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Contents 49 Case Report: The Creation of a Soft Tissue Emergence Profile with a Long-Term Ribbond-THM Provisional One distinct advantage of using fiber-reinforcing materials such as Ribbond THM for temporary restorations in traditional composite restorative techniques is the significant decrease in gingival microleakage, suggest Drs. Len Boksman and Robert Margeas. Their case report illustrates four case examples showing the type of positive tissue response that can be created with this approach. 55 Speed Dentistry: Fast Is Better — Up to a Point “Modern dentistry … is often practiced slowly; that is, more slowly than it needs to be,” argues Dr. Ellis Neiburger in this article exploring the practice of doing dental treatments faster and better — a concept he calls “speed dentistry.” Giving 25 guidelines for dentists to follow, the frequent Chairside contributor claims that by investing a little bit of time and energy toward learning to practice speed dentistry, they can greatly benefit themselves, their patients and their practice. Glidewell Publications iPad App To experience Chairside magazine on the iPad, search “Glidewell” in the iTunes Store and download the free Glidewell Publications app. 63 Digital Imaging: An Important Visual Aid in Treatment Planning and Case Acceptance Dr. Tarun Agarwal suggests that digital imaging should play a vital role in every dentist’s practice, especially when treating anterior cases. His clinical case study helps make his point by demonstrating how an affordable, off-the-shelf imaging solution can be used to effectively communicate treatment possibilities and aid in patient treatment acceptance, leading to final results that meet or exceed patient expectations. ALSO IN THIS ISSUE 8 By the Numbers 68 Chairside Photo Hunt Results 2 www.chairsidemagazine.com
Publisher Jim Glidewell, CDT Editor-in-Chief and Clinical Editor Michael C. DiTolla, DDS, FAGD Managing Editors Jim Shuck; Mike Cash, CDT Creative Director Rachel Pacillas Copy Editors Jennifer Holstein, David Frickman, Megan Strong Statistical Editor Darryl Withrow Digital Marketing Manager Kevin Keithley Graphic Designers Emily Arata, Jamie Austin, Deb Evans, Joel Guerra, Audrey Kame, Phil Nguyen, Kelley Pelton, Makara You Web Designers Jamie Austin, Melanie Solis, Ty Tran Photographer Sharon Dowd Illustrator Wolfgang Friebauer, MDT Coordinator and Ad Representative Teri Arthur (teri.arthur@glidewelldental.com) If you have questions, comments or complaints regarding this issue, we want to hear from you. Please e-mail us at chairside@glidewelldental.com. Your comments may be featured in an upcoming issue or on our website: www.chairsidemagazine.com. © 2012 Glidewell Laboratories Neither Chairside magazine nor any employees involved in its publication (“publisher”), makes any warranty, express or implied, or assumes any liability Neither or Chairside responsibility Magazine for the nor accuracy, any employees completeness, involved or in its usefulness publication of any (“publisher”), information, makes apparatus, any warranty, product, express or process or implied, disclosed, or assumes or represents any liability that or its responsibility use would for not the infringe accuracy, proprietary completeness, rights. Reference or usefulness herein to of any any information, specific commercial apparatus, product, products, or process, process disclosed, or services or by represents trade name, that its trademark, use would manufacturer not infringe proprietary or otherwise rights. Reference does not necessarily herein to constitute any specific or commercial imply its endorsement, products, process, recommendation, or services by or favoring trade name, by the trademark, publisher. The manufacturer views and or opinions otherwise of does authors not expressed necessarily constitute herein do not necessarily or imply its state endorsement, or reflect recommendation, those of the publisher or favoring and shall by not the be publisher. used for The advertising views and or product opinions endorsement of authors expressed purposes. CAUTION: herein do When not necessarily viewing the state techniques, or reflect those procedures, of the publisher theories and and materials shall not that be are used presented, for advertising you must or make product your endorsement own decisions purposes. about specific CAUTION: treatment When viewing for patients the techniques, and exercise procedures, personal theories professional and materials that judgment regarding are presented, the need for you further must make clinical your testing own or decisions education about and your specific own clinical treatment expertise for patients before and trying exercise to implement personal professional new procedures. judgment regarding the need for further clinical testing or education and your own clinical expertise before trying to implement new procedures. Chairside is a registered trademark of Glidewell Laboratories. Chairside ® Magazine is a registered trademark of Glidewell Laboratories. Editor’s Letter It was interesting to read recently that students at NYU College of Dentistry received a letter from the faculty informing them that the dental school’s default direct restorative material was being changed from amalgam to composite. It’s not that the school has completely abandoned amalgam — the amalgam technique will still be taught in preclinical, and dental school patients with clinically acceptable amalgams will not have to have those restorations replaced — but new amalgam restorations will now require justification by faculty for placement. I wonder how often amalgams will be approved? A main reason for the faculty’s decision to make composite the dental school’s default restoration is the material’s ability to be used as a “caries-specific restoration.” In other words, the faculty feels that with bonded composite resin, the students only need to remove the caries and the surrounding affected dentin before restoring the lesion. This is in contrast to an amalgam preparation that needs to be a certain depth for strength, regardless of the depth of the caries. So they made the decision to conserve as much tooth structure as possible by going with composite over amalgam. When you consider that amalgam has been a successful restorative material for nearly 150 years, some might think the conservative choice would be utilizing the material with that amazing track record. In the letter to the students, the faculty quotes a 12-year study showing that bonded composite performs as well or better than amalgam over that time period. It would seem there is more than one way to define conservatism in dentistry. At the laboratory, our most popular product is BruxZir ® Solid Zirconia. While it doesn’t have the track record of PFMs, it is the most conservative material we have for fullcoverage crowns — with the exception of full-cast gold. Considering that many patients are reluctant to have cast gold placed in their mouths, BruxZir crowns are the only tooth-colored crowns we offer that can be prepared with feather-edge margins and milled as thin as 0.6 mm. I didn’t think I would live to see composite become the restoration of choice in a dental school, or a time when a high-strength, cementable all-ceramic restoration like BruxZir Solid Zirconia would outsell PFMs by a margin of 3-1, but both are here. Yours in quality dentistry, Dr. Michael C. DiTolla Editor-in-Chief, Clinical Editor mditolla@glidewelldental.com Editor’s Letter 3
Page 1: Chairside® A Publication of Glidew
Page 6 and 7: Letters to the Editor Dear Dr. DiTo
Page 8 and 9: Contributors Michael C. DiTolla, DD
Page 10 and 11: Numbers by the 2 26% Percentage of
Page 12 and 13: Dr. DiTolla’s CLINICAL TIPS PRODU
Page 14: Dr. DiTolla’s CLINICAL TIPS PRODU
Page 17 and 18: Photo Essay The Pursuit of BruxZir
Page 19 and 20: Figure 5: This is the shade taken f
Page 21 and 22: Figure 11: Because of the pressure
Page 23 and 24: Figure 17: On the lingual, I cut th
Page 25 and 26: Figure 23: I make my next depth cut
Page 27 and 28: Figure 29: Toward the end of the pr
Page 29 and 30: Figure 35: The next step of the Rev
Page 31 and 32: Figure 41: The bottom cord provides
Page 33 and 34: Figure 47: The BruxZir crowns fit w
Page 35: Figure 53: I fill the BruxZir crown
Page 39 and 40: Interview with Dr. Dan Fischer - IN
Page 41 and 42: give you one-fourth to one-half tha
Page 43 and 44: ourselves darn hard, it’s still n
Page 45: one job I can think of in Western c
Page 48 and 49: In late 2010, Straumann introduced
Page 50 and 51: Our last step was to select Glidewe
Page 52 and 53: Strassler has written extensively o
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Dr. Len Boksman formerly was direct
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SPEED DENTISTRY Fast Is Better —
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apidly would lead to more mistakes
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7. Move faster and have your staff
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There is no one method for speed de
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centrals at the current length or s
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Retraction cord was used to gently
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