Stan Goff is a Managing Editor with MJH Life Sciences, which includes Dental Products Report, Dental Practice Management, Dental Lab Products, Modern Hygienist, and Dentist's Money Digest. He has covered the dental industry since 1999 and can be reached at sgoff@mjhlifesciences.com.  

ASI Dental Specialties’ new Classic Series Endodontic Cart—Under Cabinet is an integrated endodontic cart specifically designed with a smaller footprint and reduced height to easily store underneath dental cabinet countertops and to avoid the need for extensive renovations in the dental practice.

With this launch, the Colorado-based dental equipment manufacturer presents a useful solution to endodontic specialists facing space restrictions or seeking a refreshed look in their dental operatory set up with existing cabinetry.

This under cabinet endodontic cart is designed to be an economical, retrofit solution for clinicians who are dealing with the logistical challenges of integrating modern dental equipment into a space that already has cabinetry in place. Additionally, this model features advanced instrument integration and the ability to operate multiple handpieces through a single foot-control. The cart provides an optimized workflow and a minimalist lookin the dental operatory.

The latest offering provides the same features as the company’s Advanced Endodontic System door model but with a shorter chassis. According to ASI, it provides an easy way to upgrade the look and function of your treatment room with a fresh, aseptic advanced delivery system custom configured with the instruments of your choice. The fully functional delivery system includes air handpiece delivery, air/water syringe, endodontic air only syringe, and other standard features. Door on the right side of chassis provides convenient access to concealed water bottles; water and optional irrigation bottles can be easily accessed by sliding out.

ASI Dental Specialties has developed and manufactured integrated cart-based endodontic delivery systems in the USA for over 3 decades.

To learn more about ASI’s integrated under cabinet endodontic cart, visit: 

https://asidental.com/products/advanced-delivery-systems/classic-advanced-delivery-systems/classic-series-refit-advanced-endodontic-system/

Articles

This new Classic Series Endodontic Cart—Under Cabinet features a smaller footprint and reduced height to easily store underneath dental cabinet countertops.

ASI Dental Specialties’ Latest Endodontic Cart Delivers a Practical Retrofit Solution for an Existing Operatory

In Hand Dental, a Kansas-based company renowned for developing the In Hand Dental app, a HIPAA-compliant platform utilized for remote monitoring, teledentistry, and virtual consultations/appointments, has announced its latest partnership with Anthony P. Urbanek, DDS, MS, MD, the visionary behind the Urbanek TMJ Device & Protocol.

Urbanek's device, validated as 85% to 95% effective according to an independent university study, has successfully treated over 4,000 patients without resorting to surgery or medications. He is now dedicated to introducing his groundbreaking device to fellow dental professionals and integrating the In Hand Dental app into the treatment protocol.

“I believe the In Hand Dental app will not only be a tremendous benefit to patient management for practitioners treating with my device, but it will also help improve compliance and treatment success for their patients,” Dr Urbanek says in a press release. “There are thousands of people suffering from TMD [temporomandibular joint disorder] who could be helped by my device, and adding the In Hand Dental app to my protocol enhances the simplicity of use ten-fold.”

The In Hand Dental remote monitoring app empowers practitioners to oversee specific treatments with a patented compliance scorecard. Additionally, it facilitates real-time communication between clinicians and patients to address treatment inquiries and modify protocols based on collected data.

“There are thousands of In Hand Dental apps in use by the dental profession right now,” In Hand Dental CEO and the app’s creator Michael Gassman adds in the press release. “The app assists dentists and orthodontists in monitoring patients undergoing a variety of treatments, from clear aligners to sleep apnea to braces. We’re thrilled to partner with Dr Urbanek, and we’re excited that monitoring the treatment of TMJ/TMD patients has been added to our app’s growing list of uses.”

Practitioners interested in experiencing a private 20-minute demo of the In Hand Dental remote monitoring app and taking advantage of early adopter pricing are encouraged to reach out to Matt Quinn via email at matt.quinn@inhandhealth.com, or by calling 913-827-1603.

Dr Urbanek is a double-degree Oral and Maxillofacial Surgeon with additional extensive training and experience in cell biology and anatomy. His work over the last 4 decades has primarily focused on orthognathic, cleft lip and palate, microneural reconstruction, TMJ/TMD, trauma, and cancer reconstruction. His dissatisfaction with the outcomes of TMJ surgery prompted him to research and develop the Urbanek TMJ Device and Protocol, the only drug-free, non-surgical CAD/CAM/3D-printed resin device designed to alleviate inflammation within the temporomandibular joint (TMJ).

Unlike alternative treatments, the Urbanek Device is an FDA-cleared medical device designed to fit comfortably in the patient’s mouth and addresses the root cause rather than merely alleviating symptoms of TMD.

In Hand Dental is a HIPAA-compliant remote monitoring and multifaceted teledentistry platform that connects dentists and orthodontists with their patients. The In Hand Dental solution offers competitively priced recall, remote dental monitoring, lead generation, and virtual visits, along with treatment templates for invisible aligners, wired braces, OSA/sleep apnea, TMJ, whitening, and Botox, according to the company. In Hand Dental is powered by In Hand Health, a Kansas City-based software company.

Anthony P. Urbanek, DDS, MS, MD, collaborating with the In Hand Dental app for patient monitoring and treatment purposes.

 TMJ/TMD Pioneer to Partner with In Hand Dental for Patient Monitoring and Treatment

Acuity Direct X-Ray Photon Detection Intraoral Sensor

amdlasers.com/products/acuity-x-ray-sensor

Every dental practice looking for high-quality digital x-rays from a durable, economical system.

Most dental practices today use digital radiography and having an efficient, reliable sensor enables clinicians to take advantage of the technology on a daily basis.

Said to combine the speed of CMOS with the clarity of PSP radiographs, the Acuity Direct X-Ray Photon Detection (DXPD) Intraoral Sensor features a new sensor technology designed to provide ideal image quality and clarity. The sensors feature a thin, ergonomic design for patient comfort, and have been tested to withstand the use required to capture 500,000 exposures.

DXPD sensor technology loses fewer x-ray photons during the image capture process when compared with a CMOS sensor. This allows DXPD sensors to capture clear radiographs that provide diagnostic detail without the need for time consuming image processing, according to AMD Lasers. Because DXPD sensors require fewer layers than CMOS sensors, the Acuity sensors feature a thinner profile, and a lower cost than other sensor technologies.

The technology behind this new sensor from AMD Lasers features a more efficient direct detection technology to provide enhanced durability and affordability.

5Ws*  Acuity Direct X-Ray Photon Detection Intraoral Sensor 

Katrina M Sanders RDH, BSDH, M.Ed, RF, is a graduate and recipient of countless awards from the University of Minnesota’s School of Dentistry Division of Dental Hygiene. She is proud to currently serve on the alumni society for one of the most prestigious dental schools in the country. Katrina’s professional career emerged as an educator when she attained full-time employment with a career college in Phoenix, Arizona. A physical manifestation of Katrina’s commitment to her profession is in the development of her textbook, "Introduction to the Dental Hygiene Profession." Katrina proudly received her Master’s Degree in Educational Leadership with distinction through Northern Arizona University as a Phi Kappa Phi Honor Society distinguished member. Currently, Katrina is a distinguished speaker with Dental Hygiene Culture as she lectures nationally in a variety of dental hygiene continuing education content.

Join the Sanders sisters and Oral Cancer expert Susan Cotten, BSDH, RDH, OMT, as they dive deep on screening and the hygienist’s role in vital early detection.


About Susan – Susan Cotten, BSDH, RDH, OMT, is the founder and CEO of Oral Cancer Consulting, she developed the “Cotten Method”, a comprehensive oral cancer screening method and dental office system. She is an international speaker on oral cancer screening and holds hands-on oral cancer screening workshops for dental professionals who want to have more confidence in screening, reduce the risk of liability, and increase early detection. In her career, Susan has performed over 60 thousand oral cancer screenings and organized countless free screening events including the Denver Broncos Health and Wellness Expo. She is the Dental Lead for the Alliance for HPV Free Colorado, a director with Dental Codeology Consortium, Instructor at National Network for Healthcare Hygienists, and RDH Advisory Board member at The Oral Cancer Foundation. Susan is a 2018 recipient of the Sunstar RDH Award of Distinction, recipient of the Colorado Dental Hygienists’ Association Ethyl Covington Award, and Outstanding Contribution Award. Susan founded MAD(Make A Difference) for Healthy Smiles as a 2010-2011 member of Donny Osmond’s Make a Difference program. On a personal note, Susan loves walking the beaches of Hawaii, is a former country dance competitor, and loves watching college football.

Instagram - 

https://www.linkedin.com/in/susan-cotten-rdh-bsdh-omt-b18b8716b/

Podcasts

Join the Sanders sisters and Oral Cancer expert Susan Cotten, BSDH, RDH, OMT, as they dive deep on screening and the hygienist’s role in vital early detection. 

Floss & Flip Flops – Episode 28 – Oral Cancer Awareness Month with Susan Cotten

Nisha Gupta, DDS, graduated from the University of Michigan School of Dentistry in 2004. She went on to do a general practice residency at Metrohealth Medical Center. Following that she started a dental practice from scratch with her husband. While the practice and their family was growing, Dr Gupta spent several years learning the ins and outs of dentistry in different practice settings, from public health clinics to corporate dentistry, associateship, all while growing her own practice. She not only believes it’s important to work on clinical skills, it is also important to work on leadership skills and has spent extensive time working on leadership development and public speaking. She has been involved with her local Toastmasters group for 5 years and has achieved several awards. She has also spent a majority of her time taking continuing education specifically in implants and sleep apnea.
Dr Gupta is currently a member of the LCDS, ODA, ADA, AGD and serves on the Ohio Dental Association Judicial Affairs Subcommittee. Dr Gupta has adopted the philosophy that while dentistry is important if you don't take care of your health, nothing else matters. She started not only working on her own personal health and fitness, but branching out into the community giving talks about health, diet, and wellness, and received her certificate in Plant-Based Nutrition from Cornell University.

Labial vestibular injections just under the nostrils are often the most painful injections. With nearly 100% consistency, the Calaject computerized anesthetic technique resulted in zero pain for this otherwise stressful and uncomfortable procedure. 

Clinical images courtesy of Tony Tomaro, DDS

From a patient’s perspective, there are very few characteristics of a dental professional that really matter: Is the dentist kind? Is the dentist patient? Does the dental work last? Is the shot painful?

Administering local anesthesia—giving the shot—can often be one of the most nerve-wracking elements of being a dentist, especially when patients often have no other way to judge the quality of dental work they have received. All they can really surmise about the quality of their clinician is whether getting a shot hurts or doesn’t hurt. Despite our efforts as dental professionals to follow all the rules of local anesthesia, the results are sadly inconsistent. Some patients may find that the technique in delivering local anesthesia is fabulous and they don’t feel a thing, while others may find the exact same technique very painful.

Along with clinical expertise, there are a variety of factors that may affect the patient’s perception: (1) injection into a muscle attachment, (2) speed of injection, (3) patient’s pain tolerance, and (4) patient’s preconceived notions

Innovation in the field of local anesthesia has been slow, inconsistent, and not well adopted. Our needles, syringes, and types of anesthetic solutions today are not much different from those same things from decades ago. Often, we find ourselves telling our patients that we wish there were a better way to administer anesthesia without all the pain, fear, unpredictability, and discomfort associated with it and are stymied when patients inquire about our ability to “do it better than their previous dentist.”

Calaject helps clinicians deliver pain-free injections. The system controls the flow rate, which ensures smooth, gentle flow of anesthesia. Even palatal injections can be carried out with less discomfort for the patient. The light pen grip provides a relaxed working position and good finger support shows where the needle can be kept perfectly still in situ. The unit’s touchscreen displays actual injection pressure. The acoustic signal indicates the flow rate, and the unit is operated by a separate foot controller. The vibration-free handpiece allows clinicians to maintain visual contact with the cartridge during the entire injection.

Directa, an industry leader in the innovation of local anesthesia techniques, has developed Calaject, a computer-assisted local anesthesia delivery system for everyday use. The system controls the flow rate of anesthesia delivery, thereby ensuring that the patient receives a standardized quality of injection at every appointment. The computer settings are customized based on the location of the injection so the speed of anesthetic expression is modulated to ensure minimal tissue distention and its resulting sting.

Overall expression of anesthetic, along with requisite aspiration to avoid arterial infiltration, is conveniently controlled with a foot pedal. The machine has a convenient pen grip so that the needle can be kept still. Not only does this benefit the patient but it also allows the operator to stand in an ergonomically correct position (

During the evaluation period, I had several unique opportunities to try the Calaject on patients who otherwise would have dreaded the local anesthesia process. One instance stands out in my mind. I needed to perform several anterior maxillary restorations, necessitating local anesthesia directly under the nose. This is a procedure that I generally hate performing as it is difficult to do without causing discomfort, even when I attempt to employ the gentlest practice. I had to give several injections in that area. My first notable experience was the pen grip, which I found simply more ergonomically friendly for my hands. The most significant and memorable experience, however, was the surprising lack of response from this otherwise extremely jittery and anxious individual. The controlled slow flow from the delivery unit allowed for this, and both the patient and I were quite grateful.

 As opposed to traditional anesthetic delivery with a syringe, the Calaject delivery system involves a pen grip, allowing the practitioner to position themselves better ergonomically. 

The Calaject was given to the Catapult Education product review board, a group of dentists with a variety of backgrounds and clinical environments. They were asked to rate their experience with this highly innovative, computer-aided product with regard to the following criteria:

Ergonomic stress with Calaject compared to manual injection

Type of injection Calaject is best suited for

A majority of the respondents to the survey were very satisfied with Calaject and saw the addition of a computer-assisted local anesthesia delivery as a benefit to their practice. Respondents found it had a very favorable design with an ergonomic handpiece, an auditory signal and a visual display for the flow rate, and a self-aspirating feature with the foot pedal. Overall, the respondents found the machine and its components to be cost-effective. It was noted that because of the slower flow rate, operators were able to start procedures immediately after administration. Most importantly, the patient did not report any pain during the injection.

“Calaject offers precise control over anesthetic dosing, effectively reducing patient discomfort and minimizing injection errors. Additionally, the beeping feature of Calaject gives patients a perception that dentistry is akin to medicine, which may encourage them to take their oral health more seriously.”

“It’s essential to understand the correlation between flow rate and patient discomfort. The slower flow rate is designed to minimize discomfort, which can significantly enhance the patient experience.”

“Given the benefits and advanced technology of Calaject, I advocate for its immediate incorporation into dental and dental hygiene educational programs. Introducing this tool early in a student’s training can familiarize them with its use and benefits, including precise control over anesthetic dosing, reduced patient discomfort, and minimized injection errors. Furthermore, early exposure to such advanced technologies could foster a mindset that prioritizes patient comfort and the overall patient experience, which is crucial in modern dental practice.”

“It is a very nice looking unit. Patients said they felt no discomfort at all.”

There were a few negative responses, summarized below:

Respondents reported disadvantages when the patient moves, for instance, in a pediatric office, and that the flow rate can be too slow for pediatric patients.

Despite these unfavorable characteristics, the resounding majority of responses were highly positive, with almost every respondent mentioning that they would recommend this product to a colleague. For these reasons, the Catapult Education product review board proudly awarded Calaject with the Catapult Vote of Confidence™.

Ronvig’s Calaject, brought to you by Directa USA: Catapult’s Vote of Confidence is awarded for everyday use in computer-assisted local anesthesia delivery. 

Innovative Technology Takes the Guesswork Out of Injections

Dr. Lou Shuman is the CEO of Cellerant Consulting Group, dentistry’s leading corporate incubator and accelerator; a venturer-in-residence at Harvard’s i-Lab; the chairman of the technology advisory board at WEO Media; a long-time contributor to Dental Products Report; and the founder and creator of the Cellerant Best of Class Technology Awards.

For this column, I wanted to share the history and science of orthodontic retention, so I knew I needed to contact Brian Gray, DDS, for my conversation. He is a fellow in 3 academies and a master in the Academy of General Dentistry (AGD). At AGD, he was awarded the Lifelong Leadership and Service Recognition Award—fewer than 1% of dentists have received this award since its inception. Dr Gray is chief dental officer at Candid, and when he took on this role, one of his goals was to evolve a next generation of retainers. Candid is a dental company that provides CandidPro clear aligner solutions. Our discussion on the science of retention leads to understanding why the right materials and protocols are needed for lasting orthodontic results.

Why did you start looking at a next-generation retention solution as an important part of the whole orthodontic process?

In the past, when patients finished orthodontic treatment, they got their retainer and returned to their general practitioner [GP] for their regular dental checkups. If the patient didn’t adhere and noticed that a tooth was starting to relapse, the GP would usually send them back to the orthodontist. That extra appointment was just another hassle in their day, so often they would let it slide, and the teeth would shift even more. Retention must be for life. But it must be based in science to produce lasting results. GPs now represent such a significant part of aligner treatment that understanding retention has become an integral part of long-term patient care.

 We want a retainer to act as a gentle reminder for the teeth to stay in the final position after treatment. The true standard of care for removable retention has been the Hawley retainer—it has a long life span unless it gets lost or the dog eats it—and it can be adjusted in the case of simple relapse. A Hawley maintains tooth position because the scalloping of the acrylic on the lingual surface locks teeth in place. But the problem is, when you wear that type of retainer, it is like going back to high school. After patients have had their teeth straightened with a clear aligner system, they don’t like to wear a Hawley because it looks and feels strange.

LS: So, from a scientific point of view, what makes a good retainer?

 An ideal retention appliance has 2 important components: It needs to fit very well and maintain its shape. In other words, a clear plastic retainer needs to be precise and know where to stay. In the past, some doctors would use the final aligner as a retainer. The plastic would fatigue very easily, and then the teeth would start to shift a bit in the retainer. If the plastic is not holding the teeth in position, they tend to move in a transverse direction, sideways. But the proper retainer material changes the game.

Studies showed that certain first-generation aligner and retainer plastics would start to fatigue in as little as 1 week after being worn for 8-hour days. Based on that information, Candid started searching for a new, more reliable material. We saw improvement but still observed too much fatigue with second-generation materials. For efficient retention, patients had to update their aligners about every 6 months. So we continued analyzing the data to deliver the best retention plastic available. And we nailed it. We chose the latest clear, stain-resistant Zendura FLX material because of how well it resists cracking and deformation.

Candid performed rigorous stress analysis tests on plastic materials to see which one was going to have the best memory and last the longest. We ran fatigue tests for strength, memory, and rigidity. We then ran a double-blinded clinical trial to verify the best trim and thickness that patients found to be most comfortable.

LS: Why not use an aligner as a retainer?

There is a big difference between clear aligners and retainers. Clear aligners are designed to move teeth. Retainers are designed to keep teeth from moving—to maintain a specific position. The fit needs to be highly intimate with the teeth, so they have less of an opportunity to start movement under the plastic. A poorly made retainer will allow the teeth to drift or shift, but a well-made retainer will hug the teeth and hold them in place.

Also keep in mind that a retainer will wear out more quickly if the patient is a heavy grinder or bruxer. This causes the plastic to flex and not hold on to the sides of the teeth as well.

It is important to know that a precise-fitting retainer relies on 2 components of accuracy for success. First is the veracity of the impression or scan. Second is the validity of the model used to thermoform the clear retainer. The scan, which gives us data on tooth position, is turned into a solid lithograph model. When the models are fabricated, they must be made with a highly accurate printer. We found that Carbon printers were the best in this regard. Super-precise models allow our thermoforming units to deliver the fidelity we were looking for when we started this mission.

The most important part is the type of plastic used to form over the model. The material needs to be able to [reach] into the interproximal spaces to help hold the teeth. Without that, the teeth will be allowed to shift. When Candid came up with the design of our next-generation retainer, we looked for these key things: the proper material, being able to obtain the best data from the scan, and the highest accuracy of printing.

The next generation of retainers Candid just launched does not rest on the gingiva, and this is very important. It is designed to be supragingival, so it does not impinge at all on the soft tissue. But because it is extended lower, the retainer can now leverage physics to grab on to more teeth and lock into the interproximals between the teeth to keep them from moving. And this helps to prevent that transverse movement.

 Teeth actually relapse by wanting to return to their previous position. This has a lot to do with the periodontal ligament. Without getting too deep, there are 3 leading theories on strain-based bone remodeling in orthodontic movement. They all pretty much correlate on relapse rotation, which may occur because round circular fibers act like a rubber band. [Before orthodontic treatment], the tooth is out of position, but the circular fibers are passive. Now we move the tooth, and even though it is in an ideal position, those circular fibers are stretched and want to return to their original passive pre-rotated position. The longer the aligned tooth is held in its ideal position, the fibers start to relax and become passive in their new position. This change occurs over a lengthy period, which is why adherence and the best retentive device are so critical. It is also why Candid spent so much research and development time to create a retainer to allow the dentition to remain ideally positioned.

 The exciting part of working at Candid is their state-of-the-art [research and development team]. The company is quick, agile, and has a ton of game-changing innovations in progress. The next 18 months will see much disruption and change in our incredible profession. Candid already has a retainer update coming in July, adding some extra features. You do have to be a CandidPro provider to purchase retainers through the CandidPro website.But patients don’t have to have gone through CandidPro aligner treatment to get PermaForm retainers.

The research and science that went into the creation of this next generation of retainers from CandidPro provide significant upgrades in fit, comfort, and longevity. Patients spend much time and money on straightening their teeth, and Dr Gray and Candid are determined to keep those teeth in place.

The launch of Candid’s next-generation retainer is backed by its research of the best materials and protocols.

The Science Behind Orthodontic Retention

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.

The Transformative Potential of 3D Printing. Image credit: © xiaoliangge / stock.adobe.com

In recent years, 3D printing has emerged as a groundbreaking technology with applications across various industries. In dentistry, 3D printing has revolutionized the way dental professionals approach treatment planning, prosthetics, and even education. The precision, efficiency, and customization capabilities of 3D printing have transformed the field, offering numerous benefits for practitioners and patients alike. Many of the practices I work with have started to incorporate 3D printing into their daily routines, so I wanted to explore some of the current use-case scenarios.

One key use of 3D printing in dentistry is in the fabrication of dental models. Traditionally, dental models are created using impression material and plaster models, which are time-consuming and often result in inaccuracies. With 3D printing, dental professionals can create highly accurate, detailed models in a fraction of the time. These models are invaluable for treatment planning, allowing dentists to visualize the patient’s dental anatomy in 3 dimensions and plan procedures with greater precision.

Another significant application of 3D printing in dentistry is in the fabrication of dental prosthetics, such as crowns, implant restorations, bridges, and dentures. The technology allows for the creation of custom prosthetics that are perfectly tailored to the patient’s individual anatomy. This not only improves the fit and comfort of the prosthetic but also reduces the need for adjustments, saving time and money for patients and practitioners.

Surgical guides for dental implant procedures are also benefiting from 3D printing. These guides are designed based on the patient’s cone beam CT scans and are used to precisely position the implants during surgery. This not only improves the accuracy of the procedure but also reduces the risk of complications and ensures better long-term outcomes for the patient.

Furthermore, 3D printing is transforming the field of orthodontics. Traditionally, orthodontic appliances such as braces and aligners were fabricated using manual methods, which were often time-consuming and prone to errors. With 3D printing, orthodontic appliances can be custom-made for each patient, resulting in more comfortable and effective treatment.

Beyond clinical applications, 3D printing is being used in dental education. Dental schools and training programs are using 3D printing to create anatomical models for teaching purposes, allowing students to practice procedures on lifelike models before working on actual patients; these are far more accurate than the Dentiforms of old. This hands-on training not only enhances the learning experience but also improves the skills and confidence of future dental professionals.

In conclusion, 3D printing is revolutionizing the field of dentistry, offering numerous benefits for both practitioners and patients. From improved treatment planning and prosthetic fabrication to enhanced surgical precision and educational opportunities, the uses of 3D printing in dentistry are vast and far-reaching. As the technology continues to evolve, it is likely to play an even greater role in shaping the future of dental care. Combined with the rise of artificial intelligence, which I discussed in a previous article, it’s an exciting time to be a dentist.

Dentists can leverage the ever-evolving and advancing technology to provide better care for their patients and expand practice offerings. 

The Transformative Potential of 3D Printing

A new debridement material from Young Specialties. 

PerioDT from Young Specialties

SimplyPERIO™ from Spectrum Solutions

Opal by Opalescence

Mango Contact Sync from Mango Voice

New precision micro tools from Monaghan Tooling Group. 

Axis High Precision Micro Tools from Monaghan Tooling Group

A new lab subscription service from Desktop Health.

ScanUp™ from Desktop Health

iMatrix Clear™ from Pac-Dent

A new communication platform from Intiveo.

Intiveo Connect from Intiveo

New Dental Products – March 25 - March 29, 2024

All the latest dental product launches from the week of March 25 through March 29, 2024.

Kellie Nock is the assistant editor for Dental Products Report. She graduated from Kent State University in 2018 with a Bachelor's in Journalism. Kellie enjoys multimedia content creation with a focus on audio and video storytelling. 

Understanding Dental Implant Design. Image credit: © MclittleStock; 9george / stock.adobe.com

The mouth is complex, subject to variations in bone density, jaw structure, and overall health. These often complicated variations may present challenges when it comes to patients looking for safe, sturdy, and trusted implant options. For instance, some patients may have robust jawbones with sufficient bone density, making them suitable candidates for traditional dental implants. These implants are surgically placed directly into the jawbone and provide a sturdy foundation for tooth replacement.

Dentsply Sirona’s OmniTaper Implant System combines proven technologies with new innovations for implant treatment in virtually all clinical situations.

One must consider that not all patients possess adequate bone volume or density to support traditional implants. In such cases, alternative options like short or mini dental implants or procedures such as bone grafting may be necessary to augment the bone structure before implant placement. Part of a clinician’s role when considering dental implants for a certain case is looking at the big picture, according to Indraneel Kanaglekar, senior vice president and global dental president of dental implant manufacturer ZimVie.

“When you’re selecting an implant or when selecting an implant company, clinicians look at the technology, they look at the failure rates, the depth of the portfolio, the science behind the implant technology, as well as increasingly the digital workflow technologies and the restorative options available,” Kanaglekar says. “But for a particular case, the most important thing would be the shape and size of the implant.”

With the influx of new dental technologies and materials, clinicians are presented with myriad options when it comes to choosing which implant works best. Consider dental implants as a branching path, stemming from 2 main types—endosteal implants and subperiosteal implants. Per the American Academy of Implant Dentistry (AAID), endosteal implants are placed directly in the jawbone and are typically the standard and popular implant choice.

 These implants are usually crafted from titanium in a screw shape.

“Most of our implants are placed at or just below the bone level. And those are called bone-level implants,” Kanaglekar says. “There are some dentists who still prefer to use a tissue-level implant, which means the implant protrudes out of the bone and it sits in the tissue.”

Subperiosteal implants are placed differently, under the gum and on or above the jawbone. These implants are less standard, according to the AAID, but are often appropriate for cases where the patient lacks a healthy natural jawbone and is unable to undergo bone augmentation.¹ Subperiosteal implants involve a metal framework that rests on the jawbone, with posts protruding through the gums to support the artificial teeth. This alternative approach allows for greater flexibility in accommodating patients with compromised bone density or those who may not be suitable candidates for traditional endosteal implants.

The choice between endosteal and subperiosteal implants is influenced by various factors, including the patient’s oral health, bone structure, and personal preferences. Advances in dental technology and materials have further expanded the array of implant options within these 2 main categories. For example, the development of zirconia implants provides an alternative to traditional titanium implants. Zirconia implants may offer esthetic benefits, as they are tooth colored and can blend seamlessly with natural teeth, making them particularly appealing for patients concerned about the visual aspect of dental restorations. It is important to note, however, that zirconia implants are still relatively new to the US market, and questions regarding their efficacy and longevity may be important to consider. One study from 

 claims that a mixed titanium-zirconia implant did better in terms of survival rates, marginal bone loss, and bleeding on probing than either zirconia or titanium alone.

When a patient’s jawbone is insufficient or unable to support traditional dental implants, alternative implant types and techniques become essential to restore the structural integrity of the jaw and create a suitable foundation for implant placement. These alternatives focus on stimulating bone growth in the affected areas, effectively preparing the jaw for successful implant integration.

One such technique is bone grafting, a common procedure used in augmenting bone volume. In cases where the patient has experienced bone loss due to factors like trauma, periodontal disease, or atrophy, bone grafts involve transplanting bone tissue from another part of the body, a donor source, or synthetic materials to the deficient area. This procedure promotes the formation of new bone, strengthening and thickening the jawbone to a level that can support dental implants securely. Bone grafting is a versatile solution that caters to various degrees of bone deficiency, allowing clinicians to tailor the treatment to the specific needs of each patient.

 Bone grafting can be supplemented by the use of materials like a bone graft plug, for example the OsteoGen® by Impladent.

The use of guided bone regeneration (GBR) and sinus lifts are techniques designed to enhance bone volume and quality in specific areas of the jaw. GBR involves placing a barrier membrane over the deficient bone area, preventing soft tissue invasion and promoting the growth of new bone. Sinus lifts, on the other hand, are particularly useful for the posterior upper jaw where the bone void created by thenatural sinus cavity may impede implant placement. During a sinus lift, the sinus membrane is lifted and bone graft material is inserted into the space below, encouraging bone growth and creating a more stable foundation for implants.

Other dental implant procedures leverage new technologies for implant placement. Examples include immediately loading implants, mini dental implants, and the All-On-X series of implants.

Immediate load implants: These implants are as described, crafted with the ability to have a temporary tooth placed on the same day as the dental implant placement. These implants may provide a convenient option for patients who have the structure in place to safely take advantage of this same-day treatment. Systems such as Straumann® TLX Implant System suit both conventional and immediate loading, for optimized chairside efficiency.

Mini dental implants: These smaller implants are designed to provide a less-invasive implant experience for patients. Per the AAID, they are typically used to stabilize a lower denture.¹ MOR®mini implants from Sterngold are designed for simplicity and affordability, all while being designed for immediate loading.

All-On-X implants: Procedures using these implants leverage 4 to 6 positions in the mouth to strategically support a full arch of teeth. This type of implant technique and treatment may reduce treatment time, as it eliminates the cost, time, and added surgery of placing multiple different implants, in favor of placing a few strategic ones.

According to Kanaglekar, the design of dental implants has undergone significant evolution in recent decades, reflecting advancements in materials, technology, and a deeper understanding of biomechanics. One notable aspect of this evolution is the transition from predominantly straight implants to the adoption of tapered designs, each with distinct implications for how they integrate into the oral environment.

“Previously, around 20 to 30 years back, when the implant technology started developing, most of the implants were largely straight, or even if they were tapered, they were tapered at the apical point or at the bottom,” he says. “Over time, the technology has evolved and most of the implants are fully tapered.”

The tapered design enhances primary stability during implant placement, especially in cases where the available bone may be compromised or limited. By gradually widening toward the coronal end, tapered implants engage more surface area within the bone, maximizing initial fixation and reducing the likelihood of micromovements that could hinder osseointegration. This improved stability is particularly beneficial in situations where immediate or early loading of the implant is desired. Mimicking the anatomy of a tooth root, tapered implants distribute occlusal forces more evenly along the surrounding bone. This helps minimize stress concentrations, reducing the risk of complications such as bone resorption or implant failure over time. The biomechanical advantages of tapered implants have led to their widespread acceptance and utilization in various clinical scenarios.4 ZimVie’s T3® PRO Tapered Implants and the TSX™ Implants take advantage of the tapered design to provide enhanced clinical results including more stability and defense against peri-implantitis.

Another factor that impacts implant design is the connection, according to Kanaglekar. “The connection, meaning the screw of the abutment that goes into the implant, what type of connection is that? Now, a simple analogy would be as if it were a Phillips screw or hex screw vs an octagonal screw. It’s similar to that. And there are various types of connections,” he says. “Our implants come with primarily 2 different connections. One is what we call internal hex, and the other connection is named Certain®. We believe both these connections provide an excellent seal, where the bacteria do not enter the implant after placement, while also helping form tissue around the implant and encouraging bone growth around the implant.”

Connections play a vital role in dental implant design as they are critical components that link the implant to the prosthetic structure, such as crowns, bridges, or dentures. The connection between the implant and the prosthetic component is crucial for the overall success, stability, and longevity of the implant-supported restoration.

ZimVie’s T3® PRO Tapered Implant and Encode® Emergence Healing Abutment offer implant solutions for dental clinicians. These products utilize ZimVie’s implant innovations, like Osseotite ® and intraoral scanning visibility, respectively.

More Than Skin Deep: Surface Treatments in Dental Implant Design

Surface treatments are crucial in implant design because they significantly impact osseointegration, which is the direct structural and functional connection between the implant and the surrounding bone. The surface characteristics of dental implants play a pivotal role in determining the success, stability, and long-term performance of the implant.

“The surface technology that is used to provide roughness to the implant is another place where implants differ from each other,” Kanaglekar says. “At a very high level, there are 2 types of surface technology that you can use to make the implant surface. One is additive surface treatment, where you add some sort of rough coating on the surface. The other is subtractive, where you etch the implant, or you blast the implant and take something out of that surface and make it rougher. Over time, we have come to believe that the subtractive surface roughness technology worked really well for us.”

For ZimVie, 20 years of data have supported its Osseotite® dental implant and its increased contact osteogenesis. It has a unique 1- to 3-µm peak-to-peak surface that leverages an acid-etch process, and per ZimVie’s website, its surface features are specifically designed and sized to entangle fibrin strands of the blood clot.⁶ “What we have tried to do is create an implant that is rougher to the collar–which is the top portion of the implant–and then we still create a small amount of softness on the collar, where it encourages bone growth, but does not become so rough that it attracts bacteria.” Kanaglekar says.

The TSX Implant from ZimVie is designed for immediate extraction and loading, utilizing a hybrid of dual acid-etched and MTX™ surface technologies.

Alternatively, additive treatments use mechanical or chemical processes to add material that changes the surface of the dental implant. There are a variety of methods to adding materials to the surface, including through a superficial addition and through a deeper integration. Integration implies that the material is going directly into the implant’s substrate material, for example, introducing ions of fluoride, whereas a superficial addition typically comes in the form of coating the surface. According to a study done in BioMed Research International, coating techniques can include titanium plasma spraying, plasma sprayed hydroxyapatite coating, alumina coating, and biomimetic calcium phosphate coating.

Although both subtractive and additive are valid techniques in surface treatments, dentistry has shifted to focus on more subtractive measure, Kanaglekar says. “We believe we have some of the best surface technologies on the market. And the reason why the industry typically believes that subtractive surface technologies are better than additive is because there is a belief that sometimes these additive technologies, the particles can later on aggregate or create issues for infection,” he says. “That said, we still have some legacy lines that utilize hydroxyapatite surface coatings. And again, in that sense as well, our surface technology, what we call MP-1® HA is very different. Backed by clinical data, we believe that if you want to go for additive technologies, we believe we have the best available.”

The choice between a superficial addition or deeper integration of materials depends on specific clinical considerations, including the desired outcome, the materials used, and the targeted improvement in implant performance. Each method has its advantages and potential drawbacks, and the decision may be influenced by factors such as the patient’s oral health, bone quality, and the overall treatment plan.

Choosing the right dental implant is a critical decision for clinicians and their patients, and several factors can come into play.

“The most important thing would be the shape and size of the implant. Because if it’s a narrow ridge, then you would need a smaller implant. If it’s a thick bone and in the posterior then you would need a bigger implant,” Kanaglekar says. “The size of the implant would also be dependent on the patient anatomy and the level of bone they have.”

Clinicians may want to consider various factors in terms of the implants that they offer. “For the long term, dentists would typically want to look at the history of a particular implant’s failure rate, or long-term survival rates, as well as the science and publications available about the surface technology and about the bone loss or bone preservation around that after the implant is placed, as well as the restorative options that can provide optimum esthetic and functional benefits,” Kanaglekar says.

For instance, mini dental implants may be optimal for patients with less jawbone density who still desire a less invasive procedure. This might be ideal for patients with smaller mouths or any other patient whose jaw mass cannot support traditional dental implants.

“You will come to a natural conclusion whether, in this case, it’s better to have individual implants or an implant-supported bridge. Typically implant-supported bridge or a full arch treatment would be recommended,” Kanaglekar says. “If you have multiple adjacent teeth that are missing, or your patient is partially edentulous or fully edentulous—if there are, let’s say, 2 teeth missing but there are multiple teeth in between that are healthy and the smile is good, then the dentist is going to recommend 2 different implants even though there are 2 missing teeth. But if it’s adjacent teeth or more than 3 or 4 teeth missing and it’s a partially edentulous case, then you are most likely going to go for an implant-supported bridge or a full implant-supported denture.”

Steps to determining which implant best suits which case may lie in the dental practice’s ability to harness the right technology and tools.

Technology Workflows Bolster Implant Care

Digital workflows can be key in determining the right type of implant for your patient. From smile visualization programs to software like RealGUIDE™ from ZimVie, there are more options now to find the right fit for the dental practice.

RealGuide from ZimVieis a software module that enables clinicians to design the optimal restorative system for their patients, bolstering the digital implant workflow in the dental practice.

RealGUIDE is a cloud-based software suite that enables implant planning, design, surgical guide design, and other programs. By combining these functionalities in a single platform, RealGUIDE aims to enhance efficiency, accuracy, and collaboration, according to Kanaglekar.

“These days, the best way to assess a case would be to do a comprehensive surgical and restorative planning, which will give you a good idea on not just the shape and size of implant but how and at what angle it should be placed,” he says. “You start with taking a 3Dx-ray or a CBCT scan. We’ll also merge that with an intraoral scan, which gives you a view of the other teeth and the tissue.”

Once those are imported in the software, clinicians can best determine and design which implant will work for the case, assessing the location of nerves, assessing bone density, and moving onward to create a surgical guide for the case. The surgical guide can then be sent to ZimVie, where it can be manufactured or, if the clinician owns a 3D printer, they can print it chairside. Other platforms, such as the Romexis® 3D Implantology from Planmeca, provide platforms that enable both digital implant design and surgical guide design. Planmeca also provides a full implant library, which allows clinicians to keep a database of both implant and surgical guide designs, downloadable from Planmeca’s website.

“Going forward, we’ll continue to innovate on implant design,” Kanaglekar says. “We want to improve our implant offerings in terms of shapes, sizes, technology, but also make sure that these improvements are tied to this end-to-end digital workflow that will improve practice efficiency and restorative comfort.”

Types of implants and techniques. American Academy of Implant Dentistry. Accessed March 11, 2024. https://aaid-implant.org/what-are-dental-implants/types-of-implants-and-techniques/

Fernandes PRE, Otero AIP, Fernandes JCH, Nassani LM, Castilho RM, de Oliveira Fernandes GV. Clinical performance comparing titanium and titanium-zirconium or zirconia dental implants: a systematic review of randomized controlled trials. 

Weinlaender M. Bone growth around dental implants. 

Nandini N, Kunusoth R, Alwala AM, Prakash R, Sampreethi S, Katkuri S. Cylindrical implant versus tapered implant: a comparative study. 

. 2022;14(9):e29675. doi:10.7759/cureus.29675

Inchingolo AM, Malcangi G, Ferrante L, et al. Surface coatings of dental implants: a review. 

. 2023;14(5):287. doi:10.3390/jfb14050287

The Osseotite dental implant. ZimVie. Accessed March 12, 2024. https://www.zimvie.com/en/dental/dental-implant-systems/3i-osseotite-implant.html

Jemat A, Ghazali MJ, Razali M, Otsuka Y. Surface modifications and their effects on titanium dental implants. 

. 2015;2015:791725. doi:10.1155/2015/791725

Flanagan D. Rationale for mini dental implant treatment. 

. 2021;47(5):437-444. doi:10.1563/aaid-joi-D-19-00317

With a variety of designs and types, it is vital to determine which implant works best for which case. 

Understanding Dental Implant Design

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.

Oh, the things I’ve gotten to do in my life!Some have been a result of dumb luck, being in the right place at the right time—like catching that foul ball at a Royals game about 10 years ago. Yet some of the best things that have happened in my life were simply being faced with an opportunity and thinking: “What the heck? Take some chances.”

In the fall of 2017, long before we even thought a pandemic could happen, I was browsing my Twitter (now called X) feed and being a geek, I follow a lot of National Aeronautics and Space Administration (NASA) feeds. On that fateful day I saw a post stating that they were looking for people with a love of NASA and a social media following/presence. The offer was to apply for a special program that would allow those lucky enough to be chosen to come to Kennedy Space Center in Florida and witness a rocket launch while continually posting to their social media channels about the experience.

Now, I’m no social media guru. I don’t have tons of followers. However, I immediately thought: “What the heck? The worst that can happen is that they say no and I get to tell people NASA turned me down.” I mean, in my geeky mind, even a rejection from NASA was something to crow about.

Six months later, on April 2, 2018, I was getting a full-blown tour of the Kennedy Space Center and all the tech glory it contained. Then I stood in the press section and watched SpaceX launch a Falcon rocket to the International Space Station. I was as close to that launch as NASA deemed safe, and let me tell you, the shock wave that came off that thing hit me in the chest like a full-volume Led Zeppelin concert. It was magnificent and awe inspiring.

So what does this have to do with dentistry? Simply put, many of us in the profession are sticklers.We find something that works and we tend to stick with it—sometimes way longer than we should.In the days before digital impressions, I used to tell salespeople the hardest thing to do was to get a doctor to change their impression material—and that was so true.

However, change is good. Bluntly put, change works. Dentistry is a high-burnout profession. Not many people hang it up early, but a lot of us struggle mightily in clinical practice. Like baseball, we go through slumps and streaks. Sometimes you get a phase where it seems you can do no wrong.Patients get numb in seconds, crowns fit like they were sent straight from heaven to your office, and that class IV composite on No. 9 looks like the tooth never fractured. Other times you send folks home because anesthesia didn’t take, endo files fracture, and your “simple” crown fits like the proverbial “socks on a rooster.” The good news is that tough times don’t last but tough people do.

So this month let’s consider some things that, from a restorative standpoint, will make your life easier and your clinical results exactly what you expect of yourself.

So much of what we do today depends on chemistry, and yet not many of us have degrees in the field. That can make bonded procedures stressful and sometimes confusing.Lots of bottles, lots of syringes, and lots of confusion are frequently the norm for us.What works with what?If I bond a post with this material, will it stay or is the patient going to come back in 3 months with a crown in their hand that contains all the buildup and the post?

I love chemistry, but I am by far not an expert in the subject and that is why I love to keep it simple.One of my favorite bonding agents is Futurabond U from VOCO. There are 2 genius parts of this product. The first is that it works with everything. When the smart people at VOCO say “universal,” they mean universal. The material is both light cure and dual cure. That means even in bonded posts, the material will set in areas that the curing light will never reach adequately. Plus, it works with every bonded material out there. Futurabond U is material agnostic, which means that composites, buildup materials, and bonded cements work equally well with impressive bond strengths.

The second impressive thing about Futurabond U is the packaging/dispensing system. It comes in a blister pack that holds the 2 components of the system in separate wells. Simply push on the bubble in the package and those 2 components flow together. You then break the foil on the package and stir the contents. The genius of this is that every mix is a fresh mix. You never have to worry about solvent evaporation or the material losing potency sitting in a bottle or syringe.

Another terrific bonding agent is from Vista Apex and is called RE-GEN Universal Adhesive, which works with every material. The product is the first universal bonding agent that employs bioglass as an active ingredient. In keeping with the idea of simplicity and predictability, bioglass has more than 50 years of medical use. It was originally developed for use in orthopedic surgeries to stimulate bone growth in difficult cases. What is amazing about bioglass in our profession is that it forms a hydroxyapatite-like surface where it touches tooth structure, which means it promotes the regeneration of healthy tooth structure (hence the name RE-GEN).

Bioglass also has the amazing property of broad antimicrobial effects, which means that it helps promote healing and prevention of recurrent caries at the margin of restorations. Considering how recurrent caries is the main problem in adhesive dentistry, being able to kill bacteria at the marginal interface is a huge plus. Studies show that the average life span of a multiple surface composite restoration is around 5 years. I feel we can do better than that and I firmly believe RE-GEN products can help with that.

One line that I feel the profession needs to know more about is the Giomer-containing products by Shofu. Giomer is a proprietary filler particle that Shofu created and engineered. The products that contain Giomer release and recharge 6 ions: fluoride, strontium, sodium, aluminum, silicate, and borate. When these ions are combined, they inhibit plaque while neutralizing the acids that plaque-containing microbes create.

It’s a bit amazing to me that Giomer was created well over 20 years ago and yet many practitioners are not aware of it. As I noted above, the average life span of a multisurface composite is around 5 years. The margin is where the battle of restorative longevity is won and lost. Sending in as many reinforcements as we can to the margin can truly help make a big difference in our clinical outcomes.

I’d like to also add that Shofu has done a tremendous job in keeping prices low for its outstanding materials. As a business owner, the doctor is always performing a high-wire act to ensure profitability and Shofu is helping us in that area. As I’ve said many times in the past here, you can have the best hands in the profession, but if you cannot stay in business, you won’t be able to help many of those in desperate need of our care.

The goal of all restorative dentistry is to return the tooth being treated and the patient back to a state of health that can be maintained. In striving to achieve that sometimes difficult goal, it is important not only to place the correct material but also to place it well. Contours and contact matter to the longevity of a restoration. The restoration must return the tooth to as close to ideal as clinically possible while also allowing the patient to be able to perform their home care routine.

Composites can be difficult to place properly. The problem stems from several factors, but perhaps the most common one is that many of the matrix systems we use were designed to be used with amalgam. Composite is a completely different material from amalgam and it is important that we use a matrix system that is designed for use with it.Garrison Dental Solutions recently released a “leap forward” sectional matrix system called the Strata-G and it definitely bears a close look.

The Strata-G kit is a complete system for placing composites with amazing results. It contains rings, assorted bands (for both posterior and anterior), assorted Strata-G wedges, ring placement forceps, and mini polishers.

The system is designed to make it as easy as possible to create multisurface composites that have proper contacts and proper contours. The bands are manufactured to re-create the contour of the tooth while the rings, made of nitinol (ni-ti), open easily yet contract with a significant force. These rings allow for easy placement yet due to the ni-ti they hold the bands exceptionally well. This incredible material also creates pressure that slightly separates the adjacent teeth. When the ring is removed, the periodontal ligament rebounds, returning the teeth to their original position and in the process creating a snug and ideal contact. Basically, the form of the band creates ideal contours while the ring allows for ideal contacts.

The wedges are also key. The underside is a V shape and is formed out of a flexible polymer. The V and the polymer allow the band to have flexibility. This allows the wedge to slide easily against the band, and the wedge can bend inward at the greatest curvature of the gingival box while also expanding as it enters and exits the area. The result is a gingival margin that is sealed with minimal chance of an overhang because the wedge allows the band to perfectly contour to the gingival margin.

What I’ve hoped to accomplish here is to encourage you to try some new things that have worked well for me. Dentistry is a constantly changing landscape, and there are lots of things coming to market that can really impact our abilities, our stress levels, and our clinical outcomes. If you are looking for better ways to help make your treatment better, I encourage you to step just a bit outside your comfort zone and give some new things and new ways a try. Progress continues unabated and we need to change simply to stay current. See you next month!

Sometimes improving your dental practice is all about stepping outside your comfort zone. Here are a few techniques and products that may enable that.