Gary Radz, DDS, FACE, is an accomplished educator sharing his knowledge of dental materials and technology for esthetic dentistry. He has published hundreds of articles and has served as chair for the AACD annual meeting.

Dr Radz’s practice, Cosmetic Dentistry of Colorado, is located in downtown Denver. His general practice focuses on cosmetic dentistry. He received his dental degree from the University of North Carolina. He is a graduate and former chief resident of both AEGD and GPR residency programs. He has completed and served as an associate instructor for several post-graduate dental educational institutions.

Over the course of the past 20 years, Dr Radz has lectured internationally, teaching the materials, techniques, and technology used in esthetic dentistry. He has presented at many major national meetings including the ADA, Yankee Dental Congress, Greater New York, Chicago MidWinter, both northern and southern California Dental meetings, the Pacific Dental Conference, the Texas Dental Association and 13 years in a row at the American Academy of Cosmetic Dentistry. Since 2004 Dr. Radz has served as an Associate Clinical Professor at the University of Colorado School of Dentistry in the Department of Restorative Dentistry.

He has published over 150 articles related to esthetic dentistry, and serves on the editorial board of 7 different dental journals, including the 

. He has served as editor-in-chief of 2 dental journals, and served for 10 years as an evaluator for Reality, and now performs product evaluations for Catapult Education.

Gary M. Radz, DDS, FACE

Excellent dentistry requires great attention to detail. One of our many clinical challenges is working in an environment that includes not only moisture but blood. As challenging as this is, it is complicated by the fact that most dental materials are negatively affected by blood and moisture. As dentists, we fight this battle of blood and moisture control several times a day to maximize the effectiveness of our most common materials.

VOCO Retraction Paste is an astringent paste with aluminum chloride. It is designed to widen and dry the gingival sulcus, creating the ideal conditions for accurate, successful digital or conventional impressions. The material is a bright turquoise color, providing high contrast to tooth structure and gingiva and ensuring that the paste is visible and can be easily rinsed off after only 1 to 2 minutes. It is said to save clinicians up to 50% of procedural time compared with other methods and can be used as a replacement for or in conjunction with a retraction cord. It features a custom-engineered capsule with a long, fine, flexible plastic tip with a rounded edge rather than metal that is said to avoid damage to the gingiva and allows for precise application. Its 2-stage viscosity makes for simple application.

We are further challenged when restoring parts of the tooth that fall at or below the gum line. During this procedure, we try to gain visual access of the gum line for many clinical reasons and maintain control of any bleeding. This access almost always results in more bleeding and the need for more effective moisture control.

Today we have a variety of options for controlling moisture and bleeding. We need to pick the option that will produce the desired result in each situation.

Retraction cord has been used for many years to displace gingival tissue and help control hemorrhaging. Although effective, it is technique-sensitive, time-consuming, and often uncomfortable for the patient during and after the procedure. Another common option is electrosurgery (laser surgery) to remove excess soft tissue or control bleeding. In addition, selective infiltration using 2% lidocaine with 1:100,000 or 1:50,000 epinephrine is an effective method of hemorrhage control.

Retraction pastes have recently become an excellent option for many clinical situations. Retraction pastes have existed in the dental market for 20 years, but in the past 5 years, companies have perfected the material to make it more clinically effective and affordable. Retraction paste performs 2 significant clinical functions. First, it serves as an atraumatic option to displace sulcular tissue. Second, it is an effective hemostatic agent to help control bleeding. In addition, retraction paste is faster and easier to apply than retraction cord.

VOCO America recently introduced their retraction paste to the market, touting the product’s excellent hemostasis due to the incorporation of aluminum chloride within the paste. Aluminum chloride will not only stop hemorrhaging at the operative site but dry the area to provide a clean field of view. The paste has a unique fluidity; it flows easily from the cap with little force but within a minute of placement becomes firmer and effectively displaces the sulcular tissue. Its capsule enhances clinical performance and features a soft, long, and flexible tip that guides the exact placement of the material. Its highly visible turquoise color makes it easy to identify in the mouth. Finally, the material rinses off easily and completely with minimal effort, leaving no postoperative stain.

The most common use of retraction paste is in the impression-taking workflow. Two important criteria for capturing good impressions are visualization of all margins and complete control of sulcular fluids. Retraction pastes are highly effective in achieving this goal.

First, retraction paste is placed in preparation to take the final impression (

Figure 1. Retraction paste applied before taking the final impression.

The paste stays in place for 1 to 2 minutes before being rinsed off with an aggressive air/water spray. The retraction paste provides a clean and optimized operative field to take the final impression and composes part of an optional, though useful technique: a combination of retraction paste and traditional retraction cord (

Figure 2. After the retraction paste is rinsed off, there is a clean, dry field optimized for the impression process.

This technique modifies the 2-cord impression technique that was the gold standard for many years. In the modified technique, the dentist places a retraction cord (Ultradent UltraPak #00), finalizes the margins of the preparation, then places the retraction paste on top of the retraction cord prior to taking the final impression. This technique is much faster and less traumatic to the soft tissue than using the cord without paste.

With digital impression scanners becoming more common in dental practices, retraction paste is a great clinical accessory for digital scanning. Ease of use, speed, effective retraction, and sulcular fluid control make it a natural fit for the fast and comfortable experience of digital scanning.

When cementing a bonded restoration, any contamination of the preparation during the bonding process can negatively affect the longevity of the bond. Using a retraction paste prior to bonding can optimize the area so there are no contamination concerns. A tooth is then prepared for a veneer, ready to be bonded in place using a resin cement (

Figure 3. Retraction paste is used to control the gingival irritation caused by temporary restoration.

During the temporization process, the tissue may become inflamed and irritated due to poor home care. The retraction paste can stop the tissue hemorrhage prior to bonding. Retraction paste helps create a more ideal environment for the bonding process (

Figure 4. The irritated tissue is now controlled and ready for the bonding procedure.

Another restorative situation that benefits from retraction paste is the direct composite restoration, commonly used in Class II situations when replacing an old restoration. Once the old restoration is removed, the interproximal area may bleed and be irritated from a poor fitting and/or iatrogenic soft tissue trauma caused by the preparation process. The dentist should use retraction paste before applying the matrix system to stop localized bleeding and create a better working field for the bonding process of the composite resin. Similarly, the addition of retraction paste to the workflow makes Class V restorations at or near the soft tissue margin easier during preparation and procedure.

Retraction paste is a beneficial tool in the restorative dentist’s toolbox. In the appropriate clinical situation, it provides an optimal result with a quick and atraumatic procedure. VOCO’s recent addition to retraction pastes raises the bar for restorations with a dentist- and patient-friendly product.

Articles

VOCO Retraction Paste controls restorative procedures with no added hassle for the clinician.

Blood, Time, and Money – Stop the Hemorrhaging

The dental industry constantly moves toward higher standards of care via decreasingly invasive treatments and workflows. Updated materials, instruments, and technologies improve the outcomes clinicians can achieve for their patients. Although the benefits of these advancements are easily recognized, the many steps to get there are not always seen.

Still, every innovation that helps drive dentistry forward is worth noting and even celebrating. One way to put these innovations in the spotlight is to take a look at what they replaced. It’s easy to get used to a comfortable and effective daily workflow, and sometimes it may even seem there’s no need for change. But once something new is brought in to save time, enhance results, or otherwise make things better, it’s easy to move forward from the way things were.

This article (and its online components at dentalproductsreport.com) puts some of those former favorites front and center a final time, as dental professionals share stories of things they once used day in and day out but no longer need due to innovations that make practicing dentistry better for everyone.

How Ameet R. Sachania, DDS found a better material for posterior composites when he tried VOCO's VisCalor Bulk.

Warming to a New Bulk Fill Composite

A simple design feature makes these posts suitable for almost any situation where a post is indicated.

Adaptable Post Becomes Core Part of Armamentarium

Using Simplifeye makes running the practice easier for patients and clinicians.

Simplify the Payment Process

How the Clio Prime intraoral sensor from SOTA Imaging solved one practice's imaging challenges.

The Perfect Digital Development

Adopting Stellalife's natural rinses impacts a practice and its patients.

Natural Rinse for Better Postop Care

Finding the best mill for his practice set this clinician on a new path.

Milling Made Easy

Necessity leads one clinician to find a faceshield that delivers on both comfort and convenience. 

Pandemic Leads to Face Shield Find

Sometimes the innovation doesn't seem that large, but the effects can still change a practice.

Chemical Bonding Means Better Endo Temps

With the right tools, creating restorations with lifelike anatomy can be simplified.

A Better Shape for Shaping Anatomy

A new material selection helps eliminate postop sensitivity.

Eliminate Sensitivity and Toxicity

Using VoIP phones can change the way a dental practice and its patients connect and interact.

Move Beyond the Phone to Connect With Patients

A new option for sealing root canals helps this clinician perform at his best.

Enhanced Endodontic Chemistry Means Better Seals

3D printing leaps forward with printed, long-term crowns.

Permanent Crown Resin Replaces Conventional Restorations

Shifting from a scalpal to a laser makes treatment easier on patients and for clinicians.

Why I Tabled My Scalpel for a Dental Laser

Find out why the author believes every practice should be using an electric handpiece.

It’s Time to Upgrade to Electric Handpieces

Why Gary Radz, DDS, believes he's found an "easy button" for creating temporary crown matrices. 

Pressing the Button on a Better Temporary Crown Matrix

The dental mirror will always be essential, but it doesn't need to be limited by the past.

Reflections on the Dental Mirror

A pre-exam rinse is a good prophylactic step for many practices, and finding the best rinse is a key to success.

Replacement Rinse Leads to Better Results

Oral probiotics show favorable results for enhancing oral health in both lab testing and clinical use.

Out With Bad Bacteria, In With the Good

Why a new technology, and its fresh approach to treating xerostomia, might be the best approach for some dry mouth patients.

A New Technology to Manage Xerostomia

The Vivos sleep system aims to treat patients with sleep apnea rather than help them manage their condition.

Treating Sleep Issues at the Root Cause

Finding a system for automatic shade matching can save a practice time, improve relationships between clinics and labs, and enhance restorative outcomes.

Shade System Reduces Miscommunication

Using tooth morphology as a guide, one clinician designed an instrument set to make it easier to mimic the details of a natural tooth.

Let the Tooth Design the Instrument

One clinician is excited about the possibilities of moving his clinical imaging to the cloud.

Add Security and Convenience With Cloud Imaging

The Dental Products We’ve Left Behind (and What’s Replaced Them)

Dental professionals share stories of dental products they’ve stopped using and innovations that are their new favorites.

Restoration of endodontically treated teeth frequently requires the replacement of lost tooth structure as well as support and retention of the restorative material. Through the years, many different types of endodontic posts have been used to serve this need.

Current endodontic trends are to use conservative access, shaping, and flaring during the preparation of the tooth. Removing minimal tooth structure allows increased fracture resistance, providing a better long-term prognosis.

Because teeth have varying pulpal canal diameters and shapes, various prefabricated post systems have been introduced to accommodate the differences in each clinical situation. This has led to systems of multiple diameters, as well as parallel versus tapered posts.

Endodontic posts have been fabricated from various materials including gold, stainless steel, zirconia, and fiber-reinforced composite. There are volumes of papers discussing the benefits of each. Fiber-reinforced composites have become the most popular option in America because of an elastic modulus similar to dentin, its ease of use, and the potential for the post material to bond to tooth structure.

Designed to let the clinician adapt the fiber post to the canal flare with a vertically sliding (adjustable) conical sleeve. The sleeve is made of the same fiber-reinforced composite as the post and, when needed, slides on when the post is inserted, converting a pointed, parallel post into a custom-fitted post. Replacing cement with material of high mechanical properties increases the overall strength of the post/core.


Angelus recently brought the Splendor-SAP endodontic post system to the US. This system is a unique solution to challenges in current endodontic post kits. SAP stands for single adjustable post. It is created by using a 2-part system. The first part is a narrow, apically tapered fiber post like many other posts on the market. The second part makes this product unique. A sleeve provided with the posts and made of the same material can be placed over the post to allow for adaptation to varying diameters of coronal canal preparations

. This sleeve allows for better adaptation of the post system to the canal anatomy while increasing strength and retention. This ingenious design leads to a significant decrease in the inventory of post designs, sizes, and systems needed by the clinician.


The Catapult Education evaluators participated in the review of the post system in the first half of 2020. Each evaluator was provided with a Splendor-SAP kit that contained 5 posts and sleeves. Upon completion of the evaluation each doctor submitted a survey about their experiences with and opinions of the post system. There was no compensation to the evaluators for their participation in the review.


Within our evaluation team, ¾ currently place fiber posts, whereas the other ¼ place metal posts. Half of our evaluators performed endodontic treatment in their practices. Most of our evaluators cited flexural strength (associated with decreased likelihood of root fracture), ability to bond, and esthetics as primary reasons for choosing fiber posts.

When using the SAP system with the sleeve, most of our evaluators ranked the fit as good or excellent. When the system was used without the post (for narrow canals that did not require the use of the sleeve) our evaluators again rated the fit as good or excellent.

Half of our reviewers ranked the system as better than their current post system. Of the rest, all but 1 rated the SAP post system as “good as” their current system. Only 1 of our evaluation team rated their current post system as better than the SAP post.

Comments from evaluators included the following:

“Simple to use and simplifies my procedures.”

“Like having a universal size that can be used in a majority of cases.”

In general, our team was impressed with this unique and innovative clinical solution.


An endodontically treated tooth #21 presents with minimal coronal tooth structure and requires a post and core along with a full coverage crown to restore to function.

Using the drill provided with the Splendor-SAP kit, the endodontic filling material is removed as apically as possible without removing excess existing tooth structure.

The SAP post and sleeve are tried into place (

 and excess is removed with a diamond bur and tried to place again 

. The post and sleeve are treated as per manufacturer instructions.

The post space and remaining tooth structure are conditioned with a phosphoric etch along with a compatible bonding agent. For the cement, the author likes to use a dual cure composite resin buildup material (LuxaCore Z; DMG America) as the luting agent. The core material is injected into the post space. The post and sleeve are then inserted into the canal. Holding the post to place, the area is light cured for 30 seconds. Then the core material is injected around the visible post to create the core. This is then light cured for another 30 seconds, followed immediately by the final preparation 

A final radiograph demonstrates the conservative post placement that is now bonded to the tooth with the development of an adequate clinical crown to support the final restoration 

The author would like to thank Dan Ward, DDS, fellow Catapult Education evaluator, for sharing his photography of this case. Our Catapult Evaluation team was impressed with this product and is pleased to give it the Catapult Vote of Confidence.

Catapult is an organization that consists of more than 50 clinicians spread throughout Canada and the United States. As a company, manufacturers pay a fee for their product to be evaluated and what we deliver are truthful, independent answers from surveys that we develop with them. We have had many products that have either had to be altered before hitting the market or simply never arrived because of our openly honest evaluations. In this way, Catapult assists the manufacturer to avoid potentially releasing a faulty product, or simply a product that needs refinement. Lastly our clients are omnipresent in the industry, small to large, no favoritism, simply reviewing the latest products in our practices.

Catapult Education evaluators are impressed with this new entry into the fiber post market from Angelus Dental.

Splendor-SAP From Angelus Dental: Unique and Versatile Post System

	One of the most common restorative procedures in a general dental practice is the single unit crown. Within the procedure workflow of most crowns is the fabrication of a provisional crown. The provisional crown is critical to provide protection of the prepared tooth, allow the patient to be able to function on the prepared tooth, provide esthetic temporary replacement of the tooth, and to maintain the interproximal and occlusal integrity while the final crown is being fabricated. The provisional crown is an important part of the final success of the crown procedure.

	As this is one of the most common procedures in general dentistry it is important that the dental team is efficient in its workflow. Efficiency not only increases productivity, it will also increase patient comfort and satisfaction.

	In the spring of 2019 members of Catapult Education were asked to evaluate the Matrix Buttons by Advantage Dental Products, Inc. The primary indication for the Matrix Buttons is for use as a pre-operative matrix for the fabrication of a provisional crown or bridge. Sixteen members of the evaluation team tested the Matrix Buttons in their practices for 4-8 weeks. During that time 78 provisional crowns and five provisional bridges were placed.

	The Catapult Education members were asked to evaluate the clinical performance of the Matrix Buttons as well as to consider the economics of including the product into their practices. 

	The Matrix Buttons is a thermoplastic “button” that when placed in hot water will become pliable and adaptable to the tooth/arch form that is being treated.

	Most of our evaluators used hot water from the tap that was then placed in a microwave (for 30-60 seconds), a few others used a traditional hot water bath that was already in the operatory.

	Once heated the Matrix Buttons will become clear. This is the indication that it is ready to be placed in the mouth and adapted. Half of our evaluators did this adaptation themselves, the other half designated it to their dental assistants. Three-fourths (75 percent) of our evaluators felt that they (or their assistants) were able to easily establish a good pre-operative record. Our evaluators were split on whether or not this part of the procedure saved time, and 63 percent acknowledged that there was a “learning curve” to using the material. Once this short learning curve is achieved, the placement and fabrication of the matrix can be easy and simple. One “trick” that has proven to be effective is to wet the fingertips of the operator’s glove before handling the Matrix Buttons. If the glove is dry the material can be sticky on the glove.

The provisional crown ready to be cemented to place (Fig. 7).

	The Matrix Buttons were used with a variety of different temporary materials. Four different types of temporary material were used by our team. All four materials worked well with the Matrix Buttons matrix. A large majority reported they were able to establish good margins, contacts, and occlusion when including the Advantage Dental Products’ solution as part of their technique. 

	As a group, our evaluators did not generally see a time savings using the Matrix Buttons as part of their workflow, but also noted that it did not add time. A majority did say that they felt inclusion of the product in their workflow would save them money.

	Lastly, our evaluation team did note that they could see the Matrix Buttons as having other clinical applications. Two of our evaluators that do a lot of sleep apnea appliances noted that the Matrix Buttons would be an excellent material to use for a morning mandibular positioning appliance. Another evaluator used the Matrix Buttons as a transitional bruxism device (similar to an NTI™). It was noted by our team that there could be a number of other clinical applications for the material.

	Overall, 80 percent of our evaluators stated that they would recommend the Matrix Buttons to a colleague. Based on our team’s clinical evaluation the Matrix Buttons were given the “Catapult Vote of Confidence”.


	Temporary crown Matrix Buttons from Advantage Dental Products are user-friendly: Just wet them in hot water for about 45 seconds to soften, mold them around the teeth, and blow air on them to harden for 20 to 30 seconds. They reportedly are ideal for any crown, inlay/only, or veneer restoration procedure, and can even be used for an anterior bruxing appliance or stretched over sensitive teeth for insulation. 

Matrix Buttons from Advantage Dental Products, Inc., for provisional crowns and bridges are evaluated and awarded the Catapult Vote of Confidence.
