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:

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.

•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


Ivoclar Vivadent Sees Bright Future for Laser Technology in Dentistry

Compendium Of Continuing Education In Dentistry
June 2011, Volume 32, Issue 5
Published by AEGIS Communications

Of the many technical advances in dentistry in the past decade, the use of lasers has perhaps had as much of an impact on the industry as any. With an increasing number of clinicians realizing the benefits of using lasers, the technology has become more widely accepted in the dental industry, according to Danny Forcucci, Marketing Manager at Ivoclar Vivadent.

“When we first began offering a dental laser, we spent an excessive amount of time teaching what a dental laser is and how it works,” Forcucci explains. “Today, most clinicians have some level of understanding.”

The acceptance and growth of laser usage has been spurred on by the numerous advantages it offers compared to traditional methods of soft-tissue surgery, Forcucci suggests. Patients experience less postoperative pain and sensitivity because laser care usually produces a cleaner, healthier surgical site with less discomfort. Plus, use of lasers typically results in immediate postoperative results. Additionally, lasers cause minimal, if any, bleeding, which not only makes things more comfortable for the patient but, notably, provides better visibility for the clinician.

Dental lasers, according to Forcucci, enable clinicians to achieve highly accurate tissue contours, and there is less chance of scarring as well as a reduced need for anesthesia. Moreover, sutures are rarely needed, and the minimally invasive nature of lasers means faster recovery. “In the end, lasers can mean less stress for the clinician, staff, and patient,” Forcucci says.

Odyssey® diode lasers from Ivoclar Vivadent offer clinicians user-friendliness, featuring a simplified control panel along with the latest in solid-state diode-laser technology. Ideal for soft-tissue modification and preventive care, the unit provides accurate power output and a consistent wavelength for smooth, precise tissue alteration.

While the past decade has seen an increase in the use of lasers in dentistry, Forcucci believes the future is even brighter for dental laser technology. “I’ve seen industry projections which show that approximately two out of three US dental offices will have a diode laser in 2016, compared to approximately 25% today,” he says. “I believe that more and more states’ dental boards will allow dental hygienists to use diode lasers as an adjunct therapy in the treatment of periodontal disease. This is because there is beginning to be a greater realization that a diode laser can be used very effectively in a nonsurgical mode.”

Ivoclar Vivadent's Odyssey Navigator

As a leader in dental laser education, Ivoclar Vivadent realizes the importance of instructing clinicians in order to help them achieve optimal laser performance. The company starts with what Forcucci calls “the initial ‘out-of-box’ experience.” A local Ivoclar Vivadent representative provides in-office initial setup and laser usage training for the dentist and entire staff.

“Included in the purchase of an Odyssey diode laser is comprehensive live laser education at one of our three training centers in the United States.” Forcucci says. “Full-day training takes place regularly at one of these three locations, and the courses are typically taught by an Academy of Laser Dentistry (ALD)-certified educator. The course includes lecture, clinical videos, and hands-on. These laser courses consistently receive very high ratings from the participants.”

Looking forward, Ivoclar Vivadent sees many innovations coming to the dental industry as science and technology continue to evolve. As things change, says Forcucci, the company will be there with state-of-the-art expertise. “We’ll always listen to the needs of our customers in an effort to develop a next-generation laser that better meets their needs.”

Ivoclar Vivadent Inc.
Ivoclar Vivadent Inc.
175 Pineview Drive, Amherst, NY 14228

Webinars and Free CE!

Ivoclar Vivadent is proud to bring you our exclusive webinar series. From lasers to ceramics, we have a variety of one hour programs for you to choose and learn from. 
Simply click on the attached link to get started.  It’s a great way to earn valuable CE credits!

10 Tips for Predictable Adhesive Success
Join Dr. John C. Cranham for his upcoming webinar as he presents his Roadmap for Success with dental adhesives. During the program, Dr. Cranham will review some of the newest adhesive technologies and delivery forms, as well as present techniques for both etch & rinse adhesives and self-etching adhesives.

Expert Advances on Durability
Researchers at NYU have shown that IPS e.max lithium disilicate is more durable than veneered zirconia restorations. Dr Van Thompson, one of the lead researchers in the study, explains how IPS e.max changes everything.

Get a Grip…
On Cementation and Bonding

Join us for an in-depth look at the science and technology that goes into bonding and cementation.

Packing a Punch with Posterior Composites
Join Dr. Christopher Ramsey as he shares his approach and philosophies for enjoying success with the placement of direct composites.

The Diode Laser’s Effect on Perio
Dr. Sebastiano Andreana addresses integrating laser technology for periodontal care – because perio can’t wait.

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.

Facebook…….for Business? Yep!

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

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.


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


  • 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

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


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

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

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.



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

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.



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 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

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.


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.


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

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.


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.