Dental Tribune U.S. Edition

iNdustry News Hygiene Tribune U.S. Edition | January 2012C2 Publisher & Chairman Torsten Oemus t.oemus@dental-tribune.com Chief OPerating OffiCer Eric Seid e.seid@dental-tribune.com grOuP editOr Robin Goodman r.goodman@dental-tribune.com editOr in Chief dental tribune Dr. David L. Hoexter d.hoexter@dental-tribune.com managing editOr Fred Michmershuizen f.michmershuizen@dental-tribune.com managing editOr Sierra Rendon s.rendon@dental-tribune.com managing editOr Robert Selleck r.selleck@dental-tribune.com managing editOr shOw dailies Kristine Colker k.colker@dental-tribune.com PrOduCt & aCCOunt manager Mark Eisen m.eisen@dental-tribune.com marketing manager Anna Kataoka-Wlodarczyk a.wlodarczyk@dental-tribune.com sales & marketing assistant Lorrie Young l.young@dental-tribune.com C.e.manager Christiane Ferret c.ferret@dtstudyclub.com Dental Tribune America, LLC 116 West 23rd St., Ste. #500 New York, N.Y. 10011 (212) 244-7181 Published by Dental Tribune America © 2012 Dental Tribune America, LLC All rights reserved. Dental Tribune strives to maintain the utmost ac- curacy in its news and clinical reports. If you find a factual error or content that requires clarification, please contact Managing Editor Robert Selleck at r.selleck@dental-tribune.com. Dental Tribune cannot assume responsibility for the validity of product claims or for typographical errors. The publisher also does not assume responsibility for product names or statements made by advertisers. Opinions expressed by authors are their own and may not reflect those of Dental Tribune America. editOrial bOard Dr. Joel Berg Dr. L. Stephen Buchanan Dr. Arnaldo Castellucci Dr. Gorden Christensen Dr. Rella Christensen Dr. William Dickerson Hugh Doherty Dr. James Doundoulakis Dr. David Garber Dr. Fay Goldstep Dr. Howard Glazer Dr. Harold Heymann Dr. Karl Leinfelder Dr. Roger Levin Dr. Carl E. Misch Dr. Dan Nathanson Dr. Chester Redhead Dr. Irwin Smigel Dr. Jon Suzuki Dr. Dennis Tartakow Dr. Dan Ward HYGIENE TRIBUNE Tell us what you think! Do you have general comments or criticism you would like to share? Is there a particular topic you would like to see articles about in Hygiene Tribune? Let us know by e-mailing feedback@dental-tribune.com. We look forward to hearing from you! If you would like to make any change to your subscription (name, address or to opt out) please send us an e-mail at database@dental-tribune.com and be sure to include which publication you are referring to. Also, please note that subscription changes can take up to six weeks to process. tachment” between tooth and bone. The implant integrates directly with the bone. When inserting an instrument around a natural tooth, the resistance encoun- tered by connective tissue “attachment” creates a barrier to direct engagement with bone. The second biological characteristic of importance is that the gingival fibers sur- rounding an implant abutment comprise a horizontal/circular band, called the perimucosal seal, or the tissue cuff. There are no gingivodental or transeptal fibers or periodontal ligament as with a natu- ral tooth. The perimucosal seal creates a barrier against bacterial introduction. It is easily possible to insert an instrument through the seal and directly contact bone. Therefore, one of the key consider- ations during instrumentation is to go carefully within the perimucosal seal. Another significant aspect to consider with instrumentation around the im- plant/attachment is that these compo- nents are primarily made of titanium, a soft metal. Titanium is harder than plastic, Teflon and enamel. But it is softer than plastic that has been reinforced by carbon, glass or graphite and it is signifi- cantly softer than stainless steel. All the research agrees that stainless steel instruments and ultrasonic tips leave scratches and gouges on the tita- nium surfaces, which may harbor any subsequent accumulation of biofilm, in addition to potentially altering the bio- compatibility of the titanium surface. Graphite, glass and polymer-reinforced plastics or resins also show scratching to some degree. However, some studies and anecdotal reports indicate that rough- ened abutment surfaces have not been shown to increase implant complications. It is also generally reported in the lit- erature that plastic and Teflon can leave a surface residue that may interfere with the biocompatibility of titanium. Additional research is needed regard- ing the effects of surface scratching and residue. Even though the literature states that non-reinforced plastic or resin hand- instruments are the best choice, clini- cians agree that such instruments, alone, are not effective for the complete removal of calculus, residual cement and biofilm. New products are appearing based on the premise that materials of similar hardness to titanium will be more ef- fective at removing calculus with less scratching. These include solid titanium, carbon composite or carbon-reinforced plastic and copper alloy. Even though some of these products are already in the marketplace, the research about their performance is limited. For example, a review of the literature conclusions about titanium scalers ranges from no effect to surface scratching similar to stainless steel scalers. More details on plastics needed to improve clinicians' armamentarium Studies need to specifically define the type of plastic used in implant products. There is a decent amount of research over the past 20 years about the effects of plas- tic instruments on dental implants/at- tachments, but rarely is the type of plastic stated. This is an important detail, which may influence the clinician’s choice of ar- mamentarium. For example, a non-filled type of plastic is flexible and does not hold an edge for sharpening, whereas the filled types are more rigid and do hold an edge for sharpening. Dental applications with biocompatible polymers such as PEEK (polyetherether- ketone) and Ultem PEI (polyetherimide resin) are being studied and used in im- plant dentistry. Hand instruments Non-filled resin • Hu-Friedy Implacare • Sabra Dental Implant Solutions Filled plastic • Premier Universal/Facial carbon reinforced • Tess Implant Prophy+ polymer rein- forced • PacDent ImplaKlean carbon rein- forced Solid titanium • A. Titan Titanium Implant Scalers • Nordent Implamate • PDT Wingrove Series • Kohler Implant Cleaning Curettes • Karl Schumacher Bionik TI • American Eagle Titanium Implant Cleaning Kit Ultrasonic tips Magneto • Dentsply Cavitron SofTip single-use plastic twist-on • Advanced Ultrasonics single-use plastic screw-on • Tony Riso multi-use plastic screw-on • G. Hartzell & Son-multi-use silicone screw-on (also for use on piezo inserts) • Parkell GentleCLEAN single/multi-use Ultem wrench-on Piezo • Satelec/ACTEON PerioSoft multi-use carbon composite screw-on • EMS PI Instrument multi-use plastic insert with chuck • Brasseler USA/NSK Varios multi-use plastic insert with holder Studies also vary on use of air abrasives and implants. Most agree that this is a safe and efficacious procedure; however, there is a great deal of variation in op- erator technique. Too much time on tita- nium surfaces can scratch. Some research indicates that a glycine-based powder will scratch less than sodium bicarbonate or aluminum oxide powders. More defini- tive research is needed in this area. Air abrasive devices • Kavo Prophyflex • Deldent Jetstream, Jetpolisher and Jetsonic • Dentsply Prophyjet • Satelec/ACTEON AirMax • EMS Air-flow • EMS Air-flow Powder Soft & Perio: glycine-based Rubber cup polishing is indicated on titanium surfaces with fine prophy paste, nonabrasivetoothpasteortinoxide.Abra- sive polishing pastes are contraindicated. Finally, many periodontists I have spo- ken with on this topic have what I consid- er the most important observation: Each patient must be treated on an individual basis and given the necessary amount of education and recall frequency so that the amount of accretions do not accumu- late to the point of having to make ques- tionable armamentarium choices. A list of references is available from the publisher. ◊ Page C1 The Emerald™ is the newest addition to the line of disposable prophy angles by Denticator. As a pioneer in disposable prophy angle manufacturing, the compa- ny is excited to introduce the innovative design. The ergonomic 17-degree bend in the neck, as well as the superior gearing de- sign of the angle, is designed to improve clinician comfort, while the prominent ridges found at the base will enhance the operator’s grip. In addition, the unique color and fin- ish of this disposable prophy angle will make for easy identifi- cation. The angle is not the only notable aspect of the Denticator Emerald, though; the soft, latex-free cup features external ridges to provide improved interproximal access along with enhanced stain removal. The Denticator Emerald is available in either a 144 count box or a 500 count box. For more information, visit www.dentica- tor.com or call Denticator with any ques- tions or comments at (800) 227-3321. (Source: Denticator) New addition to line of disposable prophy angles The ergonomic 17-degree bend in the Emerald‘s neck is designed to improve clinician comfort, while the prominent ridges found at the base enhance the operator’s grip. Photo/Denticator Features include improved interproximal access Yankee BOOTH nO. 1335