Simplify and Boost Healing Processes

Often, dental products are indicated for a single purpose but, when you use the product, you find it helps you in other ways: HYBENX did just that. In periodontal disease, treating what we cannot see is the most critical aspect of care. During scaling and root planing, microorganisms are not entirely removed, and the pathogens are typically treated with antimicrobial therapies. What if we could eradicate all microorganisms in the sulcus? Microorganisms (bacteria, fungi, viruses, archaea, and protists) require water to survive.

EPIEN Medical has produced a unique product. HYBENX makes an electrostatic charge that attracts water and dehydrates the environment necessary for the microorganisms to survive. Dead microorganisms and tissue debris are rinsed away, and the natural healing processes of your body are facilitated in less than 30 seconds.

Cleared by the FDA, HYBENX inhibits infection and bacterial and inflammatory disease processes with no bacterial resistance.

Features

• Application takes seconds
• Cleared by the FDA
• Safe on dentin and enamel
• Safe on porcelain, titanium, and other metals
• No postoperative instructions
• Offers 2 viscosity choices
• Low cost

Benefits

• Eradicates bacteria

• Inhibits infectious and inflammatory disease processes
• Single treatment from infected to a healing state
• Desensitizes
• Hemostatic properties
• Reduction of drug resistant organisms

Thirteen examiners—7 hygienists and 6 dentists—evaluated this product. The examiners utilized the product to treat periodontitis, gingivitis, and peri-implantitis, as well as for periodontal maintenance, gingival drying around restorative margins, and endodontic procedures. Most of the examiners utilized the gel solution vs the liquid, and a few also evaluated both the liquid and the gel.

Figure 1

The patient’s gingival tissue before applicator placement (Figure 1).

Figure 2

The interproximal placement of applicator tip to apply HYBENX (Figure 2).

Figure 3

Interproximal dispensing of HYBENX (Figure 3).

Figure 4

Rinsing HYBENX after the required 30 seconds for healing processes to work (Figure 4).

Figure 5

The appearance of gingival tissue after placement and rinsing of HYBENX product (Figure 5).

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Ease of Use and Delivery

Overall, 71% of examiners agreed that the product allowed functional delivery, and 69% evaluated the effect as easy to use. The most common recommendation was a thinner tip design to improve access to deep pockets and narrow spaces. From start to finish, the use of HYBENX took 1 to 3 minutes for the majority (76.9%) and 4 to 7 minutes for a few (23.1%).

The products used during the evaluation contained 1 mL of solution, and some evaluators used the entire 1-mL dose; however, most evaluators (76.9%) stated that they would prefer a 0.2-mL or 0.5-mL dose, depending on the procedure.

Periodontal Resolution

Evaluators reported average (61.54%) to excellent (23.08%) outcomes of the periodontal resolution. Some commented that they were unable to evaluate the effects of the product because they placed the solution during initial therapy, and they were not able to assess improvement. Evaluators rating the product as excellent remarked on the noticeable change in pocket depth and stated they would like to continue evaluating for long-term resolution for scientific benchmarking. Of the 6 dentists, only 5 used the product to treat peri-implantitis; 3 reported average results and 2 reported excellent results.

Most (76.9%) evaluators noticed patient improvement after a single treatment using HYBENX, and the remainder reported not having enough time to evaluate progress.

Need for Retreatment

When evaluating the need to re-treat pockets after placement during periodontitis or peri-implantitis, 4 of the 6 participating dentists reported no need to re-treat. At the same time, the remaining clinicians stated it was too soon for reevaluation because of initial placement. Comments were provided that fewer sites required retreatment upon evaluation, but only a few. If retreatment was needed, the majority re-treated at 3 to 4 weeks with an average (60%) to excellent (40%) outcome for patients given new appointments for reevaluation. The remainder of the evaluations needed to occur due to adequate time lapse for reevaluation. One participant commented that it was difficult to determine whether the improvement was related to HYBENX.

Most examiners reported utilizing adjunctive therapies such as laser therapy, minocycline HCl (Arestin), chlorhexidine, Perio Protect, and ozone, whereas 3 reported not using periodontal decontaminants. Most respondents (8) did not utilize HYBENX before and after treatment for scaling and root planning. Comments indicated the product was not applied post treatment because the directions for use did not indicate reapplication after treatment. HYBENX was reported to be 100% beneficial for hemostasis and the sealing of nerve endings for those who utilized the product.

Patient Experience

Patients’ experience with HYBENX was rated as good (69%) and average (30.7%), and comments stated that clinicians should have asked about the patient experience and that it may be better to understand the patient experience with a split-mouth/same-patient study. An additional comment was provided that the patient reported a burning sensation with the product during treatment and did not like the product’s taste.

The Surprise Benefit

It was a pleasure to evaluate HYBENX in our educational institution. The most surprising benefit of this product was that it softened tenacious calculus into a claylike texture. Instead of 20 minutes to remove tenacious calculus, it took us half the time, and it increased the patient’s comfort and our field of vision because of the hemostatic properties. I now have students evaluating the need for HYBENX during patient care to assist with patient management and efficiency. The softening of calculus is a unique advantage that can impact efficiency, improve patient comfort during and after procedures, and reduce musculoskeletal fatigue.

Overall Evaluation

Favorite features of HYBENX included the following:

• Instant results
• Viscosity of gel
• Delivery system and easy to use
• Not just for single sites but for the whole mouth
• Beneficial to healing
• Significantly softened the calculus
• Reduced bleeding during scaling and root planing
• No antibiotic component

Several recommendations were made:

Directions and indications

• High-volume evacuation needs to be utilized when rinsing product
• Can be used before and after procedure
• Call out product’s additional benefits, such as dentinal desensitization, hemostasis, and reduced gingival sensitivity during treatment
• How much of the product should be used during the procedure? How much is too much or too little?
• Provide decision tree for easier treatment planning
• Provide guidance on whether this is a reimbursable procedure and range for cost
• Provide guidance for how long results should last for desensitization as a decontaminate and analgesic
• Provide guidance on frequency of periodontal reevaluation and whether this should be utilized at periodontal maintenance appointments

Product/Delivery Design

• Need for a thinner tip
• Remove red dye component for potential allergies

In summary, HYBENX is an outstanding product with excellent promise and multiple benefits. Minor adjustments such as additional directions, decision-making tools, and a thinner tip will benefit the clinician and increase overall satisfaction and usage. These will help providers understand how it can improve clinical outcomes and the patient experience, adding overarching value to the appointment. Most (69.2%) evaluators would recommend HYBENX, and 23% would likely recommend it based on treatment use. At the same time, 1 evaluator could not recommend it because of the need for additional evaluation and cases to provide a recommendation. Most evaluators (69.2%) stated that they would continue using HYBENX for periodontal treatment workflow depending on how many sites were involved, whereas 30.7% reported they would continue utilizing the product. For this reason, we are happy to issue the Catapult Vote of Confidence for this product.