Tuesday, January 31, 2012
Monday, January 30, 2012
As you've been hearing (both from me and people a lot smarter than me), the web is moving more and more to Cloud based applications.
The Cloud is a really great idea in that it means your information is stored, not on your local hard drive, but on a a computer in a remote location with a reliable high speed Internet connection. No matter where you are, as long as you have an Internet connection, you have access to this data.
You don't have to back it up, upgrade software, or do anything else. The provider of The Cloud service does everything... all you need to do is connect.
Google has done a good job of Cloud applications with Gmail, Google Calendar, and several other offerings. I've been a Gmail and Calendar user for years now and have had great experiences with both.
Even though Google Talk has been available for a while now, my schedule had been so insane that I just hadn't had a chance to work with it... and that's a shame because after some time with it, I feel that the crazier your life is, the more you need this service!
In a nutshell, Google Voice let's you use one phone number to access your entire life... no matter how many phone numbers you happen to have. You can use either a number provided by Google or specify another. When that number is called, every number you enter into the system will ring.
In my case, I've used my mobile number. I have 2 cell phones, but when you call my main mobile number, both of these phones ring. I could also have other phones ring too if I wanted.
The service provides voice mail which can be accessed over the web, through email, or through an app on your phone (the apps are available for all the popular platforms). The voice mail is also converted to text and emailed to you as well as being sent via text message to your mobile phone.
The apps also allow you to receive and respond to text messages from any device you own. A text to my mobile number will be received by me on my Gmail account, my iPhone, my Samsung Galaxy II, my iPad, and my Xoom tablet. I can respond on any of these devices and all my devices will be updated with my response.
There are other functions as well, but by now I'm sure you get the idea. I'm loving Google Voice & I'm confident you will as well. Take it for a spin & let me know what you think!
Sunday, January 29, 2012
Saturday, January 28, 2012
Founders Credit Unique “Relationship Marketing” Model and Vigorous
On-Site Research and Production for Three Decades of Success and Smiles
Eatontown, NJ (January 27, 2012) – Zhermack Inc., a company that specializes in the production of materials and equipment for dental practices and dental laboratories, is pleased to announce that it recently marked the 30-year anniversary of providing solution-centered products for the dental and laboratory industries.
Born from the vision of two entrepreneurs united by a common desire for perfection, company founders Tiziano Busin and Vittorio Mora began their work in Badia Polesine, Italy, in 1981. Because of the unique and individual skill sets of Busin, Mora, and their supporting team of talented and dedicated staff, Zhermack now has an international presence.
Continuous research, supported by investments in relationship marketing, has enabled Zhermack to constantly develop new solutions for real industry issues. An ongoing dialogue with customers and professionals ensures that Zhermack solutions always match the needs of its clients. “We make sure to have constant, uninterrupted conversations and relationships with our clients,” states Busin. “Nothing satisfies us more than hearing that the solutions conceived and developed by Zhermack really do improve the work of our end users.”
Today, Zhermack products can be found in over 100 countries, and the company has partnerships with over 400 distributors. A vast product range covers the needs of dentists and dental technicians, and includes a wide selection of silicones (VPS/A), alginates, resins, plasters, and a complete range of equipment.
Since all products are developed in their own laboratory, all Zhermack products contain unique and innovative characteristics. Zhermack directly manages all phases of the production process, continuously integrating the contribution of marketing, sales, quality research, and development and production. Because of its many immediate resources, intervention at the molecular level on individual components and semi-finished products can change chemical structure in order for Zhermack to provide professionals with solutions and constant improvement of products.
“We make products to simplify our clients’ work, designed with the intention to assure maximum functionality and precision,” remarked Busin.
Thanks to its own synthesis plant, over the years Zhermack has been able to develop many original products. For example, Zhermack’s Hi-Tech division promotes the use of Zhermack materials in various new areas, including otology, rapid prototyping, mold making, and ceramics.
Zhermack has introduced state-of-the-art products and solutions in the international market, from the first dentistry-specific alginate to more recent offerings such as its revolutionary Hydrogum® 5 premium alginate that maintains stability for up to 5 days. Other Zhermack offerings include clinical dental products, such as impression materials, hygiene products, and equipment, as well as technical laboratory products, such as silicones, stones, and resins.
Moreover, Zhermack manufactures a variety of industrial products, such as ceramics, cosmetics, jewelry, and much more. For more information about Zhermack and its products, call 1-877-819-6206 or visit www.Zhermack.com.
Zhermack Inc. is a leading producer of impression materials for dental clinicians and high-tech solutions for dental laboratories. The company’s product range includes VPS (vinyl polysiloxane) materials, C-silicones, alginates, plastic and metal impression trays, light-curing and self-curing trays, detergents, disinfectants and sterilization products, duplicating materials, dental stones, acrylic resins, and dental lab equipment.
Zhermack products are distributed through an established dealer network and used by dentists, dental technicians, and universities in over 100 countries worldwide. The company is represented internationally by its branches in Germany, Poland, and the United States, and by its representative offices in the UK, China, and Russia. Zhermack Group includes Hi-Tech and dental laboratory equipment divisions. For more information about Zhermack and its products, call 1-877-819-6206 or visit www.Zhermack.com
Friday, January 27, 2012
I had a great case yesterday that I really need to tell you about.
One of my favorite patients in the whole world is ready to have an implant restored in the space where #9 (FDI 21) once resided. If you are in dentistry, you know how in a normal situation this type of appointment is really pretty straight forward. That is not to say that anterior implants are simple… they are not. They require meticulous planning and attention to detail. However, if you've done all of that, you reap the reward by simplifying the appointments as treatment progresses.
And yet, dentistry is life and in life, sometimes even the best plans can require some fine tuning on down the road. That's the whole point of this post. That even when treatment requires some revisions, having the right training and equipment can greatly simplify the process when corrections are needed. Today I was confronted by a fair amount of tissue overgrowth around the implant. In many cases, when this situation presents itself tissue re-contouring frequently necessitates that after the re-contouring is completed it's necessary to give the tissue a few weeks to heal. The drawback to this is that it delays placement of the final restoration and the patient must endure a longer span of time with whatever appliance has been used to maintain aesthetics.
In today's situation however, I was able to use a laser to perform the re-contouring. In this particular situation using a laser at low power allowed me to remove excess tissue and to contour the tissue for the exact aesthetics that the case required. For this case I used an Nd:YAG laser at 2W and 20Hz. This setting allowed me to basically “melt” the tissue with no visible thermal damage which would have created tissue shrinkage upon healing. Also, soft tissue lasers such as the Nd:YAG and the diode have a high affinity and absorption for hemoglobin which allows them to not only remove tissue but do so in a bloodless environment since they coagulate any open vessels as they remove the tissue.
This means that I could carefully remove the excess tissue overgrowth and re-contour for proper aesthetics in a clean field. Also since the laser was being used at such a low power, no thermal damage was imparted to the tissue which means the contours that I created today will be there with no changes at the delivery appointment. Careful orientation of the fiberoptic tip kept the laser energy away from the implant and directed toward the tissue.
The laser allowed me to make necessary changes to the tissue architecture without the need for additional healing time. That means we've kept to our original schedule for the patient despite the fact that nature triedto change our plans. We accomplished re-contouring and the final impression at the same appointment without sacrificing aesthetics. Lasers have completely changed the way I practice and I'm confident they can do the same for you.
Feel free to leave your questions in the comments section.
Thursday, January 26, 2012
- Amy Morgan
- Lois Banta
- Gary Severance, DDS
- Lorne Lavine, DMD
- Cathy Jamison
And that is only a small portion of the speakers who will be there!
So read up on the details below and register. I hope to see a lot of you there!
Time to register for the Dentrix Business of Dentistry Conference
If you are a Dentrix dentist, you will want to check out this training opportunity for your entire team. Henry Schein just announced their annual Dentrix user conference – The Dentrix Business of Dentistry. This year’s conference is in Las Vegas on July 12-14 and is a great way to reward your team with a Las Vegas trip, while giving them training that will improve your practice when they return.
The user conference offers more than 40 training sessions on Dentrix, practice management strategy, dental technology and practice marketing – all delivered by leading experts.
New this year is a full clinical track highlighting the latest dental technologies and treatments.
You will want to register your team early as space is limited, visit: www.businessofdentistry.com
Wednesday, January 25, 2012
- Shock resistant to 10 feet (about 3 metres)
- Water resistant to 1.0 bar (about 10 metres)
- Pressure resistant to 1.0 bar
It certainly looks interesting and I love the idea of a phone that is actually built to take some abuse. Usually the first thing I do with a new phone is to make sure it is protected by a case ASAP. hats off to Casio for building something that can actually slip out of my hand without shattering.
Tuesday, January 24, 2012
Monday, January 23, 2012
Saturday, January 21, 2012
- Resizeable Widgets - If you want or need more info, you can expand them. If they are occupying too much screen real estate, you can shrink them
- Better Spell Checking - The device now has a true in-line spell checker which is pretty handy
- No More Contacts but People Instead - The Contacts app is now "People" and features tighter integration with social networks, especially (as you'd expect) Google+
- Better App Launcher - Now allows for disabling of apps, immediate uninstalling, and dragging for more info on a particular app
- Swipe to Remove Notifications - Gone is the tapping of the "X", now simply slide the notification to the right and it slides off the screen
There are some other nice features such as the clock and task bar are formatted differently and are now in an easy to read color. Also my default clock app is much prettier. Overall I've been quite pleased with the update and what it delivers. If I find more or have problems… you'll be the first to know!
Friday, January 20, 2012
If you're a regular reader, then you know I have a fascination & a high degree of affection for ioSafe. The company makes indestructible hard drives that can withstand fire of 1550 degrees F for 30 minutes and up to 10 feet of water (fresh or salt) for 3 days.
These things are simply engineered to withstand the most extreme of the extreme circumstances that the world can dish out. I love their products and always get a kick out of the videos that they send me. This is the latest. The company always manages to pull off something amazing at the Consumer Electronics Show in Las Vegas and this year was no exception. Most hard drives would be terrified of someone shuffling their feet on the carpet… but ioSafe put their up against a Tesla Coil.
When ioSafe goes head to head with Nicola Tesla… well you just know it's going to be fun to watch. Check it out & then head over to the ioSafe website to see & learn more about their products. They carry my highest recommendation.
Wednesday, January 18, 2012
I just read an interesting story about phone operating systems. In the early days of Apple there were mainly 2 people, Steve Jobs and Steve Wozniak. Now, everyone knows Jobs. He went on to become the driving force behind a lot or our current technologies. However, in the early Apple days, Jobs was the marketing guy... it was Wozniak who designed and built the original Apple computer. Woz, as he's now known, is one smart guy when it comes to technology. His forte wasn't public speaking or marketing, like Jobs so he sort of remains on the fringes when it comes to tech press. However, there is no minimizing of his intellect or his understanding of technology.
So here I was, surfing & reading when I come across a story that says Woz thinks there are things that Android does better than iOS. It just goes to show that even an Apple lover like Woz can appreciate what the other OS can do. So, if Woz thinks that... why even argue about which is "best".
Take a read on the article at Cnet & let me know what you think in the comments section. I've got to tell you, as a user of both Android & iOS, I have to agree with Woz. Both are good and each does some things better than the other.
Tuesday, January 17, 2012
Officite Becomes the Missouri Dental Association’s Official Website and Local Marketing Provider
Downers Grove, IL (PRWEB) January 10, 2012
Officite, the leading provider of dental websites and local marketing solutions, is pleased to announce its recent endorsement by the Missouri Dental Association (MDA). The MDA represents more than 2,000 dental professionals statewide who now have access to a comprehensive Web presence solution from the industry leader.
“Prior to endorsing a Web service provider for our membership, we did our due diligence to find a company who was aligned with our goals and mission. Officite’s experience, professionalism and commitment exceeded our expectations as the true expert in the dental website industry. We are excited to introduce this new and important service to our membership,” said Dr. Bryan Foote, member of the MDA Endorsement Committee.
To date, 13 state dental associations have selected Officite as their memberships’ dentist website and online marketing provider. Associations and their members consistently cite Officite’s technology and service as a pivotal tool for any dental practice today.
“Officite has done an excellent job in designing our customized website,” said Dr. Kelly Suchman, who practices in Lee’s Summit with Dr. John Flucke. “They have been very attentive to our needs and desires. Our website consistently ranks high with Google and other search engines. We appreciate and value Officite’s expertise.”
In addition to practice websites for dentists, Officite offers a full suite of local marketing services for maximizing a dentist’s Web presence. These include search engine marketing, social networking and patient reviews management. More recently, Officite released the first HTML5, true mobile website solution for the dental industry. Each fully-functional mobile site incorporates mobile-specific features, such as instant click-to-call, door-to-door office directions, appointment requesting and access to social media sites and patient reviews—all readily available from smartphones and tablet devices.
“Officite’s position as the leading provider of websites for dentists is evidenced through the hundreds of thousands of new patient appointments we’ve generated for our clients and the numerous relationships we’ve formed with state and national associations in our 10 years of business,” said Glenn Lombardi, President of Officite. “Our proven solution is a must-have practice marketing tool for members and a tremendous benefit for an association’s membership services.”
About the Missouri Dental Association
Founded in 1865, the MDA is a unified organization of individual members committed to the highest quality of care for the public and a resource for advocacy, education, communication, information and fellowship. The MDA is a state component of a tripartite association where members belong to the American Dental Association and their local component society.
Officite is the number one provider of Web design and online marketing solutions for healthcare practices: connecting new patients with doctors online. Since 2002, Officite has built thousands of websites for healthcare professionals worldwide that have generated hundreds of thousands of new patient appointments. Its services span from premium website design and development to a full, turnkey Internet strategy, including local search engine optimization, pay-per-click advertising, blog management, social networking and patient reviews management, all implemented through Officite’s innovative site building technology and Doctor Portal solution. Partnered with more than 20 of the leading national and state medical associations, Officite continues to transform how healthcare practices attract, connect and communicate on the Internet. To learn more about Officite, visit http://www.officite.com.
Thursday, January 12, 2012
Nature is just amazing. I'm continually blown away by the amazing healing I see the human body do. It's also stunning to sometime see how science can take something made by nature and then apply it into another area.
There are tremendous advances being made by the field of bioengineering and I was fascinated by this story I read on Foxnews.com. A large portion of that article is copied here. For the full story, the link is here.
After decades of trying, scientists may have finally found a way to make body armor out of spider silk.
Aside from being very cool, this would mean ultra-lightweight, super-strong, flexible body armor that would provide highly improved protection for America’s soldiers and law enforcement officers.
Right now, U.S. soldiers must wear very heavy, inflexible and cumbersome body armor for protection. Typically it is hard body armor, a ballistic vest with at least two large, hard ceramic plates, designed to protect the upper body from shrapnel and bullets.
Hard armor basically works by resisting the force of the bullet or shrapnel with the same degree of force. But the more protection hard armor provides, the heavier and more ungainly it becomes. The lowest level protects only against small-caliber projectiles that have less force on impact. Hard-armor design often involves the ability to scale up protection, so there are pockets into which additional plates can be inserted.
While protection is important -- reports indicate that the risk of death from gunshot is 14 times higher for law enforcement officers who don’t wear armor -- users often find themselves weighing the risk of being shot with the reduction in speed, mobility and agility that hard armor’s weight and unwieldiness can cause.
While soldiers wear hard armor on a daily basis, law enforcement officers in reduced risk situations often prefer the flexibility and lighter weight of soft body armor, which works by spreading out the blunt trauma so that the force is not received in one focused spot. Soft armor often slows down bullet or shrapnel through layers or interwoven fabrics that act like nets or spider webs.
Developing lightweight, flexible soft body armor with the higher degree of protection of hard body armor has so far been the impossible dream.
DuPont’s Kevlar fiber, the soft armor fiber widely adopted by law enforcement, is often described as five times stronger than steel -- but spider silk continues to outperform its artificial counterparts, so the pursuit of Spider-Man style armor has been underway for decades.
Strand-for-strand, researchers in the field know, the dragline of an orb-weaving spider, while weighing far less, can be three times more flexible than Kevlar and five times stronger than steel.
Contrary to its size and weight, spider silk is naturally capable of absorbing a huge amount of energy.
Last year, a team at the Heidelberg Institute For Theoretical Studies in Germany studied the building blocks to the mystery behind what makes spider silk so naturally strong.
There are two key components to spider silk fiber: the soft goo gel that is manufactured in the abdomen and the strong solid thread that it has become when it leaves the body.
This team’s findings, published in Biophysical Journal, suggest that the same components that give the soft goo silk elasticity lead to the stress distribution handy for body armor.
While capitalizing on the natural attributes of spider dragline seems like a no-brainer, the coveted prize of creating spider silk body armor has not been without serious obstacles.
Among the chalenges: cracking the genome profile of ideal spider silk; finding a way to synthesize the silk-making protein; and devising a method to mass-manufacture the protein in the volumes necessary.
For a long time, the focus has been on the silk of one of the world’s most lethal spiders -- the black widow, the dragline of which could provide material stronger than Kevlar or steel, and in a far lighter weight and more flexible way.
But farming the spiders has not been an option, as spiders tend not to play nicely with each other – they tend to turn into a fight club and fail to produce the mass volumes necessary.
In 2007, scientists at the University of California announced they had identified the black widow silk genes, and they tried injecting it into tomato plants, with the objective that the tomato seed would provide the spider silk.
Tomato plants, crops, bacteria, yeast -- even goats -- have gone in and out of fashion as vehicles for converting the spider silk gel into solid thread.
Enter silkworms. They produce fragile silk, but they have heaps of natural potential as high volume producers capable of spinning approximately a kilometer of silk thread in a few days, with a long history of successful human cultivation.
In Thailand in 1999, the Rajamangala Institute of Technology reported that it had developed body armor using only standard, low-cost silkworm silk. Tests indicated that 16 silk layers could stop a 9mm bullet, and that the vests could provide protection against high-velocity rifle shots as well as .22 caliber handguns.
More recently, silk has even been successfully exploited for “blast boxers.”
The latest breakthrough was achieved by the University of Wyoming and published in Proceedings of the National Academy of Sciences this month.
According to their publication, they have succeeded in genetically modifying silkworms to produce a combination of worm and spider silk that is as strong as spider silk.
Arguably, the Holy Grail for Spidey body armor would be cracking the bark spider, reputedly 10 times stronger than Kevlar, and then applying these new silkworm factories.
Bark spider silk is the strongest on earth, 100 percent tougher than all other documented silk.
Discovered last year in Madagascar, the bark spider not only makes the largest orb web at up to 25 meters, it has the strongest dragline silk in the world and the elasticity to absorb three times more energy than Kevlar before breaking.
From parachutes, airbags and sportswear to biodegradable fishing ropes, lines and nets, the range of potential civilian applications is diverse.
Advances applying spider silk to the medical field have already been made, and research continues into sutures, wound coverage, stronger artificial tendons and ligaments, assisting joints to heal by harnessing the resilience of silk and to help nerve repair and regrowth.
Read more: http://www.foxnews.com/scitech/2012/01/12/is-spider-man-body-armor-finally-within-reach/#ixzz1jH34iZSh
- Posted using BlogPress from my iPad
Wednesday, January 11, 2012
Here's an interesting idea for a combination of app and hardware.
The device shown above is called the Tinke. Simply place your finger over the port in the back of the device and it will measure heart rate, blood oxygen saturation, and your respiratory rate. The idea is for it to be used by the individual, but I can see that something along these lines could be easily changed by the company and adapted to the healthcare environment.
It also comes with an app that keeps track of the information it collects so this could be used to keep the info in a patient's digital record.
No word on cost yet, but it should be available as summer approaches.
Tuesday, January 10, 2012
If there's one thing I know about, it is protecting your tech. I've had more adventures over the years of dropping something valuable and either breaking it or scraping it up than I care to admit. I even dropped a then state of the art phone at the first DPR Digital Radiography Congress in San Francisco and shattered the device's screen. So I know a little bit about the heartbreak that can come from slips and drops. That's why I've become such a big fan of Otterbox. They make amazing cases to protect your gear. They are well designed, durable, and look good. I'm currently protecting my iPhone, Samsung Galaxy I, iPad, and Motorola Xoom all with Otterbox Defender cases. Hey, I tend to be tough on my toys, but with Otterbox, they never get a scratch. Here are the specs on the Otterbox Defender for the iPhone 4S. If you love your tech like I do, you really should get an Otterbox. Compatibility: iPhone 4S iPhone 4 Features: Three layers of protection Complete interaction of the device's functions Ratcheting belt clip holster included Material: Clear protective membrane on touch screen High-quality polycarbonate shell Durable silicone skin Environmental Protection: This case provides added protection against bump, shock, drop and dust intrusion. Case is NOT protective against water. Patents Pending - Posted using BlogPress from my iPad
Monday, January 9, 2012
Sunday, January 8, 2012
Saturday, January 7, 2012
LAS VEGAS, Consumer Electronics Show [Booth South 4, #35351] (Jan. 10, 2012) – Plustek Technology Inc. (www.plustek.com/usa), a manufacturer of consumer, prosumer and professional imaging devices, will exhibit a full line of new products at the world-renowned 2012 International Consumer Electronic Show (CES) at the Las Vegas Convention Center.
Reinforcing its commitment to mobility, innovation and the professional and prosumer film scanning market, Plustek is releasing four new mobile scanners, a scanner that scans 120 mm sized film at a reasonable price, and a simple to configure network attached document scanner.
New products Plustek will introduce at CES include OpticFilm 120, a professional grade film and slide scanner that scans both 120 and 35mm film; MobileOffice D412, a duplex, mobile or AC powered 12 ppm document and card scanner; MobileOffice D430, a high-speed document and card scanner designed for front desk, patient registration, pharmacy and lockbox applications; MobileOffice AD460, a duplex, AC Powered 20 ppm document and card scanner with 20 sheet Automatic Document Feeder; MobileOffice S410, a simplex 6 ppm USB powered document and card scanner that includes scan to Evernote and Google Picasa at the touch of a button; SmartOffice PN2040, a sharable duplex 20ppm network attached scanner with flatbed and Automatic Document Feeder ideal for small offices and workgroups; nDVR540, a four channel DVR with integral hard drive for analog video cameras includes browser based management; and NVR Slim240Pro, a four channel NVR with integral hard drive and Plustek Multi-Channel Video Management Software.
Other products on display will be the previously launched: OpticFilm 7400 and OpticFilm 7600i Ai 35mm film and slide scanners; MobileOffice S420 12 ppm USB and AC powered document and card scanner; SmartOffice PS286 Plus 25 ppm workgroup class document and card scanner; SmartOffice PS406U 40 ppm departmental class document and card scanner; OpticBook A300 A3 size book scanner that scans at 2.5 seconds per page and features Plustek’s patent pending Shadow Elimination Element technology; and NVR Slim240Pro ruggedized network video recorder for surveillance applications.
All Plustek SmartOffice and MobileOffice scanners include a suite of document management applications, TWAIN drivers, single touch button scanning, and scan to PDF. In addition, APIs are available to authorized system integrators.
The 2012 International CES will be held January 10-13th in Las Vegas, Nevada. For more information, visit: http://www.esweb.org/. Members of the press interested in a briefing at the Plustek [booth South 4, #35351] should contact Cindy Teng at (714) 458-1150. An electronic press kit with fact sheets and photos can be found online at: http://plustek.com/downloads/PLUSTEK_2012CES_EPK.zip.
Respected as one of the world’s leading image solution providers, Plustek manufactures and delivers high-quality scanners and other imaging products to buyers worldwide, reaching millions of consumers. In business since 1986, Plustek began as an original equipment manufacturer (OEM) for many large companies, creating an innovative array of products including: scanners, IP cameras, servers and imaging-related devices. Through a combination of design innovation and strict attention to usability and manufacturing quality, Plustek has grown to become one of the largest image solution providers in the world. In addition to supporting its sales offices worldwide, Plustek’s state of the art factories and offices are able to provide just-in-time manufacturing and engineering expertise on a contract basis. This combination of skill sets allows Plustek to introduce outstanding new products to the market with superior design, support and with unrivaled after-sales support and service. For more information, please visit www.plustek.com/usa.
Friday, January 6, 2012
Updating the Management of the Dental Patient at Risk for Osteonecrosis of the Jaw Bone (ONJ) While Taking Bisphosphonates or Denosumab (Prolia®) - Latest Reports from the American Dental Association
The stated purpose of the 47-page report is to help dental professionals make treatment decisions based on recent and best evidence, and on expert opinion, for patients being treated with drugs to manage and prevent osteoporosis — namely the bisphosphonates and the nonbisphosphonate antiresorptive agent, denosumab (Prolia®). The report can be used as an educational tool, to assist the dental professional when discussing oral health with patients receiving these drugs and when treating these patients. This report is available at www.ada.org and can be printed from the following URL:
The ADA conducted a search of Medline using PubMed for literature published between May 2008 (the end date of the last advisory statement search) and February 2011. The report focuses on patients taking bisphosphonates or denosumab to manage and treat low bone mass, including osteoporosis, and not for cancer management. The report describes therapies for osteoporosis, reviews the literature for osteonecrosis of the jaw bone (ONJ), describes staging and treatment strategies for drug-induced ONJ and makes recommendations for the dental management of noncancer patients receiving antiresorptive therapy. The report is clear to emphasize that it does not represent a standard of care; the clinical recommendations should be integrated with the practitioner's professional judgment and individual patient needs and preferences. I would encourage the readers of this newsletter to access the site (see above) and review this very informative report.
To compliment the 47-page report, the ADA published the second report as an executive summary by the Council on Scientific Affairs in the November 20011 issue of the Journal of the American Dental Association entitled "Managing the Care of Patients Receiving Antiresorptive Therapy for Prevention and Treatment of Osteoporosis."
This executive summary also focuses on patients receiving bisphosphonates and other antiresorptive therapy for low bone mass rather than on patients receiving antiresorptive therapy for cancer treatment. Patients with low bone mass, namely osteoporosis, are seen routinely by general dentists and the risks and patient care are much different for patients receiving antiresorptive therapy for cancer treatment.
Highlights of the executive summary report
The executive summary report states the risk of developing ONJ in patients taking bisphosphonates or denosumab remains low, with an estimated prevalence of 0.1 % (one case out of every 1000 individuals exposed to bisphosphonates or denosumab). In their previous estimate (2008 report), the risk was 1 case out of 140,000 person years exposure to bisphosphonates. It was also stated that the benefits of using the oral bisphosphonates to prevent osteoporosis significantly outweigh the small risk of developing bisphosphonate-associated ONJ. Also, at the present time, there are no validated diagnostic techniques to determine which patients are at increased risk of developing ONJ.
The executive summary report reminds the dental professional that ONJ can occur spontaneously in patients taking these drugs. In addition, the risk of ONJ increases with specific procedures that increase bone trauma, particularly tooth extractions. Other factors that increase risk of ONJ in patients taking these drugs are age (older than 65 years), periodontitis, use of bisphosphonates for more than 2 years, smoking, denture wearing and diabetes.
The popular bisphosphonates used in the US to treat osteoporosis in postmenopausal women are alendronate (Fosamax®), alendronate/cholecalciferol (Fosamax® D), risedronate (Actonel®), ibandronate (Boniva®), and zoledronic acid (Reclast®). Denosumab (Prolia®) is not a bisphosphonate but a monoclonal antibody which inhibits bone resorption by mechanisms different from those of bisphosphonates (see previous newsletter).
The executive summary report addressed the issues of serum CTX tests and drug holidays.
Serum CTX tests
Marx et al, (Marx RE, Cillo JE Jr, and Ulloa JJ, "Oral Bisphosphonate-Induced Osteonecrosis: Risk Factors, Prediction of Risk Using Serum CTX Testing, Prevention, and Treatment," J Oral Maxillofac Surg, 2007, 65(12):2397-410) have suggested the use of a serum bone turnover marker in assessing the risk of ONJ in bisphosphonate users. The serum bone turnover marker is C-terminal telopeptide fragments from collagen (CTX) and is measured by a serum CTX test which, according to Marx, roughly correlates to the systemic suppression of bone renewal caused by the oral bisphosphonates. Marx suggested that bone turnover markers have use in assessing the risk of ONJ. Values lower than 100 pg/ml were correlated with a high risk of ONJ, values between 100 and 150 pg/ml correlated to a moderate risk, and values greater than 150 pg/ml associated with minimal or no risk. Since bisphosphonate drugs suppress osteoclastic activity, this results in suppression of bone turnover. Thus, lower serum values of the telopeptide fragments would indicate low osteoclastic activity and low bone turnover at the time of measurement. This ultimately results in bone necrosis. Thus, individuals with low CTX values while taking bisphosphonates are assumed to have jaw bones which may not be able to normally repair themselves and these individuals would have a relatively higher risk of developing ONJ compared to individuals having higher CTX serum values.
The executive summary report states that there is simply not enough evidence to recommend the use of serum tests such as serum CTX as a predictor of ONJ. This mirrors the 2008 statement which said that until objective research studies document and correlate the specificity, predictive value and reliability of the CTX test, no recommendations can be made.
Drug holiday concept
A "drug holiday" is a discontinuance of the bisphosphonate drug for a length of time thought to achieve a reduction of risk of ONJ. It has been suggested by various researchers that one consider interrupting bisphosphonate treatment for 3-4 weeks prior to surgery and restarting after bone healing. This suggestion has not been supported by the ADA. According to the ADA, no study results to date have confirmed that drug holidays are effective in preventing ONJ without increasing the skeletally-related risks of low bone mass during treatment.
The executive summary report, like the 2008 report, goes on to make recommendations for the management of dental care of patients receiving oral bisphosphonate therapy or denosumab therapy and subdividing their recommendations according to general dentistry, oral and maxillofacial surgery, restorative dentistry and prosthodontics, orthodontics, implant placement and maintenance, management of periodontal disease and endodontics. The following are the key points from their recommendations.
General dentistry: The dental professional should not modify routine dental treatment because of the use of the osteoporotic drugs. Dental patients taking a bisphosphonate or denosumab should be informed that there is a very low risk of developing ONJ. The highest prevalence estimate in a large sample is about 0.1%. The low risk of developing ONJ can be minimized but not eliminated. The dentist is reminded that there is no validated diagnostic technique available to determine if patients are at increased risk of developing ONJ. Also, discontinuing oral bisphosphonate therapy may not eliminate or reduce the risk of developing ONJ. An oral health program consisting of sound oral hygiene practices and regular dental care may be the optimal approach for lowering risk of developing ONJ.
The executive summary report suggests a major goal in the prevention of ONJ is limiting the possibility of extensive or multifocal involvement. This is consistent with the 2008 report which said it may be prudent to proceed conservatively in bisphosphonate patients, to gain some insight as to how the patient will heal before putting multiple quadrants at risk. The 2011 summary recommends a patient with active dental or periodontal disease should be treated, despite the risk of developing ONJ, because the risks and consequences of no treatment likely outweigh the risks of developing ONJ. Leaving active dental disease untreated can lead to complications that may require more extensive and risky treatments. In certain situations, the dentist should consider obtaining written acknowledgement for consent of a chosen course of dental treatment after a discussion of the benefits, risks and treatment options.
Oral and maxillofacial surgery: Patients undergoing surgery should be informed of the risk of developing ONJ. The clinician should discuss with the patient alternative treatment plans including endodontic treatment followed by removal of the clinical crown allowing the roots to exfoliate rather than extraction, and provision of bridges and partial dentures instead of implant placement. Before and after any surgical procedures involving bone, the patient should rinse with chlorhexidine using the common regimen of twice daily rinse for 4-8 weeks after surgery. In addition, antibiotic prophylaxis, starting one day before and extending 3-7 days after dental procedures, may be effective in preventing ONJ.
Restorative dentistry and prosthodontics: There is no evidence that malocclusion or masticatory forces increase the risk of developing ONJ. All routine restorative procedures may be conducted in a patient taking oral bisphosphonates.
Orthodontics: Case reports have indicated inhibited tooth movement in patients receiving bisphosphonates. Patients should be advised of this potential complication. The duration of orthodontic treatment may be longer and uniform tooth movement may be compromised in the patient exposed to bisphosphonates and denosumab.
Implant placement and maintenance: Bisphosphonate treatment is not a contraindication for dental implant placement. Studies to date have shown similar success rates in implant placement in patients with or without bisphosphonate exposure (success 95% or greater). Dentists can inform patients that the risk of developing ONJ as a result of exposure to the bisphosphonates and denosumab is low and that success rates for implants placed in patients receiving bisphosphonate treatment is no different in the short term (less than 10 years) from the success rates for implants placed in patients without a history of bisphosphonate exposure. The executive summary report mentions the lack of data regarding effects of implant placement in patients taking oral bisphosphonates. However, the report also states that the patient may be at increased risk of developing ONJ when extensive implant placement is necessary.
Management of periodontal disease: Patients receiving bisphosphonates or denosumab who have active periodontal disease should receive appropriate forms of nonsurgical therapy. Also, as in the 2008 report, there is still no evidence that periodontal procedures such as guided tissue regeneration or bone replacement grafts increase or decrease the risk of ONJ or the success of implant treatment.
Endodontics: As stated in the 2008 report, endodontic treatment is preferable to surgical manipulation if a tooth is salvageable. The present report updates that statement with the fact that limited evidence shows that periapical healing after endodontic therapy is similar regardless of whether or not patient has a history of bisphosphonate use.
The full 47-page report is:
Hellstein JW, Adler RA, Edwards B, et al, for the American Dental Association Council on Scientific Affairs Expert Panel on Antiresorptive Agents, "Managing the Care of Patients Receiving Antiresorptive Therapy for Prevention and Treatment of Osteoporosis: Recommendations from the American Dental Association Council on Scientific Affairs."http://www.ada.org/sections/professionalResources/pdfs/topics_ARONJ_report.pdf Accessed Nov 25, 2011.
2011 executive summary:
Hellstein JW, Adler RA, Edwards B, et al, "Managing the Care of Patients Receiving Antiresorptive Therapy for Prevention and Treatment of Osteoporosis," Executive Summary of Recommendations from the American Dental Association Council on Scientific Affairs, J Am Dent Assoc, 2011, 142(11):1243-51.
Edwards BJ, Hellstein JW, Jacobson PL, et al, American Dental Association Council on Scientific Affairs Expert Panel on Bisphosphonate-Associated Osteonecrosis of the Jaw, "Updated Recommendations for the Management and Care of Patients Receiving Oral Bisphosphonate Therapy: An Advisory Statement from the American Dental Association Council on Scientific Affairs," JADA, 2008,139(12):1674-7.
Drug information is constantly changing. Promote medication safety in your practice with Lexicomp Online for Dentistry.
Thursday, January 5, 2012
Although this post doesn't strictly deal with technology, it does deal with social engineering which is a way that lots of passwords are stolen & lots of thieves get valuable information that they use to steal from honest folks. So to that end, here is information that I've received from the Missouri Dental Association:
The MDA office has learned today that some members in Missouri – and in other states – are being faxed fraudulent ADA membership invoices.
The MDA reported the concern to ADA and learned that the questions/concerns are flowing in through a number of channels from a number of states. The ADA Legal team is working on identifying the culprit through Massachusetts (the supposed source on the invoice) and pulling in IT to see if there was some breach of member data.
Expect to see an issues alert from ADA as soon as possible. In the meantime, MDA wanted to alert our members and provide some information about this issue.
Again, please watch for information from the ADA about this issue and if the MDA has any additional information to share specific to Missouri, we will send it in an enews.
If you have any questions about your MDA membership, please contact the MDA office by emailor at 573-634-3436 or 800-688-1907.
Wednesday, January 4, 2012
The CEREC 27 and a Half Year Anniversary Celebration
Will Take Place August 16 – 18, 2012 at the Venetian® in Las Vegas
Charlotte, NC (December 22, 2011) – Waiting for the big 3-0 just won’t cut it! That’s why Sirona, the company that pioneered digital dentistry more than 26 years ago and the world’s leading producer of dental CAD/CAM systems, is celebrating the 27-and-a-half-year anniversary of its industry-changing CEREC dental CAD/CAM system with a three-day extravaganza at the Venetian Casino and Resort.
Commenting on the tongue-in-cheek event name, Sirona Dental Systems, LLC President Michael Augins said, “We simply can’t wait another 3-½ years to get our customers together again. We had more than 3,000 attendees at CEREC 25 and their enthusiasm for our products and the success of the program has encouraged us to do it all over again.”
Earlier this year, Sirona launched CEREC Software 4.0 which was the most advanced and comprehensive redesign in the history of the CEREC software platform. According to Augins, “We feel the need to celebrate our on-going success with our most loyal customers and friends. What’s more, an event this big needs the best possible venue, and the Venetian in Las Vegas is the ideal location to host what we believe will be the biggest and best CEREC event to date.”
For those who prefer round numbers in their company milestones, the CEREC 27 and a Half
Year Anniversary Celebration will also commemorate the 20th anniversary of Schick digital radiography, the 10th anniversary of Sirona’s inLab® Dental Lab CAD/CAM System and the 5th
anniversary of the GALILEOS® Digital Imaging System. In addition to CEREC, special education
tracks will highlight those product lines to broaden the appeal of the event. The event, according to Augins, will be geared toward all dental and laboratory professionals and follow Sirona’s traditional and successful CE event formula, consisting of education, A-list entertainment, networking and fun.
As in the C25 event before, the CEREC 27 and a Half Year Anniversary Celebration enables participants to earn up to 18 CE credits across a comprehensive spectrum of topics and tracks, premium entertainment, and memorable parties. There will also be an exhibit hall showcasing top dental companies and their products and services.
As usual, Sirona plans to showcase a “who's who” of digital dentistry during the CEREC 27 and a Half Year Anniversary. Although final details are still in progress, the following marquee name lecturers have already agreed to participate:
- •Gordon Christensen, DDS, MSD, PhD
- •Frank Spear, DDS, MSD
- •Rella Chistensen, RDH, PhD
- •Andreas Bindl, PD. Dr. med. dent.
- •Imtiaz Manji, CEO, Scottsdale Center for Dentistry™
“The C27 and a Half Year Celebration will be a great destination for advanced CAD/CAM and digital dentistry education provided by the best educators in our field, as well as a great open communication forum for Sirona, our colleagues, clients, associates, and other professionals who hold the same interests.” Commented Roddy MacLeod, Vice President of CAD/CAM for Sirona Dental Systems, LLC. “It will be the digital event of the year!”
Although August may seem far out on the horizon, space is limited and dental and dental lab professionals are encouraged to visit www.CEREC27andahalf.com, or call toll free 855-237-3248 for additional information as it becomes available, including special early registration tuition and lodging packages.
About Sirona Dental Systems, Inc.
Sirona, the dental technology leader, has served dealers and dentists worldwide for more than 130 years. Sirona develops, manufactures, and markets a complete line of dental products, including CAD/CAM restoration systems (CEREC), digital intra-oral, panoramic and 3D imaging systems, dental treatment centers and handpieces. Visit http://www.sirona.com for more information about Sirona and its products.
Tuesday, January 3, 2012
If you're reading this, then you definitely know that I absolutely love anything to do with Tech!!!
However, not all tech is good and not all tech companies make the best decisions. I mean, hey, we're all human right? Despite the fact that large corporations are supposed to weigh decisions carefully and do a fair amount of research before making drastic changes, sometimes things just don't' work out as planned.
One of the articles that I read over my Christmas break was from CNN.com and it was entitled "Doh! The top 10 tech 'fails' of 2011". It was a fairly non-biased and straightforward piece about some products and decisions that were made that just didn't go over like they were planned.
The list? Here it is:
- Weiner on Twitter
- Go Daddy's SOPA misstep
- 'Duke Nukem Forever'
- The other tablets
- Game off at PlayStation Network
- iPhones and bars don't' mix
- PayPal plays Scrooge
- iPhone 4S battery life
- Bad year for BlackBerry
It's a good article and I think everyone can learn something from it. I'm a firm believer that we all learn tons more from our failures than from our successes. In fact, one of the things I like to do is to try and learn as much about the failures that have occurred in this world. In that way, I'm hoping to learn how to avoid making those types of mistakes myself… and believe me I've made more than most of you.
Monday, January 2, 2012
Happy New Year everyone! As 2012 begins, I'll remind you of something that I think of on a regular basis… the only constant is change.
2011 was an unusual year for many reasons. We saw political upheaval in many places, a high number of natural disasters, and an economy that struggled… and still continues to do so.
However, despite the "doom & gloom" of some pundits, I'm optimistic that 2012 is going to be a whole lot better. With more stability in the middle east after the "Arab Spring" and a presidential election that is gearing up, I truly think the economy will continue to improve. We've seen a strong progression in the stock market in a positive fashion in the last year which should bode well for the coming year as well.
For those reasons, I'm bullish on 2012 and what it means for the tech sector, for dentistry, and well… er… for the tech sector of dentistry too.
So in 2012, I will be hard at work to find the type of things you've come to expect here. My goal is to keep you informed of high tech that can help you if you are in health care (especially dentistry) as well as high tech for your personal life or if you aren't in a health care related field. I get a chance to see and experiecne a lot of cool things as Technology Editor for Dental Products Report but there is just no way I can manage to get all of those things into the magazine. That's what is so great about this blog. It gives me a daily outlet to let you know what I've managed to get my hands on or what I've managed to dig up. I've got some great ideas for this year, so check back daily.
Oh, and if you have an idea of something that you would like to see covered either here or in Dental Products Report, feel free to drop me a Tweet or an email. Here's to an *amazing* 2012!!!
Sunday, January 1, 2012
I hope everyone had a great Holiday Break!!! I know I did.
Sometimes you just really need to rest & recharge… I know I do.
2011 was a busy year for me and while I love blogging and the interaction with all of you through the comments section as well as through Twitter, the craziness of 2011 caught up with me a bit and I really needed a rest. So now that the rest is over, it's back to the full throttle schedule I usually live. Posts will resume tomorrow (Monday).