Lorne Lavine, DMD, founder and president of The Digital Dentist, has more than 30 years invested in the dental and dental technology fields. A graduate of USC, he earned his DMD from Boston University and completed his residency at the Eastman Dental Center in Rochester, N.Y. He received his specialty training at the University of Washington and went into private practice in Vermont until moving to California in 2002 to establish TDD, a company that focuses on the specialized technological and HIPAA needs of the dental community. He can be reached at drlavine@thedigitaldentists.com or 866-204-3398.

Top 4 Things You Must do to Become HIPAA Compliant. Image credit: © ZimmyTWS - stock.adobe.com

As dental offices digitize more and more of their patient data, it’s critical that they do everything in their power to protect and secure that data. The Health Insurance Portability and Accountability Act (HIPAA) law is based on the premise that patients entrust us with their most personal information, with the expectation that we will do our best to prevent it from falling into the wrong hands.

Here are the top 4 things you can do right now to ensure your practice is HIPAA compliant.

Many of you likely have been told by your information technology (IT) department that you should replace any computers running Windows Server 2012. The reason for this is that Microsoft ended support for this operating system on October 10, 2023, which means there will be no more security patches.

 An unpatched operating system is a huge risk. Offices need to either upgrade or replace their systems as soon as possible. You still have many software programs besides Windows that you use; these too must be patched. Many IT companies offer what is often called managed services, which is a fancy way of saying automated software that does the heavy lifting.

It makes sense for all offices to encrypt their data. Any data breach would not need to be reported if you can establish that the data were encrypted before the breach occurred. The good news is that Windows Server versions from 2012 or later, in addition to Windows 10, have a free, built-in encryption module called BitLocker so you don’t have to buy a separate program to encrypt your data.

Although backing up your data is obviously critical, even in the absence of HIPAA rules, there are multiple laws that relate to the backup, such as having it off-site, testing and verifying it on a regular basis, and ensuring that it is encrypted.

I’m a huge fan of cloud backup. It allows you to get your data off-site without any human intervention, and you can easily monitor those backups. The problem is that if you had to restore from that backup, it could take days depending on the size of the backup and your internet speed. I always suggest a local backup as well. I recommend a disk image; it’s basically an exact replica of the entire server that you can store on a local device. If your main server goes down, you fire up that copy of the server and you’re up and running in a matter of minutes.

If a new patient arrives at your office, you don’t just start to treat them (well, at least, I hope not!). You do your diagnosis first: x-rays, restorative charting, perio probing, etc. Then, based on your findings, you create a treatment plan. HIPAA is the same way. How will you know if your practice isn’t meeting HIPAA requirements unless you actually look? And, contrary to what some vendors might tell you, a quick online questionnaire is not a proper risk assessment. It must include a full evaluation of your IT systems, your existing policies and procedures, a site survey, vulnerability testing, and more. If done properly, it should then generate a plan of action so that you can keep on track to address the deficiencies that are found during the risk assessment.

Starting with these 4 items will put you well on the path to HIPAA compliance.

Windows Server 2012 and 2012 R2 reaching end of support. Microsoft.com. May 5, 2023. Accessed October, 17, 2023. https://learn.microsoft.com/en-us/lifecycle/announcements/windows-server-2012-r2-end-of-support

Articles

Use these key steps to keep your dental practice on the right side of patient privacy requirements.

Top 4 Things You Must Do to Become HIPAA Compliant

Keeping Blood Under Control in Restorative Procedures. Image credit: © Ultradent

Dentistry, in a controlled environment, is not so bad. Take a clinician with minimal experience and confidence, and in the absence of aggressive tongues, large cheeks, and overactive salivary glands, the dentist’s clinical results most likely will be positive and predictable.

Life, sadly, does not always present us with such ideal and controlled environments. Although the examples above are difficult enough, the biggest challenge is dealing with blood. It’s believed that 47.2% of adults in the United States have some form of gum disease. Therefore, blood is quite common in our workspaces.

The inflammation associated with this incredibly common disease leads to challenges with visibility, contamination, and marginal isolation. It ruins our restorations, carries bloodborne pathogens, destroys our impressions and scans, and can easily transform our work day in the operatory into one full of stress, frustration, and unpredictability. Simply put, blood is the bad guy.

Fortunately, there are several solutions that, when added to a restorative dentist’s armamentarium, can control blood in the working field. These include but are not limited to:

highly effective; destructive and expensive up front

 difficult, time-consuming, cost-effective

not always effective; time-consuming, expensive

variably effective; convenient, cost-effective

Most dentists would agree that a combination of the above strategies may be needed due to the diverse clinical scenarios we encounter. Situations often arise involving high levels of uncontrollable bleeding, which require potentially all of the above. On the other hand, a clinician may encounter a small amount of bleeding which requires the quickest, most cost-effective, and convenient option.

Ultradent, a highly respected materials and equipment company, is known for its broad and diverse catalog. It has long been relied upon for high-level tissue management with products such as ViscoStat hemostatic and Ultrapak retraction cord. One of their most effective, but lesser utilized hemostatic agents is Astringedent X.

Astringedent X is a 12.7% iron solution, which Ultradent says is its most powerful hemostatic agent. It is designed for even the most difficult cases of uncontrolled bleeding, along with typical everyday cases. Ultradent says it provides rapid and profound hemostasis.

Catapult Education, a bureau of dental educators and clinical leaders, was asked to test this hemostatic option in their day-to-day clinical domains. Astringedent X was sent to 16 dentists, the majority of whom perform mostly restorative procedures. All of the participating dentists use the hemostatic options listed above to maintain control over bleeding. They used the product with crown preps and class II, III, and V restorations. They used it with deep margins and in the presence of periodontal inflammation. Some used the product in preparation for final impressions and scans, both in the anterior and posterior.

The Catapult evaluators noted a few features of Astringedent X that stood out. First, it is dispensed via Ultradent’s Dento-Infusor tip, which has a unique array of brush tips. This was very well-received by Catapult evaluators; 94% found application using the tip was helpful. They found it less wasteful and more convenient to use than a cotton pellet or microbrush.

The majority of evaluating dentists had the opportunity to use Astringedent X in areas where there was significant bleeding. These would be areas in which most clinicians would have to revert to less convenient, more time-consuming, or more costly methods to achieve desired hemostasis. For example, the bleeding would normally be so excessive that they would have to use a diode laser. To really put this product to the test, the evaluators used Astringedent X in the most difficult areas of hemostasis. An impressive 81% of these clinicians noted that it was just as or more effective at controlling bleeding. Remarks included, “It was very fast acting and controlled bleeding quite well” and “Hemostasis was immediate! The product was excellent.” One evaluator even commented that this was the “best product available for controlling excessive bleeding.”

Keeping Blood Under Control

Although Astringedent X earned glowing feedback from its evaluators in terms of effectiveness, there were negative comments, primarily concerned with viscosity. Astringedent X possesses less viscosity than typical hemostatic agents such as ViscoStat. As a result, more of the product is expressed with the same amount of finger strength on the syringe. Almost all of the evaluators experienced this and realized that a learning curve must be met before being able to avoid overexpression of the product.

I had the opportunity to use Astringedent X in my office. I also conferred with another Catapult clinical evaluator, Ankur Gupta, DDS, who has a general dentistry practice near Cleveland, Ohio. Both of us put Astringedent X to the test by using it in a heavily bloody situation, and we were very impressed with how it performed. My assistant had remarked on several occasions that “this stuff is magical.” Dr Gupta shared that he had never used or heard of Astringedent X prior to the product review, but after having a chance to evaluate it, he told me that he now uses it almost every day. We agreed that it was runnier than expected, but that didn’t really bother either of us after getting the hang of it.

To receive the Catapult vote of confidence, a product must attain a higher than 90% overall satisfaction in effectiveness. Astringedent X clearly met such criteria. For this author, it is rare for a product to go from unheard of to being used every day. This is one such product. Congratulations to Ultradent for successfully providing another tool to make our lives as clinicians easier, less stressful, and more enjoyable.

Catapult evaluators tested Ultradent’s Astringedent X’s ability to put control back in the clinician’s hands during restorative treatments. 

Keeping Blood Under Control in Restorative Procedures

John Flucke, DDS, is in private practice in Lee’s Summit, Mo. He also serves as chief clinical editor and technology editor for 

® and keeps an active blog filled with thoughts and tidbits on the world of technology at blog.denticle.com.

Bioactivity and the Stunning Progress of Dental Materials. Image credit: © brankospejs - stock.adobe.com

In the early 1980s, there was a resurgence of interest in the 1960s science fiction television series 

. Movies were made featuring the original cast, who continued the adventures of the crew on the Starship Enterprise.

I’m not sure which it was, but in one of those movies the crew had traveled back in time to the early 1980s, allowing the action to take place in the time period that it was actually filmed, instead of the far-flung future. One of the scenes stuck with me. The crew somehow ends up in a Los Angeles, California, hospital. They are keeping the fact that they are from the future a secret. Dr “Bones” McCoy, played by DeForest Kelley, sees an older female patient in the hospital. She is weak and dying from kidney failure. He looks around and, making sure no one can see, gives her a pill. Later in the movie, we see this lady who is now highly energetic and all smiles, proclaiming, “The doctor gave me a pill and I grew a new kidney!”

The theater burst into laughter and applause. It was a great example of how progress in health care can change things. More importantly, I felt it showed that what we think of today as state of the art can be viewed as archaic and sometimes even barbaric when viewed through the lens of the future.

Although it isn’t possible yet, I can see a similar story in dentistry at some point in the, hopefully, not too distant future. Our knowledge of stem cells and genetics one day may allow a doctor to extract tooth #19, and then, instead of placing grafting material in the socket, the assistant will hand the doctor some material in a syringe that is marked “Tooth #19.” The doctor will express the material into the socket, close it in some way that the material stays put, and in a short amount of time a new tooth #19 will grow.

That’s still a dream, but so was the idea of carrying a computer in your pocket that had access to the sum total of all human knowledge.

Since about 2010 the profession has seen incredible progress in bioactive materials that are greatly changing the treatment we render and the results we achieve. I frequently tell my patients, “Dentistry is really amazing, but I cannot make anything better than what was installed at the factory.” Sometimes we fall victim to our own success. Patients will present with a problem and think that it is a simple matter to put them back together “better than ever.” That’s a tall order. However, often we also don’t give ourselves enough credit for the amazing things we are capable of as a profession.

One of the first and most popular bioactive materials was calcium hydroxide, which was used in bases and liners. In the definition of 

, it worked. The material was placed into an area of a prep that was deeper and therefore closer to the pulp. In the days when it first came to market, the most common and preferred restorative material was amalgam. Being that it was metal, it had the unpleasant tendency of transferring the sensation of cold very easily. Deeper preps tend to cause sensitivity for a variety of reasons, but 2 of the most common were reducing/removing the amount of insulating tooth structure and causing pulpal inflammation from the process of removing the caries.

When you combined those 2 situations with the thermal conductivity of metal, this meant that a deeper restoration was almost guaranteed to cause postoperative sensitivity. To the rescue came calcium hydroxide. Not being metallic, it had the benefit of providing a noncold transferring layer of insulation between the metal restoration and the pulp. It also had the benefit of being antibacterial, as well as the ability to stimulate secondary dentin formation in proximity to the pulp. At the time, it was a tremendous help in restorative procedures.

As I’ve said here many times, one of the best things about science and technology is that progress is always happening. That means that often even small bits of improvement can have some pretty profound results. So it is with calcium hydroxide.

The material was an easy product to apply. You simply mixed 2 pastes, picked up some of the material (which was a fairly high viscosity “goo”) with a placement instrument, and dabbed it onto/into the area of need. You could affect the set time a bit by adjusting the proportions of base and catalyst as well as by mixing, but the set was unpredictable. Often doctors didn’t wait for the material to set and would go straight to placing the amalgam directly over it. A setting time between 2.5 and 5.5 minutes simply was too long for most procedures.

The problem with not allowing the material to fully set was that as the highly dense amalgam was condensed on top of it, the base was thinned and displaced somewhat by the pressure. However, usually there was enough in place to achieve the desired result.

Yet despite its positive benefits, even when allowed to fully set, calcium hydroxide is hydrophilic. Between microleakage of the restorative material and fluid release from the dentinal tubules, frequently there was more than enough liquid to soften the material. This leads to a precipitous drop in compressive strength, which then leads to further problems.

Placing a solid material such as amalgam or composite over a material that is soft (or softens over time) leads to microflexure of the material as it is loaded by occlusal forces. Apical displacement of the material leads to sensitivity, marginal breakdown, and eventually failure of the restoration.

The good news is that this problem has been overcome by a new series of light-cured calcium hydroxide materials (Calcimol from VOCO Dental, TheraBase® from BISCO, Ultra-Blend™ from Ultradent, and others). These materials utilize a urethane dimethacrylate resin that allows them to photopolymerize while also greatly decreasing solubility and achieving high compressive strength. These materials are also significantly easier to use because they do not require separate mixing prior to application, yet they also provide all of the benefits doctors appreciate and expect from calcium hydroxide bases.

Calcium hydroxide has several benefits, and stimulating dentin formation is one of them. However, the dentin formation is reparative in nature. It basically allows the cells in the pulp to wall themselves away from insult. Dentin is formed along the border of the pulp chamber, and the pulp itself shrinks. It is sort of “painting itself into a corner” as it lays down this reparative dentin. What the next step forward in bioactivity provided was the formation of structures outside the pulp.

We’ve seen some amazing progress made with prosthetic cements. These materials have not only allowed the profession to help with sensitivity but also to help with marginal gaps. The profession has always battled marginal gaps when it comes to fixed prosthetics. In the very early days of fixed prosthetics, the cements were soluble and very small, and tight margins were needed to prevent washout of the cement. If the cement disappeared in that area, it left a void that then created a toehold for recurrent caries.

The advent of resin-based cements helped greatly. Basically, the cements were similar to permanent filling materials, so washout became a minimal concern. However, even gaps of 50 µm that could not be properly cleaned created the risk of plaque sitting undisturbed in that area and might then lead to recurrent caries.

There was also the problem of sensitivity. The act of preparation created cut dentin that could create pain as pressure differentials were applied across the ends of those cut dentinal tubules.

There is nothing better to replace missing tooth structure than tooth structure, and new cements came to market that helped do just that. Cements such as Doxa Dental’s Ceramir® allowed for remineralization, which leads to apatite formation on the surface of the tooth cement interface. This means that the material integrates with the tooth at the molecular level. Closing dentinal tubules with the material that is the building block of the tooth helps greatly decrease recurrent decay and postoperative sensitivity.

Other cements release chemicals that help reduce decay and sensitivity but in a different manner. BISCO’s TheraCem® releases calcium and fluoride. The smart minds at BISCO have developed a hydrophilic matrix that releases calcium hydroxide and fluoride ions as water is absorbed. This is another bioactive approach that decreases sensitivity and helps prevent recurrent decay.

The profession recently also has seen the concept of bioactivity move into direct restoratives. For a number of years, doctors have used glass ionomer restoratives in pediatric cases or for individuals who have dry mouth and/or a high caries rate. However, those materials can crumble, crack, or wear down extremely rapidly.

Pulpdent has an interesting product called Activa™ BioActive that offers the best of glass ionomers and traditional composites. It is a bioactive composite that puts the advantages of glass ionomers inside a strong resin matrix. This means that the material will chemically bond to enamel and dentin while also releasing fluoride, phosphate, and calcium. It also recharges to absorb those ions when it is exposed to them and rereleases them over time to help protect the tooth and the restoration.

One of the materials that I am really impressed with in the bioactive realm is the RE-GEN™ line from Vista Apex. RE-GEN is a group of products based on a material called Bioglass 45S5 (calcium sodium phosphosilicate). Bioglass is a truly amazing material that promotes the formation of hydroxyapatite while also neutralizing acid erosion. It is nothing short of groundbreaking that these products can grow tooth structure while at the same time stopping acid that is the reason for tooth breakdown.

One of the things about innovation is the matter of how it is applied. Often a product or an ingredient that is a total disruptor of an industry is released into the market a little bit at a time. That is definitely not the case with the RE-GEN technology. I give Vista Apex a tremendously high score for bringing their Bioglass products to the market as a completely new line of products. That allows doctors to get the benefits of RE-GEN in as many ways as possible. It’s a tremendous benefit to doctors, but more importantly, it brings the remarkable benefits of RE-GEN to patients…and that is who we are all striving to help.

The RE-GEN line includes Universal Adhesive, Self-Etch Adhesive, Flowable Composite, Bulk Fill Composite (dual cure), Dentin & Enamel Cleanser (Clean and Boost®), and Pit & Fissure Sealant. I am thrilled with the concept of using a bioactive material from start to finish in cases that require it. The RE-GEN line allows me to do just that. I can use a bioactive bonding agent, base with a bioactive flowable, and then restore with a bioactive bulk fill composite that I know will totally set because it is 

. This puts a shield of bioactivity throughout the restoration.

Recently, the company also announced a new RE-GEN EndoSealer. The endodontic market lately has seen a pronounced shift, thanks to advances in sealers. Utilizing BioGlass with the RE-GEN chemistry from Vista Apex is truly promising. I was asked to test the product prior to the nationwide launch, and I have had remarkable success with it. Studies have shown that a large number of endodontic failures are caused by coronal leakage between the time of obturation and final restoration. Having a bioactive material creating a seal at the canal orifice greatly decreases the chance of bacterial contamination taking place prior to the placement of the final restoration. Using the RE-GEN Endodontic Sealer and then covering the pulpal floor with RE-GEN Adhesive and RE-GEN Flowable ensures that the shield of bioactivity helps protect the filled root canal system as well.

And then we are also seeing progress in biocompatibility. The smart minds at VOCO Dental have developed a material called Admira Fusion, which has a unique makeup. Admira Fusion, simply put, is the world’s first all ceramic–based universal restorative material. There are no classic monomers such as Bis-GMA or UDMA.

Because it is ceramic based (utilizing Nano-ORMOCER), Admira Fusion has none of the drawbacks that resins do. Mainly that means there are no allergic reactions to any of the molecules patients are concerned about. However, the most impressive thing about the material is that because it is based on a 

the long-term shade consistency is impressive. As we all know, glass doesn’t stain and, because of that, neither does Admira Fusion. Its esthetics are second to none the day it is placed, and it looks exactly the same 2 years later. For clinical situations where I need outstanding esthetics and want the confidence that it will look just as good in 5 years, I reach for Admira Fusion.

We have seen some impressive changes in our profession in the past decade. I think the truly amazing thing about the progress the profession has made is the wide expanse of subjects it covers. We have seen growth and intellectual leaps in a variety of topics.

When you stop and think about it, intraoral scanning, 3D imaging with cone beam computed tomography, in-office creation of things with mills and 3D printers, and artificial intelligence have all made remarkable progress in a very, very short amount of time. And yet, quietly in the background, the researchers and chemists have been hard at work creating ways that our restorative materials can better replicate nature.

As doctors, we are pretty lucky. We get to work with restorative materials that were the thing of science fiction not that long ago. Although I may never get to tell a patient that I can do as good a job as what they were born with, the scientists in dentistry are definitely closing that gap. The best thing is that we will all benefit from these advances. And that makes me look forward to the future.

It’s amazing to see just how far dental materials have come in a short amount of time. Lets take a look back at the evolution of these materials. 

Bioactivity and the Stunning Progress of Dental Materials

Patient Voicemails are Automatically Transcribed with New Weave Feature. Image credit: © Weave

Weave, a software solutions company, aims to revolutionize the way dental practices manage patient communication with the introduction of artificial intelligence (AI)-driven voice transcription. This innovative feature, known as Voicemail Transcription, automatically converts patient voicemails into text, streamlining the workflow for dental practitioners and their team members, per a press release from the company. Whether accessed through a desktop or mobile app, this feature significantly enhances efficiency and reduces the burden of time-consuming administrative tasks.

Chief Product and Technology Officer at Weave, Branden Neish, emphasized the significance of this AI-driven solution in the press release. “AI has exploded in popularity over the past year, and we’re taking steps to ensure Weave is delivering state of the art offerings that empower our customers to enhance patient experiences and deliver top of the line care,” Neish says in the press release. “AI will only continue to grow in popularity and daily use, which will have a transformative impact on the future of the health care industry. Weave customers that have already implemented AI into their practices claim they save an average of an hour a day with the technology.”

Weave's decision to incorporate AI-driven voicemail transcription into its platform is supported by data from a customer and consumer report conducted by the company. The report revealed that 65% of consumers are open to healthcare providers using AI tools in their practices. This finding underscores the readiness of both providers and patients to embrace AI-driven solutions in the healthcare sector.

One of Weave's users Matt Nejad, DDS, a dental practitioner based in California, expressed his enthusiasm for this new AI feature. “AI is the catalyst for a new era in health care,” Dr Nejad says in the press release. “Weave’s AI-enabled voicemail transcripts are a leap in this direction, providing automation and actionable insights that empower providers to focus on what truly matters: patient care.”

Voicemail Transcription is just one of several AI-driven features introduced by Weave. Other notable additions include Email Assistant and Response Assistant, which further enhance the capabilities of the platform. Weave's website offers comprehensive information on these new features, as well as resources to help dental practices seamlessly integrate them into their daily operations. These AI tools are expected to drive efficiency, improve patient interactions, and contribute to the ongoing transformation of the dental and healthcare industry as a whole, according to the press release.

Weave has unveiled a voice transcription feature powered by artificial intelligence, which automatically transcribes patient voicemails to streamline administrative workflows. 

Patient Voicemails are Automatically Transcribed with New Weave Feature

American Academy of Implant Dentistry Conference to Bring Implant Expertise to Las Vegas. Image credit: © American Academy of Implant Dentistry

Las Vegas, Nevada is set to host the American Academy of Implant Dentistry (AAID) Expo, themed "Trends in Transformation" this year. 

This dental extravaganza will be staged in the opulent surroundings of Caesar's Palace, providing a perfect backdrop for the exchange of ideas and state-of-the-art practices in implant dentistry. As the heart of the world's entertainment capital, Las Vegas, it aims to be more than just a conference; it's an immersive experience that combines learning, and networking.

Keynote Address by Nick Clausen, MBA: "Keys to Transformational Dental Practice Success"

The conference's opening act will feature keynote speaker Nick Clausen, MBA, renowned for his expertise in dental practice management. Nick's captivating presentation, titled "Keys to Transformational Dental Practice Success," is scheduled for November 1 at 5 pm PDT. Attendees can look forward to an illuminating exploration of the essential elements that drive the success of dental practices, including strategies for attracting new patients. This inspiring session will set the tone for the 4-day event, igniting the excitement for the wealth of opportunities to follow.

Implant World Expo: The Epicenter of Innovation

One of the highlights of the AAID Implant Conference is the Implant World Expo, scheduled for Thursday and Friday. This expo serves as a hub of innovation, offering attendees the chance to witness the latest developments in implant dentistry up close. It provides a unique opportunity for attendees to interact with exhibitors and vendors, gaining insights into groundbreaking technologies and products. Moreover, several exhibitors at the Implant World Expo will extend exclusive AAID Conference discounts on select implant products, making this event even more valuable for practitioners looking to upgrade their practices with cutting-edge tools.

Networking Opportunities and Fun-Filled Receptions

In addition to the wealth of educational content and product discovery, the AAID Conference will host a series of networking receptions and gatherings. These events offer attendees the chance to relax, connect with peers, and enjoy the vibrant atmosphere of Las Vegas. The schedule includes:

Wednesday Welcome Reception: The event kicks off with a warm welcome on Wednesday, offering attendees a chance to connect and build relationships.

Thursday Implant Expo Reception: A dedicated evening for exploring the innovations showcased at the Implant World Expo.

Friday Women in Dentistry Reception: Celebrating the contributions of women in the field of dentistry and fostering a supportive network.

Saturday President’s Celebration: The grand finale of the event, providing a memorable evening to close out the conference.

The President’s Celebration promises to be a night of festivities and camaraderie, ensuring that attendees leave Las Vegas with cherished memories and lasting connections.

For those who haven't registered yet, the opportunity to attend this event remains open throughout the week of the conference. Interested individuals can visit the 

 to access further details, including a comprehensive schedule, speaker information, and registration options.

The American Academy of Implant Dentistry Conference, with its focus on "Trends in Transformation," is poised to be a transformative experience for dental professionals, providing the tools, knowledge, and connections necessary to advance in the dynamic field of implant dentistry. As November approaches, all roads lead to Las Vegas, where innovation, education, and celebration will converge at Caesar's Palace for this exceptional dental event.

The event, running from November 1st to November 4th, promises to be a "flagship" experience for implant dentistry enthusiasts, offering a platform for education, networking, and innovation in the field.

American Academy of Implant Dentistry Conference to Bring Implant Expertise to Las Vegas

Forward Science Granted ISO 13485 Certification | Image Credit: © Forward Science 

Houston, Texas, MedTech company Forward Science was recently granted ISO 13485 certification. The company was founded more than a decade ago with the mission to change lives through innovative, cost-effective products.

Since its inception in 2013, Forward Science has continuously innovated new technologies and products designed to help move science forward. For over a decade, the company has produced its products in its vertically integrated, FDA-registered medical device and drug manufacturing facility in Texas.

Forward Science’s flagship product is OralID, an oral cancer screening device that allows clinicians to visualize abnormalities that may not be seen under traditional examinations.

Recently granted the ISO13485 certification, the company upholds the international standard in quality to help ensure products are designed and manufactured according to industry-accepted best practices. This certification also indicates Forward Science can provide medical devices and related services that consistently meet customer and applicable regulatory requirements. To reach the certification, the company underwent and passed 2 independent audits that confirmed its ability to design and produce safe, reliable, and effective medical devices in its FDA-registered manufacturing facility.

"Attaining ISO 13485 Certification demonstrates that Forward Science is committed to quality, and we have a system in place that verifies it. With this certification, our team will continue to develop products that meet the gold standard for quality," explains Brian Pikkula, Forward Science’s co-founder and Chief Scientific Officer in a press release.

In September, the company announced its selection for the 2023 Best of Houston Award in the MedTech Company category by the Houston Award Program.

Each year, the Houston Award Program recognizes companies that achieve exceptional marketing success while making a significant impact on their local communities and industries. Forward Science, alongside other award winners, is acknowledged for embodying the affirmative impact of small businesses by consistently delivering great customer service and actively contributing to the enhancement of the Houston community. 

As part of the selection process, the Houston Award Program gathered and reviewed information from various sources to determine the recipients in each category. The 2023 Houston Award is characterized by its strong commitment to quality over quantity, with winners determined based on an evaluation that incorporates data from both internal assessments and third-party sources, according to a press release on the company’s website.

"At Forward Science, we've dedicated the last decade to enhancing the quality of life for clinicians, patients, and our community members,” Robert J. Whitman, CEO of Forward Science, says in the press release. “This award from The Houston Award Program is a testament to the ongoing impact of our work at Forward Science. Being recognized by our community not only acknowledges the life-changing technology we develop but also celebrates the incredible community we are proud to be a part of." 

Forward Science is a privately held MedTech company. It was founded in 2012 by 2 biomedical engineers with the goal of innovating technology to change more lives. Following the success of OralID, the company continues to focus on moving science forward in the oral healthcare industry and other launches designed to help patients reach their optimal oral health include SalivaMAX, BioStōm, TheraStōm, and OxiStōm.

Being completely vertically integrated, Forward Science designs, develops, manufactures, commercializes, and supports its products in-house, ensuring the highest quality of standards coupled with top-notch service.

To learn more about Forward Science’s manufacturing capabilities, visit 

Houston manufacturer’s products include OralID oral cancer screening device and SalivaMAX artificial saliva.

Forward Science Granted ISO 13485 Certification

DMG to Unveil Ecosite Elements Universal Composite System at GNYDM | Image Credit: © DMG 

DMG is set to introduce its new Ecosite Elements nanohybrid universal composite shade system at the upcoming Greater New York Dental Meeting, scheduled for November 26-29, 2023.

Starting November 1, 2023, dental professionals can access and purchase this innovative product designed to excel in composite restorations, especially those that demand superior esthetics.

Ecosite Elements is the culmination of extensive collaboration with leading clinicians and in-depth research by DMG scientists. This nanohybrid composite system empowers dental professionals to create esthetically impressive restorations swiftly and efficiently, according to the company.

Scott Chanin, DMD, FAGD, FASDA, an original evaluator of the system, asserts in a press release, "There’s a wide range of flexibility with this Ecosite Elements that allows you to obtain an ideal result easily. Everything you need in one system.”

Key Features of Ecosite Elements include the following:

Compact and Convenient: Ecosite Elements offers a concise range of shades across 3 modules (Pure, Layer, and Highlight). This minimizes storage and inventory requirements, resulting in cost savings. The shades are thoughtfully packaged in ergonomically optimized dispensers, enabling precise shade matching and simplified dentin or enamel replacement, layering, individualization, and coverage of discolorations.

NC1 Technology: This technology ensures perfect polishability and esthetics, making Ecosite Elements ideal for anterior and posterior applications. The precise silanization of ultrafine filler elements guarantees homogeneous distribution, delivering optimal working characteristics and exceptional polishability.

Push-and-Flow Technique: Enabled by NC1 technology, this innovative technique allows the material to adapt to different situations. The material's firm consistency during sculpting quickly transitions to a softer state, facilitating secure adaptation to cavity walls while eliminating bubbles or cracks. The result is lifelike anatomical details in the final restoration.

“Even in anterior cases, the restoration looks incredibly real,” Alan Pressman, DMD, adds in the press release. “The base VITA shade matches the opacity or translucency of the tooth next to it, and then you can cover that with the next shade module. If you are trying to match a veneer on tooth No. 8 with tooth No. 9 and there is some imperfection on the enamel, you can't tell the difference.”

Ecosite Elements joins DMG's line of innovative composite offerings, which includes award-winning materials like Luxatemp bis-acrylic provisional material and LuxaCore Z Dual core build-up and post-cementation composite. It can also be used alongside other advanced materials in the Ecosite family, such as Ecosite Bulk Fill and Ecosite Bond.

Attendees can visit the DMG booth #2822 at the Greater New York Dental Meeting from November 26-29, 2023, at the Jacob Javitz Convention Center in New York City to witness demonstrations and receive complimentary samples of Ecosite Elements.

DMG is a leading manufacturer and distributor of dental materials and equipment known for their quality and innovation. Their product range includes flagship items like Luxatemp and LuxaCore Z Dual, as well as revolutionary offerings like Icon resin infiltrant, LuxaCrown long-term crown and bridge material, and the newly introduced Ecosite Elements universal composite and DentaMile 3D printing solution. DMG remains dedicated to delivering holistic solutions and streamlined workflows to dental and lab professionals through innovation, collaboration, and unwavering commitment. 

This nanohybrid composite system is formulated to empower clinicians to create esthetically impressive restorations swiftly and efficiently and is available beginning Nov. 1.

DMG to Unveil Ecosite Elements Universal Composite System at GNYDM

Amann Girrbach has announced that it is set to launch its new Ceramill Map FX laboratory scanner in mid-December, 2023. This new addition to the CAD/CAM system is poised to offer dental professionals a new level of precision and versatility, significantly enhancing digital workflows.

The Ceramill Map FX is designed to provide dental laboratories with an efficient, modular 3D desktop scanner that meets the specific needs of its users, per a press release from Amann Girrbach. It is said to combine the essential elements of high precision, short scanning times, and future-proof modular upgrades, making it an appealing choice for dental professionals looking to streamline digital processes.

Said to be one of the most compelling aspects of this new dental scanner is its modular design, which allows users to expand and upgrade the device as needed, ensuring its long-term utility, as well as customizability for different dental labs. The Ceramill Map FX offers a basic version that caters to entry-level digitization at an attractive price/performance ratio. It can handle basic prosthetic and orthodontic indications while also offering advanced scanning options, ensuring a broad range of applications.

Another notable feature of the Ceramill Map FX is its high precision, with even the optional HD scan achieving an accuracy of up to 4 μm, ensuring the kind of quality dental work that both patients and practitioners desire. The scanner also supports various scanning options, including impression scanning and "multidie," providing maximum convenience for users. Moreover, it offers open interfaces for connectivity with all common CAD/CAM systems via .STL and .PLY files.

The Ceramill Map FX's compact size allows it to be easily integrated into virtually any dental laboratory, making it suitable even in tight spaces. Larissa Duarte, Product Manager for Lab CAD/CAM Equipment at Amann Girrbach, emphasized this point: "With the Ceramill Map FX, we have achieved an unbeatable combination of precision, economy, and versatility: without a doubt, the scanner will convince laboratories and practice laboratories that appreciate efficiency and future-proofing.

One notable advantage of the Ceramill Map FX is its compatibility with the popular Artex articulator system. The scanner seamlessly integrates with the articulator, facilitating tasks such as vestibular scanning. This feature allows for a wide array of dental applications while ensuring simple and intuitive operation.

Duarte continued to underscore the benefits of the Ceramill Map FX, stating, "Owing to the integration of the Ceramill Map FX into the digital workflow, high process reliability as well as reproducible results are also ensured."

With its launch scheduled for mid-December, the Ceramill Map FX hopes to revolutionize the way dental professionals approach digital dentistry. By offering a combination of precision, versatility, and ease of use, it aims to enhance efficiency and future-proofing for dental laboratories and practice laboratories. This innovative scanner is set to leave a lasting impact on the dental industry, providing a powerful tool for those seeking top-notch digital scanning and precision in their dental work.

This new desktop scanner from Amann Girrbach aims to offer precision and ease-of-use for digital dental workflows. 

New Ceramill Map FX Dental Scanner Aims to Promise Precision and Versatility

We know what acids can do to natural teeth, but do we know what happens when CAD/CAM resin materials make contact with acids? Some recent studies aimed to answer these questions definitively.

Acid is no friend to teeth; exposure to acids results in tooth erosion, no matter the source. Because enamel is one of the toughest materials on earth, this doesn’t bode well for restorative materials. However, although manufacturers test ceramics extensively for their level of acid resistance, German investigators indicated that CAD/CAM resins are not—or at least not to standardized evaluation methods. Therefore, in 2022, they undertook an in-vitro study investigating the long-term acid resistance of BRILLIANT Crios, CERASMART, Grandio blocs, Lava Ultimate, and SHOFU Block HC.

The team exposed the materials to tonic water, acetic acid, hydrochloric acid, and demineralized water to determine the damage these could cause the resin materials. They assessed surface roughness with confocal laser scanning microscopy and changes in surface hardness with Vickers hardness test. They also employed scanning electron microscopy, along with energy-dispersive x-ray spectroscopy and x-ray microcomputed tomography.

The research revealed minimal changes in both surface roughness and surface hardness when exposed to one of the acidic media, although CERASMART had the most significant deterioration in surface properties. The team saw leaching of barium, aluminum, and titanium from filler on the rough surface (in a 2-µm zone) but not on the polished one. The team concluded that within the confines of the study, polished CAD/CAM resin composites resisted damage from acid exposure and were safe to recommend to patients who might have erosive oral conditions.

Acid Increased Surface Roughness But Not Flexural Strength

Other research from earlier this year also explored these effects. Investigators in Egypt published a study in January 2023 that explored the effects of acid on the flexural strength and fatigue resistance of CAD/CAM materials.

The investigators experimented using high-translucency zirconia (Ceramill Zolid HT+), lithium disilicate (IPS e.max CAD), hybrid ceramic (Vita Enamic), and nanohybrid resin composite (Grandio blocs). The team immersed the products in gastric hydrochloric acid, white wine, Coca-Cola, orange juice, and artificial saliva for 24 hours. They then used a scanning electron microscope and stylus profilometry to assess surface topography and roughness. The team tested flexural strength using a universal testing machine and cyclic fatigue loadings for each of the 2 halves of the samples.

The zirconia and lithium disilicate had the highest initial flexural strengths, whereas the resin composite and hybrid ceramics had the lowest. The cyclic fatigue reduced the initial flexural strengths for all the materials except for the resin composite and hybrid ceramics. Meanwhile, the most consistent materials (shown by high Weibull moduli values) were zirconia and lithium disilicate, and the least were resin composite and hybrid ceramics.

The investigators determined that the erosive liquids induced significant changes in surface roughness for most of the CAD/CAM materials tested except for zirconia and lithium disilicate. However, those changes did not compromise the flexural strength of the material. Notably, resin composite and hybrid ceramics had greater resistance to cyclic fatigue.

Resin Materials Are Susceptible to Erosion

This isn’t the first study on the subject. Another in-vitro study out of Italy in 2021 investigated the effects of distilled water, soda, and energy drinks on the volumetric wear and surface roughness of CAD/CAM monolithic materials.

In this study, the research team prepared 48 rectangular materials using nanohybrid composite, resin, lithium disilicate, and high-translucency zirconia. After immersing in distilled water for 2 days, the team used a stainless steel ball as an antagonist in a chewing machine and exposed the specimens to Coca-Cola, Red Bull, and distilled water. The research team then analyzed the wear and surface roughness using a cutting-edge 3D profilometer and scanning electron microscope.

The findings revealed a significant disparity in the volumetric wear experienced by resin-based materials compared with ceramics (

 = .00001). In particular, distilled water induced less volumetric wear than the other solutions tested (

 = .0014). High-translucency zirconia exhibited superior surface roughness characteristics in comparison with all other materials examined.

The investigators concluded that these results underscore the critical consideration of monolithic CAD/CAM material selection when restoring worn dentition stemming from erosive processes. In particular, resin-based materials appear to be more susceptible to the erosive effects of acidic environments when subjected to a 2-body wear test.

Ceramics Experience Changes in Surface Roughness and Microhardness

Another 2021 study out of Saudi Arabia assessed ceramic materials in an acidic environment. The research team wanted to study what happened when lithium disilicate, monolithic zirconia, and feldspathic ceramics were exposed to acidic conditions regarding flexural strength, elastic modulus, microhardness, and surface roughness.

The team prepared 180 rectangular specimens (30 specimens of each of the ceramic materials). The investigators took initial surface roughness measurements on 90 specimens (30 per material) using a state-of-the-art optical noncontact profilometer, then immersed 30 specimens of each material in 1 of the following solutions: citric acid, an acidic beverage, or artificial saliva (their control). After immersion, the team assessed postimmersion surface roughness, flexural strength, and elastic modulus using the same optical noncontact profilometer and a 3-point bending test. Finally, the research team immersed the remaining 30 specimens of each material, then performed a microhardness test using a Vickers diamond microhardness tester. They used a scanning electron microscope to determine surface characteristic changes.

The research team found that there was no significant impact on the flexural strength and elastic modulus of lithium disilicate or zirconia. However, microhardness and surface roughness were significantly altered in all groups.

Zirconia-Reinforced Lithium Silicate Glass Ceramics Experience Increased Surface Roughness

Prior to these studies, a 2019 study in Iran assessed how 3 common beverages–soda, orange juice, and black tea–affected the surface roughness of zirconia-reinforced lithium silicate glass ceramics. The research team had 104 rectangular samples that were 2-mm thick and cut from VITA SUPRINITY blocks. They were then split into 2 groups; group 1 had a 2-step polishing treatment, whereas group 2 was heated and glazed per the manufacturer’s recommendations.

The investigators measured the baseline surface roughness of the material using a profilometer; divided the samples into 4 groups that were immersed in artificial saliva, soda, orange juice, and black tea; and then took the surface roughness measurements again.

The research team’s conclusions found that the highest and the lowest average surface roughness values were in the orange juice and saliva groups, regardless of the finish on the material. There was also an increase in surface roughness following immersion in orange juice and soda, again with no significant difference between finishes. However, the investigators noted that the surface roughness was slightly higher (although not statistically significant) in the polished surfaces compared with the glazed ones. So when it comes to surface roughness, orange juice and soda increase it.

There you have it—5 studies and their conclusions about what acidic environments can do to your CAD/CAM restorations. One thing all these studies have in common is that they sought to provide more information for your materials selection process. This information will help you select what’s best for the case in front of you so that when your patients have a soda, they still have something to smile about.

Schmohl L, Roesner AJ, Fuchs F, et al. Acid resistance of CAD/CAM resin composites. 

. 2022;10(6):1383. doi:10.3390/biomedicines10061383

Elraggal A, Afifi R, Alamoush RA, Raheem IA, Watts DC. Effect of acidic media on flexural strength and fatigue of CAD-CAM dental materials. 

. 2023;39(1):57-69. doi:10.1016/j.dental.2022.11.019

Scotti N, Ionescu A, Comba A, et al. Influence of low-pH beverages on the two-body wear of CAD/CAM monolithic materials. 

. 2021;13(17):2915. doi:10.3390/polym13172915

Al-Thobity AM, Gad MM, Farooq I, Alshahrani AS, Al-Dulaijan YA. Acid effects on the physical properties of different CAD/CAM ceramic materials: an in vitro analysis. 

. 2021;30(2):135-141. doi:10.1111/jopr.13232

Firouz F, Vafaee F, Khamverdi Z, Khazaei S, Gholiabad SG, Mohajeri M. Effect of three commonly consumed beverages on surface roughness of polished and glazed zirconia-reinforced lithium silicate glass ceramics. 

. 2019;16(4):296-302. doi:10.18502/fid.v16i4.2089

We know what acids do to enamel, but what are they doing to the enamel replacements? Five recent studies may reveal the answer. 

What Are Soda and Other Acids Doing to Your CAD/CAM Restorations?

Two Striper Perforated Diamond Finishing Strips from Premier Dental Co. 

ClearCorrect Updates from ClearCorrect

Denti.AI Detect from Denti.AI

New Dental Products - October 23 to October 27, 2023

The latest dental products including new launches from Premier Dental Co.,  ClearCorrect, Denti.AI, and more.

