Pearls for Your Practice
Joshua Austin, DDS, MAGD, reviews an intraoral sandblaster, a universal restorative material, and a translucent fiber post system.
MicroEtcher IIA intraoral sandblaster from Zest Dental Solutions
Several months ago, I wrote about the PrepStart H2O Hydro Abrasion System from Zest Dental Solutions. I loved having the ability to conservatively prepare small to moderate carious lesions without a handpiece. This system is versatile and great; however, it does require a small financial commitment and a drastic change in procedure. Several dentists asked if there was any way to easily get some of the benefits of microetching without making the kind of commitment required by the PrepStart H2O system. Fortunately, Zest makes just such a product!
The MicroEtcher IIA is an intraoral sandblaster that is übervaluable in today’s bonded world. We all commonly use microetching in the lab, but intraoral use is less common. Using the MicroEtcher intraorally can increase bond strength by up to 400%, according to the manufacturer. It can be used on enamel, dentin, and any other substrate in the mouth you might need to bond to. That could be a porcelain restoration you are trying to repair or maybe a porcelain-fused-to-metal (PFM) crown that has broken to the coping and needs to be repaired by bonding resin composite. Microetching has countless applications.
The MicroEtcher IIA can be installed in your delivery system using a quick-disconnect kit. It can also be used with a high-speed handpiece adapter if you don’t have a quick disconnect in your delivery system. Having a quick disconnect added to my delivery system cost me about $180 through DentalFix. That investment has been worth every penny.
What sets the MicroEtcher IIA apart from the PrepStart H2O is the variety of media you can use in it. The PrepStart H2O is made to be used with 27- or 50-micron aluminum oxide only. The MicroEtcher IIA can be used with all sizes of aluminum oxide, sodium bicarbonate, SA-85 (which removes excess resin without enamel erosion), or glass beads. Any media you could possibly need will work with the MicroEtcher IIA. The flexibility it offers is unparalleled.
I have used the MicroEtcher IIA for sclerotic dentin etching on Class Vs, pit and fissure stain removal prior to placing sealants, porcelain and PFM restoration repairs, and removing old cements on prepared teeth prior to recementation. It is simple and fast to use. It is even autoclavable (except for the jar and filter). Once you have a MicroEtcher IIA around, you will find all sorts of uses for it. I never knew I needed this little dynamo in my life, but I do. Line-drive double into the corner for Zest Dental Solutions!
3M Filtek Universal by 3M Oral Care
A couple of months ago, it was time for dreaded spring cleaning in my office. We try to take half of a day during the spring go through all the storage closets, cabinets, and drawers to clean out what is expired, empty, broken, or no longer used. I am always depressed at the volume of detritus generated by this event. Sure, it is nice to go all Marie Kondo on the place—having neat and clean storage areas is refreshing. But all of the stuff represents waste, excess overhead, and financial loss.
One material that always seems to be in the trash pile is resin composite. We always buy kits with assortments of shades and translucencies, and surprise, surprise—some of those expire before they get used. Do those rarer shades and translucencies spark joy for you? If not, it’s time to ditch them and go for a composite like 3M Filtek Universal from 3M Oral Care.
The key word with this material is simplicity. Using NaturalMatch technology, eight natural shades and two accessory shades can cover the entire spectrum of the Vita shade guide. NaturalMatch technology is made up of nanofillers, proprietary low-stress monomers and pigments that enable one-shade esthetics to blend more naturally with the dentition. This means simpler procedures. It also means simplified inventory management, which means less waste. The two accessory shades, PO (Pink Opaquer) and XW (Extra White), can enhance your ability to match natural teeth. Pink Opaquer will help you block out anything dark, such as stain or exposed metal. Extra White is for your brightest bleached patients.
3M Filtek Universal has earned the Filtek name because the performance, physical properties, and handling characteristics are just like those of its older brother, Filtek Supreme Ultra. The patented nanotechnology brings the excellent, lasting polish we expect. Between that and its lifelike fluorescence, 3M Filtek Universal might be the best blending composite that 3M Oral Care has ever made! In fact, Filtek Universal is the first 3M composite to have warming as an approved, on-label use. This is a modern material for modern techniques.
This composite comes in compules and syringes. 3M Oral Care also packages a kit that includes shades A1, A2, A3, and A3.5, plus PO. This is a great way to try the composite without buying a whole truckload. Give 3M Filtek Universal a chance, and I think you will find a beautiful, esthetic material that simplifies your restorative workflows and holds up to your expectations of the name Filtek. Ground-rule double for 3M Oral Care on FIltek Universal!
EZ-Fit Translucent Posts by Essential Dental Systems (EDS)
A few months ago, I found an old external hard drive from my dental school days. I plugged it into my laptop and found a bunch of files from my sophomore and junior years of dental school. Among the files was an MP3 of an operative dentistry lecture by Bill Robbins, DDS, MA, my mentor and hero. The topic was the restoration of endodontically treated teeth. Most of the lecture was about posts. The lecture took place in the early 2000s. It was so interesting to hear the differences in thought about posts then compared to now. The entire lecture centered around metal posts. Fiber posts were not even on the market yet, much less in wide use. Today, fiber posts are the standard. And just like we needed different metal post systems for different situations then, we need different fiber post systems today.
Essential Dental Systems (EDS) recently debuted EZ-Fit Translucent Posts. These posts are a perfect choice for teeth that are severely dentin-deprived in the coronal segment. For these teeth, we want a post that does not require aggressive preparation of the radicular dentin but has retention elements to hold the post in. Radicular dentin is precious. Using an aggressive threaded post destroys radicular dentin and shortens the life span of the tooth. EZ-Fit Translucent Posts give us the retention elements we need without the aggressive preparation. These posts are parallel through the root, but instead of active threads, they have grooves and undercuts for maximal retention.
The coronal segment of the EZ-Fit posts is more robust and gives you a better opportunity to build and retain a core buildup. After this section, each post has a second tier that compensates for the natural anatomical flare of the canal for optimum dentin-to-fiber contact, even distribution of stresses, and maximum retention. The result is a more intimate and secure dentin-to-cement interface.
The kit includes two separate preparation burs for your latch-type handpiece. The first is a traditional post prep drill that is sized along with the posts. The second is a prep drill for the part of the post at the cervical part of the tooth. It preps a small neck into the space to fit this segment of the post. This extra step should give you more core retention and stability.
Even though the posts are translucent, I would still recommend using a dual-cure buildup material or resin cement to deliver any fiber posts. Yes, light will transmit down the post, but that is a long way for light to travel. A dual-cure material will ensure even curing from the coronal all the way down to the radicular.