Pearls for Your Practice: Digital sensor, endo handpiece, bioactive cement

DentiMax LLC's Dream Sensor digital sensor system

Unless you are using a CAD/CAM milling unit, the most expensive item in your office that gets used every day is probably your digital radiographic sensor. We pay thousands and thousands of dollars for these pieces of plastic that plug into our computers. We use them multiple times a day, beat the hell out of them, and expect them to work every time without exception. We ask a lot of our digital radiographic sensors. I think it's OK to ask yourself periodically if you have the right ones for your practice.

A couple of big-name companies are top of mind when it comes to digital radiography sensors, just like with other types of dental products. Oftentimes, we see smaller companies come to market with advances and improvements that the big companies can't achieve. The DentiMax Dream Sensor is a perfect example of that.

For a digital radiographic sensor, the Dream Sensor is a workhorse. The Dream Sensor has three qualities that make it worth comparing to the big names on the market. First, the images are crystal clear because of the CMOS active-pixel technology inside the sensor. The circuitry and engineering are state of the art.

Second, comfort is a huge advantage. The DentiMax Dream Sensor is the thinnest CMOS sensor available. Thinner, rounded edges provide an easier, more comfortable experience for your patients. We can all agree about how important that is. In fact, many pediatric offices use the Size 1 Dream Sensor for kids, who are notoriously tough to use sensors on.

The third big advantage of the DentiMax Dream Sensor is its hardware and software compatibility. As an open system, the Dream Sensor works well with most major software systems. Many other digital sensor systems use proprietary file types that make importing and exporting difficult-but not DentiMax!

DentiMax offers imaging software that works well with other systems, as well as practice management software, which is unique. All of this-the sensors and software-is significantly less expensive than similar products from big-name competitors. DentiMax gives dentists options for thinking outside the box when it comes to the hardware and software needed for practicing in the 21st century! Line-drive single up the middle for DentiMax!

Brasseler's EndoSync cordless handpiece with apex locator synchronization

On Sunday, we took my 10-month-old Goldendoodle Graham to a doodle meetup at a local dog park. This is how you know we've officially jumped the shark as a society. There are designer mutts called doodles, and we've decided they need friends so we attend meetups in cities across the country. This is something that never would have happened when I was growing up. My parents had a hard time making sure my seatbelt was buckled in the backseat, much less making sure our dog was socially stimulated. Anyway, I had never been to this particular dog park before, so I punched it into my GPS, which guided the way. The reason GPS works is because you can see your car's location on the map relative to other landmarks and your destination. Without that, we'd still be in the Stone Age, navigating with printed MapQuest directions.

Thinking about GPS made me think about endodontics. Why can't we have GPS for navigating canals? Brasseler's EndoSync offers us just that! It's well documented that apex locators are useful in determining the termini of canals. Typically, we clip one onto a hand file, poke around until we hear a beep, drop the rubber stopper, and pull out to measure. After that, the apex locator disappears into the corner and we're on to rotary files. As my dad taught me in the garage, measure twice and cut once. But with endo, we tend to measure once and never again. With the Brasseler EndoSync, however, we can measure constantly.

The Brasseler EndoSync is the first cordless endodontic handpiece with apex locator synchronization. On its own, the EndoSync handpiece is great. It's small and ergonomic, and it sits in a well-designed cradle on your counter. Torque and speed are easily changed, so it works with a wide array of file systems. It's got plenty of power to get through difficult situations, and its battery life is good. The EndoSync apex locator is great as well. It's compact and has a large, readable screen.

Using a small cable that plugs into the side of the apex locator and the base of the handpiece, the two work in sync. What does that mean for you? It basically means you can get real-time location data from the apex locator while cleaning the canals with rotary instrumentation. This real-time data is incredibly useful in knowing if you are instrumenting down to the apex or not. I found that having the handpiece and apex locator in sync made my endodontic appointments faster, and I loved the radiographic results I was able to achieve.

After using the EndoSync system and having the real-time apex data during instrumentation, I wonder how I was able to do endo confidently before. This really gave me immense confidence that I was instrumenting the entire canal. Confidence in endo is so valuable. I definitely recommend giving the EndoSync system a demo-you will be impressed. Scorching double down the third-base line for Brasseler!

BioCem universal bioactive cement by NuSmile Ltd.

Although data shows that pediatric dentists do well financially, they have my sympathy. First, it's obvious that chamfers were too difficult for them-hence, the extra two years of education only to learn less sophisticated dentistry. Second, we general practitioners handle the good kids and only send the hooligans to the specialists. Third, they have to deal with materials that aren't quite as forgiving as some of the stuff we work with as GPs. How do you bond a stainless steel crown? They have to deal with zirconia too, as several preformed zirconia primary crowns are now on the market. Obviously, my first two observations were tongue in cheek. I love the pediatric dentists in my area and am thankful that I have them as a resource. But I do feel that they have a tough draw when it comes to cementing tough materials.

NuSmile BioCem is a great option for these tough situations. I am a big fan of bioactive glass ionomer cement for adult zirconia crowns. NuSmile BioCem now gives us that option for primary crowns.

One of the biggest advantages of bioactive cements is that they trigger dentin to form hydroxyapatite. Hydroxyapatite formation is beneficial because it can fill some of the microgaps in preformed crowns. But using a cement such as BioCem for primary teeth has several other advantages too.

First, it doesn't contain any hydroxyethylmethacrylate (HEMA), bisphenol A (BPA), or bisphenol A-glycidyl methacrylate (bis-GMA), which appeals to parents. It is also hydrophilic, so perfect isolation, which can be difficult with kids, isn't always a must. BioCem has a high bond strength to both zirconia and stainless steel. Its viscosity is ideal for bulk filling preformed crowns. It can even be tack cured with a curing light when used with a translucent material such as zirconia. NuSmile calls BioCem "CemBiotic," which is a play on "symbiotic." Get it? Just like high school biology. Delightful!

Another advantage of BioCem is its delivery system. Many glass ionomer cements come with difficult delivery systems. BioCem comes in an automix syringe, which makes it easy to dispense. Two different tips can be used with the automix syringe. One is a short tip that minimizes waste, and the other is a cannula tip for pinpoint placement.

BioCem is truly superior to more traditional cements in many ways. Considering that, you might expect it to be significantly more expensive. You would be wrong. BioCem is cost effective, and it's cost competitive with the traditional resin-modified glass ionomer and glass ionomer cements. Better properties, easier to use, and cost effective? That's a win-win-win. Ground-rule double for NuSmile on BioCem!