DPR Top 100: Dr Flucke's Top 5 Test Drives of 2023

Hey, gang, guess what time it is? That’s right. Unless you missed the headline above the article—and I’m guessing you didn’t—it’s time for my Top 5 Test Drive rundown. I have led a charmed life, there is no doubt about that. I say that because I love technology and I love telling all of you about the latest and greatest gear in our profession. I am fortunate because my job here at Dental Products Report® allows me to see a lot of products that are either on the profession’s “near horizon” or are newly available. I get a chance to try and tinker with some amazing things and then I get to tell all of you about them. Other than treating patients, this is my dream job. One quick thing before we get started: This is not an all-inclusive list or an endorsement of one product over another. Also, this list is not in any order of preference. The products here are simply the ones that impressed me the most. And, we’re off!

1. Amber Mill Direct Powered by Roland and Chairside Zirconia Powered by Roland

Some of you may remember that one of my Top 5 from last year was Roland DGA’s DGSHAPE DWX-42W in-office mill. I did more than a trial. I have been using the mill in my office for 18 months. Like other dental practices, we frequently use lithium disilicate and zirconia materials for everyday fixed prosthetics. However, the one drawback to these materials has been the need to sinter or crystallize them in an oven for extended periods. These are some of the best materials available, but the extended finishing time they required impeded same-day dentistry, making it more of a challenge in real time.

To the rescue come 2 new CAD/CAM material blocks from Roland DGA. Chairside Zirconia, a fully sintered zirconia, and Amber Mill Direct, a precrystallized lithium disilicate. The game-changing thing about these 2 new materials is the simple fact that neither requires any sintering or crystallization, which means no oven time. Both materials are multigradient for optimal translucency and esthetics. Restorations come out of the 42W in-house mill at full strength and are ready to seat. The workflow is simple: scan, design, mill, polish, and cement. Now dentists can utilize 2 of the most popular materials on the market today and deliver the final prosthesis the same day. We are having amazing results with both new high-quality materials. Chairside Zirconia and Amber Mill Direct, powered by Roland DGA, allow us to provide the time savings that patients want as well as the strength and esthetics that doctors demand. Material science rocks.

2. DentaSonic

More general dentists are using clear aligner therapy to improve their patients’ smiles. However, the one part of this treatment that doctors often dread and struggle with is interproximal reduction (IPR). Slenderizing the teeth to gain the necessary space for proper alignment is important but can be difficult for the doctor to accomplish. That is where DentaSonic comes in. This Switzerland-based company makes all the abrasive strips a doctor needs to perform IPR. However, the best part is that there also is a handpiece system to do the job. The DentaSonic handpiece is a reciprocating device that moves the amazing abrasive strips in a back-and-forth motion that allows the doctor to reduce the interproximal areas smoothly, easily, and quickly. The strips are flexible, which allows the doctor to maintain proper contour and shape of the teeth while easily accomplishing the task. The strips come in multiple thicknesses and there is even a polishing strip that lets the doctor bring the enamel back to a smooth surface after the IPR is accomplished.

DentaSonic sells kits that contain everything needed to get started. The handpiece-ready DiaStrips also are sold individually so you can replace them when needed. The handpiece can be purchased as air-driven DS-Twist or (my favorite) the cordless rechargeable IPR-EVO, which can be used for IPR or as a cordless endo motor. My office does a fair amount of clear aligner therapy and DentaSonic makes the process much easier—and it is much more comfortable for patients. If you are performing IPR, you need this.

3. Medidenta ACE (Advanced Cordless Endo) Motor

To do it well, endo requires a pretty significant armamentarium. Because we need a lot of things to do the treatment, our counters get cluttered. In the dental operatory, we have limited countertop space and the more things we add, the more crowded things become. Wouldn’t it be nice if someone could produce a way to do more with less? Well, someone has, and it is called the ACE Motor. It was developed for Medidenta by an endodontist named Carlos Spironelli Ramos. The product name really says it all. ACE stands for Advanced Cordless Endo, but cordless is just the tip of the tech iceberg when it comes to this device.

The ACE not only performs rotary instrumentation, but reciprocating (watch winding) instrumentation as well. It also has an incredibly nice feature of allowing you to connect the motor to the base with a thin, flexible cord, and this allows the doctor to use the apex locator as you use the motor to instrument the canal. That’s right—you can see where the file is in the canal as you instrument it. Those features are amazing and justify the product’s inclusion in this list, but wait…there’s more. The ACE is also fully programmable. You can program the correct parameters for any file system. This feature means that no matter who manufactures the file, you can set the motor to accommodate it. Also, an operator often does not want a simple 30° clockwise and 30° anticlockwise oscillation. The ACE can be programmed to perform many different degrees in both directions, giving the doctor an unprecedented amount of control. This might be the only endo motor you need for years to come.

4. CandidPro Clear Orthodontic Aligners

This year I began working with CandidPro as a bit of a trial and was so impressed that it has become my go-to clear aligner partner. I made that decision for a few different reasons. The most important to me was the high degree of communication. A CandidPro staff orthodontist is assigned to your case and is there to provide guidance and support. The Candid team is available and reliable, helping you from start to completion.

One of the other big winners for me was the less likely need for attachments. Sometimes they are a necessary part of treatment, but we are placing significantly fewer attachments than in the past. Depending on the case, the number of attachments, and the patient, placing attachments can be the most difficult part of the process. Needing fewer attachments benefits doctor, assistant, and patient.

Polymer chemistry is a tremendously evolving science and CandidPro has kept up. Its aligners are made of Zendura FLX, a material that provides gentle but steady force to move the teeth. This means that when the next aligner in the series is placed, the teeth are much less tender, which increases adherence and makes for a happy patient.

On top of those benefits, the biggest reason I have become a fan is because of ScanBox pro. Every patient receives a special device that attaches to their mobile phone. The device works with the phone’s camera as a lip retractor as well as providing a constant uniform distance from the teeth. Using the CandidPro app, the patient routinely takes video of their mouth/teeth. That digital information is uploaded to CandidPro, where the company’s artificial intelligence (AI) system analyzes the file. The AI knows which aligner the patient is wearing and where the teeth should be at that point. If the case is not tracking correctly, the system will also notify the patient and the doctor so that correcting steps can be implemented. ScanBox pro checks the patients at regular intervals and ensures the case is progressing exactly as expected. How amazing is that?

5. Vista Apex RE-GEN Endodontic Sealer

Prior to the COVID-19 pandemic, the smart minds at Vista Apex released their RE-GEN bonding agent, which is bioactive. Rather than rest on their laurels and bask in the glory of a successful bioactive bonding agent, the company went back to work on even more products for the RE-GEN line. This past year saw the introduction of RE-GEN Endodontic Sealer.

One of the best advancements in endodontics in recent years has been the introduction of bioceramic sealers. The RE-GEN sealer uses Bioglass 45S5. Bioactive glass is an interesting material. It kills pathogens due to high alkalinity, has osteogenic properties, and is extremely biocompatible. Those are all great properties for an endo sealer to have. Add things such as high dimensional stability, low solubility (washout resistance), and high radiopacity and you can see why I am excited about this material. It is packaged in premixed syringes that allow the doctor to simply deliver the material with a gentle push of the plunger.

I am also really pleased with the delivery system. The company has created small cannulas it refers to as the MST (Material Saving Tip). These very slim and flexible tips allow the user to deliver the material into the canals easily, and because the tips are slim with a minimal reservoir, little sealer is wasted just filling the tip. This means that in addition to all the other benefits, RE-GEN Endo Sealer also helps reduce waste and the resultant cost that comes with all that extra material that is not left in the tip. I was a prerelease tester of the final material before it was launched, and I have used it exclusively since then with very good clinical results.

Honorable Mention: VOCO Retraction Paste

As one of the winners of the Cellerant Best of Class awards this year, VOCO Retraction Paste was loved by me and the other voting members. It is an aluminum chloride–containing paste that aids in hemostasis and tissue retraction. It is packaged in capsules like composite, and the tip of that capsule is long and narrow, which really aids in getting the material right into the sulcus. It expresses easily and as it sets it thickens and expands, which allows for tissue retraction without needing to use a cord.

It is a turquoise color, so it is easy to see, yet washes away easily when rinsed and does not stain the teeth. One of the things I really love about it is that aluminum chloride is also used in antiperspirants, which means it absorbs fluids. That means it not only retracts, but it helps with secretions in the gingival sulcus. Often Class V composites in the esthetic zone suffer from staining at the gingival margin. That is because those gingival secretions (which are clear) creep over the margin during bonding and affect the long-term marginal stability. Using VOCO Retraction Paste and then rinsing it away before placing the composite keeps those fluids from being a problem. I use it even if I do not need retraction or hemorrhage control, simply because it works so well.

It is a great little tool. You will be glad you have it around—trust me.

Plus One

Although it was not a Test Drive for 2023, I continue to be impressed with the Bien-Air Nova electric handpiece. I began testing the Nova in December 2021 and have used it since then in a variety of cases and applications. The handpiece has cylcro gears, which give it a transmission like a Formula 1 car. In the time I have used it I do not think I have ever sent it in for service, and that is with daily use in some very demanding situations. It has 4-port water spray and a PVD (physical vapor deposition)-coated chuck that extends its life. It also is the first handpiece constructed of stainless steel.

Electric handpieces will change the way you practice. If you are not using a Bien-Air system, you should be.

Wrapping Up

So, another Top 5 Test Drive column is in the books. As always, thanks for reading and rest assured that I will spend 2024 testing and breaking all the gear I can get my hands on. I will
be back next year with another list of my favorite Test Drives. Remember,
I break the stuff so you don’t have to.