Paul LaTour

	With a thriving practice in a middle-class neighborhood of San Francisco, Dr. Peter Karsant treats patients ages two to 102, many of whom are in their 90s. Narrow diameter implants are a cost-effective solution for older patients.

	What Dr. Karsant says about ANEW narrow body implants by Dentatus 

 on a daily basis in both the upper and lower arch anteriorly and posteriorly for fixed or removable patients with a 98 percent success rate. Narrow diameter implants are 

, and once they integrate, your body can’t tell the difference between a regular diameter implant and a narrow diameter implant. The results have been no different than the results I have gotten with regular diameter implants, but narrow diameter implants are minimally invasive and reduce procedure times, which is very attractive to my older patients. I can help my patients who would have otherwise foregone treatment. 

Cover story: DPR investigates the state of the dental implant

	What I like best about the ANEW implant is the ability to change the abutment heads just as you would for regular diameter implants. These implants are less expensive for the dentist, require no special surgical motor and I pass that savings onto the patients. All patients love the cost savings and the end result. Ben Grieve, the national sales representative for Dentatus, is always available to answer questions, as are the people in the main office in New York. Everyone is readily available and questions are handled immediately. This system is very easy to navigate for both the dentist and the dentist’s lab.

	I learned to place implants after graduation through the University of Pacific (UOP) Larry Lum implant study club. When I was teaching pre-clinical removable at UOP, Dr. Gene LaBarre and I started a narrow diameter implant continuing education course. We were teaching the 

 and after finishing my part of the lecture I stepped out into the lobby to think about a difficult case I had before me.

	The patient could not wear a partial lower denture and had failing bridgework. He would not do a bone graft and did not have sufficient width for a regular diameter implant. When I stepped into the lobby, the Dentatus representative asked me if I had seen their ANEW implant, which I had not. Once I saw it, I realized this  implant was just what I needed for my patient. I purchased the kit on the spot and placed my first two ANEW implants shortly thereafter, one in the second bicuspid and one in the first bicuspid on the mandible. They were a lifesaver and the case has been in function now over seven years as a roundhouse lower.

	Unpacking the benefits of using narrow diameter implants

	Narrow diameter implants, which were introduced in the late 1990s, present a cost-effective alternative to larger implants, particularly when there is limited interdental space or where bone grafting would be required.

	Narrow diameter implants are particularly beneficial for older patients who, despite having financial resources, tend to be conservative about how they spend money and care very much about wanting to limit the number of dental visits that treatment requires.

Articles

DPR talks to Dr. Peter Karsant about how his patients have been able to benefit from the ANEW narrow-diameter implant system.

"I realized this implant was just what I needed"

	Dr. Michael Koceja of Columbia Family Dentistry in Vancouver, Washington has been in practice for three decades, and at his current location since opening it five years ago. He’s been in private practice since 1994 after eight years in the U.S. Navy Dental Corps.

	On a recent shopping excursion to his local big-box retail store, Dr. Koceja, DDS, overheard a woman asking a shelf stocker for advice about which teeth whitener product she should buy. He couldn’t help but crack a smile at the absurdity of asking for this kind of advice from a random store employee with no discernible background in dentistry.

Related reading: Top 9 ways to make your patients want to whiten

	If she had known, she could have asked Dr. Koceja who has been handing out 

	“Everybody wants whiter teeth,” he said. “We can help our patients with that. We know the differences between the products. When you buy something at the store, you have to go totally on advertising … or by asking the guy who stocks the shelves.”

	Why did you begin using Sheer White! strips at your practice?

	I’ve been using it pretty much since I opened this practice about four or five years ago. The big reason I liked 

was because all the past strip whiteners didn’t stick to the teeth. After a few minutes you’re chewing them around and spitting them out. They became irritating to wear, so people just didn’t wear them.

	What do you like best about Sheer White!?

	The strips are easy to use and they are relatively inexpensive. People can wear these. I find that the trays just don’t work for most people. With Sheer White!, they can put the films on and go to work. They can drink something. They can speak without any problem. A lot of times you even forget that you have them on. And there is very little sensitivity caused by them.

	I have used them and that’s why I like them. I like to try things. I’ve been through the trays, so I’ve pretty much tried all of them over the years. I just find that these are easy to use. They really stay on tight.

	The biggest thing is people say they are easy to use and they like the results. They can wear them during the day. You can’t really wear a gel tray during the day unless you’re at home or going to bed. Most people do not tolerate wearing the tray to bed and waking up with it still in their mouth. It’s usually laying somewhere. So that’s the nice thing -- it’s very convenient. You can wear them to work. You get ready for work, throw them on before you leave for the day. That’s probably the biggest feedback I get is that they are easy.

	Would you recommend Sheer White! strips to colleagues?

	As dentists, we can do a couple different things. We’re used to using trays and gel, and that’s all compliance-based. If the patient wears it and is compliant, it can work. In-office whitening can be more sensitive whereas I have no complaints about sensitivity using the Sheer White! strips. Because of the price point, you can sell it through the office, which we do, or we can give it out as a gift for new patients or if someone has completed a lot of treatment. I think people really like that little extra something. They might spend thousands of dollars on dentistry, and here’s a little something for you. Patient happiness is a big factor for us. People refer other patients when they’re happy. That’s what the business is all about. It becomes an easy referral source at the cost that it takes to give out a whitening kit.  

	The CAO Group’s Sheer White! System Teeth Whitening , described as the world’s first in-office teeth whitening strips with one-minute chair time, are offered through exclusive distribution partner, Henry Schein, Inc. The strips are uniquely designed with CAO’s Comfort Fit Technology™ and require no soft tissue retraction or isolation. The dental professional simply takes one minute of chair time to apply the strips to the patient and then sends them on their way to wear for 30 minutes. Additionally, Sheer White! Take-Home personal treatment kits are available.  

Dr. Michael Koceja of Columbia Family Dentistry has been using CAO Group's Sheer White! whitening pretty much since he opened his practice about four or five years ago. The big reason he likes Sheer White! is because all the past strip whiteners didn’t stick to the teeth. After a few minutes you’re chewing them around and spitting them out. They became irritating to wear, so people just didn’t wear them.

“Everybody wants whiter teeth; we can help our patients with that.”

	When Dr. Lawrence W. Kolar was in the market for a new electric handpiece, his needs were twofold: He was looking for more torque but less vibration than the current model he was using.  

	After a one-week trial run with the new KaVo MASTERmatic M25L (1:5) and the KaVo MASTERmatic M05 L mini (1:5) models, he was convinced. Only a week later at the ADA annual meeting, Dr. Kolar went straight to the KaVo booth and placed an order for seven handpieces. Here, he tells us why:

	What was your initial assessment of the handpieces?

	My first reaction was that there must be something wrong with the handpieces because there was such a low sound when I turned them on! I assumed they were running at a much reduced RPM than the old electrics that I then had been using. To my surprise, the dental unit indicated that the handpiece was running at the proper speed. 

	When I used some carbide fissure burs and diamond crown preparation burs on some extracted teeth that I had, I was amazed at the rapid rate that the handpieces could cut, with minimal noise, minimal vibration and a smoother cutting surface. It was hard for me to believe that anything with that power could operate so smoothly and also be relatively lightweight and possess a relatively small head. The balance of the handpiece in my hand was remarkable. 

	I think that when purchasing handpieces, it is best to look at more than cutting power, but the cutting power is what surprised and pleased me the most on the new KaVo models.  That said, “uncontrolled power” is useless, so I have to point out that it was the combination of power, complemented with the smoothness, quiet operation, lack of noticeable vibration and the balance in my hand that sold me on KaVo.  It was the package of all the aforementioned attributes that made KaVo the most logical choice for me.  

	Many times, [dentists] purchase “must-have” equipment that later does not live up to our expectations. This buyer’s remorse often times makes us reluctant to make further purchases of other, needed equipment. However, in the case of my KaVo purchases, I have experienced absolutely no buyer’s remorse. Indeed, I intend on purchasing additional KaVo handpieces (both the M25L 1:5 models, plus the slow speed electric attachments, which I also own). The performance of these handpieces is superior to anything that I have ever owned or tried.

	I have pointed out my new purchases to my patients. I mention to them that I always update my practice with new, improved equipment and materials, so I point out the handpieces and the fact that they are smoother, quieter and have very little vibration. Numerous patients have responded that based upon their own past experiences in my office, that the new KaVo models are quieter and smoother. Believe me, people are much happier with this type of experience and they tell me so!

	Why would you recommend this product to colleagues? 

	I have recommended the KaVo M25L (and even the M05L for dentists who have lots of [pediatric] patients, or for dentists that want the minimum head size without sacrificing power). My recommendations are always based upon my experience with the KaVo handpieces, plus my experiences with other brands. I tell them the truth. In my experiences, the KaVo M25L is the best dental handpiece available on the market. 

For more information about the KaVo M25L or any other KaVo handpiece, call 888-ASK-KAVO or visit 

Dr. Lawrence W. Kolar tells Dental Products Report about his experience using KaVo MASTERmatic handpieces.

Why this handpiece was a game-changer for one practice

	Hal Stewart, DDS, and his dental assistant, Anne Armstrong, have found Uveneer to be a welcome addition to his Flower Mound, Texas dental practice. 

	They use Uveneer-a dentist-designed innovative system that creates contoured and polished composite veneers-for a variety of procedures, and quickly came to appreciate the user-friendly and time-saving advantages offered by the state-of-the-art technology.

	As a key opinion leader, I was sent a Uveneer kit by Ultradent. This was in the summer of 2015. When I reviewed the kit and the accompanying video, Uveneer made sense for my practice.

More on Uveneer: Uveneer allows dentists to create permanent composite veneers

What results have you experienced from using Uveneer?

	Quick, predictable tooth form and an unmatched polished surface. 

	When doing direct resin veneers, creating the form and then getting a great final polish are both challenging and time-consuming for the average dentist. Uveneer helps the dentist save chair time and create predictable and beautiful esthetics.

	My patients have been very pleased that I can offer a major esthetic procedure at a fee that is affordable for them. Patients are really pleased not only with the esthetics but with the shorter appointment times. And Uveneer is profitable for my practice even though I can charge significantly less than what I would charge for a porcelain veneer.

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Dental assistant Anne Armstrong on using Uveneer: 

	When we’re doing a procedure and something comes up such as a Class V restoration, it just makes a very user-friendly and convenient way to restore that problem and take care of that issue. 

	It’s very easy to get out and have it accessible. It doesn’t even have to be out on the counter, and Dr. Stewart can say, “Let’s do Uveneer on this,” and I can go directly to get that little box. It’s just so user-friendly. The other composite-restoring kits we’ve used before have a few different pieces, but this is just the one basic kit and your composite instruments. It’s been so easy to learn and easy to work with. 

	It is easier on the patients because Uveneer makes the whole procedure go easier and faster. The patients are happy they are getting in and out quicker. Seeing them leave happy with the results-that’s the best thing right there.

	There’s always an emergency here or there, so it’s nice to have that extra 45 minutes that you save by using Uveneer. That saved time may allow us to fit in more patient time. Or it gives Dr. Stewart more time with that patient alone so he can address something else with their dental care. 

What are some other advantages Uveneer offers?

	I love how there is less tooth enamel destruction while using it. You don’t have to pick away as much tooth enamel. It’s predictable-the outcome is going to be what we expected. It’s been great. I’ve really been impressed with it.

Why one practices uses Uveneer-a dentist-designed innovative system that creates contoured and polished composite veneers-for a variety of procedures, and quickly came to appreciate the user-friendly and time-saving advantages offered by the state-of-the-art technology.

How user-friendly Uveneer saves one practitioner time and energy

Operating a successful dental practice often means finding a balance between doing quality work in an efficient manner and not sacrificing anything for the patient. Discovering where that balance lies often depends on what part of the United States your practice resides. 

At Bizga Dental, Inc., in Parma, Ohio, a suburb of Cleveland, Dr. Timothy M. Bizga realized he can’t bill patients on an hourly basis like his colleagues in places such as Chicago or California. So for him, it’s all about being as efficient as possible.

Completing Class II restorations in an efficient manner without sacrificing quality

You want to be able to price yourself where you’re still affordable and everybody wins. Patients get quality and you get a reasonable return for your time investment,” Dr. Bizga said.

 Use SureFil SDR flow  bulk fill flowable

Six years ago, Dr. Bizga began using SureFil SDR flow material on restorations and knew right away this was the perfect flowable for his practice. The material eliminated many of the incremental stages to restorations that were necessary in the past to minimize polymerization stress. 

SureFil SDR flow is a self-leveling, highly adaptive flowable composite that can be used in bulk fill applications. That allows users to put up to 4mm of composite at a time rather than the 2mm or less that is necessary with traditional flowable and composite restorations. 

“It really takes on the shape of the preparation without having to manipulate it. You express this material into the preparation you’re filling, and it just flows and fills and adapts very well so you don’t have voids or pockets,” Dr. Bizga said.

Dr. Bizga said he’s not able to charge what some dentists can in other parts of the country for restorations or other dental work because his patients in the Cleveland region can’t support those costs. Insurance companies also dictate the amounts they’ll allow patients to receive for dental procedures. 

o finding SureFil SDR flow material was a huge boon to his business. He found he was able to maximize his time and profit by using the flowable for quadrant restorations, meaning he could do three fillings in an hour at a reasonable fee, again, without sacrificing quality.

	“When I started using it, I realized how much time I was wasting in doing restorations with the traditional methods you’re taught in school. I’m able to do more steps in less time but get the same results. You’re able to give the patient something that is quicker, but not inferior.”

	It didn’t take long for Dr. Bizga to realize SureFil SDR flow material was for him. He began using it six years ago and hasn’t looked back.

	“I’ve never wavered on it. Sometimes you waver on products. It comes out, then you find something else that is better so you switch. I’ve never switched off this because I’ve never found anything better,” Dr. Bizga said. “It’s a win-win for you and the patient."

Timothy M. Bizga, DDS, is a general dentist practicing in Cleveland, Ohio. His practice focuses on comprehensive care with Dr. Bizga’s special interests in implants, cosmetics and facial esthetics. His background in dentistry is lengthy and diverse. Once a former chairside assistant, he also worked as a dental lab technician, making his perspective unique among others in the field of dentistry. He graduated from Saint Louis University with a bachelor’s degree in biology before receiving his DDS from the University of Michigan School of Dentistry, at which time he was the recipient of the Francis B. Vedder award for excellence in prosthodontics. 

	Dr. Timothy Bizga uses DENTSPLY Caulk's material to perform Class II restorations in an efficient manner.

How SureFil SDR flow can solve problems

 at his practice in Bolingbrook, Ill. more than a year and a half ago and has been very pleased with the many positive results his team and patients have experienced.

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How did you learn about TPH Spectra and when did you begin using it?

I was part of the initial evaluation before it even got to market, so I’m a little different in that respect. It took one try for me to like it. The product I had been using had a nice consistency, but when I started using TPH, it gave me the same kind of feel as I was using before but it was a better shade match. I found I didn’t have to do all of the things you have to do with the regular composites. The two viscosities of the material gives me the ability to work either in the posterior or the anterior of the mouth, so it is very versatile.

What types of results has TPH Spectra delivered for you?

The results have really been wonderful, whether you’re talking about the anterior or the posterior, because it’s cosmetically fantastic. I don’t have to layer, so it’s quicker. The color-matching is excellent in the anterior and the posterior. The wear has been fantastic. I’ve been using it a while so I’ve been able to see that. The manageability and consistency of the material is awesome. I don’t have to struggle to get it in.

What makes TPH Spectra special to you and your team?

The optics they’ve developed make it really special because of the blending into the natural enamel. Before I’d need a bunch of different shades for the composites because I would need to layer it. Now I just need one or two different shades and I can pretty much match all of the different shades that I need. So whether I’m working in the back or the front, I don’t need a lot of materials or a lot of shades like I did with other systems to worry about matching up shades. I don’t have to layer it.

Compared to the other composites we have used, TPH Spectra is very easy to shade match. I don’t need to keep track of seven or eight different shades. We use about three shades 95 percent of the time. Also, because Dr. Simos is not spending as much time layering the composite to match the shade, on front teeth, like other composites, the procedure always seems to go faster with TPH Spectra. The shades always seem to match without much hassle and the finished polished filling looks as natural as the other teeth.

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From a patient’s perspective, it’s effortless, it’s much more predictable because they see the better results. People seem to be responding pretty favorably. They notice a big difference when the chair time is going from an hour to 20 minutes. They see the difference in the work, too, because noticeably the optics of this material is so much better than what I’ve ever used before. It polishes up really nice. It blends into the natural tooth really well. And the patients notice that. They don’t see a line in their front tooth and they don’t see a discrepancy in the shade. I think just the predictability [is great].

I do a lot of cosmetic dentistry, so I deal a lot with the front teeth for people. One thing I deal with a lot is the front teeth that are chipped off and they’ve been to other dentists. When I do the procedure, patients all seem to say the same thing: “Gosh this looks so much better.” And: “The other guy seemed to have more trouble with what they were doing.” So it’s a technique that is noticeable with the patients because you don’t have to struggle to layer these materials and struggle to get the right shade match.
	

TPH Spectra is part of Dentsply Caulk’s Class II Solution, which includes The Palodent®  Plus Sectional Matrix System, Prime&Bond Elect® Universal Dental Adhesive, Enhance® Finishers, and SureFil® SDR® flow Bulk Fill Flowable Base.

TPH Spectra has been a trusted brand for decades

For 20 years, Dentsply Caulk’s TPH brand has been a name dentists know and trust.

In 2004, Dentsply Caulk released TPH 3 and even though it was a clinically proven, high-quality product, they knew they’d need to update the formula if they wanted to continue to meet their customers’ changing needs. That update is the new TPH Spectra Universal Composite.
	
Dentsply Caulk is a well-known, trusted company in the dental industry and TPH is among Caulk’s trusted brands. Many dentists are already familiar with the TPH name, and know it’s a long-standing, reliable, high-quality brand in the industry. TPH Spectra offers dentists both high and low viscosity options, easy handling and simplified shading-exactly what dentists told the team at Dentsply Caulk they wanted in a composite. Dr. Qizhou Dai, a Caulk chemist who was interviewed by DPR earlier this year, is proud to have formulated TPH Spectra and enjoys hearing how much dentists love it.

“TPH is a classic product. It has been on the market for many years, is clinically proven and gives assurance of quality and performance,” he said. “Basically, in their office, dentists have to accumulate multiple different brands of products for shading and handling. With TPH Spectra, we simplify it. Dentists only need limited shades to cover the whole shade spectrum, and you choose the handling you like. You can use low or high viscosity with TPH Spectra. It gives you options.”

On-Demand Webinar: Learn how to prescribe highly esthetic partial and complete dentures

A quick look at how TPH Spectra delivers great outcomes

Figure 1: Tooth No. 4 after an initial layer of SureFil® SDR® flow

TPH Spectra Universal Composite is based on the resin

of TPH3 and contains nanohybrid- and micro-filler components. The result is a composite that has the potential to perform well in either the anterior or posterior, and should have tooth-like translucency, improved polishability and stain resistance, and good wear resistance. TPH Spectra also comes in two handling choices: a creamy light-viscosity formulation, and a packable high-viscosity formulation. For both viscosities, the physical properties are similar.  

Figure 2: Placement of TPH Spectra™ HV composite, shade A2

In order to make shade selection simpler, TPH Spectra is available in the seven most popular shades: B1, A1, A2, A3, A3.5, A4, and C2. According to DENTSPLY’s internal data, the seven shades of TPH Spectra represent more than 80% of total sales from the previous TPH3 formulation.   

Figure 3: After placement and curing of the final layer of TPH Spectra™ HV composite, Shade A2

Figure 4: The final restoration after finishing and polishing
	 

Reducing the number of TPH Spectra shades is possible because the composite offers excellent color blending between restorative materials and natural tooth, often called, “the chameleon effect.” Again, building and improving from the previous TPH3 composite formulation, TPH Spectra has a refractive index that falls directly between enamel (1.63) and dentin (1.54). Because of TPH Spectra’s excellent translucent properties and an appropriate refractive index similar to natural tooth structure, it will have an excellent chameleon effect and create restorations that are unable to be detected.

Figure 5: The final restoration on Tooth No. 4 at a 2-year follow-up.

This article originally appeared in the June 2014 issue of Dental Products Report. For articles about other great products in action, 

 Dr. Sam Simos began using TPH Spectra at his practice in Bolingbrook, Ill. more than a year and a half ago and has been very pleased with the many positive results his team and patients have experienced.