Glidewell Labs Annouonces All PFM Cases Will Use Obsidian® Lithium Silicate in Place of Feldspathic Porcelain

The death knell of the PFM restoration is upon us.  Take a read of Glidewell's announcement below.

 Glidewell Laboratories, industry-leading provider of dental laboratory products and services, announced today that production of conventional feldspathic PFMs will cease companywide effective October 1, 2016. All future PFM cases prescribed from the lab will use Obsidian® lithium silicate ceramic in place of feldspathic porcelain.

When compared to conventional PFMs, Obsidian Pressed to Metal crowns and bridges represent a higher standard of care in ceramo-metal restorations. Obsidian lithium silicate ceramic exhibits over four times the flexural strength and two times the chip resistance of traditional porcelains. The material polishes beautifully and is kinder to opposing dentition than previous PFM ceramics. The increased toughness of Obsidian makes it ideal for bridges, cases with insufficient vertical space for full-contour zirconia, and screw-retained restorations.  

Obsidian’s greater translucency matches shades and blends more naturally with real dentition. Obsidian Pressed to Metal restorations also enable a new level of marginal precision, with tolerances as tight as 20 microns. Each metal understructure is digitally designed and then fabricated with a computer-controlled selective laser sintering machine, which uses a laser to bind metal powder into a 3-D shape. This precision established with these techniques helps prevent bacterial invasion and cement washout in delivered restorations.

Jim Glidewell, CDT, said, “Obsidian Pressed to Metal crowns are without question the next step in the evolution of PFMs.” Obsidian Pressed to Metal restorations are priced at the current PFM rate of $109 per unit for non-precious alloy and at a reduced rate of just $116 per unit for white noble alloy.

For more information about Obsidian lithium silicate ceramic, visit http://www.obsidianceramic.com.

Glidewell Laboratories is a privately owned corporation that has more than 46 years of history as a provider of high-quality restorations to dental practitioners nationwide. Its CAD/CAM processing capabilities are recognized as among the most advanced in the industry. To view its large selection of clinical videos, CE courses, and products and services, visit the Glidewell Laboratories website,http://www.glidewelldental.com.

FDA Bans 19 Chemicals Used In Antibacterial Soaps

The FDA is banning some antibacterial components from consumer grade soaps.

Here is all the info straight from the source:

The U.S. Food and Drug Administration today issued a final rule establishing that over-the-counter (OTC) consumer antiseptic wash products containing certain active ingredients can no longer be marketed. Companies will no longer be able to market antibacterial washes with these ingredients because manufacturers did not demonstrate that the ingredients are both safe for long-term daily use and more effective than plain soap and water in preventing illness and the spread of certain infections. Some manufacturers have already started removing these ingredients from their products.

This final rule applies to consumer antiseptic wash products containing one or more of 19 specific active ingredients, including the most commonly used ingredients – triclosan and triclocarban. These products are intended for use with water, and are rinsed off after use.  This rule does not affect consumer hand “sanitizers” or wipes, or antibacterial products used in health care settings.

“Consumers may think antibacterial washes are more effective at preventing the spread of germs, but we have no scientific evidence that they are any better than plain soap and water,” said Janet Woodcock, M.D., director of the FDA’s Center for Drug Evaluation and Research (CDER). “In fact, some data suggests that antibacterial ingredients may do more harm than good over the long-term.”

The agency issued a proposed rule in 2013 after some data suggested that long-term exposure to certain active ingredients used in antibacterial products — for example, triclosan (liquid soaps) and triclocarban (bar soaps) — could pose health risks, such as bacterial resistance or hormonal effects. Under the proposed rule, manufacturers were required to provide the agency with additional data on the safety and effectiveness of certain ingredients used in over-the-counter consumer antibacterial washes if they wanted to continue marketing antibacterial products containing those ingredients. This included data from clinical studies demonstrating that these products were superior to non-antibacterial washes in preventing human illness or reducing infection.

Antibacterial hand and body wash manufacturers did not provide the necessary data to establish safety and effectiveness for the 19 active ingredients addressed in this final rulemaking. For these ingredients, either no additional data were submitted or the data and information that were submitted were not sufficient for the agency to find that these ingredients are Generally Recognized as Safe and Effective (GRAS/GRAE). In response to comments submitted by industry, the FDA has deferred rulemaking for one year on three additional ingredients used in consumer wash products – benzalkonium chloride, benzethonium chloride andchloroxylenol (PCMX) – to allow for the development and submission of new safety and effectiveness data for these ingredients. Consumer antibacterial washes containing these specific ingredients may be marketed during this time while data are being collected.

Washing with plain soap and running water remains one of the most important steps consumers can take to avoid getting sick and to prevent spreading germs to others. If soap and water are not available and a consumer uses hand sanitizer instead, the U.S. Centers for Disease Control and Prevention (CDC) recommendsthat it be an alcohol-based hand sanitizer that contains at least 60 percent alcohol.

Since the FDA’s proposed rulemaking in 2013, manufacturers already started phasing out the use of certain active ingredients in antibacterial washes, including triclosan and triclocarban. Manufacturers will have one year to comply with the rulemaking by removing products from the market or reformulating (removing antibacterial active ingredients) these products.

The FDA, an agency within the U.S. Department of Health and Human Services, protects the public health by helping to ensure the safety, effectiveness, and security of human and veterinary drugs, vaccines and other biological products for human use, and medical devices. The agency also is responsible for helping to ensure the safety and security of our nation’s food supply, cosmetics, dietary supplements, and products that give off electronic radiation, and for regulating tobacco products.

Here is a list of the newly banned chemicals:

• Cloflucarban
• Fluorosalan
• Hexachlorophene
• Hexylresorcinol
• Iodine complex (ammonium ether sulfate and polyoxyethylene sorbitan monolaurate)
• Iodine complex (phosphate ester of alkylaryloxy polyethylene glycol)
• Nonylphenoxypoly (ethyleneoxy) ethanoliodine
• Poloxamer-iodine complex
• Povidone-iodine 5 to 10 percent
• Undecoylium chloride iodine complex
• Methylbenzethonium chloride
• Phenol (greater than 1.5 percent)
• Phenol (less than 1.5 percent) 16
• Secondary amyltricresols
• Sodium oxychlorosene
• Tribromsalan
• Triclocarban
• Triclosan
• Triple dye

A New Link between Traumatic Brain Injury and Posttraumatic Stress Disorder

As someone who has suffered a severe concussion (and several less severe  ones) I'm fascinated by the whole field of Traumatic Brain Injury (TBI) and what it can lead to... Especially since I may become a victim at some point in time.

Here's a great summary of a study that is helping scientists understand the links between TBI and PTSD.  This is a pretty common situation in soldiers that were in Iraq and Afghanistan.

Philadelphia, PA, February 22, 2012 – Mild traumatic brain injury (TBI) and posttraumatic stress disorder (PTSD) are cardinal injuries associated with combat stress, and TBI increases the risk of PTSD development. The reasons for this correlation have been unknown, in part because physical traumas often occur in highly emotional situations.

However, scientists at University of California at Los Angeles provide new evidence from an animal model of a mechanistic link underlying the association between TBI and PTSD-like conditions.

Using procedures to separate the physical and emotional traumas, Dr. Maxine Reger and colleagues trained rats using fear conditioning techniques two days after the rats had a concussive brain trauma. This ensured the brain injury and experience of fear occurred on different days.

Dr. Michael Fanselow explained their findings: “We found that the rats with the earlier TBI acquired more fear than control rats (those without TBI). Something about the brain injury rendered them more susceptible to acquiring an inappropriately strong fear. It was as if the injury primed the brain for learning to be afraid.”

To further understand why this happened, the researchers analyzed a small piece of brain tissue, the amygdala, which is the brain's critical hub for fear learning. They found that there were significantly more receptors for excitatory neurotransmitters that promote learning. “This suggests that brain injury leaves the amygdala in a more excitable state that readies it for acquiring potent fear,” added Fanselow.

These findings now suggest a causal link between TBI and the increased susceptibility to PTSD, and identified an important role for the amygdala in this effect. “The next challenge is to characterize the neural circuitry and neurobiology of this effect. These are critical steps in building from these findings to preventative or therapeutic advances,” commented Dr. John Krystal, editor of Biological Psychiatry.

Although this work was performed in rats, these findings also suggest that people who suffer even a mild traumatic brain injury are more likely to develop an anxiety disorder, and that proper management of stress after such an injury could be critically important to maintaining ones’ mental health.

The article is “Concussive Brain Injury Enhances Fear Learning and Excitatory Processes in the Amygdala” by Maxine L. Reger, Andrew M. Poulos, Floyd Buen, Christopher C. Giza, David A. Hovda, and Michael S. Fanselow (doi:10.1016/j.biopsych.2011.11.007). The article appears in Biological Psychiatry, Volume 71, Issue 4 (February 15, 2012), published by Elsevier

Cosmedent Casi

Cosmedent’s Casi is an innovative double-ended composite sculpting instrument designed to follow the curvature of natural tooth structure. Its built-in convexity and anatomical curvature gives the Casi an advantage for anatomical shaping. The larger end is for sculpting and shaping the central and canines, the smaller end for laterals and lower anterior teeth. This lightweight and easy-to-use instrument comes in a titanium coated finish.

For information about Cosmedent’s Casi, call 800-621-6729 or online at www.cosmedent.com.

Back After an Extended (and I mean *Extended*) Break

Sometimes I work, sometimes I work too hard, and sometimes I attack life.  During those attack phases, I grab life with my teeth like an angry Pit Bull and shake it for all its worth.  Unfortunately for me, those attack phases kept getting closer and closer together.  I finally ended up at a point where I was just exhausted from the pace I was keeping.

On advice from my doctors as well as my friends, I took some much needed time off to just see what it's like to live at a 'normal" pace.  Now that I'm rested and recharged, I'm ready to get back after it.

Starting on Monday I will resume my normal blogging schedule of Monday through Thursday posts.  I hope you enjoy what I have to say and will tell your friends about the blog and my column in DPR.  Thanks for your understanding during my sabbatical.  I've missed all of you!