1. Southern Utah Dental Review

2. Anesthetics

3. Carbide Burs ¼, ½, 2, 4, 6, 8 34 169 245 330 (Pear) 556/557 702/703
1557

4. Diamond Burs 801 Rounded or Flat 379 Tapered or Straight
Can also do a One-Time Use Diamond from Midwest Buy 4 (25-packs) at $39.29 each and get 1 free
Standard Burs can average $26.99 per 5-pack

5. Cements and Liners Dycal (Dentsply) Fuji Liner (GC America)
Vitrebond Plus (3M ESPE)

6. Do I Cement or Bond and With What?

7. Bonding to Ceramic
Macromechanical- no sharp edges or surfaces (promotes cracks). Create retentive preparations rather than alter the inside of the restoration.
Micromechanical- acid etching and sand blasting. Acid etching with HydroFluoric acid works well for silica based materials because it will etch glass. Phosphoric acid does nothing to any surfaces except enamel and dentin. However, acid etching won’t touch alumina oxide and zirconia cores and may cause cracking. Sandblasting works best for both.
Chemical- only with silane and only if silica is present. Use HF to etch silica-based ceramics.

8. Cement Types
Luting cements- cements that achieve retention by filling in the gaps between the tooth and the restoration. Adhesion is at best a surface phenomenon of wetting and micro-mechanical interlocking.
Bonding cements- stronger than luting cements so “gap filling” offers greater retention. Bonding to tooth structure through the smear layer or into dentinal tubules is more than just a surface phenomenon. Bonding to restorations can be achieved through the use of primers which allow for the chemical adhesion to inorganic fillers, or metal oxides.

9. Luting Cements Used almost exclusively with metal based restorations.
Self curing, with generally two components (liquid/powder or paste/paste) for mixing.
Four classes: zinc phosphate; polycarboxylate; conventional glass ionomer; resin-modified glass ionomer (marginal Fl release).
Of these classes, only conventional glass ionomer and RMGI cements have true indications in modern dentistry. Their indications are limited to metal; metal-based; or core strengthened, glass-free ceramic restorations with retentive preparations. Examples: FujiCem, RelyX Luting, Ketac Cem

10. Luting Cements Paste/paste system
Easy mixing, radiopaque, 3min. working time
Low film thickness (10 microns ).
Do not use a dentin conditioner (removes smear layer).
Fluoride release, low solubility

11. Bonding Cement
Composite resin cements: are modified composite resin materials with high adhesion, low solubility, and good esthetics.
Like any direct composite materials, this class of cements must be used with a bonding system. There are Three subtypes: total-etch system, self-etching system, self-adhesive systems.

12. Composite Resin Cements
Total-etch system- most systems are dual cured or light cured. The steps are as similar and diverse as that for direct composite restorations. Examples: Variolink II, Calibra, Duolink, RelyX Veneer cement. In general, any of these systems are moisture intolerant.
Self-etching systems- Typically a dual cured, two part system where the acid etching and bonding steps are replaced with a self-etching primer mixed and activated with a bonding agent. The manufacturer’s instructions usually require PhD in interpretive science to decipher. Examples: Panavia F

13. Composite Resin Cements
Self-adhesive cements- 3M-RelyX UniCem is the #1 selling cement in the US market. It is a capsule dispensed dual cured cement that eliminates separate etching and bonding steps. It is uniquely moisture tolerant, and has a low risk of post- operative sensitivity. It has a broad range of applications and a simplified technique. Kerr MaxCem.
Best for metal crowns.

14. Resin Cements – RelyX Unicem 2 and RelyX

15. Choosing The Right Cement
The determination of the cement type begins with the clinical situation not vice versa. This is determined in the treatment planning stage.
The key factors that determine restoration and cement type are: esthetic demands, ability to maintain a dry field, occlusal forces, remaining tooth structure, prep design (retentive or non-retentive), and margin location.
In general, weak restorations must be adhesively bonded with strong cements.
Ceramic restorations require either micro-etching or acid-etching of the undersurface and silane coating to achieve bonding with resin cements; this is not achievable with luting cements.

16. Other Types of Cements PolyCarboxylate – Durelon (3M ESPE)
Glass Ionomer -
Ketac Cem (3M ESPE)
Fuji I (GC America)
RMGI -
RelyX Luting and Luting Plus (3M ESPE)
Fuji Cem and Fuji Cem 2 (GC America)

17. Other Types of Cements Bonded Resin Cement - RelyX Unicem Aplicap *
Dual Cure and Self-Adhesive – NOT for Veneers
RelyX Unicem 2 Self-Adhesive (3M ESPE) *
Claims no need for etching, priming or bonding of tooth
RelyX Veneer (3M ESPE)
Light Cure only – all types of colors to choose from
Variolink Veneer (Ivoclar) *
For Veneers, Inlays and Onlays
NX3 (Kerr)
Light-cure and Dual-cure available in 5 shades
MaxCem Elite (Kerr)
Single Step for all restorations
MultiLink (Ivoclar)
Calibra (Dentsply)

18. Cement Recommendations
PFM/Metal
Inlays/Onlays
Composite Crowns, Inlays, Onlays
Strengthened core
Crowns, bridges
Alumina/Zirconia
Feldspath or
Pressed ceramic
Crowns, Anterior Veneers
E-Max - Lithium Discilicate
Glass Ionomer X
RMGI
Bonded Composite Resin

19. Temporary Cement Premier Implant Cement (Premier)
Resin based design for security and able to retrieve
Integrity TempGrip (Dentsply)
Zinc Oxide, Non-Eugenol
TempBond (Kerr)
Clear version claims to have Triclosan (anti-bacterial to prevent gingivitis but may inhibit muscle contraction – FDA is checking on it)

20. Desensitizers Gluma (Heraeus) MicroPrime (Danville)
Comes in Liquid Bottle, Single Use and Gel
MicroPrime (Danville)
Has the old B version and now G version that is comparable to Gluma at a much lower price
Prestige Dental has it for $50.95 / Gluma is $ in the Benco Catalog

21. Differences Between Self and Total Etch
Enamel acid-etching involves demineralizing portions of hydroxyapatite crystals to develop a porous surface for micro-mechanical bonding. Today, acid-etching is performed on dentin, and with a total-etch (TE) or self-etch (SE) technique.
Total Etch - In the TE technique, the outer layer of dentin is decalcified, removing the smear layer and opening the underlying dentin tubules. This exposes collagen fibers that are then infiltrated with a primer, followed by the application of a resin adhesive. Primer and adhesive are applied simultaneously in many systems. In this procedure, it is critical that you completely seal dentin tubules to avoid bacterial invasion and/or sensitivity. Generally this technique is used for larger direct restorations and indirect restorations.
Self Etch - Rather than removing the smear layer, the SE approach involves the application of an acidic primer that will promote micro-mechanical bonding of the adhesive to the smear layer and the underlying dentin. This technique minimizes the potential for postoperative sensitivity by preventing the collapse of the collagen fibers that can occur after conditioning and drying in the TE process. The SE technique has less clinical history, but appears to be best in less invasive procedures such as shallow Class I or Class II restorations.

22. Primers and Bonding OptiBond (Kerr) – Total-etch
XP Bond (Dentsply) – Universal Total-etch “(1 bottle/1 coat)”
ScotchBond Universal (3M ESPE) – Total or Self-etch
Claims to bond to metal and Zirconia surfaces
Adper Single Bond Plus (3M ESPE) – Total Etch
iBond (Heraeus) – Has both Total and Self-etch products
Claims to Desensitize as well with the Self-Etch
Peak Universal (Ultradent) – Works with both Self and Total-etch techniques,
Also contains Chlorhexidine for added bond longevity and strength
BondForce (Tokuyama) – Self-etching, Fluoride releasing
Clearfil SE (Kurary) * - Self-etching primer and bonding agent
Clearfil S3 (Kurary) – Self-etch, one-step, fluoride releasing
All-Bond ACE SE – Self Etch
Brush N’ Bond (Parkell) – Self-etching but seems to be more of a sealer

23. Universal Composite
Estelite Omega (Tokuyama) – Spherically filled supra-nano (82% filler)
Estelite Sigma Quick (Tokuyama) –“Radical Amplified Photopolymerization Technology”
Filtek Supreme Ultra (3M ESPE) * - Nanotech provides retention of a microfill and the strength of a modern hybrid
GrandioSO (Voco)
Vit-L-Escence (Ultradent)
Tetric Evoceram (Ivoclar)
Heliomolar (Ivoclar)
Venus Diamond (Heraeus)
Esthet-X HD (Dentsply)
N’Durance (Septodont)
Premise (Kerr)
Herculite Ultra (Kerr)
SonicFill (Kerr) – $ on average for handpiece / Up to 5 mm then cure

24. Flowable Composite Filtek Supreme (3M ESPE)
Also Filtek Bulk Fill – Cure up to 4 mm
Starflow (Danville) – Claims to have highest compressive strength
Surefill SDR (Dentsply) * - Up to 4 mm, 15 of .25 g. for $70-80 (3.75 g.)
Venus Bulk (Heraeus)- Up to 4 mm
HyperFIL (Parkell) – 22 g. for $65.25, Doesn’t work well with self-etch. Claim to need Brush N’ Bond.
Tetric EvoCeram Bulk Fill (Ivoclar)
Contains Ivocerin – Patented light activator to help full light curing

25. Core Build-Up Materials
Clearfil Photocore (Kuraray) – light-cure
CorePaste (DenMat) - self-cure
Build-It FR (Pentron Clinical) – dual-cure
Luxacore Dual (DMG America) – dual-cure
FluoroCore 2+ (Dentsply) – dual-cure

26. Crown and Bridge Temp Materials
Integrity (Dentsply) *
ProTemp Plus (3M ESPE)
Structur 2 (Voco) * - Appears to be best price
Luxatemp (DMG America) – Star, Plus and Solar
PerfecTemp II (DenMat)
ExactaTemp (Exacta)
MaxiTemp (Henry Schein)

27. Are you Impressed?

28. Alginate Identic (Dux) – Jeltrate (Dentsply)
Kromaphase Dust free or Regular Powder (Color change from purple to mix, pink to load and white to seat then 30 sec.)
Jeltrate (Dentsply)
Chromaclone (Ultradent) * – Walterberry and Bubble gum Flavors, Same color changes as Kromaphase
COEflex (GC America)

29. Bite Registration Blu-Bite HP or Clear (Henry Schein)
Blu-Mousse (Parkell) *
30 sec. working and 30 sec. set time
SuperDent (Darby Dental)
Genie (Sultan)
Superfast has 60 sec. setting time in Mint flavor
MegaBite (DenMat)
Spearmint flavor – 55 sec. set time
Vanilla Bite and Chocolate Bite (DenMat – just bought from Philips Discus)
What else to say, its chocolate flavored!!! Claims 45 set time.

30. Vinyl Polysiloxane Aquasil Ultra (Dentsply) *
Has XLV, LV, Monophase, Heavy and Rigid Options
Exafast NDS (GC America) *
Regular, Monophase and Heavy Options
90 sec. set even in a wet enviornment
Genie (Sultan) *
Berry flavored with Extra Light, Light, Regular and Heavy Body
Imprint II Garant (3M ESPE)
Precision Plus (Burkhart)
FlexiTime (Heraeus)
Has an Advanced ThermaSense (ATS) which allows fast setting material with flexible working times.

31. PolyEther Impregum F (3M ESPE) Impregum Soft Base/Catalyst Mix
Cartridge mix from tip, Easier removal

32. Bleaching

33. Take Home Bleaching Venus White Pro (Heraeus)
16% - Daytime of 4-6 hours, Nightime 8-10 hours
22% - Daytime of 60 minutes 1-2 times a day
Opalescence PF (Ultradent) – Melon, Mint, Regular
10% hours or overnight
15% hours
20% hours
35% - 30 minutes
Opalescence Oh! (Ultradent)
Same as PF but in individual doses
Zoom NightWhite and Day White (Philips)
NightWhite 10%, 16% and 22% are Hydrogen Peroxide 4%, 6%, 8% respectively
DayWhite is 9.5% and 14% (The 14% was named 38% but they changed the name to not have people thinking it was a full 38% HP. It is a mix of HP and Carbamide)

34. In-Office Bleaching Opalescence Boost 40% (Ultradent)
2 – 20 minute applications
Claims to strengthen enamel, decrease sensitivity and prevent caries
Patient kit - $51.99
Venus White Max 38% (Heraeus)
3-4 – 15 minute applications
Contains potassium nitrate to decrease sensitivity
Patient kit - $55.99
Pola Office 37.5% (SDI North America)
3 – 8 minute applications
No mixing materials, Contains potassium nitrate, with or without light
Patient kit - $75.99
LumaWhite Plus 35% (Luma-lite)
Includes “Stay Bright” professional take-home maintenance kit/enhancer
Patient kit - $68.99

35. In-Office Bleaching Zoom WhiteSpeed BriteSmile Dash
Clinicals show proven 8 shades brighter in 45 minutes
Uses LED light to accelerate the bleaching gel
BriteSmile
Similar to WhiteSpeed
In concentrations of 15 or 25% Hydrogen Peroxide
Dash
30% hydrogen peroxide whitening gel. No syringe-to-syringe mixing
Sensitivity management. Includes a syringe of Relief ACP, that combines chemical sensitivity relief (potassium nitrate) and long-term relief with ACP (Amorphous Calcium Phosphate) and fluoride.
These are all Philips brands. They also have a Zoom Whitening Pen for maintenance with 5.25% Hydrogen Peroxide.

36. Final Wrap-Up Sample Requests Treatment Videos Discounts/Rebates
How to for Cutting/Temping/Bonding Veneers
Possibility of Starting CE Library
Discounts/Rebates