Joshua Austin, DDS, FAGD
Dryz Gingival Hemostatic Retraction Paste compules by Parkell
I used to be a two-cord guy. I would pack a smaller cord around a crown preparation to refine my margins, followed by a larger cord that I would remove right before the impression. With the advent of retraction pastes several years ago, I have transitioned away from using the second cord. Hemostatic retraction pastes can easily mimic the effects of a second cord but have a much better hemostatic effect. Although I have tried several different pastes over the years, I recently settled on Parkell's Dryz Gingival Hemostatic Retraction Paste.
When the Dryz paste was only supplied in plastic syringes, I found it to be difficult to extrude through the applicator tips. I pushed so hard that I bent a plastic syringe. After that, I went back to the product I had used previously. So when I saw that Dryz was repackaged, I was skeptical, but I ordered some to try. I am glad that I did.
Dryz now comes in a compule form, just like composite. The compules fit into a regular composite gun, and each compule is enough to treat a tooth or two-depending on how much you extrude. The way I use Dryz is pretty simple. I do a rough preparation of the tooth, pack my size 0 or 00 cord, and refine the margins. When I reach the point at which I formerly would have packed the second cord, I express Dryz into the sulcus, all the way around the tooth. I then have the patient bite into a Roeko Comprecap for two to four minutes. After that, I remove the Comprecap and rinse the Dryz away with water and air. Over the working time, the Dryz laterally expands the sulcus, allowing me to impress or scan the margin. It also is a very nice hemostatic that usually eliminates any gingival bleeding. Every so often, I will use Dryz at the floor of a Class II box if I am having trouble controlling hemorrhage, or I will use it around a carious Class V with inflamed gingiva. For me, it works better than a second cord.
Dryz has become a handy item to have around. Unlike the previous formulation, it expresses easily, and it's simple to use. I highly recommend having some around for your routine, fixed prosthodontic procedures or even just for situations in which you have trouble controlling gingival hemorrhage. Sharp double down the line for Parkell!
Members of the dental industry love the term "sandblasting." The problem is that it's an inelegant, incorrect term in the context in which we use it. We should be using the term "microetching" instead. Why? We aren't using sand! We are using a variety of different media but no actual sand. So from here on out, let's stick with "microetching."
Countless studies show that bond strengths are increased when teeth are microetched prior to restorations. Whether it be for sealants, direct composite, crowns, or veneers, bonds are better when the substrate is microetched. We all have microetchers in our labs, and some of you might have microetchers in your dental units. Traditionally, however, microetchers have been expensive, requiring installation by professional technicians. I recently demoed the EtchMaster by Groman Dental, which is an excellent, cost-friendly option that can increase your success with bonded dentistry.
The unit that I demoed was the four-hole handpiece adapter. It screwed directly into my dental unit, just like a handpiece. With the EtchMaster, airflow is controlled via the chairside foot pedal. What makes the EtchMaster so great is the wide array of media available in the EtchMaster tips, which are color-coded by abrasivity for quick and easy selection. Options include hard abrasives, such as 27- and 50-micron aluminum oxide for bond enhancing. Also available are different grades of polishers for stain removal from tooth surfaces and restorations. Calcium carbonate and sodium bicarbonate tips for prophy polishing are available, too, giving you more flexibility with the EtchMaster.
I enjoyed using the EtchMaster. The first time I used it was during a veneer case. After removing the provisionals, I used 27-micron aluminum oxide to clean the preparations. The resulting matte finish on the tooth was clean and even-a perfect substrate for bonding. My hygienist has used the softer tips to air polish patients with heavy stain and to polish around orthodontic appliances with great results. Groman Dental claims that the EtchMaster makes less of a mess than other air polishing units. Although I have only used a few other ones, I would absolutely agree with the claim. This is, by far, is the least messy unit I have ever used. My hygienist agrees.
If you are doing any bonding, or if you routinely see patients who build stain, the EtchMaster is a no-brainer. It is inexpensive and easy to incorporate, and it does an excellent job. Depending on the tip you choose, it offers a wide variety of applications. This will enhance your clinical success with bonding and make your hygienist's difficult prophys easier. The EtchMaster by Groman Dental is the epitome of a three-run home run. I could not recommend it more!
A-dec|W&H Synea 400 and 500 series handpieces
In a previous column, I mentioned my motto on products that are used daily: Invest in quality staples. If you are going to pinch pennies, do it for items you won't use often. For a restorative dentist, it's hard to think of a product that is more of a staple than the handpiece. Handpieces are the workhorses of the restorative dentist. If you haven't already, spend a few minutes on eBay searching "dental handpieces." You will find a ton of cheap, foreign-made handpieces at prices that will astound you. You can get 10 of these high-speed, air-driven handpieces for under $200. I've tried these before, and the old adage applies ... you get what you pay for. Essentially disposable, these knockoffs typically break down after only a couple of uses. For the price, I guess that's fine, but I prefer for the one piece of equipment that I can't work without to be more dependable and reliable. I think it's a wise move to invest in high-speed handpieces. I'd rather have five reliable, high-quality handpieces than 100 cheap ones. The A-dec|W&H Synea handpieces are as nice as I have ever used. With a few of these, you could tackle the world!
The Synea line of handpieces offers an array of choices to meet just about any need. The two main choices are the Synea 500 and the Synea 400. The 500 is the top-of-the-line, flagship handpiece in the A-dec|W&H family, while the 400 offers many of the same best-in-class qualities as its cousin but at a more economical price. Within the 400 and 500 families, A-dec and W&H offer high-speed, low-speed, and straight options. The 500 family includes a short, high-speed version not available in the 400 line. For more of a breakdown of all of the differences between the 500 and 400, visit us.a-dec.com/en/Products/Handpieces.
The Synea handpieces are an absolute joy to use. Both versions cut smoothly with clean and even water spray, and illumination is bright. They feel substantial and comfortable in the hand, but they aren't too heavy. The 500 has a scratch-resistant coating on it that helps it to look new, even after many autoclave cycles. Furthermore, whether service and warranty are included should always be a factor when purchasing a handpiece or any other equipment. With A-dec and W&H, you know that you are purchasing through companies that will take care of your equipment if breakdown occurs. Both the 500 and 400 carry a 24-month warranty. Next time you are in the market for handpieces, I strongly encourage you to take a look at the A-dec|W&H Synea line. The cost is competitive with other premium-brand handpieces, and the line includes options for everyone. Line drive double into the gap!