Day to Day Technology to Improve Your Practice

  • Lasers
  • Erbium Lasers
  • Hard Tissue
  • 3 Delivery Modes
  • Fiber
  • Hollow Wave Guide
  • Articulated Arm
  • Purchasing Suggestions
  • Hands-on before you buy
  • Return policy?
  • Delivery system?
  • Consumables
  • Service policy?
  • Training?
  • After purchase costs?
  • Things I’m frequently asked:
  • Is anesthesia ever necessary?
  • Do I prepare all teeth without existing amalgams with the laser?
  • How can I predict the caries depth
  • Diagnodent
  • Spectra
  • Midwest Caries I.D.
  • How do I protect adjacent teeth?
  • More things I’m frequently asked:
  • Does the purchase cash flow?
  • Does it work as advertised?
  • Do patients like it?
  • Will I get referrals?
  • Will I use it?
  • Is it hard to learn?
  • Diode Lasers
  • Currently 3 wavelengths
  • 980, 940, and 810 nanometers
  • Great for soft tissue
  • Small
  • Affordable
  • Excellent hemostasis
  • Delivery either through optical fiber or single use tips
  • Some have wireless foot controls
  • Many units are now “handhelds”
  • Ivoclar Navigator Diode
  • Charger stand
  • In stand – use or charge
  • Out of stand 45 minutes of power
  • Cordless foot pedal
  • Unidose fiber tips
  • 2 lengths 3.5mm & 6mm
  • Kavo GENTLEray
  • 980nm wavelength
  • Sturdy
  • 30 Pre-Programmed settings
  • Corded
  • Touch screen
  • Discus NV
  • 810nm
  • Cordless
  • 6.3”L x 0.65” diameter
  • 1.9 ounces
  • 2.0 Watts Maximum
  • Wireless foot pedal
  • Charger stand
  • Fiber tips
  • Nd:YAG
  • Delivery is done by a glass optical fiber (usually 200 or 300 microns)
  • Fiber is cleaved and autoclaved after use
  • Units are larger than diodes
  • Wavelength is 1064nm
  • Generates less overall heat than diode, but delivers more power per pulse
  • More expensive than diodes
  • Can provide variable pulse widths
  • Variable power
  • Variable repetition rates
  • The design and electronics that create the Nd:YAG beam allow for extremely precise control
  • This allows the operator an unparalleled ability to remove only the desired target tissue and nothing else
  • Control of the firing of the laser allows the operator the luxury of a “what you see is what you get” experience
  • Manufacturers
  • Millennium Dental Technologies
  • Why Nd:YAG and Diode?
  • Frenectomies
  • Soft tissue crown lengthening
  • Troughing of crown margins
  • Biopsies
  • Hemostasis!
  • Herpetic lesion treatment
  • Aphthous lesion treatment
  • WYSIWYG cosmetic re-contouring
  • Laser perio treatment
  • LED Curing
  • Enables curing equal to fast halogen lights
  • Diodes are incredibly long lasting
  • Minimal heat during curing
  • Low power
  • Quiet operation
  • LED’s generate slight heat at the light guide tip, but do generate heat on the diode substrate
  • Ask manufacturers how they dissipate heat in their lights, especially in sealed devices
  • Ask questions regarding spectral output
  • Should be in the range of 450-470nm
  • LED Advantages
  • Most are cordless
  • High speed cure
  • Low heat
  • Quiet
  • More efficient output
  • Better depth of cure
  • Drug Databases
  • More than 1.5 million Americans are injured every year by drug errors
  • At least 25% of all medication related injuries are preventable
  • 4 out of 5 U.S. adults take at least one medication or dietary supplement every day; almost 1/3 take at least 5
  • The average 75 year old has 3 chronic conditions, regularly uses 5 prescription drugs and multiple OTC products, and sees more than one physician
  • 65% of patients who walk into a physician’s office leave with a prescription
  • Solutions
  • Books
  • Online databases
  • PDA’s
  • Local network databases
  • Books
  • Disadvantages
  • Big
  • Slow
  • Easily outdated
  • Not green
  • Advantages
  • Difficult to lose! 
  • Online databases
  • Disadvantages
  • Requires a computer
  • Requires an Internet connection
  • Requires a subscription in most instances
  • Advantages
  • Time savings
  • Fast!
  • Computerized – Copy & Paste
  • Reliable
  • Constantly updated
  • Drug interaction database
  • Fully searchable
  • Easy to use
  • Photos
  • Cost
  • $60-325
  • Price depends on product
  • There are free versions, but they don’t have as much information
  • My favorites
  • Lexi-COMP Online for Dentistry
  • Eight Databases
  • Drug Information
  • Drug Interactions
  • Dental Office Medical Emergencies
  • Oral Soft Tissue Diseases
  • Manual of Clinical Periodontics
  • Lexi-Natural Products Online
  • Clinician’s Endodontic Handbook
  • Your Roadmap to Financial Integrity in the Dental Practice
  • ePocrates Online
  • Prescription Medications
  • Adult & pediatric dosing
  • Alternative Medications
  • Pill Photographs
  • Tables
  • MultiCheck Interaction Database
  • Ability to print info for patients
  • Endo
  • Apex Locators
  • Elements Diagnostic Unit
  • Sybron Endo
  • Apex locator and pulp tester in one unit
  • Satellite unit can be placed where convenient
  • Root ZX II
  • J Morita
  • Can be upgraded with an optional 0-800 rpm low speed handpiece
  • Resilon
  • Resin percha
  • Flexible points that bond to the canal wall
  • Used with a special self etching dual cure sealer
  • Can be heated for warm vertical
  • Can be used in Obtura
  • Handles like gutta percha (only better!)
  • Significantly less leakage than GP
  • Easily re-treatable
  • Resilon Technique
  • Proceed with your preferred instrumentation technique
  • Dispense the sealer (self-etching)
  • Place sealer in your usual manner
  • Fill the root space with Resilon points using your usual technique
  • Cure coronal portion with curing light
  • Etch, bond, and seal using flowable (Ultradent Perma-Flow Purple)
  • Place build-up or temp
  • Sealer in root system will self cure in 25 minutes
  • Can be used with System B
  • Set temperature to150C and the power to 10
  • Can be used with Obtura gun
  • 25 gauge tip=160C
  • 23 gauge tip=140C
  • 20 gauge tip=120-130C
  • Ultradent Endo-Eze
  • Gutta percha coated with UDMA resin that bonds to the sealer
  • EndoRez sealer that bonds to the canal and the point
  • Conservative apical management
  • Bonded obthration
  • Ultradent also makes a ton of great endo products (too many to mention here)
  • Mechanically file upper 2/3’s with reciprocating handpiece and Endo-Eze files
  • Use rotary or manual instrumentation to prepare apical 1/3
  • Placed EndoRez sealer
  • Place EndoRez point
  • Etch, bond, and seal using flowable (Ultradent Perma-Flow Purple)
  • Place build-up or temp
  • Doctor Comfort
  • AnterioRest
  • Back Support from the front!
  • Addent Microlux
  • 3 different uses
  • Fiber optic mirror for all routine exams wherever more light and a mirror are needed
  • Transillumination tip
  • Oral tissue exam tip
  • Endo canal locating tip
  • Battery powered
  • Quick Hits
  • 3D Cone Beam imaging – Gendex GXCB-500
  • Oral Cancer Detection
  • Trimara Identafi 3000 Ultra
  • Velscope
  • Dentlight DOW
  • Turbine Improvement
  • ProDrive Systems
  • Automated Patient Communication
  • LighthousePlz
  • DoctorBase
  • Digital Operatories
  • Electronic health records will soon be required by law
  • Digital operatories are a must in the master plan of implementing a chartless digital patient record
  • 2 monitor system recommended
  • Use one computer with 2 monitor outputs
  • Use Windows Extended Desktop to create a system to allow dragging between monitors
  • Exorvision monitors are highly recommended
  • Keyboard and Mouse
  • Wireless Gyro-mouse
  • Sold as Go 2.4 Optical Air Mouse and Compact Keyboard Suite
  • Available from website and retailers
  • Digital operatories allow
  • Digital radiography
  • Digital photography
  • Computerized BP
  • Drug Databases
  • Intraoral cameras with video capture
  • Electronic charting
  • Electronic chart notes
  • Communication
  • Family Service Radios
  • Intraoral Cameras
  • Acteon 717
  • Gendex eZ1
  • Air Techniques Polaris
  • More benefits of operatory computers
  • Video
  • Movies/TV
  • Patient Education
  • Chart notes
  • Medical History
  • Lab case tracking
  • Prescription writer/tracker

Digital Caries Diagnosis & Restoration

Devices:

•Midwest Caries I.D.

•Kavo Diagnodent

•Air Techniques Spectra

•Acteon SoproLIFE

Caries I.D.

•Uses LED to illuminate the tooth

•Works on “optical signature”

•Detects changes in refection and refraction of light passing through the tooth

•Requires calibration

•Works in a moist environment

•Indicates a “hit” with beeps

Diagnodent

•Uses 655nm diode laser (red)

•Detects fluorescence of decalcified & carious tooth structure

•Fluorescence is detected, measured, & scored

•Teeth need to be dry & free of organic debris

•Requires calibration

•Indicates a “hit” with increasing audible tone & numeric score

Spectra

•Uses 405nm LED’s

•Detects fluorescence of carious bacterial byproducts

•Picture is taken, photo is analyzed, caries or healthy tooth structure is displayed

•Teeth need to be dry & free of organic debris

•No calibration needed

•Indicates a “hit” with “Doppler Radar” type image

SoproLIFE

•Uses 450nm LED’s

•Detects fluorescence of disturbed/affected dentin

•Picture is taken (device also doubles as an intraoral camera)

•No calibration needed

•Has a detection & a treatment mode

•Indicates a “hit” with red fluorescence on image