Tuesday, February 28, 2017

Convergent Dental Introduces Solea SW 3.1.1: Significant Advancements in Usability and Patient Comfort

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Company Unveils Latest Software Innovation at this Year’s 

Chicago Midwinter Dental Meeting


Needham, MA (February 23, 2017) – Convergent Dental Inc., developer of Solea®, the industry-leading, computer-aided, CO2 all-tissuedental laser system, is pleased to announce the launch of Solea SW 3.1.1 at this year’s Chicago Midwinter dental meeting. The latest software provides dental professionals with unprecedented usability and control while further enhancing the patient experience. With updated algorithms that control how the laser cuts both hard and soft tissue, Solea SW 3.1.1 facilitates the onset of analgesia more quickly and effectively than ever before, and provides exceptional cutting speed ability in both hard and soft tissue.


“Solea SW 3.1.1 marks yet another milestone in improved usability that makes it easier for any dentist to confidently treat patients without anesthesia,” remarked Michael Cataldo, Convergent Dental CEO. “We are constantly gathering data on how our customers use Solea and how their patients experience it. That gets fed into the product development process and incorporated into software improvements that improve cutting speed, analgesia, the ability to control bleeding and more. Simply put, the more Solea is used, the smarter it gets. All of that accrues to the benefit of our customers and their patients, no matter when Solea was integrated into the practice. Every system in the market gets the same updates delivered over Wi-Fi keeping every customer up to date. Solea SW 3.1.1 is another testament to our commitment to increasing customer value long after the initial purchase.” 


Solea SW 3.1.1 is readily available at no charge to all Solea customers with an active service contract. Customers simply type in a four-digit PIN number on their existing Solea unit, and the new Solea SW 3.1.1 is automatically downloaded. No additional external service is needed; there is no waiting on technicians; just a no-hassle simple download for a seamless transition.    


The innovative software update was well received during its beta test phase. According to Dr. Yooson Kim, an early adopter of Solea, “After a quick and simple download, from the first use of Solea SW 3.1.1 it offered an improved experience for both me and my patients. The onset of analgesia was almost automatic, and the cutting speed just keeps getting faster. I didn’t think it was possible for Solea to be even simpler to use but Convergent Dental has exceeded my expectations once again.”

Dental professionals are encouraged to experience how the Solea SW 3.1.1 can work for them by visiting Convergent Dental at the 2017 Chicago Midwinter dental meeting at Booth #4431. 


For further information about Solea, please visit www.convergentdental.com or call 844.GOSOLEA.



About Convergent Dental, Inc.

Convergent Dental, Inc. is a privately owned dental equipment and technology company. Solea® is the only computer-aided, CO2 laser system to be cleared by the FDA for all-tissue indications. With Solea’s unique wavelength and computer controls, dentists can reliably perform procedures anesthesia-free, blood-free, suture-free, and pain-free. Reliably anesthesia-free and blood-free procedures pay huge dividends for patients in the form of a vastly improved dental experience and dentists in terms of significant practice growth. For more information, please visit www.convergentdental.com. Follow the company on Twitter, Facebook and LinkedIn.



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Monday, February 27, 2017

Ultradent Announces Mosaic Composite!

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At last week’s Chicago MidWinter meeting, Ultradent began taking orders for their newest composite named Mosaic.
This material has been in development for a while now and I’m very excited that it is at last available for order.
One of the things I really like about Ultradent as a company is their steadfast commitment to quality.  They just won’t bring something to market that is not the absolute best they can produce.  What this means to you as a customer is that you know this material has met or exceeded the company quality control specs before you ever get your hands on it.  I had a chance to experiment with Mosaic in the lab at Ultradent about a year ago.  I was impressed with it then, but they were determined to make a few improvements to it before making it available for purchase.
I began to use it fairly exclusively near the end of October 2016 and have been putting it through clinical testing ever since.  In my experience with it, I’ve found it to be an outstanding material.  It is available in both enamel and dentin shades giving you a wide range to deal with and performs exceptionally well with layering.  The handling is exquisite with a great consistency that does not slump and is easy to sculpt.
Mosaic also has incredible polishability making it have a natural shine and luster.
This is definitely a composite to have in your office.  After working with it for the last quarter, I can say this product is *highly recommended*!!!

Here is the press release from Ultradent:

Ultradent Products, Inc. Proudly Introduces 

Mosaic™ Universal Composite


SOUTH JORDAN, Utah, February 21, 2017 Ultradent Products Inc. proudly introduces Mosaic™ universal composite, which balances beauty and performance for lasting, lifelike restorations. Mosaic composite can be used for all restorative purposes: basic or complex. Its well-balanced nanohybrid formula produces restorations of the highest quality. Combining the strength properties required for posterior use with the esthetic characteristics desired for anterior use, Mosaic universal composite ensures superior results both visually and functionally.


Mosaic universal composite’s smooth, pliable consistency allows for total control during manipulation. Once the material is shaped, it won’t flow or slump out of place. Available in 20 intuitive dental and enamel shades, it provides predictable shade matching using single, double, or multiple-layer techniques, as it was designed to emulate the same levels of translucency and opacity seen in natural dentition. Dentin and enamel shades also mimic the same fluorescence that occurs in natural dentin and enamel. The proprietary dispersion of nanofillers in Mosaic composite allows for a high polish and long-term gloss retention, allowing the restorations to maintain a long-term luster. Low volume shrinkage and low shrinkage stress reduce the potential for strain on the restoration during polymerization, while high compressive and flexural strength ensure that the restoration can withstand repetitive chewing and biting forces. 


Mosaic universal composite comes in unique, four-gram syringes, featuring an innovative design with a smooth, contoured handle and barrel to allow for easy cleaning while still being easy to grip and identify. It is also available in convenient .2-gram unit-dose singles. 


To learn more about Mosaic universal composite, please call 800.552.5512, or visit ultradent.com. 



About Ultradent Products, Inc.

Ultradent Products, Inc. is a leading developer and manufacturer of high-tech dental materials, devices, and instruments worldwide. Ultradent’s vision is to improve oral health globally. Ultradent even works to improve the quality of life and health of individuals through financial and charitable programs. For more information about Ultradent, call 800.552.5512 or visit ultradent.com.



Friday, February 24, 2017

KaVo™ Introduces Comprehensive Product Portfolio at 152nd Chicago Midwinter Meeting

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Global leader in dental instrumentation brings imaging and treatment units under its banner of quality 


Kavo is expanding its product offering beyond market-leading handpieces to include innovative treatment units and imaging solutions. The 152nd Chicago Midwinter Meeting — February 23-25, 2017 — is the first major tradeshow to feature all aspects of the new KaVo (Booth No. 1604), and the team is eager to introduce the North American market to its comprehensive product line.

The new KaVo imaging portfolio is the result of bringing the award-winning Instrumentarium Dental™ products under the KaVo brand. For more than six decades Instrumentarium Dental has been at the forefront of extraoral imaging innovation. It is KaVo’s intention and commitment to continue to grow the “OP™” hallmark and heritage under the KaVo brand.

In addition to developments on the imaging side of the business, KaVo treatment units will be available to the US market for the first time. The ESTETICA® E50 Life and ESTETICA E70/E80 Vision units are much more than dental chairs. They represent the pinnacle of KaVo ingenuity and state-of-the-art platforms for technology integration.


This transformation will also simplify the way KaVo supports its customers and products. A new KaVo.com website and single number for service and support,
1-888-ASK-KAVO, will launch on February 24, 2017.


KaVo is also marking this significant milestone with a new, modern logo. This rebranding helps emphasize KaVo’s position in dentistry as a global technology and equipment leader.


“Around the world, the KaVo brand is synonymous with quality,” said Alistair Simpson, Vice President of Global Marketing for KaVo Kerr. “Starting with this year’s Chicago Midwinter Meeting, we are excited to demonstrate to the market that reputation extends far beyond handpieces and instrumentation. Dental Excellence was the goal KaVo first set in 1909, and it continues to be our commitment to the dental professionals we serve.”

Expanding the KaVo portfolio does more than just combine expertise; it lays the groundwork for a truly integrated workflow and innovation rooted in practice problem-solving. For more information on KaVo visit imagine.kavo.com.



About KaVo 


KaVo is a dental products manufacturer with a comprehensive array of dental products ranging from skillfully designed dental instruments, to state-of-the-art dental practice equipment. KaVo’s full family of dental products also includes dental x-ray and diagnostics, dental CAD/CAM systems, dental education resources, as well as dental laboratory equipment and extensive opportunities for product accessorizing and upgrades.

Thursday, February 23, 2017

KaVo Kerr Debuts New Products, New Integrated Presence at 152nd Chicago Midwinter Meeting


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Over the years, the parent company of Kavo Kerr Group has made many acquisitions of companies in the dental space.  This is what has lead to the creation of Kavo Kerr Group as the umbrella over all of the companies.  It appears that now they will be displaying at trade shows in more of a “unified manner” so as to bring this unity to the forefront.  Here are the details: 



The combined team delivers a tradeshow experience designed to engage and educate dental professionals.

Exhibiting at a major tradeshow as a united organization for the first time, KaVo Kerr is excited to bring a new look and new products to the 152nd Chicago Midwinter Meeting this February.

KaVo Kerr, uniting two global leaders to deliver dental excellence, will debut a new logo representing the organization’s new identity. The logo is symbolic of our two organizations, represented as two building blocks, linked together to promote growth, innovation and forward thinking.

At the Chicago Midwinter Meeting, KaVo Kerr will share one dynamic booth — Booth No. 1402. In addition to bringing our integrated workflow solutions together in a single place where dentists can explore and engage, the new booth will feature an educational theater in its center dedicated to education. Over the course of the weekend there will be a number of presentations that highlight products, dental applications and technology trends. Dental professionals can stop by the booth, learn about the daily schedule and join those that are of interest to them. This is a physical representation of KaVo™ and Kerr™’s shared history and ongoing commitment to education and customer support. 


The booth will also be the showcase for a number of exciting product launches from equipment, restoratives and endodontics — details to follow.

“KaVo Kerr’s activities at the 2017 Chicago Midwinter Meeting reflect our ongoing efforts to connect with dental professionals around their core needs: education, inspiration and innovation that drives clinical excellence,” said Phil Prentice, Vice President of North America for KaVo Kerr. “The updated booth is exciting, but we are even more thrilled to see how this new space creates more opportunities for conversation with our customers.”

For more information on KaVo Kerr, visit www.kavokerr.com.


About KaVo Kerr


KaVo Kerr is a cohesive organization comprised of two global leaders, united to provide dental excellence and serve as a single premier partner for the dental community. KaVo Kerr operates with a common vision inspiring and helping our customers, their patients and our own associates realize their potential. KaVo Kerr offers solutions for endodontics, restoratives, treatment units, infection prevention, imaging, rotary and instruments.

Wednesday, February 22, 2017

KaVo™ Introduces ESTETICA™ Treatment Unit Line to North American Market

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E70/E80 Vision and E50 Life bring premium option to the KaVo Treatment Unit portfolio.


KaVo is proud to announce that members of its ESTETICA treatment unit line are available to dental practices in the United States and Canada. With the introduction of KaVo ESTETICA E70/E80 Vision and KaVo ESTETICA E50 Life units, KaVo will now be able to offer a treatment unit for various segments of the market.


Both the E70/E80 Vision and E50 Life feature integrated functions that allow doctors to do more procedures in a seamless manner for an optimized workflow. The integrated sanitation function, for example, allows an office to quickly clean suction hoses and lines, leading to increased patient and staff safety. The three units also share an ergonomic design that facilitates natural, intuitive movement for a healthy posture. 

“Dental professionals around the world are already experiencing the difference KaVo treatment units make in the operatory,” said Phil Prentice, Vice President of North America for KaVo Kerr. “We are excited to finally bring the integration, quality and design to dentists in North America. The wait is over.”

The ESTETICA E70/80 Vision provides optimal support for a wide variety of procedures and features a Dentist Element that represents a completely new operating concept for quick and direct access to important functions for time-saving and smooth treatment processes. It features a surgical function with a small, convenient surgical motor and integrated saline solution pump. In addition to being highly functional, this premium unit is also highly esthetic; its new Blue Line Edition, for example, is available in ocean or smoke blue with device components in modern dental white.


The ESTETICA E50 Life allows the clinician to focus on the areas of practice that are most important while experiencing the support of a high-quality and reliable treatment unit. Features include modern chair design, an optimized soft upholstery form and integrated Trendelenlburg movement for patient comfort. All device components are available in modern dental white.


To see the difference up close, be sure to visit the KaVo booth (No. 1604) at the 152nd Chicago Midwinter Meeting, February 23-25, 2017. For more information on KaVo visit imagine.kavo.com.



About KaVo 


KaVo is a dental products manufacturer with a comprehensive array of dental products ranging from skillfully designed dental instruments, to state-of-the-art dental practice equipment. KaVo’s full family of dental products also includes dental x-ray and diagnostics, dental CAD/CAM systems, dental education resources, as well as dental laboratory equipment and extensive opportunities for product accessorizing and upgrades.



Tuesday, February 21, 2017

Kerr™ Endodontics Launches OptiDam™



First-of-its-kind three dimensional rubber dam designed for stress-free positioning and patient comfort. 


February 10, 17 – Kerr Endodontics, a global leader in endodontic equipmentand consumables, is proud to announce the North American launch of OptiDam, a three dimensional rubber dam unlike any other.

Practicing dentists recognize the simple truth behind the use of rubber dams: They are critical to the success and safety of endodontic and restorative procedures. OptiDam exceeds industry expectations to provide the first three dimensional, low radiopacity rubber dam that offers dental professionals stress-free positioning and patients outstanding comfort.


OptiDam’s design focuses on four core deliverables:

  • Efficacy: Its 3D design offers dentists optimal visibility and accessibility to the treatment area. A clean operating area leads to greater success in procedures.
  • Practicality: Low radiopacity means there is no need to remove the dam during X-rays. Further, its anatomical shape leads to reduced tensioning, meaning dentists don’t need to worry about the dam snapping out of place.
  • Ease of Use: A distinctive nipple design guides the dental professional during positioning for easer assembly and removal. Its intelligent shape means the saliva ejector can comfortably fit underneath the dam.
  • Comfort: Specifically shaped to allow patients to breathe freely, the dam also features versatile anterior and posterior versions to adapt to the dental procedure as needed.


“Not merely soliciting feedback from dental professionals, but truly listening for source of discomfort and inefficiencies in their day-to-day work is essential to the development process behind products such as OptiDam,” said Phil Prentice, Vice President of North America for KaVo Kerr. “The rubber dam is a staple of dental procedures and we believe we’ve elevated a basic tool to something extraordinary that will have a noticeable and immediate impact on the dentist’s work.”


For more information on OptiDam and for the entire Kerr Endodontics family of products, go to KerrDental.com or call 800-KERR123.




About Kerr Corporation


For nearly 125 years, Kerr has been serving the comprehensive needs of the entire dental care community in pursuit of enhancing oral health. Individual Kerr brands are encompassed within the Kerr Restoratives, Kerr Endodontics, Kerr Rotary, and Kerr TotalCare platforms. By providing best-in-class, patient-based solutions, we believe that in partnership with those we serve - “Together we’re more.”

Monday, February 20, 2017

The Medicare Rules to Know from the Motley Fool

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For years, The Motley Fool has been known as a site you can trust for good information.  Recently the site put out an article on Medicare information.  If you are of age to use Medicare, I think it’s in your best interest to read the following tips.  If you would like the full article, you can access it here.  

Medicare rule No. 1: Don't be late enrolling

This rule is surprisingly important -- because if you're late enrolling in Medicare, you can be penalized -- rather significantly. Here's the scoop: You're eligible for Medicare at age 65, and you can sign up anytime within the three months leading up to your 65th birthday, during the month of your birthday, or within the three months that follow. Miss that seven-month-long "Initial Enrollment Period" and your part B premiums -- which cover medical services, but not hospital services -- can rise by 10% for each year that you were eligible for Medicare, but didn't enroll. 


Medicare rule No. 2: Shop around

Once you're enrolled in Medicare, you'll need to choose between original Medicare, featuring parts A and B, and Medicare Advantage plans, which are sometimes referred to as Part C. With traditional (or "original") Medicare, Part A covers inpatient hospital stays, hospice, and skilled-nursing facility stays, while Part B covers outpatient services, such as preventative care, laboratory tests, ambulance services, medical equipment, and necessary doctor services.

Medicare Advantage plans, meanwhile, are administered by private insurers, but are regulated by the U.S. government. Each must offer at least as much coverage as original Medicare (i.e., the benefits you'll find in Part A and Part B). Many go beyond that, though, offering broader coverage, such as vision care, dental care, and/or prescription drug coverage. (Those in original Medicare typically buy Part D for prescription drug coverage, and they may buy Medigap coverage, too, for even greater coverage.) 

So which Medicare plan is best for you? It depends on your needs and preferences. Original Medicare is accepted by most doctors, and you can see them without referrals. So you can find and see a doctor anywhere in the U.S., which is especially handy if you're a traveling retiree.

Medicare Advantage plans feature defined networks of doctors (though some of the networks are quite large) and steeper costs for seeing out-of-network physicians, and they're typically limited to your local region. (Some do, on a limited basis, cover healthcare outside the U.S., unlike original Medicare.) 

Original Medicare will often have you footing 20% of many bills with no limit on how much you end up spending. A Medicare Advantage plan, meanwhile, might charge you a certain copay per doctor visit or service, and many services will simply be paid for through your premium.

Importantly, Medicare Advantage plans also feature out-of-pocket spending caps. (The average out-of-pocket cap was recently $5,223, but many plans feature caps below $3,000, and the limit for 2017 is $6,700.) Once you hit the limit, the plan will pay all further costs. Better still, many plans charge the enrollee nothing in premiums. (The Medicare program pays the insurance company offering it a set sum per enrollee, and if the insurer thinks it can make a profit without charging its customers anything, it can do so.) The average monthly premium for Medicare Advantage plans was recently $33.

There's no one-size-fits-all answer when it comes to deciding between original Medicare and Medicare Advantage. Think about which doctors you see, what services you need, and what drugs you take, and then compare coverage and costs for available plans. You can check out details for available plans by using the Medicare Plan Finder at the Medicare website, which also shows you star ratings for Medicare Advantage plans and Part D (prescription drug coverage) plans in your area. The top score is five stars, and you should favor four- or five-star plans.


Medicare rule
 No. 3: Once you have Medicare, use it!

Both original Medicare and Medicare Advantage plans offer lots of preventive screenings at no extra cost to you -- such as mammograms and colonoscopies. Get screened for cancer, diabetes, and anything else your doctor deems sensible. You're also entitled to an annual wellness visit at no extra cost to you. You may be able to access smoking cessation or weight-loss counseling at little to no cost, and some plans may offer discounts on gym memberships or other wellness benefits.

Find out whether your plan offers "telemedicine" benefits, which give you access to doctors and other providers via the telephone or Skype-like video calls. You may not want to haul yourself all the way to your doctor's office if you're not feeling well -- and a telemedicine consultation may be a good solution, or at least a starting point. Telemedicine is becoming more widespread, so look into it.

If you know the most important Medicare rules, you can avoid paying more than you need to for healthcare coverage. You also may be able to stay healthier and enjoy a longer life.


The $16,122 Social Security bonus most retirees completely overlook 
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Thursday, February 16, 2017

Mavrik Dental Systems Working to Make In-Office Tooth Whitening Better

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For years dentistry has been trying hard to come up with some type system that will deliver the same beautiful results from in-office bleaching that we are capable of producing with take home bleaching.  Up to this point in dental history what we’ve had are high strength solutions that can whiten quickly, but also leave the very sensitive.  Many times this has created a situation that mimics the old medical joke of “the cure is worse than the disease”.  Dentistry has put up with enough over the years when it comes to patients being frightened, but simply adding to the problem is ludicrous.

However, we are also faced with the fact of people being unhappy with their smiles and wanting to change them for the better.  To the rescue of this problem comes a company called Mavrik with their brand new device called the Thera-Smile.  In the early 2000s, a trend spread across dentistry.  That trend was to use a high powered light that would warm the bleaching solution and help accelerate the chemistry.

There were several attempts along these lines.  Companies tried high powered ARC lights, very bright and powerful LED’s, and even lasers.  These devices were always very expensive for the office to purchase and were marketed to patients on television and in women’s magazines.  Often, due to the advertising, women knew about the lights before the industry even got word to the dentists.  Due to the expense of the lighting systems, doctors had no choice but to charge high fees for the procedure.

Then, the science would come along and word would quickly spread that the light did little, if anything, to aid the whitening process.

Well, Mavrik is a different animal in the tooth whitening jungle.  First of all, the device does not use a light at all!!  Instead it uses a process to warm the chemistry (no light needed) and it has a unique intraoral mouthpiece that connects to a an on-board vacuum pump.  The vacuum pulls air out of the mouthpiece causing it to be suction form fitted to the ideal fit.  In my opinion, the biggest marketing hurdle the company faces is the fact that machines have been tried in the in-office bleaching space before… without much success.  Even though the device is completely different from lights, that is still something to overcome.

Then there is the cost.  I’m not sure of the cost of the device, but I can assure you that something this sophisticated will not be inexpensive.  Many offices are now used to advocating take home tray based whitening, so it will be interesting to see where this all goes.

In closing out this post, l’m very enthused about the science Mavrik is using.  It’s approaching in-office whitening from a completely different angle and looks to make an interesting move into the market.  How this all shakes out, only time will tell.

Wednesday, February 15, 2017

The Music of Prince is Now on Streaming Services

As a guy who came of age in the 80’s and wasn’t much younger than His Royal Purpleness, I was greatly saddened last spring when Prince passed away at his home in Minnesota.
The man, who at one time changed his name to an unpronounceable symbol, truly was an artist in every sense of the word.  While I didn’t love ALL his stuff, I loved a good portion of it and the artist known as Prince made a tremendous impact on my generation.
When he passed away, one of the things I was really bummed about was that I couldn’t stream his music.  I ended up just looping my Prince collection for about 96 hours until I could finally deal with the fact that he was gone.
But now comes word that his music is finally going to be on streaming services.  Supposedly his catalogue will be available on Amazon Music, iHeartRadio, Spotify, and Apple Music.  While some of the services are speculation, the fact that the catalogue will be streamed is NOT speculation.  The announcement was made on NPR.  If you’d like to view the page, here is the link.  Otherwise here is the story:

After months of well-sourced rumors, the streaming service Napster (formerly known as Rhapsody) and another source have confirmed to NPR that Prince's records under Warner Bros. — which include the epochal classics 1999Purple RainDirty Mind, and Sign o' the Times — will be available to stream this Sunday, the day of the 59th Grammy Awards.

As the company wrote: "The rumors are true ... music fans rejoice!"

That Napster broke the news is a very strong indication that other streaming services, like Spotify, will also have the catalog. (Spotify and Apple declined to comment.) Amazon Music, iHeartRadio and Apple Music, that last according to an anonymous source, will also have the catalog available.

Many have noted Prince's aversion to streaming (apart from signing a strict deal with Tidal, he removed his music from most other streaming services) without considering his forward-thinking approach to both business and technology. For that, you could do much worse than the comprehensive accounting of the Purple One's technological and business history that Billboard's Jem Aswad laid out last year or Hasit Shah's essay on this site about the ways in which his attitude toward technology was misunderstood.


Even without his most famous recordings held off Apple Music and Spotify, Prince was the ninth-most successful recording artist of 2016 — so now we wait and see what, if any, digital records he'll break. Again.

Tuesday, February 14, 2017

Gemini Laser Testing is Done

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After a couple of months of clinical usage, I’m ready to make my opinions know on the Ultradent Gemini Laser.
The Gemini is the first entry into the soft tissue laser market for Ultradent.  Company insiders tell me that the reason they hadn’t come to market before this is that they were wanting a product that set them apart.  something new and different that properly reflected their dedication having better products.
The Gemini is a dual wavelength diode laser.  You can use it in 810nm mode or in 980nm mode.  Both wavelengths are very effective on soft tissue and provide very good hemostasis.  However, it’s truly groundbreaking function is its “dual wavelength” feature.  This means that you can select to use both 810 *and* 980 simultaneously.  This allows for fast and smooth removal of soft tissue.  Over the years, the major complaint against diode lasers has been their tendency to leave small tissue tags.  This usually is not a problem clinically, but for offices using digital impression systems, the presence of tissue tags can sometimes complicate the scanning process.  By utilizing the dual wavelength feature, the Gemini increases clinical speed while greatly decreasing tissue tags.
The device is cordless with a rechargeable battery.  This makes it completely portable in the office.  It is very light and easy to take from room to room.  I’ve also been *very* impressed with the “Heads-Up Display” on the Gemini.  The flat piece of glass in the photo above is completely clear until you turn the Gemini on.  At that point, the image appears on the glass.  I always make it a point to start the laser in front of the patient and it has never failed to get an impressed reaction.  Patients are blown away at how beautiful and high tech the Gemini is.
The foot pedal is wireless and makes it much easier to use as you can place the foot pedal anywhere you would like.  As anyone practicing today knows, we have way too many cords to deal with.  Adding cords to foot pedals just increases the “sphagetti” we are dealing with.  Any chance a manufacturer has to eliminate cords is *greatly* appreciated!
The device utilizes unidose tips which screw onto the handpiece.  I’ve found these tips to be sturdy and easy to use clinically.  Each box of tips also comes with a small plastic piece that allows the user to bend the tip canola in a variety of angles.  This makes reaching all areas of the mouth much easier.  Also, in the picture above, you can see the tip showing just behind the display screen.  The white area of the tip contains a very high intensity white LED that creates surprisingly bright illumination of the field.  Since I mentioned the position of the handpiece in the picture above, I should also mention that it is being held in that spot by a magnet that keeps the handpiece in the small cradle behind the screen.
The Gemini comes preprogrammed with a variety of procedures and has plenty of power for all procedures.  There are 2 tip lengths available; 7mm uninitiated and 5mm initiated.  In my testing I preferred the 5mm initiated tip as initiating is just one more step to do.
The device also has voice controls that can be turned off if you prefer.
Overall, this laser has performed extremely well.  It is ergonomic and easy to use.  The aesthetics impress patients and it truly is a “next generation” product.  The Gemini is highly recommended!!!

Monday, February 13, 2017

ADA Says No Evidence to Support Pre-Med for Joint Prosthetics

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For as long as Ive been in dentistry (even including my training) dentistry has been advocating prescribing antibiotics for patients with prosthetic joints.  At first the rationale was that any procedure that caused the gums to bleed could introduce oral bacteria into the bloodstream and those bacteria could attach to the prosthesis and cause an infection.  That would then lead to a hospital visit with copious doses of IV antibiotics to stop the infection.  It could also potentially lead to failure of the joint which could lead to surgery with all of its potential complications or perhaps even death.

Over time, the opinion of the experts changed.  It was then thought that the risk was only to recently placed prosthetics.  The opinion then shifted again to the point that maybe there was no risk at all or a minimal risk, but no one was quite sure.

To minimize the risk of this infection, the patient was given a dose of antibiotics before blood producing dental procedures so that any bacteria introduced into the bloodstream would be killed.  Now, to lay people this may not seem like a big deal, but to those of us in healthcare, there were potential problems with this.  Namely they were:

  • The cost of the antibiotics.  While this was usually minimal, it was more cost and the “hassle factor” of getting the prescription.
  • Potential allergic reactions.  Anytime a patient takes a medication, there is a chance of them developing an allergy and having a reaction.  While this is fairly rare, it does exist, and when it happens, has the potential to be a serious consequence.
  • The potential to contribute to the development of resistant strains of bacteria.
Now comes word from the ADA as of Friday February 10, 2017, that antibiotics are no longer needed for any patients that have prosthetic joints.  The statement from the ADA is below, published in its entirety.  I’ve got the link if you would like to view the ADA webpage on this subject that includes all of the reference papers and other info.   

Approximately 332,000 primary total hip arthroplasties and 719,000 primary total knee arthroplasties were performed in the United States in 201096% of hip replacement and 98% of knee replacement 1surgeries were performed on patients 45 years and older. Reported infection rates for such operations range from 0.8% to 2.2%.2-Infections can be caused by introduction of microorganisms at the time of surgery, hematogenous seeding, or contiguous spread of infection from an adjacent site.2,Infections of total joint replacements can result in failure of the initial surgical procedure and the need for extensive revision, prolonged antibiotic treatment, functional impairment, considerable cost of care, and even death. 

In 2014, the American Dental Association (ADA) Council on Scien- tific Affairs (CSA) assembled an expert panel to update and clarify the clinical recommendations found in a 2012 joint ADA and American Academy of Orthopaedic Surgeons (AAOS) evidence report and guide- line.4,5 In accord with the 2012 ADA/AAOS evidence report, the updated ADA systematic review (published in the January 2015 issue of The Journal of the American Dental Association) found no statistically sig- nificant association between dental procedures and prosthetic joint in- fections (PJI). On the basis of the review of the evidence, the 2015 ADA Clinical Practice Guideline stated, In general, for patients with pros- thetic joint implants, prophylactic antibiotics are not recommended prior to dental procedures to prevent prosthetic joint infection.5

The ADA panel found no association between dental procedures and PJIs and no scientifically based efficacy for using antibiotics to prevent PJIs.5 The panel did acknowledge that there may be special circumstances in which a clinician may consider antibiotic prophylaxis despite the lack of scientific evidence. However, the guidelines did not list any special circumstances.


Because there is weak evidence that some patients with certain medical conditions, diseases, and disorders may be at higher risk of experi- encing PJI independent of dental procedures, the AAOS contacted the ADA to participate in the develop- ment of appropriate use criteria (AUC) to assist orthopedic surgeons and dentists in managing the care of these patients. (Note: The AAOS began developing AUC in 2011 as a tool to implement evidence-based clinical practice guidelines. AUC are created to inform clinicians for whom a procedure should be per- formed. This involves using clini- cian expertise and experience, in conjunction with the relevant evi- dence, to rate the appropriateness of various treatments in a set of hy- pothetical, but clinically realistic, patient scenarios. For more informa- tion, visit http://www.orthoguidelines. org/go/auc/.) Although dental treat- ment is not considered a risk factor for PJI, the AAOS and ADA convened a group of subject matter experts to consider if antibiotic prophylaxis might be appropriate in any of these higher-risk patients.

To create the AUC, the AAOS used the RAND/University of Cali- fornia Los Angeles Appropriateness Method (RAM).6 The process involved reviewing the available evi- dence, compiling a list of potential clinical indications or scenarios,

and convening an expert panel comprised of representatives from multiple stakeholders to determine the appropriateness of each of the proposed clinical indications for treatment as appropriate,” “may be appropriate,or rarely appropriate.The literature reviewed for the AUC was derived primarily from the sci- entific articles used to develop the 2012 AAOS/ADA guidelines4 and 2015 ADA clinical practice guidelines.5

With the AUC,6 subject matter experts attempted to define clinical situations in which antibiotic pro- phylaxis in defined potentially at-risk patients might reduce the theoretical risk of experiencing post- surgical PJI. A writing panel comprised of AAOS and ADA rep- resentatives developed clinical sce- narios of situations in which dental treatment might theoretically create a higher risk of experiencing PJI. The following medically complex patient populations and related issues were used to develop a matrix to gain consensus on any potential benefit from antibiotic prophylaxis until more definitive scientific data be- comes available:

- planned dental procedure;
- an immunocompromised status; - glycemic control;
- history of periprosthetic or deep PJI of the hip or knee that required an operation;

- time since hip or knee joint replacement procedure.

Once approved by the writing panel, the theoretical risk scenarios were presented to a separate expert voting panel (made up of ADA and AAOS representatives) to determine the appropriateness of antibiotic prophylaxis for each scenario (that is, when antibiotic prophylaxis

is rarely appropriate,” “may be appropriate,or is appropriate). The voting panel identified relatively few patient subpopulations for whom antibiotic prophylaxis might be indicated before certain dental procedures. Of 64 total prophylactic antibiotic voting items, 8 (12%) items were rated as appropriate,17 (27%) items were rated as may be appro- priate,and 39 (61%) were rated as rarely appropriate.A Web-based application of the AUC is available at www.orthoguidelines.org/go/auc.


There is no evidence to support
an association between dental pro- cedures and risk of experiencing PJIs.
The parameters that were used as potential scenarios for the AUC, in which antibiotic prophylaxis may be appropriate, do not indicate an increased risk of experiencing PJI due to hematogenous spread (bacteremia) from dental procedures or possibly other daily, oral healthrelated hygiene behaviors.7 These scenarios may indeed have some added risk of developing PJI in a small number of patients, but they are independent of dental treatment.

The AUC is a decision-support tool to supplement clinicians in their judgment regarding anti- biotic prophylaxis for patients with a prosthetic joint who are under- going dental procedures. It is not intended as the standard of care or as a substitute for clinical judgment. As developed, the AUC could facilitate the treatment of defined high riskand immune compromisedpa- tients. It affects a narrow cohort of patients for whom antibiotic pro- phylaxis might be considered. Although there was not complete consensus on all aspects of the AUC development process or outcomes,

a consensus of ADA-appointed expert panel members and CSA members agreed that this tool could benefit dentists, physicians, and patients by reducing antibiotic prescriptions.

Discussion of available treat- ment options applicable to each patient relies on communication between the patient, dentist, and orthopedic surgeon, weighing the potential risks and benefits for that patient. Prophylactic antibiotics before any clinical procedure that may cause bacteremia are chosen based on the nature and suscepti- bility of microflora at the treatment site, as well as the possible economic and health impact to patients
and populations. Any perceived po- tential bene
fit of antibiotic prophy- laxis must be weighed against the known risks of antibiotic use, including Clostridium difficile infec- tion, allergic reaction, and the development, selection, and trans- mission of antimicrobial resistance factors.8

It is appropriate for the dentist to make the final judgment to use antibiotic prophylaxis for patients potentially at higher risk of expe- riencing PJI (independent of dental treatment) using the AUC as a guide, without consulting the orthopedic surgeon. However, if the orthopedic surgeon recommends antibiotic prophylaxis or the patient prefers it, despite the dentists recommendation against premed- ication, the prescription should be provided by the surgeon.

The 2015 ADA clinical practice guideline is valid and should continue to inform clinical de- cisions for dental patients in ambulatory settings. The guideline

states clearly that the [e]vidence fails to demonstrate an association between dental procedures and PJI or any effectiveness for antibiotic prophylaxis. Given this information in conjunction with the potential harm from antibiotic use, using an- tibiotics before dental procedures is not recommended to prevent PJI.The CSA and ADA-appointed expert panel members encourage dental health care professionals to continue to use the 2015 ADA clinical practice guideline, consult the AUC as needed, and respect the patients specific needs and preferences when considering antibiotic prophylaxis before dental treatment.


In general, for patients with prosthetic joint implants, prophylactic antibiotics are not recommended prior to dental procedures to prevent prosthetic joint infection.5 n http://dx.doi.org/10.1016/j.adaj.2016.12.002 

In 2014, the American Dental Association (ADA) Council on Scien- tific Affairs (CSA) assembled an expert panel to update and clarify the clinical recommendations found in a 2012 joint ADA and American Academy of Orthopaedic Surgeons (AAOS) evidence report and guide- line.4,5 In accord with the 2012 ADA/AAOS evidence report, the updated ADA systematic review (published in the January 2015 issue of The Journal of the American Dental Association) found no statistically sig- nificant association between dental procedures and prosthetic joint in- fections (PJI). On the basis of the review of the evidence, the 2015 ADA Clinical Practice Guideline stated, In general, for patients with pros- thetic joint implants, prophylactic antibiotics are not recommended prior to dental procedures to prevent prosthetic joint infection.5

The ADA panel found no association between dental procedures and PJIs and no scientifically based efficacy for using antibiotics to prevent PJIs.5 The panel did acknowledge that there may be special circumstances in which a clinician may consider antibiotic prophylaxis despite the lack