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Pearls For Your Practice

Dec. 20, 2016

iOptima electric handpiece system

by Bien-Air

For many reasons, I cannot imagine being without electric handpieces in my practice. First, we live in a monolithic world dominated by lithium disilicate and full-contour zirconia. As these restorations become ubiquitous, more and more will need to be replaced. I cannot imagine trying to cut through a BruxZir crown that has been bonded without an electric handpiece. Second, our monolithic world is also becoming more digital. I don't use impression material for my indirect restorations. When scanning, smooth and continuous margins are important. With an electric handpiece, I can dial down the rpm to easily get smooth chamfers every time.

There are plenty of great electric handpiece options on the market today. One is the iOptima by Bien-Air. You may have seen advertisements for the iOptima recently. It's the one with the iPod Touch interface. How cool is that?! As a confessed Apple fanboy, I will admit that I was swooning over this system at first sight. The large, color Retina display of the iPod Touch is the perfect interface for controlling an electric handpiece system. My previous electric handpiece system had a control box with a touch screen, but the interface wasn't intuitive and lacked many options that the iOptima offers.

iOptima installs into your dental unit like any other electric handpiece system. The iPod Touch sits on your bracket table on a special cradle that contains most of the "guts" of the system and powers the iPod. The iOptima micromotor is brushless, which increases performance, reliability, and flexibility.

When launched, the iOptima app offers simple choices. Are you performing a restorative or endodontic procedure? Under the restorative menu, there are a ton of procedures to choose from, including everything from crown preparation, to porcelain adjustment, to deep caries removal. All of these procedure selections have unique specifications, like speed, torque, direction of rotation, etc. You can also set up custom procedures if you want to dial something in a little differently. As a restorative dentist, this is an absolute dream.

From an endodontic perspective, all of the popular file systems are preprogrammed by the good folks at Bien-Air. This is incredibly nice and makes it simple to know that you are using the endodontic files within the recommended parameters. The option for customized settings is also available on the endo side.

I had my usual equipment repairperson install my iOptima system. The first thing out of his mouth when he saw the box was "Bien-Air makes a hell of a nice handpiece." I always find it very telling when equipment repair technicians tell me that a certain piece of equipment holds up well. He is called on to repair dental equipment all day long. When he says something holds up well, that means something to me.

All of this technology translates to a better clinical result from my hands, which is where the rubber meets the road. I felt a smoother, more powerful handpiece in my hands with the Bien-Air iOptima compared to my old electric system. Smash-hit triple to the wall for Bien-Air!

SpeedCem Plus self-adhesive resin cement

by Ivoclar Vivadent Inc.

I am fortunate be invited to lecture to many different groups around the country about the topics I cover in this column-from bulk-fill posterior composites to shade guides and anything in between. When I am lecturing, I consistently field more questions about cementation protocol than anything else. Many clinicians are confused about making the right choices when it comes to cementing indirect restorations. I am always happy to see products hit the market that can simplify the decision-making process.

Ivoclar Vivadent Inc. offers some great cements. From an adhesive standpoint, Variolink Esthetic is a home run. It's my first and only choice for anterior indirect restorations. Multilink Automix is a great self-etch resin cement that I routinely use for bonding in posterior ceramic restorations. Ivoclar's new and improved SpeedCem Plus is an excellent addition to its lineup in the self-adhesive category.

SpeedCem Plus has a great combination of ease of use and performance. Ivoclar has specifically designed the chemistry to enhance its effectiveness with zirconia and metal restorations. And because most implant restorations interface between metal or zirconia, SpeedCem Plus is a great option there too. SpeedCem Plus cleans up easily and is highly radiopaque, but the best part is how user-friendly it is. Simply clean your restoration with Ivoclean, prime with Monobond Plus, load SpeedCem Plus directly into the restoration, and deliver. No need for additional adhesive or bonding agents.

This isn't just a one-trick pony though. SpeedCem Plus works great with IPS e.max. I always say, "Ivoclar invented e.max. I trust they know how to cement it." Although it's not nearly as shade-diverse as Variolink Esthetic, SpeedCem Plus is available in three shades: translucent, opaque, and yellow. My choice is always translucent, but options are nice.

I find that most cementation questions regard zirconia. IPS e.max behaves similarly to feldspathic porcelain, so we have a good understanding of bonding in relation to that. Zirconia can sometimes behave more like a metal. When BruxZir hit the market, no zirconia primers were available. Only since zirconia primers, such as Monobond Plus, hit the market have we been able to bond to zirconia reliably. That has caused great confusion regarding the use of resin cements with zirconia. When used in conjunction with Ivoclean (to remove salivary phosphates accumulated during try-in) and Monobond Plus (as a zirconia primer), SpeedCem Plus is a great choice when you need to bond zirconia restorations. Solid double to the gap for Ivoclar on SpeedCem Plus!

Front Office Rocks

My fiancée, Andrea, works with Pacific Dental Services (PDS) as an owner. Several months ago, she hired a new office manager and sent her to a week-long training course at PDS's headquarters in Irvine, California. That must be nice, huh? As a solo practitioner, I don't have the luxury of being able to punt a new employee to a professional training program to be brought up to speed. I have to handle it in real time, in my office, in between patients, as time allows. That's how most of us roll. It's no wonder that we consistently have basic team issues day in and day out. What if you could delegate team training to a professional in an economic way that doesn't require any time out of the office? Front Office Rocks can do just that, and I have to admit that it is one of the best services I have ever brought into my practice.

Headed up by Laura Hatch, a dental office manager in San Diego, Front Office Rocks is a subscription-based website (frontofficerocks.com). Members of Front Office Rocks get access to professionally made videos addressing issues throughout the office-covering everything from why team members shouldn't eat at the front desk to the importance of HIPAA, all with one simple membership. In fact, over 150 videos are available in five different categories. The videos are all well done with a high production value. These weren't filmed on an old camcorder in a dark, dank office. My team found them succinct, informative, and fun to watch.

As the head of the team, the dentist sets up the account. You can create profiles for each of your team members within your account, and they can all have unique login credentials. You can specify which group of training videos you would like each team member to have access to. For instance, you may want your entire team to watch videos related to scheduling; however, only the office manager should watch the videos specifically about that.

Each video is just a few minutes long and focuses on one particular detail. This makes the training very "snackable." No 45-minute videos here. Your team can knock a few out each day as they have time. A quiz follows each video, so you can review the quiz results to make sure your team is absorbing the information.

Team training is an impossible task. As the dentist, you need to be producing. You can't spend your days reviewing phone etiquette tips with your team. That is the power of Front Desk Rocks. You can assign your team some videos, and let Laura Hatch do the work for you . . . all for less than $150 a month. From my experience with Front Office Rocks, that is a bargain! Check out some of the sample videos on the home page. I have a feeling you will be impressed. Solo home run down the line for Front Office Rocks!

Opalescence Go by Ultradent Products Inc.

It's 2016. It surprises me that patients still constantly ask about whitening. Fifteen years ago, I would have thought that over-the-counter whitening options would have swallowed the market by now; however, at least one-third to half of my new patients ask about whitening.

Having quick and easy whitening options is a must for our practices. Take-home whitening, in my opinion, is the best option for everyone involved-with less rebound, fewer side effects, less chair time, and lower overhead. Not all hygienists are comfortable taking alginate impressions, and the hygiene schedule doesn't always allow adequate time for them. Opalescence Go from Ultradent Products Inc. is a great option for situations when patients are interested in take-home whitening but time or staff availability won't permit taking impressions for trays.

Opalescence Go is a professional-strength whitening gel in prefilled disposable trays. The trays, called UltraFit trays, mold and adapt to individual patients better than strip-like products. This adaptation makes the whitening experience more comfortable, which means improved compliance and happier patients. In addition, the UltraFit trays extend to the first molar, providing more complete whitening than OTC options.

The Opalescence Go trays are obviously filled with Ultradent's awesome Opalescence whitening gel. For my money, Opalescence is the best whitening gel on the market. The potassium nitrate and fluoride reduce sensitivity while strengthening enamel.

Opalescence Go is available in three strengths: 6%, 10%, and 15%. The wear time depends on the strength selected. The higher the strength, the shorter the wear time. And between mint, melon, and peach, everyone should be able to find a favorite flavor.

Opalescence Go is a perfect option for your patients who are interested in whitening. Striking while the iron is hot is important for elective services, and Opalescence Go allows you to do that!

SalivaMax supersaturated calcium phosphate solution by Forward Science

Oral mucositis is a difficult problem for our patients. It can cause constant pain and discomfort and affect patients' ability to enjoy food and drink. Xerostomia can be a contributor, along with current medical or dental treatments. In the past, treating oral mucositis was a problem since we didn't have a lot of options. I'd tried Pink Magic Mouthwash (a generic name for a compounded mix of lidocaine and soothing agents) with little success. I'd even tried both topical and systemic steroids, which should never be done without careful consideration and which oftentimes requires consultation with the patient's physician. Not having options can be frustrating. That is why SalivaMax by Forward Science is such a great product; it provides a solution for a problem.

SalivaMax is a powder available by prescription that forms a supersaturated calcium phosphate solution when dissolved in one ounce of water. The solution has a concentration of electrolytes similar to saliva. This helps buffer the pH in the patient's mouth and soothe oral tissues. It does not have the "I've got someone else's spit in my mouth" feel that other saliva substitutes have. It feels more like rinsing with salt water, which our patients are accustomed to.

SalivaMax is indicated for oral mucositis, xerostomia, and hyposalivation. This is great for patients who have Sjogren's syndrome and for those who are undergoing radiation or chemotherapy. I have also used it following appointments involving significant restorative work, in which many teeth were prepped and cords packed. Because of the soothing feeling patients get after using SalivaMax and its ease of use, patients have been very compliant. Also, the little packets that SalivaMax comes in are convenient and easy for patients to use on the go.

Finally, Forward Science offers a patient assistance program to reduce the cost, which is really nice. Their website has plenty of information and is a great resource for patients (forwardscience.com/salivamax). SalivaMax is a great tool to have in your bag to help your patients!

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