Nobio's Infinix Composite Continues to Impress in Clinical Trial

 

As many of you know, I've been fortunate enough to be able to work with the new composite from Nobio called Infinix.  The cool thing about Nobio is they are not a restorative company, they are a "chemical company".  By that I mean they are not just looking to change dental restoratives, but also to change the way a lot of things are made by adding their bacterial killing molecules to those products.

Infinix is a composite material created to kill bacteria that comes into contact with it.  If it follows through in the real world as it has in the lab, this may be a total game changer for the profession and the patients we serve.

Here in the U.S. I think I might have been the first dentist to actually place an Infinix restoration.  While I am truly honored to be able to say that, I also think that means it's my job to let the rest of the profession know what I've experienced.  

I'll continue to provide updates, but I've got to say that things are "so far, so good".  I'm about 20 restorations into my trial and I have nothing but good things to say at this time.

The above photo shows a MO and DO restoration done with the material.  I currently only have one shade to work with and that is A-2.  I tell you that because in the clinical photo it is easy to spot the material.  The good news is that it is close enough that they are not noticeable except to those in the profession.  The patients who have received these restorations have been very happy with them.  The company is planning on more shades in the future, but at this point, they wanted to get material to me to use and A-2 was the first shade available.

The material handles well.  It is not sticky and is easy to place.  I prefer to use warm composite and I'm happy to say that the warm material handles as expected.  I prefer to prep with a 2-3mm bevel at the cavosurface margin and it finishes very well.  I tend to use micro-fine finishing diamonds first and then to polish with Ultradent Jiffy Polishers finishing with the Jiffy Brush.

The material polishes well and has a nice shine after polish.

The real benefit of course should be the long term viability of the materials.  I am placing these restorations across a wide spectrum of patients and will follow them carefully as they come in for recare.  It's a nice material to use, but my real hope is that it increases the life span of our restorations.

I'll be posting more as my experience progresses...

SprintRay Receives FDA 510(k) Clearance for NightGuard Flex

 

As I stated here recently, I love SprintRay products.  I have been using SprintRay printers in my office for several years now and I am *very* impressed with their performance, quality, and durability.  The printers are, to put it simply, workhorses.  They churn out models, implant surgical guides, occlusal guards, and temporary crowns.

You'll notice the term "occlusal guards" in the above paragraph.  I should specify that the term applies to rigid resin based occlusal guards.  For the non-dentist folks who read the blog I should explain that an occlusal guard is a dental device that a patient wears (normally while sleeping) to protect the teeth from damage caused by clenching and grinding.  I should also explain that  there are 2 types of materials that are used to make these devices.

The first material is hard acrylic.  The idea behind this material is that it is very resilient and can resist strong biting forces that are generated by the patient musculature.  Depending on the material used, hard guides can last for years.  The drawback is that they need to be very well balanced with the biting (occlusal) forces distributed equally.  Basically it needs to be designed and adjusted so that all the teeth touch it equally at the same time.  The main drawback is that patients who are strong grinders can break this material.

The second material, which is what I personally prefer to use, is a softer more rubbery material.  It can act as a "shock absorber" to the teeth, is almost impossible to break, and does not require as much adjustment.

Due to my preference to clinically use softer materials, I was excited to learn that SprintRay recently received FDA 510(k) clearance for a new material Nightguard Flex.  This new resin allows the doctor or the dental lab to 3D print appliances made with a flexible material!  

Here is the info from the SprintRay press release:

SprintRay Inc., an industry leader in digital dentistry and 3D printing solutions, today announced that the United States Food and Drug Administration (FDA) has granted the Company clearance to market its NightGuard Flex 3D printing resin as a Class II medical device in the United States. The SprintRay NightGuard Flex is indicated for the fabrication of orthodontic and dental appliances such as mouthguards, nightguards, and splints, and joins SprintRay's industry-leading line up of end-to-end dental 3D printing solutions.

SprintRay NightGuard Flex resin was developed, in part, to meet the growing demand for night guards due to the COVID-19 pandemic. According to an American Dental Association survey, more than 70 percent of dentists are seeing an increase of patients experiencing teeth grinding and clenching, conditions often associated with stress. SprintRay's NightGuard Flex 3D printing material is a flexible resin for 3D printing night guards and splints. NightGuard Flex is designed to deliver the best possible patient experience with high impact strength and wear resistance, comfortable and flavorless material and same-day patient delivery. Additionally, NightGuard Flex drives greater efficiency for dental practitioners by eliminating the need for third party resins and creating uniform, end-to-end dental 3D printing workflows.

"Nightguards are costly and can take several weeks to get back with traditional production methods using outside sources," said Amir Mansouri, Ph.D., CEO of SprintRay. "Today, Sprintray's NightGuard Flex resin has totally changed the patient and doctor experience in the treatment of bruxism and teeth grinding. Our patient-centered design is durable, flexible, more comfortable, and enables faster delivery and greater access for patients to receive their nightguards same-day, through chairside SprintRay 3D printing and at more affordable prices."

This announcement follows the launch of SprintRay's Protect A Smile campaign, a program designed to support occlusal health through 3D printing, as well as SprintRay's North American distribution partnership agreement with Nobel Biocare, which furthers the Company's mission to increase patient access to innovative dental technology solutions.

The EndoUltra Cordless Ultrasonic Agitator

 

I perform a lot of endodontics in my office.  That simple fact means that I am always looking for ways to improve patient outcomes as well as perform more efficiently.  I think this is especially true when it comes to endodontics.  No one ever wants a root canal "to take longer".

Endodontics requires a high degree of precision and because of that the procedure can be time consuming.  Anything worth doing is worth doing well, but that doesn't necessarily mean that quality always requires a long procedure.

There is also the simple fact of irrigation and chemical cleansing of the canal system.  If you have ever seen a scanning electron microscopic view of a canal system (and you probably have) you'll understand that simple mechanical instrumentation cannot do all the necessary work of removing diseased tissue and bacteria.

Because of that simple fact, irrigation has become tremendously important while performing endodontic treatment.  The other part of irrigation is being sure that the irritants reach into all the small areas of the canal system.  That's why it's not only important to use copious irrigation, it's also important to provide some type of agitation to those irritants.  This ensures that they are replenished in those tiny areas as well as to provide some "shock waves" that also can loosen debris as well as having some potentially lysing effects on bacterial cell walls.

I've used several different devices to accomplish this task, but my current favorite is the EndoUltra from Vista-Apex.  The device is small, ergonomic, wonderfully effective, and affordable.  If you do endo in your practice, effective irrigation and agitation of those chemicals is critical to clinical success.

I have been using the EndoUltra device for about 2 years now and have nothing but good things to say about it.  Take a look at the video I shot this summer to hear all about it.  I was lucky enough to spend some time on a site visit to the Vista-Apex facility this past summer and saw some impressive things.  While there, they asked if I could sit down and do a testimonial video on the EndoUltra and I was happy to do so.  I use it and believe in it, so talking about it was easy.  Give the video a view and I think you'll be as impressed with this device as I am.

An Attempt to Reinsert Dental into Medicare

 I don't normally like to even mention politics on the blog.  Number one, there are enough blogs doing that already.  Number two, I don't like discussing politics.  😃

However, because this is politics that has the definite possibility of affecting dentistry, today we'll wade just a bit into what is going on.

Those of us in the profession are most likely aware that in the beginning of the budgetary debate this fall, there were initial attempts to include dental as part of Medicare.  The American Dental Association was opposed to the way the way it was proposed and worked hard with congress to find a compromise.  I won't go into great detail on all of that here as there are pages and pages of info on this that presents it much better than I can.  Just do a Google search for all the answers.

The heart of the matter today is that the process has hit a snag.  Evidently discussions were held among senators who agreed on the details and things were moving along nicely.  However, now Senator Bernie Sanders has decided to change a part of the bill to try to re-include the Medicare dental piece.

I bring this up so that regular readers here will be aware of the situation.   There is a great explanation of the situation at Bloomberg.com that you can read by following this link...  

SprintRay Announces North American Distribution Partnership with Nobel Biocare

 For the last 3 years or so I have been using SprintRay 3D printers.  We do all kinds of cool things with them in the office and they are workhorse products.  They are incredibly accurate, easy to use, and they just keep working!

I was excited to recently learn that the SprintRay folks now have a distribution partnership with Nobel Biocare.  Read on for the details...

SprintRay Inc., an industry leader in digital dentistry and 3D printing solutions, today announced a partnership with Nobel Biocare, a world leader in the field of innovative implant-based patient solutions for tooth replacement. As part of the partnership, Nobel Biocare will become an authorized distributor of all of SprintRay's innovative 3D printing technology.

"SprintRay is excited to introduce our industry leading, end-to-end 3D printing solution to Nobel Biocare's extensive global network of dental professionals," said SprintRay's Chief Growth Officer, John Cox. "This partnership extends SprintRay's reach and penetration into implant dentistry – one of the industry's fastest growing segments."

Together, SprintRay and Nobel Biocare will deliver best-in-class implant workflow solutions to patients around the world. The combination of Nobel Biocare's innovative implant solutions, combined with SprintRay's frictionless 3D printing technology, will result in reduced implant delivery times, same-day placement of implants and highly accurate guided surgery templates. While historically, traditional dental implant procedures take months to complete, through Sprint Ray and Nobel Biocare's collaboration, patients can receive same-day, chairside care through 3D printed surgical guides and immediate implant restorations.

"Nobel Biocare has a philosophy of continuous innovation, driven by patient need," said Patrik Eriksson, Nobel Biocare's president. "We are proud to partner with SprintRay and to distribute their 3D printing technology, which can drastically reduce time to teeth."

"Practicing dentists have always had to manage the competing interests of speed versus accuracy and quality," said Dr. Kenneth Parrish, DMD, PhD. "As the only 3D printing manufacturer dedicated to dental applications, SprintRay understands the challenges faced in day-to-day practice. Time consuming emergency work-ins to your schedule can now be replaced by the touch of a button to easily and cost effectively create and deliver a replacement restoration, saving chair time and eliminating patient frustration."

SprintRay's recently launched ProCure 2, the most advance curing system available today that reduces curing times to five minutes, will be offered as part of the partnership. The ProCure 2 enables same-day placement of dental implants and allows for Nobel Biocare's All-on-4® restorations to take place in one appointment.

MouthWatch Demonstrates How TeleDent™ Connects Patients Across All Healthcare Touchpoints to Dental Care

 

One of the things I've learned over the past couple of years... I've had some relative end up in skilled nursing facilities.  There is not a great deal of attention, at least in the facilities that I have visited in the last 2-3 years, on oral health or dental care.

That situation is only going to get worse in the next few years because of the incredible progress we've seen in our medical care.  Folks are living longer than ever before and because of that, there is going to be a much increased need for dental care in those facilities.  We are constantly discovering ways to include the lifespan of our population.  That is a wonderful blessing for many, but we have not been as able to increase ways to deal with dental problems in that population.  How are we going to be able to examine and diagnose problems in a patient population that may not be able to physically enter a dental office?

The other thing I've learned... and we have ALL learned, is that there are certain times where we NEED to be physically separated from others.  What if a patient that is Covid-19 positive has sudden swelling from a large carious lesion?

The above two examples are the reason why dentistry already needs, and will continue to need and improve upon the concept of remote communication and triage.

One of my favorites in the remote dental space is Teledent.  As a member of the Cellerant Best of Class voting panel, I've been part of us voting Teledent as the Best of Class winner for two years in a row.  Part of the reason for that is the company's focus on innovation and improvement year after year.  During the Greater New York Dental Meeting that started on Sunday, the company has announced even more innovation.

Here is what the company has to say:

 MouthWatch, LLC a leader in innovative teledentistry solutions, will be highlighting its enhanced TeleDent platform which continues to connect individual practices and multi-location dental groups to innovative opportunities for improving dental care delivery. 

Dental decision makers can learn more about how teledentistry is making convenient access to care a reality in sustainable, profitable ways. MouthWatch will be demonstrating these new enhancements during the Greater New York Dental Meeting at booth #3121.

According to MouthWatch Founder and CEO Brant Herman, “The latest TeleDent enhancements were designed to encourage frequent, convenient, and visually enriched communication between providers and patients and ultimately persuade patients to be more actively engaged in improving their oral health, no matter where they might be.” 

The latest TeleDent™ enhancements can deliver the following benefits:

• Deploy across multiple locations and a variety of dental and medical environments
• Improve patient retention

• Attract new patients 

• Increase patient value  

• Boost operatory efficiency and production

• Enhance care plan acceptance

• Minimize operatory use for consultations

• Reactivate lapsed patients and delayed treatment plans

• Share dental care communications with allied healthcare providers

TeleDent delivers all the benefits of a sophisticated, scalable telehealth platform to a dental care environment. For more information, visit https://www.mouthwatch.com/teledent-software/

About MouthWatch, LLC

Headquartered in Metuchen, New Jersey, MouthWatch, LLC is a leader in innovative teledentistry solutions, digital case presentation tools and intraoral imaging devices. The company is dedicated to finding new ways to constantly improve the dental health experience for both patient and provider.

In recent years, the company received the following significant awards and accolades: The 2020 and 2021 Cellerant Best of Class Award  for TeleDent™, the provider-focused, patient-friendly teledentistry platform. In 2021, TeleDent also won Dentistry Today’s  Top 100 Products, Reader’s Choice Top 25, and Top Aesthetic and Restorative Products awards. The MouthWatch Intraoral Camera won Dentaltown Magazine’s Dental Townie Choice Award™ in 2021 and 2021 as well as Dentistry Today Magazine’s Top 100 Products Award in 2020. 

What’s more, the company’s latest product, The MouthWatch Plus+ HD intraoral camera, introduced in September of 2021, has already won a Dental Products Report Top 5 Editor’s Choice Award and  a Dentistry Today Reader’s Choice Top 25 Innovative Products Award. The company was also included in the 2020 and 2021 Inc. 5000 list of the Fastest Growing Privately Held Companies. For more information, visit www.MouthWatch.com.

Soft Tissue Crown Lengthening Utilizing a Diode Laser

For over 20 years I have been working with lasers in my practice.  Over those years, I have used every wavelength available to dentistry in a variety of procedures.  Lasers are truly nothing short of amazing and even though I have used them for an incredible number of different applications, I am sometimes still amazed at what they can accomplish.  Today I'd like to discuss one of the best applications for soft tissue lasers in dentistry.

The concept of soft tissue crown lengthening can give patients an incredible smile with noticeable results from an aesthetic standpoint while leaving no trace of the fact that a laser was used.  Creating symmetrical gingival contours in the aesthetic zone can be difficult to accomplish with most standard modalities, but with a diode laser it is fast, easy, and predictable.  Here is something I've put together that helps explain things:

Diode lasers offer a tremendous advantage in soft tissue crown lengthening than traditional modalities. Before lasers became affordable tools for soft tissue surgery, frequently the only other options were either electrosurgery or scalpel.

The electrosurgery unit was affordable and fast, but it provided much less predictability in results. Thermal damage from the unit was the main problem. Tissue that has been burned shrinks upon healing as the device creates an area of necrosis. This leads to uneven and asymmetrical results that are not in line with cosmetic principles.

Similar problems exist with the scalpel option. Tissue that is cut under strict sterile surgical conditions, even with the best of hands, can heal unevenly. This tendency to heal unevenly can necessitate the need for “touch up” surgery to create a more even healing and appearance.

When one cannot comfortably predict where the tissue will be when it has healed, true cosmetic results are impossible to achieve.

Into this realm steps the diode laser. Lasers can provide outstanding cosmetic results without postoperative pain or touch up surgeries.

Properly used at low power, a diode laser can create an aesthetic result that leaves the healed tissue in the exact same position in 3 weeks, that it was the day of the procedure. Using low power, a diode laser can “melt’ tissue during cosmetic recontouring. This eliminates thermal damage and tissue shrinkage due to overheating.

Prior to diode lasers, cosmetic crown lengthening or cosmetic recontouring required significant healing time to not only allow the tissue to recover, but also to factor in the possible need for touchup surgeries.

However, with a diode laser, the operator can use the laser, then prep and impress on the same day knowing that on the day of delivery the tissue will be in the exact same position it was on the day of the procedure. This saves an incredible amount of time. No patient wants to wait longer to receive their new smile, yet no doctor wants to prep if they cannot predict where the gingival margin will be in three weeks.

The diode laser provides fast and predictable results that benefit both the patient and the practitioner.