New Data Wiping Program Attempts to Blame/Frame Honest Security Researchers

While I wish I could tell you that today's post is a Halloween joke, that simply is not the truth.  The cyber world is frequently an unsafe place, and this is another instance of that...

Here is an interesting story that, at least at this point, does not have a large number of victims, but is fascinating in its deployment.

As many in the tech world know, Putin and the Russian security services have tremendous reach in the cyber realm.  There are instances such as the 2016 US election interference, data crashing worms, the takedown of the IT systems of the Seoul Olympics, and multiple attacks on the Ukrainian power grid prior to the 2022 invasion.

Now comes an attack that attempts to blame/frame security researchers and a computer website for a new destructive program.  Called Azov, it masquerades as RansomWare, when in fact its sole purpose is to totally encrypt hard drives with no way to decrypt.

It leaves a ransom note that reads:

When the victim reads this ransom note, they see a list of potential criminal partners near the top.  All of those listed have denied an knowledge or involvement with this situation.  Also, if you read the entire note it seems to be pointing to a pro-Russia approach to the invasion of Ukraine.

If possible, do not allow Azov onto your systems and if you are one of the unfortunate individuals affected by this, hopefully you have reliable backups as there is NO decryption key.

For the full story, you can follow this link to bleepingcomputer.com.  

Amber Mill DIRECT and Perfit FS Now Undergoing Testing in our Office

For those of you who either have a mill in your office or are considering getting one (and if you aren't, NOW is the time to be looking into it), I have some interesting news.

For a lot of offices, they don't want to necessarily transfer ALL of their lab functions in-house.  What many offices are looking for is materials that can be polished to a finish instead of needing to stain and glaze using an oven.

However, along with that aspect, there is also the aspect of wanting certain materials that *require* firing in an oven.  Many offices would love to have the aesthetics of lithium disilicate or the strength of zirconia.  However, as we know lithium disilicate in its original state is lavender in color until it is fired.  Then there is zirconia which needs to be fired to shrink to the exact size needed to fit the prep.  If zirconia is *not* fired, the material will not fit.

Well, now those two concerns are no longer valid.  Amber Mill DIRECT is a lithium disilicate that is the correct shade when milled and can be polished to a high level.  Next up is Perfit FS which is a zirconia sintered block that does not require an over either.

Basically this means that offices wanting to do in-office milling can do so while getting the matterials they want with the convenience they need.

I've been fortunate enough to receive some samples of both materials and I will be milling some cases with them in the not too distant future.  Once we get some cases under our collective belts, I'll be posting more about how they perform.  I got a chance to see some of these milled restorations at the recently held SmileCon in Houston and in the DGShape booth, they looked amazing.  However, I'm a skeptic by nature and will withhold judgement until I work with the materials myself.

In the meantime though, here is a photo of a Perfit FS that I saw in Houston.  I'll be reporting back when I have more to say on these materials...

Cutting the Cord... and Costs With a New Approach to Gingival Retraction

 

Here's a little something I put together after experimenting with VOCO's Retraction Paste.  As most of you know I'm always looking for ways to increase efficiency.  No one wants a dental procedure to take longer.  So when i see an opportunity to increase my efficiency, I explore it.  I've found one of those great little ways to increase efficiency is with this product.  Read on for my thoughts...

Fixed prosthetics are an intrinsic part of any dental practice. While the market for dental implants continues to grow, the majority of crowns are placed on natural teeth. This means that clear and easily recognizable margins are necessary and will continue to be necessary as the market for naturally supported dental fixed prosthetics continues to grow. As life expectancies continue to increase, an aging population will seek to maintain their quality of life and the number of fixed prosthetic procedures will increase along with those life expectancies.

There has also been growth in the last decade in the purchase and implementation of digital impression systems. These systems continue to experience market penetration growth with estimates being that around 20% or more of practices have expanded into this aspect.

However, whether performed by analog or digital means, the importance of good clinical technique is imperative for clinical success in fixed prosthodontics. This is especially true when consideration is made for the proper capture of the preparation margin. While many aspects of the preparation are intrinsic to long-term clinical success, perhaps nothing is more important than properly capturing the margin.

Tradition

Traditionally the most common way to expose the margin for an impression has been the use of retraction cord. Even though the profession has evolved and improved, retraction cord has continued to be taught in dental schools and used in the majority of clinical cases, even though other choices exist.

Retraction cord is time consuming. A proper length of cord must be dispensed and then placed into the gingival sulcus to allow the tissues to expand and relax in a more open orientation. The actual physical process of placing retraction cord is time consuming and incredibly technique-sensitive. Apply too little pressure in the placement and the cord comes free without providing adequate retraction. Apply too much pressure and the connective tissues of the sulcus can be damaged and pushed away from the tooth, paving the way for gingival recession or iatrogenic infection. There are even instances of impression material being expressed subgingivally, creating foreign body infections from a hardened piece of material left under the tissues that were separated by over-aggressive retraction cord placement.

In some instances, a two-cord technique is used that basically doubles the amount of time to place, while also increasing the chances for cord displacement or iatrogenic injury.

There is also the concern of being able to visually identify the cord in the sulcus. Stories abound in the profession of patients presenting with a localized infection of a single tooth recently prepared for a crown and the doctor finding a strand of retraction cord still wedged snugly into the gingival sulcus with a resulting foreign body reaction in full bloom around it. Someone simply missed the tiny piece of cord.

Placing cord is a very specific and intense skill, demanding exceptional dexterity. It is a difficult skill to teach, and many doctors prefer to place cord themselves as opposed to delegating the placement to an auxiliary. However, this ties the doctor to the procedure and does not allow for other processes (such as hygiene checks) to be completed, therefore slowing the entire office workflow.

There is also the consideration of effectiveness of cord in all cases. In patients with high salivary flow, the cord can be washed out of the sulcus and require the procedure to be repeated thus slowing the workflow even more.

Considering Costs

Not only are assurances of long-term success a motivator, cost savings can be as well. Often doctors consider the “hard costs” of impressions when attempting to analyze office costs without taking into consideration the “soft costs” of time, frustration and lack of optimized workflow.

Survey data from the American Dental Association tells us that the average dental practice prepares about 360 crowns per year, which translates to 30 crowns per month. Factor into the equation that dental office overhead is roughly $5.00 per minute and it is easy to see that “soft costs” of time and optimized workflow mentioned above come into play in a very real way. If 5 minutes is spent in properly placing a single piece of retraction cord, that translates to around $25 just to cover the cost of placing the cord.

Improving Efficiencies and Workflow

One of the things successful doctors embrace is the concept of “just because we’ve always done it that way doesn’t mean we have to always do it that way”. There is no better example of this than achieving successful retraction in fixed prosthetics.

VOCO has developed a Retraction Paste that offers several advantages over the traditional placement of retraction cord.

First of all, the material is a paste, which means that expressing it into the sulcus is significantly less traumatic than pushing cord into place with a stainless steel instrument. The paste is provided in small capsules that hold 0.3 g of material, which is enough for approximately 3 single units. It is expressed from the cartridge via a traditional composite dispenser gun.

The compule has an extra-long tip with a very small diameter that allows the operator to place the tip into the sulcus and express the paste gently so that it provides consistent and atraumatic placement of the material. The lumen of the tip is carefully formed out of plastic with rounded edges so that it can be placed into the sulcus without the risk of traumatic injury to the soft tissue.

The paste contains aluminum chloride, which chemically dries the sulcus of blood, saliva, and crevicular fluid while also widening the sulcus. It has a two-phase consistency for ease of use. When first expressed from the cartridge, the paste is of low viscosity. This allows the material to be gently expressed and delivered precisely into the sulcus. Once placed, it changes to a higher viscosity and expands slightly to allow for adequate displacement and expansion of the tissues.

Once the paste is expressed into the sulcus, it remains there for 1-2 minutes and is then rinsed away with water. The material is easily removed by air/water spray and its unique bright turquoise color helps to assure the operator that all remnants have been removed prior to impressing.

Better Direct Restorations

Often in Class V restorations, there is either the need for retraction or drying. Many operators will notice that around 12 months post op, many buccal Class V restorations begin to develop a dark line around the gingival margin. This line is caused by less than ideal bond strengths in this area that allow for bacteria to begin to grow under the restoration. The most common cause of these “black lines” is contamination of the gingival margin with crevicular fluid.

This fluid is hard to stop mechanically as it tends to seep continuously despite the operator’s best efforts at control. Placing retraction paste is a great advantage in placing these restorations. The aluminum chloride in the paste is a tremendous drying agent and placing it prior to beginning the bonding process greatly helps in preventing contamination of the field.

It is also tremendously helpful for retraction during the restorative process. Doctors who use cord in these procedures are often faced with a dichotomy: Do you pull the cord prior to restoring or after? Sometimes the cord can aid in retraction by leaving it in place, however, there is also the risk of the cord becoming entangled in the restorative material which can lead to myriad problems. Using paste instead of traditional cord greatly simplifies this restorative process.

Summary

While retraction cord has served the profession well, it is imperative that doctors continue to explore procedural options that can help lead to better clinical outcomes.

VOCO’s retraction paste is one of those options. Whether the objective is analog or digital impressions or improving outcomes in indirect restorations. A paste that is easily dispensed, works quickly and predictably, and is removed easily offers the doctor options that are not routinely available with retraction cord.

Retraction paste can improve clinical workflows as well as providing for better and more predictable patient outcomes.

SOTA’s Dental Imaging Software Gets Pearl’s AI Pathology Detection Capabilities

 Pearl and SOTA have partnered to offer native support for Pearl’s industry-leading, FDA-cleared radiologic AI solution Second Opinion® within the SOTA Cloud® software platform. SOTA Cloud® will be the first dental imaging software in the United States to offer a fully-integrated clinical AI feature set.

Pearl, the global leader in dental AI solutions, and SOTA Imaging, the leading manufacturer of dental imaging hardware and software, announced today a partnership to integrate Pearl’s FDA-cleared Second Opinion® real-time clinical pathology detection artificial intelligence (AI) solution with SOTA’s popular SOTA Cloud® dental imaging software. Native support for Pearl’s chairside AI within SOTA’s cloud-based imaging interface means that, for the first time, dentists in the United States can conveniently capture, display, and perform AI-assisted clinical evaluation of dental radiographs within a single software platform.

"Together with SOTA, we are pushing the envelope of dental imaging further toward a fully AI-powered dental future,” said Ophir Tanz, Pearl’s founder and CEO. “AI will be a basic utility in dentistry, and we see obvious advantages to making that utility an integral feature of the tools that dentists are already using. Through this partnership, dentists using SOTA Cloud® can seamlessly access Pearl’s AI capabilities to obtain better, more consistent insights from patient imagery and present cases to patients more effectively –– leading to better outcomes, a higher standard of care and more productive patient communication."

Pearl’s Second Opinion® is a clinical AI system cleared for use as a patient-facing radiologic aid to dentists in over 90 countries. With native Second Opinion® integration, dental practices using SOTA Cloud® –– the robust cloud-based dental imaging software which SOTA introduced last year to complement its line of state-of-the-art intraoral cameras and X-ray image sensors –– can view automatic AI detections of most conditions commonly found in dental x-rays.

“Understanding the needs of clinicians and ensuring that dentists are able to focus solely on providing the best possible patient care has always been the top priority when developing our software,” said SOTA founder and president Brian Kim. “Our partnership with Pearl speaks directly to that focus by giving practices using SOTA Cloud® push-button access to the most innovative AI technology available for streamlined patient communication and improved image-based diagnostic evaluations.”

To register for SOTA Cloud® with fully-integrated AI capabilities, visit: https://info.sotaimaging.com/sotaxpearlpartnership

To learn more about Pearl’s Second Opinion®, visit: www.hellopearl.com/products/second-opinion.

To learn more about SOTA Cloud®, visit: www.sotaimaging.com/sota-cloud/

About Pearl

Pearl is shaping the future of dental care by delivering AI and computer vision solutions that advance efficiency, accuracy, transparency and patient care. Founded in 2019 by Ophir Tanz, Pearl is backed by Craft Ventures and other leading venture capital firms. For more information or to request a demonstration, please visit https://www.hellopearl.com.

About SOTA

SOTA Imaging is a leading manufacturer of dental imaging hardware and software since 1987. SOTA Imaging solutions include Clio Prime & Clio Pedo digital x-ray sensors, the Claris i5HD intraoral camera, SOTA Image and SOTA Cloud dental imaging software, and aerosol reduction solutions, including the Cazoo Extraoral Aerosol Evacuator. Contact SOTA at (888) 266-7682, sales@sotaimaging.com, or sotaimaging.com.

OraCare Names Kristin Goodfellow RDH as Chief Clinical Officer

 

Hygienist, Thought Leader, and Educator Assumes Expanded Role to Further OraCare’s Growth and Mission 

OraCare is excited to name Kristin Goodfellow, RDH to the position of Chief Clinical Officer. OraCare was founded in 2009, by three dentists seeking to improve the standard of care in dentistry, patient hygiene, and overall oral health. Goodfellow became the company’s first full-time employee in 2015, and has been instrumental in driving rapid growth and industry leadership. 

“Kristin first started working in one of my practices as a dental hygienist, and early on, I noticed the take-charge attitude, humor, and positive influence she brought to the clinical department. My team knew she had enormous potential to help shape the trajectory of the brand,” said CEO Dr. Robert Martino who also owns and operates seven dental practices in West Virginia. “In the last several years, Kristin has become the public face of the company. She impresses us daily with her clinical knowledge and her drive to make impactful changes on the industry and has been instrumental in helping OraCare achieve rapid growth.”

Originally, from Pennsylvania, Goodfellow now calls the mountain state of West Virginia home. She graduated from West Virginia University with a bachelor’s degree in Communication Studies, then continued on to Allegany College of Maryland where she completed her degree in Dental Hygiene. During her hygiene program, Goodfellow was recognized with the Proctor & Gamble Preventative Dentistry Award, for her outstanding patient communications skills. “I’m so proud of what the OraCare team has accomplished and am honored to assume the Chief Clinical Officer role,” said Goodfellow. “It’s mind blowing to consider where we come from over the last seven years and just how many practices and patients we have touched in that time.” 

In addition to her responsibilities at OraCare, Goodfellow is an educator and hygiene thought leader. She has been a contributing author to many dental industry publications and is an accomplished speaker having presented at numerous national conferences and continuing education events. She currently holds positions on the RDH editorial advisory board and is a member of the Cellerant Best of Class Hygiene panel. 

“Increasing the standard of care is the core of OraCare. Kristin is a true advocate of this, whether she’s working with provider practices or delivering one-on-one patient care,” said Dr. Martino. “She’s the obvious choice for our Chief Clinical Officer role which expands her responsibilities, reach, and impact in driving OraCare’s mission of improving dental hygiene and oral health.”

About OraCare

OraCare products are dedicated to raising the standard of care in dentistry through the

development, production, and delivery of revolutionary products. Our unique partnership

with the dental community is built upon the promise that you can only find our products

in the dental office setting. Each product in our line is backed by real science and

centered around the ingredient-activated chlorine dioxide. Our company was founded

for dental professionals by dental professionals, so we understand the doctor-patient dynamic. All of our products reflect a commitment to creating better patient health and advancing the dental profession in partnership with our providers. 

Congrats to my Friend Dr. Cesar Sabates as he Wraps Up His ADA Presidency!!!

 

I've mentioned him here before, but I want to give him one more round of applause.  My good friend and classmate Dr. Cesar Sabates is wrapping up his term as president of the ADA and I am so proud of him!  He has worked tirelessly for the profession over his career and it is amazing to think that he made it to the pinnacle of organized dentistry.  He took over the job when the world was still rapidly changing due to the pandemic and he's managed to steer the profession into better times.  Here is a write up about him that appeared in the ADA News as Dr. Sabates kicked off the SmileCon meeting in Houston last week...

Houston — SmileCon 2022 got off to a roaring start on Oct. 13 with thousands of dentists and dental team members celebrating the profession.

"This meeting is a great example of the Power of 3," said ADA President Cesar R. Sabates, D.D.S., in opening remarks in the George R. Brown Convention Center. "Local, state and national societies coming together with one shared purpose: for our communities and celebrating each other.”

SmileCon 2022 is a joint meeting with the 2022 Texas Dental Association Meeting and the 2023 Greater Houston Dental Society's Star of the South Dental Meeting.

"I hope that your SmileCon experience gives you the feeling of being inspired and more connected than ever before,” Dr. Sabates said. “Because if there's one thing I want you to remember it’s this: You belong to something big. Whether you're caring for a patient in your chair or meeting a student during office hours or working with materials in a lab, your work has an impact on the overall health and wellbeing of our communities."

Ransomware Attack Hits CommonSpirit Health

 As a reminder to all the dentists out there who read this blog every day, you have to be vigilant and take cyber security seriously.  Attacks are happening all too frequently and can be devastating.  Here is the statement from hospital system CommonSpirit Health...  For the full response, follow this link.

We have been managing a response to a cyberattack that has impacted some of our facilities. Patients continue to receive the highest quality of care, and we are providing relevant updates on the ongoing situation to our patients, employees, and caregivers. Patient care remains our utmost priority and we apologize for any inconvenience this matter has created. 

As previously shared, upon discovering the ransomware attack, we took immediate steps to protect our systems, contain the incident, begin an investigation, and ensure continuity of care. Our facilities are following existing protocols, which includes taking certain systems offline, such as electronic health records and patient portals. In addition, we are taking steps to mitigate the  disruption and maintain continuity of care. To further assist and support our team in the  investigation and response process, we engaged leading cybersecurity specialists and notified  law enforcement. 

We continue to conduct a thorough forensics investigation and review of our systems and will also seek to determine if there are any data impacts as part of that process.  

There is no impact to clinic, patient care and associated systems at Dignity Health, Virginia Mason Medical Center, TriHealth or Centura Health facilities. For the other parts of our health system that have seen impacts on operations, we are working diligently every day to bring systems online and restore full functionality as quickly and safely as possible.  

Central to our decision-making has been and will continue to be our ability to carry out our mission in a manner that is safe and effective to those we serve. At CommonSpirit Health, we are dedicated to meeting the needs of the communities we serve and are guided by our core set of values, which include integrity, excellence, and collaboration. We are grateful to our staff and  physicians who are doing everything possible to mitigate the impact to our patients and ensure continuity of care.