Renee Knight is a freelance writer and editor who's been covering the dental industry for 15 years. 

Renee Knight

	Earlier this year, Dr. Alan Young decided to make the switch to Mr. Thirsty One-Step from Zirc. He saw the product at the CDA meeting in Anaheim, California and knew it was something he wanted to incorporate into his periodontal practice in Garden Grove, California.

	Before he found Mr. Thirsty One-Step, Dr. Young used an isolation device that required a proprietary hose and came as sterilizable units that were actually pretty difficult to sterilize--two challenges he doesn’t have to worry about with Mr. Thirsty One-Step. This is a disposable, hands-free isolation device that requires no maintenance and can be used with his existing hosing and HVE system.

Related reading: Zirc - The 2016 Innovator Profiles

	What Dr. Young has to say about Mr. Thirsty One-Step

	This device keeps the field dry without additional suction and just does a good job. The mouth block helps patients maintain their position and can be adjusted--which is one of the best things about Mr. Thirsty One-Step. You’re basically using one unit for each patient, so if you need to adjust it you can. It’s disposable, so you’re just going to throw it away any way. I’d also have to throw the other unit away if I made adjustments, but that unit wasn’t disposable.
	
	

 offers tongue retraction, cheek retraction and suction, all in one unit, so you’re not pulling on the patient’s cheek as much. It’s more of a gentle motion. The bite block gives you access, so you don’t need to worry about patients closing and it offers constant suction. Even with saliva ejectors you can miss and have to adjust. So it’s inexpensive, disposable and uses your existing hose and equipment.

 One-Step makes you more efficient and, if used in the right way, it can free up the assistant’s job to suction or to retract. Mr. Thirsty eliminates that because it does the retraction and the vacuuming for you. My assistant likes it because if I’m using it, she doesn’t have to do half the things I usually need her to do. There’s always something that can be done in the dental office, and this frees up the assistant for other tasks.

	This product also offers a big benefit for hygienists. This is a wonderful product for them. Most hygienists don’t have an assistant, so Mr. Thirsty One-Step makes their job easier. They have visibility. They have suction. They can use it for root planing and don’t have to keep asking the patient to stay open.

	Cost is the main benefit, and I also like the fact that it’s disposable. Another big selling point is the ability to use existing high-speed tubing, which wasn’t the case with the product I used before. It’s a really good, inexpensive, reliable aid that frees up your assistant and gives you access and a clean field.  

	This device retracts, isolates and evacuates while providing an unobstructed field, creating the ideal intraoral work environment. Hands-free isolation means you don’t need to stop repeatedly to use the saliva ejector. With the time savings, users have the freedom to perform additional tasks, increasing efficiency and productivity. Mr. Thirsty One-Step has two sizes and is 100-percent disposable, eliminating any post-procedure processing. Mr. Thirsty One-Step acts as a shield to the airway. The bite block allows the jaw to rest while keeping the mouth open.

Articles

Before he found Mr. Thirsty One-Step, Dr. Alan Young used an isolation device that required a proprietary hose and came as sterilizable units that were actually pretty difficult to sterilize--two challenges he doesn’t have to worry about with Mr. Thirsty One-Step. This is a disposable, hands-free isolation device that requires no maintenance and can be used with his existing hosing and HVE system.

I Use That: Mr. Thirsty One-Step from Zirc

	Dr. Barrie Matthews decided it was time to invest in a CAD/CAM system in 2011. He knew CAD/CAM was changing the game in dentistry, and he wanted his practice, Big Sky Smile Center, in rural Montana to be part of it.

 system and has one in his office in southeastern Montana and his recently opened office in northeastern Montana.

What Dr. Matthews says about Planmeca FIT System

 where farming and ranching is our backbone. As a result, I have patients who travel 150 miles one way just to see us, sometimes with very little advanced notice and with limited time, so I don’t want to send their crown(s) off to the lab and temporize when they can get a clinically superior result from my Planmeca FIT System. We really value their time and their schedule; temporizing creates more of a time commitment in their already limited schedules. I don’t have a lab down the street I can work with that will give me a quick turn-around time, so a CAD/CAM system is a necessity to providing the care our patients deserve and desire. 

Related reading: Unpacking the differences between intraoral scanning options

	The Planmeca FIT offers unsurpassed benefits in comparison to a traditional lab-fabricated crown. My patients get same-day crowns-no bulky, ugly temporary crown to deal with, no time spent waiting on a lab, no need for a second visit (which is especially important to my farming and ranching patients), and no questioning the outcome of the final lab-fabricated crown. My patients, within a few hours, have a crown that is not only perfectly customized for the perfect fit, feel and look, but the lithium disilicate crown they receive is also so much stronger than a PFM and the clinical results are unparalleled with a predictable, consistent, and stunning outcome. To have full control of the outcome is a very powerful clinical tool. 

 is constant training. If you don’t make sure your team members immerse themselves in it, every day, you will fail the technology and you will fail your patients. I’ve seen it happen on more than one occasion. Dentists invest in a $100,000 machine they never use, or can’t use because they don’t understand and their team doesn’t understand all it’s capable of. We use ours every day. If you’re doing 12 to 15 crowns a month you’re going to get ROI almost immediately, and I do 30 to 50. 

What dental assistant Kristi Certain says about Planmeca FIT

	I love that we can give patients same-day care; it’s more convenient. It means they don’t have to take an additional day off of work, find a second babysitter or travel to come back to get their crown permanently cemented on. 

	Planmeca FIT gives me the ability to be artistic in ways I never imagined possible. I don’t think I could go back to making temporary crowns, nor would I want to. The Planmeca FIT enables us to provide our patients with service and clinical results that are above and beyond the standard. 

Cover story: Are digital impressions REALLY better than traditional?

	The software is very easy to use, regardless of your computer skills. Following the steps Planmeca provided for us, we can easily manage even the most complicated cases. 

	My favorite cases are the multi-unit anterior crowns. We recently had a patient who needed multiple posterior and anterior crowns due to recurrent decay. After talking to her one-on-one, I found out she has always hated her smile; she has crowding, well-water staining and old discolored restorations. We treatment planned the restoration of her maxillary arch with our same-day crowns. She was blown away with the outcome; it was amazing and life changing for her.  

For more information about the Planmeca FIT system, contact Planmeca USA by calling 630-529-2300 or by visiting 

Dental Products Report talks to Dr. Barrie Matthews, a dentist in Montana, about his experience using the Planmeca FIT CAD/CAM system in his pracitce.

How chairside CAD/CAM can provide the care that patients deserve

	Dr. Daniel Brunner incorporated the 3Shape TRIOS 3 intraoral scanner into his practice about six months ago, in early 2016. He wanted a machine that could do full-arch impressions in a short amount of time without any powders or materials.

	After researching other options, Dr. Brunner, of East Cobb Oral Surgery in Marietta, Georgia, decided the 

 was the best fit. Here, he tells us why, while Michael Gaisinsky, MCenter USA Chief Operating Manager and one of Dr. Brunner’s lab contacts, talks about the benefits from the lab perspective.

Related reading: How to scan with ease and simplicity

	What Dr. Brunner says about the 3Shape TRIOS 3

	It’s very simple to operate the TRIOS 3 and to acquire images. I like the color and being able to visualize the teeth and soft tissue. It gives me the ability to take shade guides and high-definition, high-resolution pictures that I can send to the lab. There really are a lot of advantages for my practice.

	This technology is also great for my patients. Most patients don’t like to have impression material in their mouth because it causes them to gag. It can even make some patients feel claustrophobic. And, of course, if you don’t capture a good impression on the first try, you have to redo it. Taking a digital impression is much more convenient for my patients and it also gives the practice a more modern feel. Everyone knows about digital technology today, so whenever you can incorporate that into your practice it gives you a different level of expertise.

	After I take a scan, a lot of patients tell me it’s the best impression they’ve ever had. I get a lot of comments about the cleanliness and the simplicity. Patients also like it when we show them the impression on the screen. They can see what their teeth look like and we can point out other problems like staining or decay. It’s a good teaching tool.

	The scanner also simplifies lab communication. It’s instantaneous, so I get feedback from my labs right away if I have questions about a case, and I can make notes right in the software.

has been a really great practice builder. Once you switch to digital impressions, it’s going to seem more antiquated to take PVS (polyvinyl siloxanes) or alginate impressions. Obviously there’s an expense up front but you don’t have the recurring material costs and it saves on storage space.
	I also use the [scanner] in conjunction with my CT scanner. I can virtually plan an entire case with my patients so they can see what the restoration is going to look like before we even start the procedure.

Related reading: Monitoring patient oral health with TRIOS

	What Michael Gaisinsky says about the TRIOS 3

	The main benefit is speed. There is almost no waiting time between when the doctor sends the digital impression and when I receive it [and can start designing the case]. I immediately receive it on my computer.  

After researching other options, Dr. Daniel Brunner, of East Cobb Oral Surgery in Marietta, Georgia, decided the TRIOS 3 was the best fit. Here, he tells us why, while Michael Gaisinsky, MCenter USA Chief Operating Manager and one of Dr. Brunner’s lab contacts, talks about the benefits from the lab perspective.

How the TRIOS 3 intraoral scanner serves as a practice builder

	Dr. Lou Graham first started using Kerr Dental’s Maxcem Elite Chroma in his Chicago practice earlier this year. Already he’s experienced the benefits this next generation self-etch/self-adhesive resin cement can bring, from its color cleanup indicator to its one-peel cleanup. 

What Dr. Graham says about Maxcem Elite Chroma 

	When a dentist needs additional retention for less retentive preps, resin cements are routinely required and poise the issue of isolation and clean-up. All too often the window of clean-up is short and dentists remove the excess cement as fast as they can.  The fear is leaving excess cement, which leads to a plethora of problems. An equal problem is removing the cement too early, because if bleeding occurs (and it often does) or gingival crevicular fluid is present, both circumstances lead to instant micro-leakage. 

	Multiple manufacturers have identified this problem. Kerr, as one example, has launched Maxcem Elite Chroma, which has a unique approach to resin cement removal.  Like other companies that have created a larger window of time for cement removal along with easier cements to remove, this particular product has a color change that indicates when it’s “safe” to remove the cement. 

Related reading: A review of Kerr Restoratives' Maxcem Elite Chroma

	When the dentist “loads” the crown with the cement it dispenses pink. As it sets, it turns white. This is the beauty of this cement. Imagine you have inserted the crown. Your option is to wait and watch it self-cure and as it does so, it turns white. That is the “safe” signal to begin cleanup. It occurs between one to two minutes, giving you a 45-second clean-up window. The cement then peels away.; simply insert a double knotted piece of floss and clean interproximally.

	When tack curing, if you use a light that’s weak or you are too far from the cement, it might not be cured enough. If the light is too strong it might cure too fast. With this cement, if you finish a two-second cure and the cement is still pink, you know it’s safe to cure a few more seconds. If the cement has already turned white, you know to stop curing. When the transition of pink to white occurs, it’s time to begin clean-up. 

	This is a self-adhesive resin cement, so per the manufacturer, you don’t need to use a bonding agent on the tooth. Do I use silane internally on my dilithium crowns? Yes, and though it’s optional to use zirconia primers when cementing zirconia crowns, I prefer to do so. Is proper cleaning of the internal surfaces of the crowns important?  Of course.

	The only time you would ever etch is when you are cementing to enamel margins. In that case you would selective etch for 15 seconds, rinse, suction dry and then place your crown with Maxcem Elite Chroma. 

	There is no question ease of use is the main benefit. A color shift that guides you to “safe” removal and the fact it can be tack or self-cured with a large removal time that allows easy peel off makes this resin cement a wonderful new addition in our practice. And this material is not runny; it has an excellent consistency that allows complete seating .

	For the patient, resin cementation was always a challenge because they’d usually need to be numb. Since using the product, I have not required anesthesia. Patients love this. For me, this a huge benefit because after the five-minute full set, I can confirm the occlusion one last time and if any minor adjustment is required, it’s a simple task.

Related reading: Kerr Restoratives launches Maxcem Elite Chroma

	Maxcem Elite Chroma is said to be the first self-etch/self-adhesive resin cement offering a color cleanup indicator, and also offers One-Peel™ cleanup, automix delivery system, easy no-refrigeration storage and compatibility with all indirect restorations. Maxcem Elite Chroma is said to form a strong and durable bond with a wide variety of dental substrates and is compatible with all indirect restorations: anterior or posterior ceramics, PFMs, metal restorations and CAD/CAM materials. Radiopaque for easy identification on X-rays, the cement is available in a dual-barrel, automix syringe system supplied with single-use automix tips and optional curved dispensing tips designed to allow the user to deliver the desired volume of cement directly into restoration and/or tooth preparations.

One practitioner shares his experience with Kerr Dental's self-etch/self-adhesive resin cement.

I Use That: Mexcem Elita Chroma

	The team at Mint Hill Dentistry is committed to providing patients with the most beautiful restorations and the best care possible. That’s why they’ve used VOCO products in their practice for more than 12 years. 

 is extensive, and includes Amaris, GrandioSO, Quick Up, 

	Owner Dr. Earle Sullivan reports great results from using Futurabond U. 

Futurabond U is an all-purpose bonding agent that can be used for almost any type of restoration,” he said. “The bonding agent is packaged in individual single-use packets, which ensures ‘fresh chemistry’ every time. Over the years we’ve noticed that we virtually never have post-operative sensitivity after composite restorations, which we attribute to Futurabond U.”

Related reading: How to complete a direct restoration with VOCO's Futurabond U [VIDEO]

	Dr. David Sullivan, Earle’s son, believes turning to trusted products helps ensure the practice’s quality of care. “VOCO makes high-quality products that are backed by extensive research,” he said. “The main benefit to our practice is knowing we are using some of the best materials available from a top notch company that cares about quality and research.”

	Here’s a look at why Drs. David Sullivan, Earle Sullivan, John Burd, Taso Roupas and dental assistants Carly Grinolds and Nhia Vang trust VOCO, and how these products have benefited their patients and their practice. 

What the doctors say about VOCO products: 

Dr. Taso Roupas on Amaris, a highly esthetic light-curing composite

“Amaris is an excellent esthetic composite system when working on anterior teeth. It allows the restoration to naturally blend in with the shade of the patient’s own enamel and dentin.”

Related reading: How to ensure a successful bond with Futurabond DC

Dr. Earle Sullivan on VOCO’s Universal nano-hybrid restorative

“GrandioSO is an excellent composite for all indications.” 

	VOCO’s Quick Up tissue colored implant pick-up system features a new Quick Up method. It is indicated for a variety of uses, including as a self-cured composite luting material for attachments, such as ball, Locator

 and telescopic anchors in full and partial dentures.

	Dr. David Sullivan likes how fast and easy the product works in the practice. “Quick Up is an excellent way to cure precision attachments or implant attachments into dentures. It is much easier and faster to use than traditional acrylic.”

More from VOCO: How to directly fabricate provisionals with Amaris Gingiva from VOCO America

	Rebilda DC is a dual-cured core build-up composite in an automix delivery system and is yet another VOCO product used regularly at Mint Hill Dentistry. Dr. John Burd has great success with the product. “Rebilda is an excellent core buildup agent. We never have core buildups debond,” Dr. Burd said.

	“The patients are always pleased with the esthetics. It’s very common after doing a filling on a patient’s front tooth for that patient to say, ‘Wow, it looks just like it did before!’” Dr. Roupas said. “VOCO composites allow for natural looking esthetic restorations, which is something our patients notice and appreciate. Our team members also love working with these VOCO products. They’re all easy to use. The packaging is well designed and allows for easy and efficient manipulation of materials for both the assistant and the doctor.

Related reading: Futurabond U by VOCO offers single dose delivery for all adhesive procedures

	“We would all encourage other dentists to use these products from VOCO because of their quality, ease of use and esthetic results. They’re also well researched, which is important to us.”

	Dr. Earle Sullivan added, “These materials are straight forward to use and easy to handle. Not only that, the company has been excellent to work with over the years.”

Dental assistant Carly Grinolds on using Futurabond U:

“FuturaBond is easy to use because you simply squeeze the packaging to mix it and it’s ready to go. I like that it’s single use and disposable. This is much easier to use than getting multiple bottles and mixing drops in a dish!”

What dental assistant Nhia Vang says about QuickUp: 

“I really like the Quick Up material compared to traditional acrylic for picking up locator and ERA attachments. It’s easier to clean up and faster to use. I also like the bonding agent we use… it has everything all in one

The team at Mint Hill Dentistry is committed to providing patients with the most beautiful restorations and the best care possible. That’s why they’ve used VOCO products in their practice for more than 12 years.

Easy-to-use VOCO materials allow for natural-looking esthetics

 first began using Komet USA’s F360 NiTi endodontic file system about two years ago.

	Back then, he had the opportunity to test the two-file system and give 

 his feedback. He was thrilled with the results, and he has been using the files in his Germantown, Wisc., practice ever since. He also uses Komet’s PathGlider mechanical file.

	Here, Dr. Joseph deGuzman and his office manager, Lisa Piering, outline how the PathGlider and the F360 NiTi endodontic file system make their jobs easier while also benefiting their patients.

What Dr. deGuzman has to say about the PathGlider and the F360 NiTi endodontic file system:

	The PathGlider provides a very easy way of creating the glide path. Creating the glide path so you can use the other files is one of the most important elements of a successful root canal preparation.

	There’s no question the PathGlider makes me more efficient. It’s just quicker. It also cuts really well.

	Once you have the glide path, you can easily transition to the F360 files to finish the canal preparation. This system is very efficient. The two-file system allows me to get the adaptable size very quickly, and it’s very easy to use.

	These files probably cut my cleaning and shaping time in half. They cut very well, they still retain the shape of the canal and they transition from file to file very efficiently. You can get to the optimal size you want, which is 35, very quickly and with fewer files than normal.

	You can’t get passive movement of the cleansing solution until you reach 35. It gets you where you really want to be with the size of your apex with very few files quickly and efficiently.

	These files also offer benefits to our patients because they result in less chairtime. The cleaning and shaping process is just so much quicker. I don’t think a lot of patients really know what goes on during a root canal preparation, but some of my patients have commented on how quickly it was over.

	I tested the files in my practice for about six months, and the only thing I could comment on was how efficient they were. From that point on, they’ve been part of my armamentarium. I even began to leave post-cleaning and shaping solution in the space longer because I was done so much faster than before. The files are very efficient and just really save you a lot of time.  They get you to the ideal size you absolutely need at the apex of your canal space to ensure cleansing.

What Office Manager Lisa Piering has to say about the F360 NiTi endodontic files:

	I like that there are fewer files. The F360 NiTi endodontic files are efficient and save us a lot of time. Because it’s a two-file system, we also have fewer files to stock and to keep around.

	The files also benefit our patients because they reduce open-mouth time. 

	F360™ single-use endodontic files offer root-canal preparation with two files, allowing for increased cutting efficiency due to the Double-S™ file design. Sharp cutting angles and large chip space are said to ensure the removal of debris, significantly reducing preparation times. Files can be used for most root canal anatomies, while the single-use instruments reduce risk of fracture due to cyclic fatigue and eliminate cross-contamination risks.

Back then, he had the opportunity to test the two-file system and give Komet his feedback. He was thrilled with the results, and he has been using the files in his Germantown, Wisc., practice ever since. He also uses Komet’s PathGlider mechanical file.

I Use That: Komet USA’s PathGlider™ and F360® NiTi endodontic file system help ensure successful root canals

	The dental office is no place to show your undergarments.

Sounds like common sense, but recently a reader wrote on 

 that she was dealing with just that problem. It’s not uncommon for her to see what type and what color underwear one of the practice’s young hygienists is wearing, something she finds a bit unprofessional.

This post prompted us to seek out some advice. What is and what isn’t appropriate for the dental office? What type of dress code policy should practices have on hand? What should be done when a team member doesn’t adhere to the policy? Here’s what we found out.

Trending article: How to handle team members who have a verbal confrontation

No matter how big or small your practice, you need a dress code.

 Some small practices opt not to have a dress code, but that is a mistake, said Penny Reed Limoli, owner of the 

. No matter how small your office is, you’re not immune to someone coming into the practice with something you, and likely your patients, deem inappropriate. It’s best to have a policy from the beginning, so your employees know how they’re expected to look when they walk into the practice.  

This policy should be in writing and be part of the office personnel manual, Image expert 

 said. All potential hires should have the chance to read the policies before they accept the job. The dress code should outline clothing and personal care expectations, with photos included to show employees the best way to wear their uniforms.

“The biggest mistake that doctors make is to either think their team members professional appearance will never be a problem or to lead from a position of weakness – afraid that their team members will be upset with them if they are told specifically what is acceptable and what is not,” Hurley-Trailor said.  “My experience in this area is just the opposite.  Having very specific dress code guidelines and enforcing them consistently leads to team pride and reduces the inner friction that occurs when everyone is left to make this important business decision on their own. “

Remember, new patients determine very quickly if your office is for them, Hurley-Trailor, said. This is based on an emotional response they get when they meet the dentist and the team for the first time, so that first impression better be good.

 If you don’t already have a policy, this is a great time to create one, especially if a team member has brought a problem to your attention, Limoli said. If a team member notices a problem, chances are your patients have noticed it as well.  The office manager and practice owners should sit down together to hammer out a dress code. Feel free to share initial thoughts with team members and ask for their input, but make sure they understand their suggestions may not make the cut. Some team members may think it’s perfectly OK to wear eyebrow piercings in the dental practice, when the practice owners do not.

“This whole topic has to fall under the umbrella of patient expectations,” Limoli said. “We have to put ourselves in the position of what do I expect when I go into a practice. I’ve been in the industry almost 20 years and it’s more competitive than I’ve ever seen it, and I would do everything I could to make the best impression on patients when they come into the office. Most people still aren’t comfortable in a dental office. The reception area has to be neat and clean and so does the team, and that includes the doctor.”

Trending article: 3 steps to legal, humane employee termination in the dental practice

 Even if it seems like common sense to you, if a certain type of dress could lead to a potential problem you should included it in the dress code. Here are examples of items Limoli said you should include in your office dress code:

		Scrubs should not be wrinkled or stained.

		Employees should not smell of cigarette smoke or wear too much perfume.

		Appropriate undergarments should be worn, and that means underwear that doesn’t show through scrubs.

		No skin should be exposed while doing the job.

		Pants should be long enough to at least touch the top of the shoe.

		Remember the dress code should be very detailed, Hurley-Trailor said, and include all of your clothing and personal care expectations.

Related reading: Top tips for tats and piercings in the dental practice

  If you really want to convey professionalism in your practice, Limoli recommends looking into team uniforms. That means everybody wears the same color everyday, whether that’s navy blue or light blue every day or maybe different colors for different days of the week.  The doctor’s uniform should be a little different, maybe a different color scrub or include a lab coat, so it’s easy for patients to distinguish the doctor from the rest of the team.

“One of my clients has one of the best dress codes. If they’re going to wear a t-shirt under their scrub top, it must be white or navy because that’s what complements the scrubs. If a team member wants to wear something over a scrub shirt, they need to wear one of their lab jackets or team sweatshirts,” Limoli said. “It can be expensive getting that started, but it’s a marketing expense and it takes out of the equation what team members are going to wear.”

 Once you have a policy in place, you have to be consistent when it comes to enforcing it, Hurley-Trailor said. And you have to make sure you include repercussions for dress code violations in your dress code, so team members know what to expect if they come to work in something they know they shouldn’t be wearing.

“You absolutely cannot ignore infractions with one person and try to enforce those same guidelines with another,” she said. “ We take offense when we think we are being treated unfairly and that perception occurs when accountability is not handed out in an impartial manner.  There is a country song that says: “I hate the sin, not the sinner,” and that should be the way we approach implementing a dress code.  The focus is on NOT breaching the guidelines that say no dangly earrings by the clinical team, not getting upset with the person wearing those earrings.”

When a team member comes to you with concerns about another team member’s dress, you can’t ignore it, Hurley-Trailor said. Check to make sure that everything is clear in the written policy and if it isn’t, bring it up at the next team meeting.  Let the team know that maybe you haven’t been as clear as you should have been about your expectations. It’s important that you address the rules, not the individual, if your policies and enforcement have been lax. If you feel the expectations are clear, talk with the team member privately in your office.

Trending article: Can you send your dental employees home without pay? 

 How we dress in the work place matters, Hurley-Trailor said, with studies showing that personal actions are effected by how we’re dressed. Not only that, how we’re dressed changes how people treat us. This becomes even more important in a dental practice.

“Every day we are encouraging our patients to trust us and follow our clinical recommendations,” Hurley-Trailor said.  “When our patients see us in the very best light and treat us with respect, it encourages us to treat ourselves and our recommendations with confidence.”

 The dental office is no place to show your undergarments.

What are they wearing?

	As a pediatric dentist, he knows how important it is to teach children the value of maintaining their oral health from an early age-and to make visiting the dentist as stress-free and fun as possible. He wants his patients to enjoy their time at his practice, and to leave looking forward to their next visit. 

That’s why he’s created a fun, kid-focused environment in all of his practices, complete with video games in the waiting room and TVs in the operatory.

While Dr. Waggoner focuses on creating a fun, welcoming environment for his patients, he also knows the products he uses make a big difference in their overall experience. Before he invests in a new product, he thinks about how it will benefit the children he treats. He always has their best interest at heart, he said, which is why he switched to the ScanX from Air Techniques nearly 10 years ago. This digital system not only makes the imaging process more comfortable for his patients, it also provides him with high quality images in a matter of seconds.

For more on Dr. Waggoner’s experiences with using Air Techniques ScanX, watch the video below:

 As a pediatric dentist, he knows how important it is to teach children the value of maintaining their oral health from an early age-and to make visiting the dentist as stress-free and fun as possible. He wants his patients to enjoy their time at his practice, and to leave looking forward to their next visit. 

Find out how Air Techniques’ products helps one pediatric dentist make dentistry more comfortable for his patients

	As the population continues to age, more patients will turn to implants to replace missing teeth rather than ill-fitting dentures or partials. These patients are more educated about implants than ever before, and they’re excited about the possibilities they offer, from a more confident smile to the ability to eat with no pain or discomfort.

But there’s a lot you need to learn before you can successfully implement implants into your practice. Not only do you need the proper training, you need to stay up-to-date on the latest products and techniques designed to make implant placement more predictable and effective.

Once you dedicate the time necessary to hone your skills and obtain the knowledge you need to successfully place implants, you’ll not only be able to offer patients a service that improves their quality of life, this new skill will renew your passion for dentistry and increase your practice revenues.

To help you learn more about dental implants and the benefits they can bring your patients and your practice, we reached out to implant experts and asked them to answer a set of true/false questions. The experts offer insight into why these questions are true or false, and hit on a variety of implant-related topics from who should be placing implants, to how CBCT technology can improve diagnosis to the benefits of new cement-free solutions. The questions were submitted by 

DPR’s Chief Dental Editor Dr. John Flucke

Free on-demand webinar: Understanding medical billing and its relationship with 3D

Before reading the responses, take a look at the true/false questions and test your implant IQ. See how many questions you can answer correctly, then check out what the industry experts had to say.

-All GPs should be surgically placing implants.
	-Mini Dental Implants can be a great option for edentulous patients.
	-CBCT technology can help improve diagnosis and make treatment planning more predictable.
	- Cement-free solutions offer enhanced flexibility and reduce the risk associated with cement excess.
	- Maxillary anterior single-tooth implant restorations are easy and could be a good place to gain experience with dental implants.
	- Edentulous patients' first choice of care, if possible, may include an implant assisted 2-implant mandibular overdenture.
	- The proximity of an implant to a tooth or another implant is not important.
	- Implant crowns in the posterior always should be splinted if there is an adjacent implant present.
	- Every implant case should be done using a surgical guide.
	- Every implant case should be done with a 3D scan as part of the treatment planning process.
	- Implants can only be immediately loaded when splinted together in a full arch prosthesis.
	- Occlusion for an implant crown should be the same as that of a crown on a natural tooth.
	- Socket preservation has no effect on the eventual success of an implant and its prosthesis.
	- GPs don't really need much training to begin placing implants in their practices.
	- Mini implants are equivalent to larger root form implants in reliability and functionality.

Category Cruncher: The importance of implants

Continue to Page 2 to read what dental professionals had to say about the above statements ...

 All GPs should be surgically placing implants. False.  

Not all GPs should be placing implants. The only GPs that should place implants are those willing to put in the time and finances necessary to acquire the education and skills they need to place implants properly. You need special equipment, special knowledge and to dedicate a sufficient amount of time to get that knowledge and sharpen your skills to perform these procedures for your patients. It’s not something anybody can do. It takes a dedicated person.

Once you have the proper equipment and education, you also need to look at the nature of every case. Not all cases are the same. There’s a huge difference between placing an implant in an area that has sufficient height, width and bone, and treating someone with a severely resorbed jaw in need of reconstruction with a bone graph. You have to be honest with yourself and only perform cases within your skill level.

 Mini Dental Implants can be a great option for edentulous patients. True. 

Karen Capiz, U.S. Marketing Manager, Implants Portfolio, 

 are a great option for edentulous patients. As dentists know, edentulous patients often suffer from a loss of bone structure and ridge resorption in the jaw. With 3M ESPE MDIs, patients need just 4.8 mm of bone tissue width for successful integration, which is significantly less than the bone mass required for success with traditional implants.

Related reading: How the general practitioner has been critical to the future of implant dentistry

MDIs also can be placed much quicker than traditional implants and have a much shorter recovery time. Because MDIs are self-tapping, auto advancing and generally very narrow, dentists can often place them without cutting a flap or performing a bone graft. Placement can occur with the dentist simply drilling a small pilot hole to perforate the cortical bone and then screwing the implant into place.

With no need for a bone graft or time to allow osseointegration (MDIs are designed for stability in soft and dense bone), MDIs often can be loaded immediately after placement and require minimal to no recovery time, which is a significant benefit to patients and dentists – especially for the elderly or those with compromised health.

Many long-time edentulous patients have extremely ill-fitting dentures and a poor quality of life. In one day, this procedure offers immediate stabilization, allowing patients to resume normal eating habits and regain the confidence to speak and smile normally.

Cost is another consideration. MDIs can be a more affordable treatment path, and at times costs patients have as much as traditional implants.

It’s of course important to consider every patients’ individual needs to determine what options are best for their long-term health – but MDIs offer an affordable solution that requires less bone mass, a less invasive procedure and less recovery time, a combination that makes them a good treatment option for edentulous patients.

Related reading: How technology can simplify the placement of dental implants

Continue to Page 3 to further test your implant IQ  ...

CBCT technology can help improve diagnosis and make treatment planning more predictable. True.

With CBCT technology, I gain an added perspective into a patient’s specific dentition that allows me to achieve accuracy and to avoid potential surgical and restorative complications. The images support my ability to diagnose, plan and treat. Knowing the precise data on such aspects as buccolingual dimensions, concavities, bone height, and anatomical anomalies brings me great confidence before, during and after surgery.

, features software tools to help me proceed from surgically placing the implant and abutment to final restoration. I also can combine 3D images with intraoral scans for a comprehensive representation of the hard and soft tissues.

Not only does my i-CAT provide information that helps me establish diagnosis and implant placement plans, this imaging modality also offers many great benefits to my patients. The new Smart Scan Studio Simulator’s presentation option helps them better understand why I am choosing a certain path of treatment. Therefore, they may be more willing to accept my treatment plan, and be more compliant with my treatment recommendations.

With all of the advantages that i-CAT affords my implant practice, I would never consider going back to a 2D practice. I live in a 3D world now. 

Related reading: Highlighting narrow diameter overdenture implants

 Cement-free solutions offer enhanced flexibility and reduce the risk associated with cement excess. True.

Cemented implant restorations were introduced as a way to manage esthetics and occlusion when dealing with implant angulation issues. They also provided the team (dentist and technician) with techniques and processes they were familiar with, namely cement-retained restorations.

Tooth-supported cemented restoration have existed for more than 100 years with few, if any, related biological issues. However, the same cannot be said when it comes to the cemented implant restorations.

Cement excess can elicit adverse soft tissues responses ranging from inflammation, increased plaque accumulation to peri-implantitis and its associated bone loss-which ultimately can result in implant loss.

Fragile soft tissue (hemidesmosomal) attachment to the implant, subgingival margin placement, poor control of cement flow and inappropriate cement use all contribute to an increased likelihood of peri-implant disease.

the American Academy of Restorative Dentistry

 and the Academy of Osseointegration) as well as numerous high evidence systematic reports have found implant restorations have fewer biological issues when a screw-retained restoration is used rather than a cement-retained restoration.

Angulated Screw Abutment from Nobel Biocare

, not only provide a biologically friendly solution, they also address implant angulation issues. Esthetics and occlusion are easier to control, enhancing the flexibility of the screw-retained restoration and reducing the risks associated with residual excess cement.

Related reading: Nobel Biocare launches new, complete, cement-free posterior solution at IDS 2015

Continue to Page 4 to further test your implant IQ  ...

 Maxillary anterior single-tooth implant restorations are easy and could be a good place to gain experience with dental implants. False.  

This region and restoration requires significant attention to multiple details in treatment planning and delivery of care. Considerable skill and experience are necessary to address functional as well as difficult anatomical and esthetic factors the treating dentist can easily overlook or under appreciate. Treatment planning is critical and relies on the pre-surgical work-up, including the clinical and radiologic examinations.

Clinicians may be confronted with tissue deficiencies caused by various conditions. Such deficiencies may require bone augmentation procedures such as onlay grafts or guided bone regeneration (GBR) techniques, which may use simultaneous or staged approaches to regenerate adequate volumes of bone for implant placement. Soft tissue handling, precise implant placement, a restorative driven 3D approach and adequate follow-up are among challenges clinicians face.                 

Successful implant surgeons working in the esthetic zone have a sound biologic knowledge of the hard and soft tissues and the anatomy at the implant site, a thorough surgical education and sufficient surgical familiarity with esthetic implant placement.

This treatment requires experienced and seasoned clinicians for both surgical and restorative treatments as well as collaboration with an excellent dental laboratory. This team approach minimizes the potential for complications and maximizes the benefits for our patients and the entire implant team.  

Related reading: Sterngold reveals new implant system

 Edentulous patients' first choice of care, if possible, may include an implant assisted 2-implant mandibular overdenture. True.  

Dr. Russell Nishimura, President of the Academy of Osseointegration: 

Many studies have documented the multiple benefits, efficacy and long-term results implant overdentures provide in the lower jaws. The increased support, stability and retention leads to greater patient satisfaction, comfort and confidence. This treatment dramatically reduces the number of patients once considered “problem denture wearers.” 

Without dental implants, patients may not be able to adequately control their dentures during speech and mastication, and their residual ridges may not be able to withstand the functional forces dentures place on their oral tissues. Clinicians may find the fabrication of an overdenture is facilitated by stable and accurate records implants provide. This leads to predictable results, improved stability and retention, as well as enhanced speech and esthetics.

The 2-implant mandibular overdenture is probably the greatest value in implant dentistry for patients.  It can replace a whole arch of missing or failing teeth and provide improved function with minimum surgery and expense. The anterior mandible has demonstrated the highest success rates, and there are multiple methods to retain the 2- implant overdenture. This includes bars with clips, ball attachments and the Locator attachment. 

The mandibular overdenture is a well-documented and established treatment modality, and some clinicians consider it the standard of care for elderly patients. 

Bench Mastery: Kahng on an ideal implant bridge (Video)

Continue to Page 5 to further test your implant IQ  ...

 As the population continues to age, more patients will turn to implants to replace missing teeth rather than ill-fitting dentures or partials. These patients are more educated about implants than ever before, and they’re excited about the possibilities they offer, from a more confident smile to the ability to eat with no pain or discomfort.