200 mark! Please pass on the page to help get more likes. I value your feedback and will continue to post more valuable information, CE opportunities, Tips and tricks and material updates. Also be on the look out for Ivoclar Raving Fan Interviews. Thanks for all you do!
Nate

Helioseal highlighted by the New York Times

Dentists Back Sealants, Despite Concerns

Cavities or chemicals? That’s the dilemma for parents worried about a controversial substance found in the popular sealants that are painted on children’s molars to prevent decay.

The chemical is bisphenol-A, or BPA, which is widely used in the making of the hard, clear plastic called polycarbonate, and is also found in the linings of food and soft-drink cans. Most human exposure to the chemical clearly comes from the food supply. But traces have also been found in dental sealants.

Although the Food and Drug Administration has reassured consumers that the chemical appears to be safe, it has received increasing scrutiny in recent months from health officials in the United States and Canada.

The National Toxicology Program, part of the Department of Health and Human Services, has raised concerns about BPA, particularly over childhood exposure to the traces that leach from polycarbonate baby bottles and the linings of infant formula cans. The 2003-4 National Health and Nutrition Examination Survey by the Centers for Disease Control and Prevention found detectable levels of BPA in 93 percent of urine samples collected from more than 2,500 adults and children over 6.

BPA has estrogenlike effects, and animal studies have suggested that exposure may accelerate puberty and raise a potential risk of cancer. This month, the journal Environmental Health Perspectives reported that the chemical might interfere with chemotherapy treatment. And last month The Journal of the American Medical Association reported that adults with higher levels of BPA in their urine were more likely to have heart disease or diabetes.

Despite these concerns, the American Dental Association remains strongly in favor of sealants. Dentists note that numerous studies show that any exposure they cause is negligible and temporary, lasting no more than three hours after the initial application. And other studies have found no detectable levels of BPA in most American-made sealants. Meanwhile, sealants have been shown to offer years of protection against cavities.

“This is such an enormously valuable tool to prevent tooth decay,” said Dr. Leslie Seldin, a New York City dentist and consumer adviser for the American Dental Association. “The BPA issue, I think, is so minuscule in impact that it doesn’t really warrant the attention it’s been getting.”

Dental sealants have the consistency of syrup so that they can seep into the crevices of molars. A light is used to harden the sealants, which are then buffed smooth. The coatings prevent the growth of bacteria that promote decay in the grooves of molars.

Just this month, a review of 16 studies by the Cochrane Collaboration, a nonprofit group that evaluates medical research, showed sealants offered significant protection from cavities. In the seven studies that compared sealants and regular brushing alone, the 5- to 10-year-olds who used sealants had less than half as much decay on biting surfaces four and a half years after the treatment. One study with a nine-year followup found that only 27 percent of sealed tooth surfaces had developed cavities, compared with 77 percent of unsealed surfaces.

The Cochrane review did not address BPA, but it did cite a March review article in The Journal of the Canadian Dental Association, looking at 11 major studies of BPA exposure from dental sealants. That review, financed by the nation’s health system and conducted by researchers with no industry ties, concluded that patients were not at risk for exposure to the chemical. And it noted that dentists and patients could further limit any exposure with simple steps like buffing tooth surfaces and gargling and rinsing after sealants are applied, all of which are standard practices in most dental offices.

The review also found that three products did not release detectable amounts of BPA: Helioseal from Ivoclar Vivadent; Seal-Rite from the Pulpdent Corporation; and Conseal f from SDI (North America). All carried the 2007 American Dental Association seal.

The amount of BPA exposure can vary depending on the sealant. In a 2006 article in The Journal of the American Dental Association, researchers from the United States Public Health Service and the Centers for Disease Control and Prevention studied the effects of two dental sealants on 14 men, based on saliva and urine samples. They found that patients treated with an Ivoclar Vivadent product called Helioseal F showed no change in urinary or salivary levels of BPA, while patients treated with Delton Light Cure sealant, from Dentsply Ash, were exposed to about 20 times higher doses of BPA.

Linda C. Niessen of Dentsply International said in a statement that the A.D.A. says sealants are safe, and she notes that any exposure from a sealant is “significantly lower and occurs infrequently” compared with other sources of BPA.

Parents concerned about BPA exposure should ask their dentists what type of sealants they use and whether it has been tested for BPA. But researchers from the Centers for Disease Control and Prevention offered this bottom line: “Sealants should remain a useful part of routine preventive dental practice.”

TARA PARKER-POPE

Simple Steps to Brushing Your Children’s Teeth

Step #1: Let your kids pick out the supplies. There are lots of fun character toothbrushes and toothpastes on the market. Escort your kids to the store, and have them pick out their favorite. They’ll be much more willing to brush their teeth if they’re excited about their toothbrush and toothpaste.

Step #2: Grab the egg timer out of the kitchen and set it for two minutes. Then have your kids brush until it dings. This makes it more of a game and also gives them a goal.
 
Step #3: Switch to an electric toothbrush (Sonicare or Oral B are good brands). A manual toothbrush isn’t as effective or as fun as an electric toothbrush, especially when kids are involved.

 
Step #4: Have them brush your teeth first (with YOUR Toothbrush of course) first. Laugh and make faces or act playfully as they brush your teeth so they see it as an enjoyable activity, then encourage them to brush their own teeth as you watch.
 
Step #5: Make it a family affair. Brush your teeth alongside your kids and they’re likely to mimic your tooth-brushing habits.

Step #6: Stick to a schedule. Kids like routine, so set regular tooth brushing times and stick to them. Before long, it’ll just become a part of their day.
 

CLINICAL TIPS FOR POLISHING CERAMICS: E.MAX AND ZIRCONIA

Adjusting occlusal contacts is frequently required at the time of try-in and/or post-insertion. If there is a minor occlusal adjustment needed, my suggestion is to use only a rubber abrasive polishing wheel and not a diamond. A diamond is needed only if there is a significant adjustment to be made.

If a diamond is used in this process, proper polishing of the surface is necessary to achieve a smooth surface. A polished ceramic surface is less abrasive than one that is glazed, so there should be no need for re-glazing of the restoration. The larger the diameter of the polishing wheel used, the more efficient and effective the process. A point may be necessary to get into the depth of the anatomy, however it is the least effective because of its size.

The three key points for this procedure are:

1. Diamond: Use a fine grit diamond in a friction grip slow speed handpiece. An electric handpiece is more effective than one that is air driven. Run the handpiece at 20,000 RPM with water spray. Avoid a high-speed handpiece because it will create excessive heat and trauma in the ceramic. A light touch is required to avoid excessive heat and vibration. You will then need to use a rubber Polishing Wheel. (Left: Fine Diamond.)

2. Rubber Polishers: I use Brasseler’s Dialite LD (lithium disilicate) and ZR (zirconia) series. Each have a medium and a high shine wheel. An electric handpiece should run at 10,000 RPM to a maximum of 15,000 RPM, with only light pressure used. Electric handpieces have constant torque even at a slow speed, so they are more effective than air driven handpieces. Begin the process with the medium shine wheel. This step should take approximately 30 seconds. Next use the high luster rubber wheel with the same technique as described above. (Right: Medium Dialite LD.)

3. If you use Polishing Paste: Polishing paste should be used with a bristle brush wheel in a slow speed latch handpiece. The product I use is the Dental Ventures of America Zircon-Brite ‘G.’ This is very effective for polishing the grooves in the posterior anatomy. (Left: High Shine Dialite LD.)

Happy polishing!

This Article was first posted on Spear Education. http://www.speareducation.com/spear-review/2012/08/clinical-tips-for-polishing-ceramics-e-max-and-zirconia/

5 Minute Fillings? What if a Composite changed the way you placed Fillings?

Imagine if you could take five to seven minutes off of every filling? That could help aid in some serious production time. What if you could also deliver a superior restoration in the process? What if a Composite changed the way you placed fillings? This is Tetric EvoCeram Bulk Fill! The first ever packable bulk fill composite that allows you to layer 4 millimeter increments without the use of expensive handpieces, or flowables that need a capping layer.

 

Tetric EvoCeram Bulk Fill is a unique nano-hybrid composite material developed specifically for the fast, efficient, “bulk placement” of direct posterior composite restorations.

 

Just Bulk, Sculpt & Cure!

Tetric EvoCeram Bulk Fill features three unique patented technologies:

  • Polymerization Booster for deeper depth of cure
  • Light-Sensitivity Filter for extended working time
  • Shrinkage Stress Relievers ensure superior marginal integrity

BULK
The material’s smooth consistency facilitates excellent adaptation to cavity walls eliminating the need for flowable liners or additional dispensing equipment.

SCULPT
The well-balanced filler composition results in excellent physical properties allowing the material to be contoured immediately after placement without the need for a final “capping” layer.

CURE
The patented “Polymerization Booster” provides a fast, complete cure.

 

Clinical Cases of Tetric EvoCeram Bulk Fill

 

What People Are Saying

This is a great product. At first I was a little skeptical. After placing several restorations, I admire its ease of use and shade matching ability, and it polishes wonderfully. Ivoclar Vivadent – you’ve got a winner here!— John Cranham, DDS, PC (Chesapeake, VA, USA)

I love the radiopacity of this material … it’s incredible!— Chris Ramsey, DMD (Jupiter, FL, USA)

Bulk, Sculpt and Cure … it’s really that easy.— Michael Sesemann, DDS (Omaha, NE, USA)

I like it! Great material, easy handling, packable, holds really well when giving occlusal anatomy and it polishes nicely.— Daniel Vasquez, DDS (Oceanside, CA, USA)

Get Yours Today! Visit Us:

http://www.ivoclarvivadent.us/tetric/bulkfill/buy2-get1.php

Clean Up The Confusion with Ivoclean

 Ivoclean from Ivoclar Vivadent effectively cleans the bonding surfaces of prosthetic restorations after intraoral try-in. The paste is easy to use and can be universally applied.

During intraoral try-in, the contamination of restoration surfaces with saliva cannot be avoided. However, this contamination can pose a problem when the lab-fabricated restorations are adhesively cemented afterwards. Ivoclar Vivadent’s solution to this problem: Ivoclean, the universal cleaning paste that effectively cleans the bonding surfaces of prosthetic restorations after intraoral try-in. Consequently, it creates optimum prerequisites for the adhesive luting procedure.

Universal and easy-to-use
Ivoclean is suitable for all types of restorative materials: They include glass-ceramics, zirconium-oxide ceramics, aluminium-oxide ceramics, precious metal and base metal alloys as well as lab-fabricated composite restorations. Ivoclean is easy to use: Simply apply the cleaning paste to the bonding surface of the restoration, leave it to react for 20 seconds and then rinse it off thoroughly with water. Subsequently, dry the bonding surface with oil-free air.

Tetric EvoCeram Bulk Fill Clinical Case

Tetric EvoCeram Bulk Fill features a polymerization booster, which enables 4-mm thick layers of the material to be cured in only ten seconds (for example with bluephase style). Additionally, it contains a shrinkage stress reliever which keeps shrinkage stress as low as possible during polymerization.  Due to the material’s excellent shade adaptation, high quality results can be achieved easily and efficiently.  

This is a case that was done yesterday using the Tetric EvoCeram Bulk by Ivoclar Vivadent. We really liked the handling of this material. Some of the dentist in the practice were using the Quixx by Dentsply Caulk and felt that the filling materials were too translucent. This was a beautiful material as you can see, much different than other brands.
 

Bulk and Sculpt!

Think you have a Bulk Fill resin? Think again. A new Evolution from Ivoclar Vivadent. Bulk and Sculpt. No expensive equipment. No sticky flowables. Just pure science and innovation. Check it out at:

http://www.ivoclarvivadent.us/online/tetricbulkfill/orderform/index.php

Tetric EvoCeram Bulk Fill is an easily mouldable nano-hybrid composite suitable for the bulk filling technique. It allows a new level of efficiency to be achieved in posterior tooth restoration: one filling, one material, one increment.

Tetric EvoCeram Bulk Fill features a polymerization booster, which enables 4-mm thick layers of the material to be cured in only ten seconds (for example with bluephase style). Additionally, it contains a shrinkage stress reliever which keeps shrinkage stress as low as possible during polymerization.
Tetric EvoCeram Bulk Fill is available in the three universal shades IVA, IVB and IVW (for slightly reddish, slightly yellowish teeth and for deciduous teeth or light-coloured permanent dentition). Due to the material’s excellent shade adaptation, high quality results can be achieved easily and efficiently.

Advantages
•Bulk filling of 4 mm – one filling, one material, one increment
•Very easy to contour, even under operatory light
•Smooth consistency and excellent adaptability
•Low shrinkage stress
•Natural shade blend

The One-Two (Three) Punch!

Although it has been on the market for several years, I want to start first by pointing out the exceptional design on the VivaPen.  ExciTE F in the VivaPen allows exceptional control with ideal chemistries in the material since it eliminates the problems with leaving the cap off or accidentally dispensing 10 drops instead of one.  While that isn’t an issue with something like water, we all know that the adhesive agents are some of the most expensive things per gallon on the planet – so the last thing we want to do is accidentally waste it!  With the VivaPen delivery of ExciTE F, the adhesive can be placed precisely where it is needed and massaged into the dentin or on the enamel, and it is assured to be fresh and delivered in a controlled fashion.  A perfect method of preparing the tooth for the adhesive process!

The next ‘punch’ is Variolink Veneer.  This is an exceptional material that has some unique advantages over other alternatives available.  To start, this material is designed to be used under veneers and so in aesthetic cases.  It goes without saying that it is only logical to use the material developed by the same company that designed the world leading veneer materials, Empress and e.Max.  in addition to the common sense involved, there is the issue of color instability in most conventional adhesive cements.

Every base/catalyst system has amines in it that creates this color instability – resulting in the material turning dark over the first few years after delivering the new smile.  Imagine the frustration of having a beautiful translucent porcelain restoring your smile to your ideal goal, only to have it turn dark under the veneers a couple

years later!  The solution is in an adhesive resin that is designed to be color stable and that would be a light cure only system.  Since the problem was in both the base and catalyst in the dual cure systems, it needed to be completely re-engineered.  Fortunately it also includes a fantastic advantage to boot!

In the Variolink Veneer system there is a range of choices, not based on color, but based on the value.  When delivering a smile it is very often the case that in looking at the smile in the mouth it is just a little too stark and lifeless or it needs a bit of a punch to add that spark or pizzazz the patient is looking for.  In either case, the Variolink Veneer has you covered.  It is offered in a +1, +2, and +3 value or a -1, -2, and -3 value as well as a neutral.  The effect this can have in warming up that smile that is a little too stark or adding that sparkle to that smile that is just a little bit short of what the patient wants.  If you deliver beautiful smiles to your patients, this belongs on your tray setup!

The third punch is the power of the bluephase light.  Cordless lights have been plagued with ergonomic issues and power issues and battery issues and have lacked versatility.  The bluephase has addressed all of those issues and is a dramatic improvement in curing over many of the lights available.  The power it delivers allows you to rapidly cure the restorative material and progress through the procedure with confidence that your resins are as completely cured as they can be!  The concerns about rapid curing being detrimental turn out to be clinically irrelevant and in direct resin placement, the current materials have addressed the shrinkage issue anyway.  When bonding through Empress or e.Max, the power and ergonomics of the bluephase light make it a clear choice winner!

If you aren’t already using these materials and products, you owe it to yourself and your patients to get your hands on them – you will be glad you did!

What a great time to be a dentist!

If you have any questions contact your local Oklahoma Ivoclar Vivadent representative, Nate Smith.

Best in Business,

Dr. Mark Duncan DDS, FAGD, DICOI, LVIF

In 2007 Dr. Duncan was invited to join the full time faculty at the Las Vegas Institute and has moved to Las Vegas where he teaches with the Institute and maintains a faculty practice. Together with the faculty at the Las Vegas Institute, he is involved in teaching advanced esthetic and occlusal concepts along with practice management concepts to students from around the world.
http://www.lviglobal.com

Facebook…….for Business? Yep!

facebook-button

Facebook recently announced more than 750 million active users worldwide. That’s ACTIVE users. Half use Facebook several times a day. Plus, 75% of marketers plan to increase their use of Facebook in 2011!

So let me ask you a question. Is your business leveraging the power of Facebook? Keep reading to learn what’s changed with Facebook just for businesses.

How Has Facebook Changed?

Facebook has changed a lot in the previous months—for example:

* Tabs are gone.

* Static FBML has been phased out.

* Users can masquerade as a page.

If a user can masquerade as a page, one of your competitors can leave a comment on your pages, promoting their page (brand) to your users. Get ready for a new kind of spam!

But there are many positive changes as well.

* Pages have been redesigned to be cleaner and less cluttered.

* You have more control over your news feed.

* You can get an email when anyone comments on your pages.

* iFrame apps have replaced Static FBML.

* You can offer deals to people checking in on a mobile device.

And did you know that you can make Skype calls from Facebook?

Facebook is doing everything it can to become a one-stop source for people’s communication needs. And this is precisely why it’s so important for businesses.

Pediatric Dental Solutions: Oral health management for children and adolescents

excite-vivapen

Healthy teeth and healthy gums are very important for the overall health of children and thus for their personal development.
The i-Kids program offers professional solutions for a customized oral health management for children and adolecents. The special program offers quality products and services which allow you to implement your treatment strategies successfully, efficiently and effectively in children and adolescents. The i-Kids product line comprises diagnostics, therapeutics, filling materials and oral care products for the different treatment requirements of your young patients.

Indications

  • The i-Kids program offers solutions for the special oral health care needs of young patients.

Advantages

  • The products meet the specific requirements for the treatment of children and adolescents.
  • A coordinated product line composed of strong individual products
  • A positive experience for young patients

Benefits for the practice team

  • i-Kids helps you to make every dental visit a positive experience.
  • The program allows you to offer young patients successful, customized oral health management.
  • i-Kids supports you in establishing long-term relationships with the children and their parents.
CRT-Bacteria-kid124x100CRT-bacteria

CRT Bacteria

CRT Bacteria allows for the early detection of caries causing bacteria in children.  If at risk children are identified, preventive measures can be taken to prevent the onset of caries.

Proxyt-kidProxyt Tubes

Proxyt

The cleaning and polishing of teeth and restorations is essential in the prevention of caries and periodontal disease.  Proxyt is a prophy paste that allows gentle cleaning of young teeth, providing clean, smooth and long-term beautiful looking teeth.

Fluor-Protector-kidFluor-Protector

Fluor Protector

In order to stay healthy, teeth need to be supplied with small amounts of fluoride throughout their lifetime.  Fluor protector provides children with an invisible, tasteless varnish that will continuously release fluoride to their teeth between visits.

Cervitec-Plus-kidCervitec_Plus

Cervitec Plus

An innovative varnish which protects at-risk, exposed and sensitive tooth surfaces in children.  The proven combination of 1% chlorhexidine and 1% thymol firmly adheres to tooth surfaces, creating a shield of long lasting protection.

Helioseal-kidHelioseal

Helioseal

Pits and fissures present a high caries risk in children due to their complex shape.  Helioseal protects particularly susceptible areas by sealing them.  This smooth, impermeable layer, which tightly seals fissures, facilitates cleaning in young patients.

Compoglass-F-KidCompoglassF-Syringe

Compoglass F

Children with carious, deciduous teeth need fast and uncomplicated restorative treatment when they visit the dental office.  Compoglass F combines the benefits of glass ionomers and composites, while releasing fluoride to reduce the risk of secondary caries.  This makes Compoglass F the filling material of choice for children who have high carious risk.

OptraPol-Kidoptrapol

OptraPol

When placing composite or compomer restorations in children, polishing is needed.  OptraPol achieves excellent polishing results in just one working step, without having to change instruments.  This provides smooth tooth surfaces and less plaque accumulation in less time.

OptraGate-JrOptraGate_Junior

OptraGate Junior

Children must be treated as quickly as possible, but quality is also important.  The innovative OptraGate Junior lip and cheek retractor makes the teeth and oral cavity easy to reach, ensuring faster and better quality treatment procedures.  The OptraGate Junior is latex free and painless, allowing unimpeded movement of the jaw, making it comfortable to wear during all treatment sessions.

Using Tetric EvoCeram for Predictable Posterior Restorations

figure_9

Inside Dentistry

The material’s filler technology offers many advantages over traditional formulations.Wilson J. Kwong, DMD

In the dental composite industry, there are many companies and products that claim to provide superior features, innovations, and proven technologies. Although there are many treatment options and materials to choose from, they all do not provide the same results. When dealing with restorations, most products cannot deliver the longevity, esthetics, and functionality desired by patients and practitioners alike. It is important for practitioners to choose products that are proven to accomplish everything they, as well as their patients, seek from their restorations. One such product, Tetric EvoCeram® (Ivoclar Vivadent,http://www.ivoclarvivadent.us), provides innovation and proven results in one complete package. Tetric EvoCeram is an innovative nano-optimized universal hybrid composite that offers many advantageous features that work together to provide excellent esthetics and functionality.

Because Tetric EvoCeram filler technology is composed of nano-sized particles, there are many advantages over the traditional formulations of composite materials. The nano-sized particles promote a smoother surface, which allow practitioners to quickly and easily polish restorations to a high gloss.1 Lower wear allows restorations to last longer than composite materials of the past, decreasing the need for patients to return to the office for replacement of restorations completed with this material.1 Shrinkage rates are also exceptionally low (< 1.6%), promoting better marginal integrity of the restoration.1

Another exciting feature of Tetric EvoCeram is the composite’s high radiopacity. This innovation enables practitioners to clearly see the restoration upon completion and final x-ray.1Because it is radiopaque, practitioners are able to see if the restoration was placed properly and ensure that there are no issues, such as leakage.

Tetric EvoCeram is composed of three different types of nanoparticles, which include fillers, pigments, and a modifier. The various sizes of ceramic fillers promote the aforementioned strength, polishing properties, high gloss, and low wear that one could come to rely on for predictable results. Spherical mixed oxide is the basis for the material’s consistency. This oxide promotes optimal light refraction, which imparts a lifelike translucency to not only the material, but the completed restoration as well.1 Prepolymers, which are also used in the formulation of Tetric EvoCeram, are responsible for the exceptionally low shrinkage rates demonstrated by the composite.1

Ytterbium trifluoride, a patented filler created by Ivoclar Vivadent, is responsible for the exceptionally high radiopacity of the composite. Research shows that high radiopacity is not only useful, but actually essential for a sound diagnosis.2 As previously mentioned, this feature allows practitioners and technicians to clearly distinguish the restoration from natural tooth structures and secondary caries on dental radiographs.2 These combined features create a singular material that presents improved handling properties, a non-sticky consistency, and enhanced stability.1

Additionally, the formulation of this nano-optimized composite creates the ability to blend completely with the tooth’s natural structure and the surrounding natural dentition. With Tetric EvoCeram, practitioners do not have to rush through restorations, as working time is ample. Because of these characteristics, restorations created with Tetric EvoCeram are long-lasting and demonstrate a natural fluorescence.

Tetric EvoCeram is available in syringes, as well as Cavifil injectors (Ivoclar Vivadent). Cavifil single-dose restoratives tend to be a better option, as the use of a spatula or a modeling instrument is not required.3 The longer tips of the injectors allow practitioners to easily and comfortably reach areas in the oral cavity that tend to be difficult to work on, such as molars.3Cavifil can also be turned 360° in the injector, so that no matter what the position of the jaw, a practitioner is able to complete the restoration.3

The high-viscosity material is easily dispensed through Cavifil, because of the high transmission ratio of the injector.3 Even if a variety of shades or opacities are required, the Cavifil is still a great option, as the tips can be easily changed.3 The Cavifil injector is also a cost-effective tool, because even though it was designed to be used primarily with Ivoclar Vivadent products like Tetric EvoCeram, other manufacturers’ products can be dispensed by the Cavifil as well.3

As a result of Tetric EvoCeram’s life-like translucency and ability to match nearly perfectly with the surrounding natural dentition, a high level of esthetics can be achieved with a single shade.1 The product is available in three levels of translucency, which include dentin, enamel, and transparent, providing practitioners with a variety of esthetically pleasing options in both anterior and posterior restorations.1 Tetric EvoCeram syringes and Cavifil follow a color-coded system; the labels of the syringes and the caps of the Cavifil are clearly labeled according to each shade, making identification and selection much easier.1

Case Presentation

The patient was a 58-year-old man who wanted to upgrade his old amalgam restorations to bonded composites (Figure 1). The patient also presented with an active underlying immunosuppressive condition, which wasdiscussed during pre-treatment planning. During this planning, the patient asked for “white fillings” to replace the previous amalgams on the lower left first and second molars (Teeth Nos. 30 and 31).

Consequently, the old amalgams were removed, and the caries underneath were identified and then excavated (Figure 2). Evidence of leakage was present in the preparation, and some of the grooves were stained. However, the integrity and structure of the teeth were good.

The cavity preparation was prepared with a cleaning solution of hydrogen peroxide and chlorhexidine to remove any debris. After cleaning, the enamel was etched for 10 seconds using an etchant gel (Figure 3). The dentin was then etched for 10 seconds, giving the enamel a full 20 seconds of etching (Figure 4). Once the preparation was etched to satisfaction, a copious amount of water was used to remove all of the etching gel and excess material.

Using a Vivapen, ExciTE F (Ivoclar Vivadent), a bonding agent featuring beneficial fluoride content, was liberally placed in the preparations in an agitating motion for 20 seconds. This was followed by a light air-dry to evaporate the solvent, and then the preparations were light-cured for 10 seconds. This process was also completed at angles around the cavity preparations to cure undercut areas (Figure 5).

It is important to note at this point in the procedure why a bonding agent that used fluoride was placed on the preparation. Research suggests that as a means of protection against recurrent caries, which are typical with restorations such as the one that presented, fluoride-releasing materials are necessary.4 These types of materials offer protection to hard dental tissues and the surrounding areas, decreasing the chance of post-procedure secondary caries.4This is why it was not only important, but necessary to use a composite material that released fluoride when placed on the preparation.4,5 

A flowable, light-curing nano-hybrid composite (Tetric EvoFlow, Ivoclar Vivadent) in shade A1 was then placed on the floor of the preparation and light-cured for 20 seconds (Figure 6). The depth of the cavity preparation was only 3 mm, allowing one increment of material. Most light-curing units can cure down to 5 mm, however (Figure 7).

A universal, light-curing radiopaque nano-hybrid composite (Tetric EvoCeram) was then placed in one increment and sculpted with a cylindrical instrument and a flat composite instrument. The preparation was cured for 20 seconds, and Tetric Colour was placed into the grooves to accentuate anatomy. This was followed by a final light-cure and flash removal with fluted carbide finishing burs (Figure 8).

Once final occlusal adjustments were made, a final polish was completed using rubber points, wheels, and brushes (Astropol, Ivoclar Vivadent) (Figure 9). The Astropol brushes were also used for and in the grooves.

Conclusion

Tetric EvoCeram is a nano-optimized universal hybrid composite suitable for anterior and posterior restorations. It is also ideal for replacing failing amalgam restorations (Figure 11). This is because of the handling characteristics of Tetric EvoCeram, which now enables clinicians to realize greater efficiency and predictability when suggesting and implementing direct composite restorations. In particular, the material handles very well, with little tackiness on the instruments, and it polishes wonderfully. These characteristics also ensure that patients will be happy with the esthetics and function of their restorations.

References

1. Tetric EvoCeram®. 2009. Nano-optimized composite restorative. [Brochure]. Ivoclar Vivadent, Amherst, NY.

2. Tetric EvoFlow®. 2007. Nano-optimized composite restorative. [Brochure]. Ivoclar Vivadent, Amherst, NY.

3. Ivoclar Vivadent USA. Clinical Accessories/Instruments—Cavifil Injector. 2010. Available at:http://www.ivoclarvivadent.us/content/products/detail.aspx?id=prd_t1_1075236776&product=Cavifil+Injector.

4. Gjorgievska E, Nicholson WJ, LastIljovska S, Slipper I. The potential of fluoride-releasing dental restoratives to inhibit enamel demineralization: an SEM study. Prilozi. 2009; 30 (1): 191-204.

5. Chen MH. Update of dental J Dent Res. 2010;[Epub ahead of print] anocomposites. J Dent Res. 2010;[Epub ahead of print]

About the Author

Wilson J. KWong, DMD
Private Practice Vancouver
Vancouver, British Columbia

The bluephase G2 top rating by CR

bluephasewithmeter

I am happy to inform you that the bluephase® G2 is the featured video on the ADA Online Buyer’s Guide for the Month of June. The video highlights the features of the bluephase® G2 as well as our top rating by CR. This is all just a continuation of all of the positive momentum we are seeing with our curing lights. The link to the video can be found below. Please let me know if you have any questions.

STRENGTH, ESTHETICS, CERAMICS? MAX OUT YOUR POTENTIAL!

A new day has dawned upon us… did you notice it?

A few years ago Ivoclar introduced a revolution in dentistry and radically improved our ability to correctly treat our patients.  Even though the ADA no longer defines our profession as the ‘Art and Science’ of dentistry, what Ivoclar has done is allow us to continue that approach under the new definition of Dentistry!

This is interesting and important to what we are doing in our practices because it specifically guides us to provide treatment and consider the impact of that treatment on our patients.  In the world of fixed restorative, one of the major frustrations has been to find a solution for significant destruction of the tooth that would not create additional destruction – or more simply, to create a fix that doesn’t cause more problems.  The new material e.Max does exactly that!  Combine the wear characteristics of e.Max being in the same range as natural tooth structure with the advanced protocols that can eliminate bruxism, and we are now talking about treating the disease and considering their impact on the human body!

e.Max has wear rates over two years that are within the range of enamel!  So many of our choices cannot claim this and we were forced to accept progressive deterioration of the mouth because the materials did not function as natural tooth structure.  The e.Max is also significantly stronger than pressed ceramics – some 250% stronger when bonded in place.  It is strong enough that you can actually conventionally cement it though I am hard pressed to understand why you would.  The advantages of adhesively places restorations are too numerous to not become expertly proficient at using adhesively retained restorations as your primary, or perhaps sole, treatment.  The ideal combination of the restorative material e.Max and the bonding resin Variolink II and the power of the bluephase light and there is little that can’t be accomplished!

Although it is not widely appreciated or understood yet, the emerging approach of Neuromuscular dentistry cannot be ignored.  It offers the benefits of conventional occlusal perspectives and has the additional advantage that we can create physiologic muscle harmony by intent.  Finally we have the ability to objectively measure where the muscles are comfortable and design a functional envelop for the patient that allows muscle harmony along with joint balance and proper articulation of the teeth.  Astonishingly, when this occurs the parafunctional habit of bruxism can be totally eliminated!  If bruxism is eliminated, and the patient is given the benefit of a material like e.Max with ideal wear characteristics, it is finally possible to offer our patients conservative restorations that will replace and restore the broken, missing, or diseased tooth while maintaining the healthy and strong natural tooth structure – and perhaps keep that restoration for life!

It is painfully apparent that we are enjoying one of the most rapidly advancing times in the history of dentistry.  In the arena of materials, we now enjoy beautiful esthetics with great bondability and strength characteristics that don’t create their own problems.  Predictable and tooth conserving adhesive dentistry is truly an option!  There is diagnostic equipment that allows us to see and understand so much more in our patients!  From 3D imaging technology to objective measurement tools to allow us to evolve into the next level as a profession; we are in a time of unparalleled change and growth.  In the world of occlusion we once thought the teeth were the only important structure – then evolved out thinking to include the bones and proper alignment of the joints.  The next evolution in understanding simply incorporates the muscle and soft tissue in the diagnosis, and when that is included, we can maximize the properties of materials like e.Max.

What a great time to be a dentist! Check it out at http://www.ivoclarvivadent.us/emaxchangeseverything!

If you have any questions contact your local Oklahoma Ivoclar Vivadent representative, Nate Smith.

Best in Business,

Dr. Mark Duncan DDS, FAGD, DICOI, LVIF

In 2007 Dr. Duncan was invited to join the full time faculty at the Las Vegas Institute and has moved to Las Vegas where he teaches with the Institute and maintains a faculty practice. Together with the faculty at the Las Vegas Institute, he is involved in teaching advanced esthetic and occlusal concepts along with practice management concepts to students from around the world.
http://www.lviglobal.com

Introducing the bluephase Style

The bluephase style represents the latest in LED curing light technology. With patented Polywave™ technology to cure all dental materials, a newly designed light probe for easy access to posterior teeth and the option to be used cordless or corded, bluephase style provides the ultimate curing experience for you and your patients.

bluephase style has been designed with the end user in mind. With improvements such as its slim and lightweight design, the intuitive two button operation and the inductive charging system, you will wonder how you ever worked without it!

Advantages:

  • Slim and ergonomic design makes it comfortable for all hands
  • Polywave LED with halogen like broadband spectrum of 385-515 nm
  • Newly designed light probe provides easy access to posterior teeth
  • Large treatment field due to 10mm light probe
  • Cordless or corded operation
  • Intuitive two-button operation
  • Energy efficient LED technology allows for continuous curing

Ivoclar is On The Grow! Major investment results in significant job creation and retention.

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Amherst, N.Y. – Ivoclar Vivadent Chief Executive Officer Robert  Ganley and Buffalo Niagara Enterprise (BNE) President & CEO Thomas Kucharski announced today that the company will invest more than $4 million on a major expansion of their North American headquarters on Pineview Drive in the Town of Amherst.  A leading international dental company with a comprehensive product portfolio, Ivoclar Vivadent’s expansion of their facility is anticipated to create 33 new jobs while retaining an existing 215 employees.  

“Ivoclar Vivadent is very happy to finalize our plans for expansion of our North American headquarters, at our current home here in Western New York,” said CEO Robert Ganley.  “There is a thriving dental industry community here and our employees are a critical part of our company’s success.  We are very pleased that this expansion will allow us to continue to grow and prosper along with the local dental industry, benefitting from the experience and commitment of our strong existing workforce,” Ganley continued. 

Globally headquartered in Schaan, Liechtenstein, Ivoclar Vivadent has operations in 24 nations that provide products to customers in 120 countries around the world.  In addition to administrative & headquarters functions, the Amherst facility that will be expanded by an additional 25,000 square feet houses research & development, sales and marketing, education and training services and some distribution functions.  The company hopes to complete the expansion by the end of next summer.

The Buffalo Niagara Enterprise facilitated the incentive process for the company and provided assistance with workforce issues.  BNE’s President & CEO Thomas Kucharski said today’s announcement is more than just a shot in the arm for the local economy, but also good news for his group’s efforts to attract additional dental laboratory and dental product manufacturing companies to the region.

“From leading international companies like Ivoclar Vivadent to mid-sized suppliers, the dental sub-sector of life sciences is a $30 million industry in our region,” said Kucharski.  “Ivoclar Vivadent played an important role in helping us develop the dental opportunities campaign that we launched last March.  Beyond the impact of the sizeable investment and job impact, the commitment they have made to our region with this project sends a tremendous message to the rest of the global dental industry about the unique elements our region offers.”

Ivoclar Vivadent is  recognized as a global leader in the dental industry. The company distinguishes itself by offering advanced products and services for each phase in the life cycle of a tooth, from prevention to prosthetics.  The company is also unique in that it is a global company headquartered in Liechtenstein, with a CEO who travels the world while calling Buffalo his home base. 

Empire State Development and the Amherst Industrial Development Agency were also key partners in assisting Ivoclar Vivadent with their expansion.

“ESD is proud to support Ivoclar Vivadent’s efforts to provide an effective and efficient environment to produce its products and grow its market share,” said ESD President, CEO and Commissioner Kenneth Adams.  “The dental market is very competitive and this company was faced with the decision to relocate its manufacturing and North American headquarters out of New York State or expand its operations in Amherst.  I am pleased it chose New York State, where Governor Cuomo and ESD are working hard to put people back to work, get our economy back on track and restore New York State as the Empire State.”

“The Amherst IDA is once again honored to assist Ivoclar Vivadent with their expansion of their North American Headquarters in the Audubon Industrial Park.  Ivoclar is an international leader in dental technology with a comprehensive portfolio of advanced dental products. Their investment in the Buffalo Niagara region serves as a beacon to dental product firms throughout the world that our region, home to the SUNY-Buffalo Dental School, is an excellent location for investment.  We thank Ivoclar Vivadent for its continuing commitment to Western New York,” said James J. Allen, Executive Director, Town of Amherst IDA.