Upcoming Events / / Event Details

Tooth Preparation Considerations for Optimal Outcomes in Fixed Prosthodontics

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Date: 2020-12-08 06:00:00

Location: Online lecture

Contact Hours: 0

Event Details

This live 90-minute lecture / hands-on program is designed to introduce simple and consistent techniques for the preparation of natural dentition when full coverage restorations are indicated.

Indications and contra-indications for esthetic indirect restorative materials will also be reviewed and proper clinical adjustment, polishing techniques, and armamentarium will also be discussed and performed by the participant.

Hands-On Learning Objectives:
  • How to anatomically prepare teeth resulting in adequate space for proper thickness and contour of restorative materials.
  • Understand how interproximal taper, occlusal surface area, and axial wall length affect retention and resistance. 
  • Refining the marginal finish line to maximize the fit of the definitive restoration. 
  • Indications and contraindications for different materials, such as high strength ceramics and zirconia used in fabrication of aesthetically beautiful and functional dental restorations will be discussed.
  • To learn efficient, predictable adjustment and polishing techniques for successful delivery of ceramic restorations.
Register Now!

Restoration Kit Included with Registration

Please have the following materials on-hand in you operatory.  These are not included in the hands-on kit
  • Explorer 
  • High Speed Handpiece 
  • Slow Speed Handpiece
  • Air/Water Syringe
  • Curing Light
  • Gauze
  • Alcohol

Register Now!
Event 3 of 3

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CASE PRESENTATION: Treatment of Deep Caries of Tooth No. 9 in Adolescent

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Date: 09-22-2020 07:58:09 am



A 13-year-old girl presented to the practice for her recall visit. Upon examination, we detect­ed caries on the distal of tooth No. 9. A diag­nosis of deep caries was confirmed with x-rays. After discussion of treatment options with the patient’s parents, we chose a minimally invasive approach that included the use of a laser for tooth preparation. 

Tooth preparation was performed using the LiteTouch erbium laser (AMD Lasers). Because of the use of a laser, we were able to complete the tooth prep without any anesthesia. According to proper protocol, we used a total of 2.3 W and low energy combined with air and water. 
Because of the deep preparation required for the caries removal, we needed to provide pulpal protection. One layer of TheraCal LC resin-modified calcium silicate pulp protectant/liner (BISCO) was applied. Each layer was light-cured for 20 seconds. The calcium release* from TheraCal LC makes it stable and durable as a liner. 

Next, using the selective-etch technique, Futurabond U (VOCO) was applied per manufacturer instructions. The application of Futurabond U was followed by 2 increments of Admira Fusion (VOCO) shade A2. The restoration was finished and polished using Gazelle composite polishers (Microcopy). 
The patient and her parents were pleased with the outcome of the treatment. They were especially impressed with the use of the laser to prepare the tooth as well as the excellent esthetics.



GO-TO PRODUCT USED IN THIS CASE

THERACAL LC
TheraCal LC is a light-cured, resin-modified, calcium silicate filled liner designed for use in direct and indirect pulp capping and as a protective liner under composites, amalgams, cements, and other base materials. It can be used as an alternative to calcium hydroxide, glass ionomer, RMGI, IRM/ZOE, and other restorative materials. TheraCal LC performs as a barrier1,2 and protectant of the dental pulpal complex. TheraCal LC’s precise placement allows its use in all deep cavity preparations. The light-cured set permits immediate placement and condensation of the restorative material. Its proprietary formulation allows for a command set with a light-curing unit while maintaining ease of placement due to thixotropic properties. The proprietary hydrophilic resin formulation creates a stable and durable liner.

* BISCO has on file the calcium release data for TheraCal LC.
1. Sangwan P, Sangwan A, Duhan J, Rohilla A. Tertiary dentinogenesis with calcium hydroxide: a review of proposed mechanisms. Int Endod J. 2013;46(1):3-19

2. Savas S, Botsali MS, Kucukyilmaz E, Sari T. Evaluation of temperature changes in the pulp chamber during polymerization of light-cured pulp-capping materials by using a VALO LED light curing unit at different curing distances. Dent Mater J. 2014;33(6):764-9.
Article 36 of 39

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CASE PRESENTATION: Direct Composite + Post for Endo-Treated Discolored Anterior

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Date: 09-22-2020 07:38:08 am



The technique presented here is one I developed as an alternative to a lab-fabricated veneer when correcting discoloration caused by pulpal necrosis on an anterior tooth. By placing a direct composite “veneer,” I am able to manage the shade directly (i.e., at chairside), thereby eliminating the complexity of matching an indirect restoration. This process allows me to create an optically biomimetic internal aspect. With an indirect veneer, we use a more superficial opaquer, thus creating a clinical crown that is optically different than adjacent virgin teeth.
Primarily to add strength, I further enhance esthetics by placing a nonmetallic post (FibreKor, Pentron) because a substantial amount of discolored dentin was excavated and replaced by composite. Because the post is not metal, it does not affect the final shade. 

History
An 18-year-old male patient, in routine care in my practice, was referred to me by an endodontist for evaluation and treatment. He presented with the chief complaint of darkening of his maxillary central incisor, tooth No. 9. He explained that after a traumatic skateboarding injury, he required a root canal, which subsequently resulted in this unwanted discoloration. 
We discussed both the indirect and direct restorative options, and the patient was happy to try the less invasive, direct approach. 

Treatment: First Visit
Palatal aspect: Without administering local anesthesia, I removed the hemosiderin-stained dentin from the palatal aspect. I cemented (GC FujiCEM2, GC America) a fiber post into place and removed the excess length. Next, I placed composite using a dentin shade (G-ænial Universal Flo, GC America) as a core into the post access opening. Because neighboring teeth desiccate during placement of the post, a second visit was scheduled to capture the true shade. 

Treatment: Second Visit
Facial aspect: To reveal the dentin-shade core, I prepped the facial aspect to enhance retention of the composite. In addition to sandblasting the existing composite core and the unprepped enamel (Microetcher, Zest Dental Solutions), I created intracoronal subgingival troughing. I placed veneering composites (G-ænial Sculpt, GC America) in increments that were each light-cured after placement—first, flowable (bleach white shade) to effectively mask the still-stained dentin remaining in the root; next, a layer of dentin opaque; and finally, a layer of enamel body. 
Final finishing and polishing created a lifelike and undetectable restoration. The patient was pleased.

fig 1

Article 34 of 39

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CASE PRESENTATION: The Right Magnification for Any Procedure

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Date: 08-18-2020 08:50:49 am

Effortlessly match the appropriate magnification level and field size for each procedure using the OmniOptic loupe system from Orascoptic

Many years ago, while still in dental school, my mentor, Dr. Harold M. Shavell, told us, “No one should be allowed to graduate from dental school without a 35-mm camera and a set of loupes!” After all, you can’t do what you can’t see. The year was 1979. While the use of magnification in den­tistry has certainly grown over the years, it is still not considered a standard of care by all dentists. But since we work in a clinical discipline where the difference between success and failure can be measured in tenths of millimeters or less, it makes absolutely no sense to perform dental procedures without the aid of mag­nification. Furthermore, most of us perform a variety of procedures, and the more exacting or focused the treatment is, the more important it is to have greater magnification for optimal visual acuity.
Orascoptic’s OmniOptic system allows me to easily match the most appropriate magnification power and field size to each specific procedure. It is the first loupe system that combines a customized frame with a selection of telescopes of varying magnifications (2.5x, 3.5x, 4.5x, and 5.5x magnification power). 

The OmniOptic system allows us to conveniently change the magnification as a procedure dictates, rather than having an inventory of loupes with different magnifications where the entire loupe and frame need to be removed and replaced each time a change in the power is desired. The frame is customized to the:  
•    Interpupillary distance and optical center—this determines the location of the telescopes on the frame
•    Declination angle—this determines the angle/tilt of the telescopes
•    Eye prescription, with or without bifocals.
 
The telescopes are customized to the individual’s comfortable working distance chairside at an ergonomically comfortable position from the patient’s oral cavity.

Application-Specific Views
With a generous 4+ inches of field size, 2.5x magnification is perfect for hygiene procedures, oral cancer screenings, and many quadrant-focused procedures. The 3.5x or 4.5x magnifications are ideal for individual teeth to check and refine margins, to examine tissue prior to master impressions, or during cementation of porcelain veneers or crowns.
The 5.5x can enhance efficiency during endodontic procedures, such as locating the canal orifice prior to instrumentation. I also found it helpful for laser dentistry—to better visualize laser-tissue interaction during cutting procedures—and for surgical procedures, such as extractions or implant placement/restoration where pinpoint accuracy is critical.







GO-TO PRODUCT USED IN THIS CASE

OMNIOPTIC
Accommodating 4 magnification powers ranging from 2.5x to 5.5x, the OmniOptic is an ideal system for users looking to increase their magnification power over the course of their career. The unique design features a magnetic anchor built into the carrier lens of the frame, allowing clinicians to upgrade their magnification power without having to succumb to the process of ordering a new loupe.
 
Article 30 of 39

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HOT TOPIC: If You’re Not Using Gen-8 Adhesives, You Should Be!

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Date: 07-15-2020 08:04:26 am

The benefits of using 8th-generation universal ahesives are both numerous and indisputable. So, why are so many of us still clinging to older,less reliable, more technique-sensitive systems. Inertia? Familiarity? Fear of change?

The hesitancy among some colleagues to investigate these adhesives is puzzling to me. I have been using   one for about 3 years, and it is absolutely the most user-friendly bonding agent that I have used in my 30 years of clinical practice. I am urging all my colleagues  to simply try one of the many universal systems of the market, and here, I’ll explain why.

These adhesives are based on proven chemistry from previous formulations, with the added advantage of the MDP monomer. This functional, hydrophilic monomer, which has mild etching properties, enables these universal adhesives to be used in all modes: total-, selective-, and self-etch. Even with self-etch techniques, you get 30 MPa bond strength to enamel.

Many of us, including myself, feel more comfortable etching enamel in the selective-etch technique. With an 8th-generation adhesive, if you inadvertently etch dentin, you are still fail-safe. With a conventional
self-etch, this would compromise bond strength. Additionally, universals are typically HEMA-free, which also ensures strong, durable dentin bonding.
 

“THESE ADHESIVES ARE BASED ON A PROVEN CHEMISTRY FROM PREVIOUS FORMULATIONS, WITH THE ADDED ADVANTAGE OF THE MDP MONOMER.”

Another interesting side note: I was recently introduced  to the “super dentin” concept. A team of Japanese researchers found that unetched surfaces combine
with the adjacent hybrid layer—enabled by the MDP monomer—to develop an acid-base resistance zone that significantly reduces the risk of recurrent or secondary caries. This is especially beneficial  when  you  selective- etch on a Class V or on the floor of a Class II proximal box.
 
Simplify and Streamline
So, there truly is no reason NOT to be using an 8th-generation universal adhesive. Chances are, your preferred material manufacturer has one. While there are slight differences between the systems, universal adhesives are compatible with all etching modes and with any clinical situation, so you can simplify procedures, streamline product inventory, and reduce waste—most of them have a two-year shelf life. Try it. You’ll like it.
 
When using previous-generation adhesives, you have to be very careful not to over-dry dentin and not to leave it too moist. Doing so would not only impact bond strength, but it can also create a scenario of sensitivity. Loaded with more photoinitiator, universals offer quick application and short curing time, so they eliminate adhesive-related sensitivity.
Article 25 of 39

Online Continuing Education / Course Details

ADA Credits: 2 | AGD Credits: 2 | Cost: $29.00

Technique Guide to Basic Layering with an Omnichromatic Universal Composite

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Course Type: Self-instruction journal and web based activity

Target Audience: Dental Assistants, Dental Hygienist, Dentists from novice to advanced

Educational Objectives

After completing this course, the reader should be able to:

•  Discuss how and when to use an omnichromatic composite

•  Explain the importance and uses of block out with traditional and omnichromatic composite

•  Describe the traditional concepts of composite shade selection.


Download this course PDF

_________________________
 

Abstract

For decades, dentistry has recognized the need to block out (cosmetically mask) deep stains and lingual deficiencies in tooth structure to prevent unsightly show-through. This paper describes past and present concepts in composite resin in general and blocking out in particular. In addition, the paper reviews both the historic and current literature regarding shade selection and multiple shade composite resin systems are described. Use of an omnichromatic composite is detailed, with case reports focusing on its use with its associated blocker. We conclude that in many instances in cosmetic restorative dentistry it is possible to eliminate multiple shades of composite, replacing them with just one omnichromatic shade and, when needed, its associated blocker. 

COMMERCIAL SUPPORT This educational activity is made possible through an unrestricted educational grant from Tokuyama

ADA Credits: 2 | AGD Credits: 2 | Cost: $29.00

Course 109 of 124

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10 Factors In Avoiding Damage to Dental Handpieces

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Date: 06-24-2020 08:32:26 am

Tired of Handpiece Breakage? Here Are 10 Helpful Tips...                            





10 Factors

In Avoiding Damage to
Dental Handpieces​

 
 
 
 

1

Never use chemicals of any sort unless specifically indicated

 

2

Never use soaps during cleaning unless indicated,and if soap is indicated, don’t use one containing chloride

3

Never use pre-soak or immerse in any liquid, including water, holding solutions, or liquid chemical sterilant-disinfectant

 

4

Never leave the low-speed attachment and motor attached to each other when reprocessing

       

5

Never leave a bur in the attachment during cleaning

6

Never have a bur/dummy bur in  the attachment during autoclaving unless specifically indicated in the instructions for reprocessing

7

Never autoclave motors and  attachments at higher reprocessing temperatures or different cycles than recommended by the manufacturer

8

Never use a dry heat sterilizer as the higher temperatures will degrade resins and plastics

 

       
 

9

Never

use a chemiclave

10

Never skip indicated
lubrication

 
       


 

 

Article 24 of 39

Online Continuing Education / Course Details

ADA Credits: 1 | AGD Credits: 1 | Cost: $19.00

State of the Art of Universal Adhesives

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Course Type: Self-instruction journal and web based activity

Target Audience: Dental Assistants, Dental Hygienist, Dentists from novice to advanced

View Video

Educational Objectives

After completing this webinar, participants will be able to:
» Assess which bonding technique is better (total-etch, self-etch or selective-etch) and why
 
» Apply a universal bonding agent in any of the above mentioned bonding techniques
 
» Answer the questions, "Are all universal adhesives truly universal?" and "Are all universal adhesives designed to bond to all surfaces?"

Abstract

The dental market has a vast array of adhesive systems available for the clinician, which can seem overwhelming at times. This CE webinar will cover the benefits of switching to a universal bonding agent and the clinical impact that this change will have on all bonding protocols to the tooth structure as well as other restorative surfaces.

Supported through an unrestricted educational grant from BISCO

ADA Credits: 1 | AGD Credits: 1 | Cost: $19.00

Course 103 of 124

Online Continuing Education / Course Details

ADA Credits: 1 | AGD Credits: 1 | Cost: $19.00

Super, Gorilla, or Elmer’s? Which Glue for Zirconia Adhesive Cementation – Why and When?

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Course Type: Self-instruction journal and web based activity

Target Audience: Dental Assistants, Dental Hygienist, Dentists from novice to advanced

View Video

Educational Objectives

After completing this webinar, participants will be able to:
»     Perform enhancing zirconia preparations for crowns and bridges 

»     Identify when to use self-adhesive regenerative resin cementation 

»     Maximize adhesion for zirconia and when to use it

Abstract

Clinicians most often choose materials that are aesthetic, durable, and comfortable with zirconia a large percentage of indirect restorations today. Proper preparation and cementation techniques are undeniably related to long term restoration success. When the preparation is less than ideal or functional stresses high, there has been a substantial amount of dentist who have had zirconia restorations become un-cemented or broken. There has been considerable confusion about how to improve the bond and retention with zirconia. This course will discuss the best techniques for routine cementation and for those times when maximum adhesion is necessary.

Supported through an unrestricted educational grant from BISCO

ADA Credits: 1 | AGD Credits: 1 | Cost: $19.00

Course 99 of 124

Online Continuing Education / Course Details

ADA Credits: 2 | AGD Credits: 2 | Cost: $29.00

Bioactive Materials A Clinical Perspective

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Course Type: Self-instruction journal and web based activity

Target Audience: Dental Assistants, Dental Hygienist, Dentists from novice to advanced

Educational Objectives

After completing this course, participants will be able to understand the concepts of bioactive materials, as well as be able to:
1. Define bioactivity and how it relates to dentistry
2. Understand the history of bioactivity related to dentistry
3. Understand the science behind various bioactive approaches and experimental research
4. Identify the potential benefits of bioactive materials
5. Incorporate bioactive therapy in a clinical restorative setting.
 

Download this course PDF
______________________________

Abstract

Modern bioactive dental materials are pushing the science and art of dentistry to new heights. Techniques and materials are evolving, and the paradigms of treatment have shifted from replacement of tooth and bone structures to actively inducing the human body to work in conjunction with engineered materials to deliver better health outcomes. This article will review the history and development of bioactive materials and include some of the exciting new treatment modalities of modern clinical practice.

COMMERCIAL SUPPORT This educational activity is made possible through an unrestricted educational grant from Apex Dental Materials.

ADA Credits: 2 | AGD Credits: 2 | Cost: $29.00

Course 95 of 124