Turning on to electric

Sept. 1, 2005
I want to buy electric handpieces. My sales rep likes the W&H/A-dec.

By Michael Miller, DDS

Iwant to buy electric handpieces. My sales rep likes the W&H/A-dec. I see where KaVo is top rated in REALITY, but I did not see an evaluation of the W&H. I demoed the W&H and liked it. Any concerns with this or any recommendations?

A-dec, the exclusive distributor of W&H handpieces in the U.S., chose not to participate in the evaluation process. Therefore, we cannot comment on the performance of W&H handpieces. In the 2005 Annual Edition, there are three different electric handpieces from which to choose. In addition, we have just begun the evaluation of the brand new, all-titanium Ti-Max NL400 from NSK sold in the U.S. by Brasseler. It also features a brushless motor. Nevertheless, our top-rated electric handpiece remains the ElectroTorque Plus from KaVo. It features a brushless motor and is the recipient of our Product of the Year award.

I need some advice to select an intraoral camera system. I’m looking at three - Air Techniques’ Acclaim, SciCan’s Ultimate, and Dentrix Image Cam 2.0. I currently run Dentrix management software, but not their image software. I want portability, USB attachable, auto focus within a range, capture feature with memory, and a reasonable price. Suggestions for other systems are open. I’m looking at five docking stations and three cameras.

There are several new intraoral cameras in the 2005 Annual Edition, with the most unique coming from Digital Doc, although the AcuCam Concept IVFWT from Gendex and the ImageCam USB 2.0 from Dentrix also ranked high in our ratings. All of these products deserve your consideration. Air Techniques and SciCan chose not to participate in our evaluation program.

I continually read that bleach trays work just as well without reservoirs. Logically it would seem that they would work better with reservoirs allow because they room for the bleach without being displaced when the trays are seated. What then is the rationale for trays and no reservoirs? I have also heard comments from other offices that some patients experienced sensitivity (perhaps from the trays themselves when made with no spacer), but then the trays were remade with a reservoir and the sensitivity subsided. No change in the gel or wear time was made, just switching from no reservoir to trays with them. Any ideas?

Our clinical evaluation found absolutely no difference in bleaching effectiveness or sensitivity, regardless of reservoirs being used or not. In our evaluation, we used Sof-Tray material from Ultradent, which is probably the best on the market. Although we have evaluated other tray materials, they were not put to this specific test. Nevertheless, there is no disadvantage to making trays with reservoirs except for the time factor.

Clearfil S3Bond is a new material and you probably have not had the chance to evaluate it yet. However, based on the track record of its predecessor, do you expect it to be a viable contender in the self-etch/prime market, and perhaps even replace Clearfil SE Bond?

It would be difficult for any adhesive to top the performance of SE Bond, but our preliminary bond strength tests on S3Bond are quite impressive. Another promising all-in-one adhesive is G-Bond from GC. Both of these products as well as still another all-in-one, Xeno IV from Caulk, are currently under full evaluation. We will publish the results of the evaluation shortly.

I have been using Prisma TPH for many, many years. My dental supplier now tells me that it has been discontinued and asked if I wanted to order Prisma TPH3. Is this product new? Is it “safe” or is it best to wait a few years to tell? If I liked the handling and shades of plain TPH, what tried and true product would you suggest I use as my general all-purpose composite that also comes in compules? I use Renamel Microfill for my esthetic cases.

While we have just begun a complete evaluation of TPH3, our preliminary investigation indicates you can safely switch to it without worrying that it is not as good as its predecessor - it does look like an improvement over TPH. Switching to a new composite is not as risky as using, for example, a new adhesive - new ones are not radically different than old ones. You may want to purchase a few shades of the new version and see if it meets your needs.

At a number of different courses, I have heard varying ideas as to the suitability of using root-filled teeth as abutments for bridges. Are there any hard and fast rules for this based on good evidence?

While we are not aware of any changes in the principles of bridge abutments, the use of endodontically treated teeth depends on many classical factors, such as whether a wide (2 millimeters) circumferential ferrule can be placed apical to the core buildup. Without this ferrule, the success of the abutment will suffer. Incidentally, a post is only necessary if the remaining tooth structure is not sufficient to retain the core buildup. It is not necessary to place a post for every endodontically treated tooth.

Besides spot etching, is there any other way to retain a temporary laminate that works?

Try to lock the provisional material interproximally. If this is not possible, then you could use a 1/4 round bur to put several shallow undercuts in the preps.

Can you please clarify how to cement and/or bond crowns with zirconia copings? Sandblast? Etch? Silanate? Which type of cement do you prefer?

It seems that aggressive sandblasting is the best approach. Etching does not seem to help, nor does silane. As far as cements, you can never go wrong with a resin cement such as Panavia F 2.0 (Kuraray), but virtually any other resin cement will also work. Resin ionomer cements like Fuji Plus (GC) can also be used.

Dr. Michael Miller is the publisher of REALITY and REALITY Now, the information source for esthetic dentistry. He is an international lecturer and a fellow of the American Academy of Cosmetic Dentistry, as well as a founding member. He maintains a private practice in Houston. For more information on REALITY and to receive a complimentary issue of his monthly update, REALITY Now, call (800) 544-4999 or visit www.realityesthetics.com.