today daily AGD Annual Meeting June 22, 2012
AGD News / Exhibitors / Scenes from Thursday
Table of contents
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[1] =>
th
e AGD
!
DAI
LY
AT
DENTAL TRIBUNE
The World’s Dental Newspaper · U.S. Edition
FRIday, june 22, 2012 — Vol. 3, No. 2
www.dental-tribune.com
scenes from the agd
joining forces
putting it to the test
Out-of-state visitors,
Army doctors, art for
your dishes, new products
and much more.
A flowable restorative
combines with a self-etch,
prime and bonding product
to save you money.
Can these crowns really
help you see esthetic
improvements in your
anterior restorations?
” pages 6 & 7
” page 8
” page 9
So much to see
Exhibitors show off
their newest products
here at the AGD
By Dental Tribune Staff
B
etween the hands-on workshops, the Welcome Reception
and the general session on
social media, Thursday at the
AGD Annual Session was filled to the
brim with things to do and products to
see. But it’s only just beginning.
During the next two days, there is plenty more to explore here in Philadelphia.
From numerous continuing education
offerings to networking opportunities to
new products, the world of dentistry is at
your fingertips.
If you haven’t yet had a chance to scope
out the exhibit hall, here are a few booths
you’ll want to be sure to stop by.
” See SEE, page 2
Ad
A crowd fills the AGD exhibit hall soon after it opens on Thursday afternoon. Photo/Anna Kataoka-Wlodarczyk, Dental Tribune
[2] =>
2
“ SEE, Page 1
• Carestream Dental (booth Nos.
614/616) is introducing its new CS 1600
multi-use intraoral camera. According
to the company, it’s got the widest focus
range on the market (1 mm to infinity), is
easy to use and features the same unique
liquid-lens autofocus technology as Carestream Dental’s 1500 intraoral camera.
It also has a sophisticated 18-LED illumination system and an optional polarizer
filter to reduce glare.
• Ultradent Products (booth No. 705) is
showing off Edelweiss, a uniquely engineered composite veneer system that it
first launched in May. It’s billed as a lowcost, esthetic alternative to custom lab
veneers.
According to the company, each composite veneer in the Edelweiss system is
laser sintered, combining a high-gloss,
uniform surface with a thermally tem-
Ad
agd news
pered base. Ultradent intends Edelweiss
as a solution for those seeking a lowercost alternative to custom lab veneers,
unlocking the opportunity for dentists
to offer esthetic smiles to more patients.
• Shofu (booth No. 1128) is introducing
BeautiSealant, a tooth-colored, fluoride
recharging, pit and fissure sealant with
a self-etching primer that speeds treatment time by eliminating the need for
phosphoric acid etching.
According to the company, the product helps preserve healthy enamel that
is easily demineralized with harsh acidetchants while still maintaining superior bond strength. Seeping deeply into
pits and fissures, the HEMA-free primer
bonds equally to enamel or dentin, preparing the tooth surface for a secure and
long-lasting bond.
• For those who want to grow their practices, Viva Concepts (booth No. 854) has a
novel idea: you can hand out gift cards to
Dental Tribune Daily U.S. Edition | June 22, 2012
your existing patients, which they can
pass along to friends and family members.
With a selection of more than 20 card
templates and the option of custom designs, you can pick your design and create a specialized offer. A magnetic stripe
on the back of the card is a swiper that
is used when the card is redeemed and
makes patient referrals easy to track.
• Finally, there are plenty of products on
display at VOCO America (booth No. 425),
including its new Quick Up implant pickup system, which is designed to eliminate
the risk of interlocking. Made specifically
for bonding attachments, Quick Up can
also be used for reattaching secondary elements, such as bar retainers, in a
denture. With everything in one system,
Quick Up is designed to improve workflow and chairside efficiency.
The exhibit hall is open until 7 p.m. today and from 10 a.m.–3 p.m. Saturday.
DENTAL TRIBUNE
The World’s Dental Newspaper · US Edition
Publisher & Chairman
Torsten Oemus t.oemus@dental-tribune.com
Chief Operating Officer
Eric Seid e.seid@dental-tribune.com
Group Editor
Robin Goodman r.goodman@dental-tribune.com
Editor in Chief Dental Tribune
Dr. David L. Hoexter d.hoexter@dental-tribune.com
Managing Editor Show Dailies
Kristine Colker k.colker@dental-tribune.com
Managing Editor
Fred Michmershuizen
f.michmershuizen@dental-tribune.com
Managing Editor
Sierra Rendon s.rendon@dental-tribune.com
Managing Editor
Robert Selleck r.selleck@dental-tribune.com
Product & Account Manager
Gina Davison g.davison@dental-tribune.com
Product & Account Manager
Mara Zimmerman
m.zimmerman@dental-tribune.com
Marketing Manager
Anna Kataoka-Wlodarczyk
a.wlodarczyk@dental-tribune.com
Sales & Marketing Assistant
Lorrie Young l.young@dental-tribune.com
C.E. Manager
Christiane Ferret c.ferret@dtstudyclub.com
Dental Tribune America, LLC
116 West 23rd St., Ste. #500
New York, N.Y. 10011
(212) 244-7181
Published by Dental Tribune America
© 2012 Dental Tribune America, LLC
All rights reserved.
Dental Tribune strives to maintain the utmost accuracy in its news and clinical reports. If you find a factual error or content that requires clarification, please
contact Managing Editor Robert Selleck at r.selleck@
dental-tribune.com.
Dental Tribune cannot assume responsibility for the
validity of product claims or for typographical errors.
The publisher also does not assume responsibility for
product names or statements made by advertisers.
Opinions expressed by authors are their own and may
not reflect those of Dental Tribune America.
Editorial Board
Dr. Joel Berg
Dr. L. Stephen Buchanan
Dr. Arnaldo Castellucci
Dr. Gorden Christensen
Dr. Rella Christensen
Dr. William Dickerson
Hugh Doherty
Dr. James Doundoulakis
Dr. David Garber
Dr. Fay Goldstep
Dr. Howard Glazer
Dr. Harold Heymann
Dr. Karl Leinfelder
Dr. Roger Levin
Dr. Carl E. Misch
Dr. Dan Nathanson
Dr. Chester Redhead
Dr. Irwin Smigel
Dr. Jon Suzuki
Dr. Dennis Tartakow
Dr. Dan Ward
Tell us what you think!
Do you have general comments or
criticism you would like to share? Is
there a particular topic you would like
to see articles about in Dental Tribune?
Let us know by e-mailing feedback@
dental-tribune.com. We look forward to
hearing from you! If you would like to
make any change to your subscription
(name, address or to opt out), send us an
e-mail at database@dental-tribune.com
and be sure to include which publication
you are referring to. Also, please note
that subscription changes can take up to
six weeks to process.
[3] =>
[4] =>
exhibitors
4
Dental Tribune Daily U.S. Edition | June 22, 2012
Atraumatic extractions
with Luxator Periotome
Instrument can help the
dentist divide and conquer
the forces retaining a tooth
By Dr. Simon Jones
The extraction of a tooth is probably
the most traumatic event a patient can
experience in the dental office, and if the
extraction doesn’t go smoothly, things
can become quite stressful for the dentist as well.
When the use of a simple surgical instrument can make the extraction process infinitely easier for both patient and
dentist, I find it surprising not all dentists reach for a Directa Dental Luxator
as their first instrument of choice.
To understand how best to remove a
tooth, it helps to appreciate the structures and forces that are holding the
tooth in position. It is only by overcoming these forces that the tooth can be
removed.
First, consider the bone structure surrounding the roots. As the bone sits intimately against the root surface, any
irregularities, undercuts or curvatures
of the root will provide mechanical retention. To overcome this retention, the
socket must be dilated until the path
of removal of the root is unimpeded by
bone.
The second factor resisting the removal of the tooth is the periodontal ligament, composed of collagen fibers. Like
millions of little ropes, the cumulative
strength of these fibers resists the strongest of biting forces. Imagine how much
force would be required to overcome this
combined strength in an attempt to simply pull out a tooth.
The third force to overcome is that of
atmospheric pressure. Withdrawing a
tooth from its socket will create a void
or vacuum at the apex of the socket, and
until this void is filled with blood or an
ingress of air, then atmospheric pressure
will effectively push on the tooth to keep
it in position. Anyone who can remember back to the Magdeburg Hemisphere
experiment in school physics will know
that simple atmospheric pressure resisted the force of two teams of horses pulling in opposite directions.
Little wonder then that simply using a
combination of forceps and brute force
can lead to unnecessary loss of alveolar
bone, root fracture and a subsequently
more stressful experience for both patient and dentist. Dealing with the fracture of a maxillary tuberosity can certainly ruin your day!
The careful and considered use of a
Luxator helps the dentist to divide and
conquer the forces retaining a tooth,
making the extraction process an infi-
Fig. 1: Luxator Periotome
Photos/Provided by Directa AB
Fig. 2: Luxator severs the periodontal fibers and dilates the socket.
Fig. 3: Correct handling of Luxator
Periotome.
Here at the AGD
For more information, stop by the Directa AB
booth, No. 433. More information about Directa
Products may be found at www.directadental.com
or by contacting U.S. Sales Manager Frank Cortes at
(203) 788-4224 or by e-mail at frank.cortes@directa
dental.com.
nitely more predictable and stress-free
process.
The appropriate size of Luxator is chosen to match the diameter of the root,
and the angle of the blade is chosen to
give the best access. The tip of the Luxator is gently inserted into the gingival
margin, with the blade angled slightly
toward the root surface. This ensures
that the Luxator enters the periodontal
ligament between the crestal bone and
the root.
Once in the periodontal ligament, the
Luxator is worked down the length of the
root with a side-to-side rocking motion
and steady axial pressure (Fig. 2). This
motion first severs the periodontal fibers, and then as the blade is introduced
further, the socket is dilated to allow an
easier path of removal. Finally, as the
periodontal ligament is severed and the
socket dilated, bleeding and air ingress
overcome the vacuum that resists tooth
removal.
The Luxator should be inserted around
as much of the circumference of the root
as possible to evenly dilate the socket.
Fig. 4: Luxator Periotome vs.
Luxator Forte
Once this has been achieved, the final
delivery of the tooth may be performed
with forceps, although this is often not
required with single-rooted teeth.
When using a Luxator, the uniquely
designed handle should sit neatly in
the palm of your hand, cradled by your
fingers and thumb, with the index finger extended toward the tip of the instrument (Fig. 3). This allows for precise
control of the tip and prevents the risk
of slipping. Excessive force should be
avoided; the Luxator is a surgical instrument and should be used as such, not as
an elevator.
To complement its range of Luxators,
Directa now produces an elevator called
the Luxator Forte. Having dilated the
socket using a Luxator, if it is felt that
greater dilating and elevation forces
are required, then the stronger Luxator
Forte should be used. The Luxator Forte
is easily recognizable by its black handle
(Fig. 4). This sequence of luxation, followed by elevation, generally means that
forceps are only ever used for the final
easy delivery of the tooth.
The Swedish dental company Directa
not only invented the name Luxator but
has developed this range of instruments
to perfection. The use of high-grade, surgical-steel blades and a two-part moulding technique for the uniquely ergonomic polymer handle combine to provide a
high-quality instrument that will give
Fig. 5: An atraumatic extraction is performed.
About the author
Dr. Simon Jones is a leading U.K. dentist with a
practice in Middlesbrough, northeast of England.
He qualified in 1985 and has worked mainly in the
British National Health Service since then. For the
past six years, he also served as a vocational trainer
for the Northern Deanery of Newcastle University
Dental School.
years of reliable service and will endure
countless cycles of washing disinfection
and autoclaving.
Having used Luxators for more than
20 years, I cannot imagine undertaking
the extraction of any tooth without first
severing the periodontal fibers with my
trusty friend. It would be the equivalent
of struggling to remove my boots without first undoing the laces.
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[6] =>
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scr apbook
Dental Tribune Daily U.S. Edition | June 22, 2012
Scenes from Thursday
Stop by the Army Healthcare Services
booth (Nos. 422/424/426) and get more
information from Dr. John Geary, left,
and Dr. Katherine Martin.
The AGD Annual Meeting attracts attendees from all over. Here, from left, are Juliana Blackington, Samantha Ripley, Patty Jo Pantillo, Jane
Bowden and Karen Greatorex, all from Belfast, Md.
Janet McGettigan, left, and Stephanie
Weis of Garrison Dental Solutions (booth
No. 707).
Danielle Piquette and Joe Graffius of
Obtura Spartan (booth No. 538), offering
‘endodontic excellence since 1979.’
Teresa Gee of Essential Dental Systems
(booth No. 813). Many of the company’s
patented instruments and systems are
invented by endodontists.
Clockwise from top left, Sponsorship and Advertising Manager of the Greater New York
Dental Meeting Dr. Joseph Schachner, Executive Director of the Greater New York Dental
Meeting Dr. Robert Edwab, Kersin Yam and Dana Soltis are all smiles at the booth, No. 407.
Stephen Arbakov, left, and Mike Van Nostran
at the Ortho Organizers booth (No. 504).
Dr. Bill Paveletz of VOCO America (booth
No. 425), which offers dental materials such
as Futurabond DC, Profluorid Varnish and
Remin Pro.
Lelani Le of Glidewell Laboratories at the
booth, Nos. 527/529.
[7] =>
Dental Tribune Daily U.S. Edition | June 22, 2012
Lynne Calliott, far right, of Shofu explains the advantages of
BEAUTIFIL Flow Plus to two attendees at booth No. 517.
7
scr apbook
George Toto, left, and Judie Tinker of
Directa AB (booth No. 433), makers of the
FenderWedge and the FenderMate.
Pick up these dental-themed, handpainted wine glasses and plates
at the Professional Obsessions booth, No. 540.
Jason Rush of Philips Sonicare and Zoom
Whitening with a few of the products that
are available at the booth (No. 501), including
flourideRx and breathRx.
Find Mike Anthenelli, from left, Gerri Bowman and Andrew Fikse at the Patterson Dental booth (Nos. 815/817).
James Ortmann of Hager Worldwide at the
booth (No. 510).
Bill Colanti of Technology4Medicine
with the LightWalker, a universal,
dual-wavelength laser system. Check
it out at booth Nos. 505/507.
Have a question? The folks at the
information booth will be happy to help
you out.
Orlando Navarro, left, and Adrian Lopez at the DoWell Dental Products booth, No. 716. Ask the
company reps about the benefits of PiezoART.
Photos by Anna
Kataoka-Wlodarczyk
Dental Tribune
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8
exhibitors
Dental Tribune Daily U.S. Edition | June 22, 2012
BEAUTIFIL Flow
Plus, BeautiBond
join forces in kit
Package saves money for customers using both
Two of Shofu’s most acclaimed products are now available in two new kits offering discounted pricing.
The new kits will contain six syringes of
the flowable restorative BEAUTIFIL Flow
Plus in either zero-flow or low-flow viscosities and a box of 50 0.1 ml unit dose
bottles of BeautiBond™, the seventh-generation bonding agent.
The new kits are expected to synergize
Ad
The new kits from Shofu contain BEAUTIFIL
Flow Plus (six 2.2 gram syringes with choice
of F00 or F03 viscosities in shades A1, A2,
A3, A3.5, A2O (opaque) or incisal) and
BeautiBond (50 0.1 ml unit dose bottles).
Photos/Provided by Shofu
sales of both products, while at the same
time providing significant cost savings
to customers already using both products.
BEAUTIFIL Flow Plus
BEAUTIFIL Flow Plus represents the
next generation of restorative materials, with a syringe-delivery that provides
void-free adaptation and strength and
durability of leading packable composites.
High radiopacity that is 15 percent
greater than enamel ensures the base
and liner will never again be mistaken
for secondary caries.
Viscosity and handling characteristics
have been optimized for greater control
while delivering smooth and virtually
self-polishing results. Shofu’s proprietary S-PRG (surface pre-reacted glass)
filler technology provides the only composite resin with sustained fluoride release and rechargability.
BeautiBond
BeautiBond is a seventh-generation
self-etch, prime and bond all-in-one
product.
Unique dual-functioning monomers
(phosphonic acid and carboxylic acid)
work independently, achieving equal
bond strength to dentin and enamel
comparable to sixth-generation adhesives.
BeautiBond has a film thickness of
only 5 µm, providing indistinguishable
margins. Bonding requires only one
thin application, no shaking or agitation
required, and a 30-second application
time.
Here at the AGD
For more information on the new kits, call Shofu at
(800) 827-4638, visit www.shofu.com or stop by the
Shofu booth, No. 517.
[9] =>
Dental Tribune Daily U.S. Edition | June 22, 2012
9
exhibitors
Fig. 1 Photos/Provided by Glidewell Laboratories
Fig. 2
Fig. 3
Fig. 4
Photo essay: BruxZir Solid Zirconia
meets an anterior esthetic challenge
By Michael C. DiTolla, DDS, FAGD
This article illustrates advancements by
Glidewell Laboratories to improve the esthetic properties of BruxZir® Solid Zirconia restorations. As the lab’s research and
development department refines its processes, improving the material’s translucency, the esthetics continue to improve.
First appointment
Our goal is to replace the PFM crowns
on teeth #8 and #9 (Fig. 1) with BruxZir
Solid Zirconia crowns.
First, we take the shade before the teeth
become dehydrated. I use the VITA Easyshade® Compact (Vident; Brea, Calif.),
which displays the shade in both VITA
Classical and VITA 3D-Master® shades.
After taking the shade, I hold the selected 2M1 3D-Master shade tab to the tooth,
along with the 1M1 3D-Master shade tab
for contrast. Next, we photograph the
shade tabs in the mouth. This is probably
the most important part of communicating shade to the technician.
I use an Ultradent syringe to place PFG
gel (Steven’s Pharmacy; Costa Mesa, Calif.)
into the sulcus of teeth #8 and #9. Next,
I use a STA Single Tooth Anesthesia System® device (Milestone Scientific; Livingston, N.J.) to anesthetize teeth #8 and #9.
The Razor® Carbide bur (Axis Den-
Here at the AGD
For more information on BruxZir crowns or to
see them for yourself, stop by the Glidewell
Laboratories booth, Nos. 527/529.
and loupes to inspect around the temps
and gingival embrasures for excess cement.
Second appointment
tal; Coppell, Texas) easily cuts through
porcelain and metal substructures, and
when used in combination with my KaVo
ELECTROtorque handpiece (KaVo Dental;
Charlotte, N.C.), it is simple to cut through
the existing PFM. I torque the crown with
a Christensen Crown Remover (Hu-Friedy;
Chicago). After using a periodontal probe
to sound to bone to ensure I have enough
biologic width to safely remove some
tissue (Fig. 2), I use my NV MicroLaser™
(Discus Dental) to remove 1.5 mm of tissue.
With the margins exposed, I use an
856-025 bur (Axis Dental) and KaVo
ELECTROtorque handpiece to drop the
margins to the new gingival level. My
assistant then relines BioTemps® Provisionals (Glidewell Laboratories) on teeth
#8 and #9 with Luxatemp provisional
material (DMG America; Englewood, N.J.).
Using a thin, perforated diamond disc
(Axis Dental), we open the gingival embrasures to avoid blunting the interproximal papilla, and we make sure the gingival margins aren’t overextended and the
emergence profile is flat.
We use TempBond® Clear™ (Kerr Corp.;
Orange, Calif.) to cement the BioTemps
After two weeks, we remove the temps
and clean the preps with a KaVo
SONICflex scaler. After trimming the
gingival margin with the diode laser, I
place an Ultrapak® cord #00 (Ultradent;
South Jordan, Utah), cutting the cord
intraorally on the lingual to avoid any
overlap. To make the margin visually obvious, I place a second cord (Ultrapak cord
#2E) before refining the preparation.
As I pack the top #2E cord on tooth #8,
you can see how the top cord on tooth #9
exposes the margin (Fig. 3). Now we can
begin finishing the preps using a fine grit
856-025 bur.
Two moistened ROEKO Comprecap
Anatomic compression caps (Coltène/
Whaledent; Cuyahoga Falls, Ohio) are
placed on the preps, and the patient is
asked to bite with medium pressure for
eight to 10 minutes. The Comprecaps are
then removed and the top cords pulled.
We syringe medium body impression
material around the preparations for the
impression and then take a bite registration. The temporaries are then replaced.
Third appointment
After two weeks, the temps are off, the
BruxZir crowns are approved, and we
place a layer of desensitizer on the teeth
(G5™ All-Purpose Desensitizer [Clinician’s Choice; New Milford, Conn.]).
I use a Warm Air Tooth Dryer (A-dec;
Newberg, Ore.) after applying both coats
of the G5, while my assistant places ZPRIME™ Plus (Bisco; Schaumburg, Ill.) inside the crowns. We then load the crowns
with a resin-modified glass ionomer cement (RelyX™ Luting Plus Automix [3M/
ESPE]) and seat them, using a pinewood
stick (Almore International; Portland,
Ore.) to ensure they are fully seated and
the same length.
In this “after” picture (Fig. 4), the amazing thing is there isn’t any porcelain on
these BruxZir crowns; they are solid zirconia. This is why they are stronger than
all other restorative materials, except
cast gold.
Also, the facial anatomy on the crowns
makes them look like real teeth. Because
that anatomy is built into the CAD/CAM
database, Glidewell Laboratories can deliver it every time — provided the clinician gives the lab enough reduction.
While I’m not suggesting you suddenly
switch all of your anterior restorations
to BruxZir crowns, you may want to
consider using it for patients with parafunctional habits or old PFMs, where
an esthetic improvement is essentially
guaranteed.
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exhibitors
10
Dental Tribune Daily U.S. Edition | June 22, 2012
From intraoral scan to final
custom implant restoration
Here at the AGD
By Perry E. Jones, DDS, FAGD
This case demonstrates the optical
scanning of Inclusive® Scanning Abutments (Glidewell Laboratories; Newport
Beach, Calif.) utilizing the iTero™ digital
scanning system (Align Technology; San
Jose, Calif.) with software version 4.0.
Digital data was used with laboratory
CAD/CAM planning to fabricate custom
all-ceramic implant abutments and a
four-unit fixed prosthesis. The abutments and fixed prosthesis were fabricated using advanced computer-aided
milling technology.
For more information about the Inclusive Scanning
Abutments, stop by the Glidewell Laboratories
booth, Nos. 527/529.
•
Fig. 1: Inclusive Scanning Abutments
attached to implants. Photos/Provided
by Perry E. Jones, DDS, FAGD
Fig. 2: Abutment planning (labial view) with
3Shape’s DentalDesigner software and
Prismatik CZ™ add-on module (Glidewell
Laboratories).
•
•
Dental history
The patient was a 52-year-old healthy
Hispanic male who sustained a traumatic avulsion and lost his maxillary
incisors in an automobile accident. Following healing, a four-tooth transitional
removable partial denture was constructed. He was seen by the oral and
maxillofacial surgery service of Virginia
Commonwealth University for dental
implant therapy.
Treatment plan
The patient was informed of the alternatives, benefits and potential complications of various treatment options
before deciding to pursue implant restoration of his missing teeth.
The treatment plan included placement of two Replace® Select Straight RP
4.3 x 13 mm implants (Nobel Biocare; Yorba Linda, Calif.) with 5 mm healing abutments, followed by a six-month healing
period and restoration with all-ceramic
custom abutments and a four-unit, allceramic fixed prosthesis to restore the
anterior incisors to form and function.
Surgical procedure
Using local anesthesia, two Replace Select Straight RP implant fixtures were
placed in the area of teeth #7 and #10,
using standard Nobel implant placement protocol. Placement angulation
and depth were verified and deemed
satisfactory. Standard RP 5 mm healing
abutments were placed, and the fully reflected tissue flap was closed with interrupted sutures.
Restorative procedure
Following six months of healing post-implant placement, intraoral photos were
taken to record and confirm the healthy
remaining dentition. Osseous integration was confirmed with a panoramic
X-ray, followed by resonance frequency
analysis (RFA) using an Osstell® ISQ implant stability meter with SmartPeg™ attachment (Osstell USA; Linthicum, Md.),
which displayed an implant stability
quotient (ISQ) of 78 on a minimum-tomaximum scale of 1–100.
Counter rotation with a torque wrench
•
•
Fig. 3: Inclusive All-Zirconia Custom
Abutments #7 and #10.
Fig. 4: Four-unit BruxZir Solid Zirconia fixed
bridge cemented in place.
confirmed no rotation to 35 Ncm. The
implant fixtures were considered acceptable for restoration.
The 5 mm healing abutments were removed, Inclusive Scanning Abutments
were placed on the implants, and the accompanying titanium screws were tightened (Fig. 1).
Using the iTero scanner with updated
software (version 4.0), a full maxillary
arch scan, full mandibular arch scan and
centric bite in maximum intercuspation
were completed.
A three-dimensional digital record of
the patient’s anatomy was created from
these scans and electronically submitted
to Glidewell Laboratories to be used in
the CAD/CAM restoration process.
At Glidewell Laboratories, the virtual
scan was registered to the scanning abutments, providing the dental technicians
with the implant system, size, axis, position relative to the adjacent anatomy
and locking feature orientation. A virtual zirconia abutment was designed using 3Shape’s DentalDesigner™ software
(3Shape Inc.; New Providence, N.J.) and
the Glidewell Digital Abutment Library
(Fig. 2).
From this, the corresponding physical Inclusive All-Zirconia Custom Abutments (Glidewell Laboratories) were
milled. Similarly, a BruxZir® Solid Zirconia four-unit fixed bridge (Glidewell Laboratories) was designed and milled using
state-of-the-art CAD/CAM technology.
The custom zirconia abutments were
trial-fitted in the patient’s mouth with
slight tissue blanching noted (Fig. 3).
In the same visit, the final four-unit
all-ceramic milled BruxZir Solid Zirconia bridge was tried-in and examined for
proper occlusion. There was “tight” anterior coupling for this case as evidenced
by the history of provisional denture
fracture. The occlusion was checked and
presented as so precise that no adjustment was required.
The anterior view of the final prosthesis demonstrates optimal mesial-distal
width proportion, incisal edge proportion, pontic-tissue contact and excellent shade/esthetics (Fig. 4). Further, the
occlusal view demonstrates an optimal
incisal edge arch form. The soft-tissue lip
position and speech phonetics appeared
to be optimal.
Following the trial seating, the fixed
bridge was removed, the zirconia abutment retention screws torqued to 35
Ncm, the abutment screws covered with
cotton/Cavit™ Temporary Filling Material (3M™ ESPE™; St. Paul, Minn.), and
the prosthesis cemented with GC Fuji
PLUS™(GC America; Alsip, Ill.).
•
•
•
•
•
•
* Note: Cadent (Carlstadt, N.J.) was acquired by Align Technology (San Jose, Calif.) in May 2011.
•
References
•
•
Baldissara P, Llukacej A, Ciocca L, Valandro
FL, Scotti R. Translucency of zirconia copings made with different CAD/CAM systems. J Prosthet Dent. 2010 Jul;104(1):6–12.
Birnbaum NS, Aaronson HB. Dental impressions using 3D digital scanners: virtual
becomes reality. Compend Contin Educ
Dent. 2008 Oct;29(8): 494, 496, 498–505.
•
•
Chang YB, Xia JJ, Gateno J, Xiong X, Zhou X,
Wong ST. An automatic and robust algorithm of reestablishment of digital dental
occlusion. IEEE Trans Med Imaging. 2010
Sep;29(9):1652–1663.
Christensen GJ. Will digital impressions
eliminate the current problem with conventional impressions? J Am Dent Assoc.
2008 Jun;139(6):761–763.
Drago C, Saldarriaga RL, Domagala D, Almasri R. Volumetric determination of the
amount of misfit in CAD/CAM and cast implant frameworks: a multicenter laboratory study. Int J Oral Maxillofac Implants.
2010 Sep-Oct;25(5):920–929.
Ender A, Mehl A. Full arch scans: conventional versus digital impressions — an invitro study. Int J Comput Dent. 2011;14(1):11–
21.
Fasbinder DJ. Digital dentistry: innovation
for restorative treatment. Compend Contin Educ Dent. 2010;31(4):2–11.
Garg AK. Cadent iTero’s digital system for
dental impressions: the end of trays and
putty? Dent Implantol Update. 2008
Jan;19(1): 1–4.
Henderson, S. Align Technology Completes
Acquisition of Intra-Oral Scanning Leader
Cadent. 2011 May 2 [cited 2011 Oct 17].
Available from: http://investor.aligntech.
com/releasedetail.cfm?releaseid=573469.
Jones PE. Cadent iTero digital impression
case study: full-arch fixed provisional
bridge. DC Dentalcompare. 2009 Jul 8 [cited 2011 Jul 28]. Available from:
www.dentalcompare.com/FeaturedArticles/2082-Cadent-iTero-DigitalImpression-Case-Study-Full-Arch-Fixed
-Provisional-Bridge/.
Jones PE. Cadent iTero optical scanning
digital impressions for restorative and invisalign. Dental Product Shopper. 2011 Jun
28 [cited 2011 Jul 29]. Available from:
http://dentalproductshopper.reachlocal.
net/articles/cadent-itero-optical-scanningdigital-impressions-restorative-andinvisalign.
Kurbad A. Impression-free production
techniques. Int J Comput Dent.
2011;14(1):59–66.
Priest G. Virtual-designed and computermilled implant abutments. J Oral Maxillofac Surg. 2005 Sep;63(9 Suppl 2):22–32.
Smith R. Creating well-fitting restorations
with a digital impression system. Compend
Contin
Educ
Dent.
2010
Oct;31(8):640–644.
Touchstone A, Nieting T, Ulmer N. Digital
transition: the collaboration between dentists and laboratory technicians on CAD/
CAM restorations. J Am Dent Assoc.
2010;141 Suppl 2:15S–219S.
Zweig A. Improving impressions: go digital! Dent Today. 2009 Nov;28(11):100, 102,
104.
[11] =>
Dental Tribune Daily U.S. Edition | June 22, 2012
11
exhibitors
Calm-It Desensitizer
DENTSPLY Caulk has patented its integrated brush unit-dose delivery system
used for Calm-It™ Desensitizer.
U.S. patent No. 7,959,370 was awarded
to DENTSPLY for its all-in-one unit dose
dispenser that includes an integrated
application brush. The built-in brush
makes application of the desensitizing
material easier and faster. The steps are
simple: snap open the unit dose vial, apply and gently air dry.
Calm-It Desensitizer is fast and provides pain relief in seconds. It lasts,
Photo/Provided by PLANMECA
PLANMECA ProMax 3d Mid
The new PLANMECA ProMax® 3D
Mid is a 3-D imaging, panoramic, extraoral bitewing, cephalometric, all-inone CBVT unit that can accommodate
all of your clinical needs.
The PLANMECA ProMax 3D Mid provides an extended selection of 3-D volume sizes combined with traditional
2-D panoramic and cephalometric
imaging, giving it the ability to meet
all of your diagnostic needs, including
implantology, endodontics, periodontics and orthodontics as well as den-
eliminating or reducing dentinal hypersensitivity and eliminating discomfort
from cervical erosions for six months.
Calm-it Desensitizer is well-tolerated
by other dental materials such as restoratives, adhesives, cements, temporary materials and amalgams. Calm-it
Desensitizer comes in a 6-ml bottle.
For more information, contact your
local DENTSPLY Caulk distributor, call
(800) 532-2855, go to www.caulk.com or
stop by the booth, No. 702.
Photo/Provided by DENTSPLY Caulk
tal and maxillofacial surgery and TMJ
analysis.
The volume sizes range from 3.4 by
4.2 cm to 16 by 16 cm. This selection
allows for optimizing the imaging area
according to specific diagnostic task —
always complying with the best practices of dentistry, including the ALARA
(as low as reasonably achievable) principle to minimize radiation.
To learn more, stop by PLANMECA’s
booth, Nos. 722/724, here at the AGD.
Ad
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