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give you one-fourth to one-half that, and it’s really a lost
opportunity. It prevents the dentist from being able to place
larger, direct-bonded restorations.
For the RMGI, it’s succumbed to the same gig: put it in a
double-barrel type device and run it through a static mixer.
When you’re doing that, you’re leaning more toward a resin
cement with a minimal amount of resin-modified glass
ionomer. Doing this was kind of a stepping stone to our resin
cement. The best resin cement today can’t perform as well
as UltraCem RRGI. Additionally, they don’t get the fluoride
release like a RMGI can get. So, all in all, to push the level
of the RMGI to a higher level, you’re getting a great, strong
cement to metal with the self-etching feature, over twice
the bond strength to dentin as what you’d get with the best
out there heretofore, and you’re getting the fluoride release.
You also get a great film thickness that’s around 25 microns.
So we’re kind of passionate about that. Furthermore, to
eliminate the need for that plier that’s required to break the
capsule before you can put it into the Wig-L-Bug ® (Dentsply
Rinn; Elgin, Ill.) to mix it, and to eliminate the Wig-L-Bug
mixing and then to eliminate the little mix device, it brings
about a lot of simplicity in our own office. Our guys have
fallen in love with it because it’s so simplistic. Schools love
it, too. You can probably remember when you had one
Wig-L-Bug mixer between maybe 20 to 40 students, and you
had to leave the patient and travel some distance to get your
little capsule mixed, and then you headed back hoping you
would be able to get everything in place before it set.
MD: Not only that, but I remember mixing about 10 crowns’
worth of cement for every actual dose of cement that I needed to
cement one crown. So, I’m sure that for
the schools it’s also going to eliminate a
lot of waste, in addition to streamlining
the cementation appointment. That
really is amazing that you’ve been able
25
to have UltraCem be self-etching and
take advantage of those higher bond
strengths, yet still have the fluoride release
and not have to kowtow to going
20
down the paste-paste route.
Now you mentioned the bonding agents.
I think dentists are probably a little
confused. I think sometimes they see
products that appear too good to be true.
One company releases a product like
this and then the bigger companies, like
the 3Ms, figure it’s selling so well that
they need to release their own one-bottle
system or their own paste-paste cement
to keep up with the Joneses. I guess
when the reputable companies release a
product, the dentist tends to think: this
product must be OK.
PPM
15
10
5
DF: Yeah, it’s frustrating. And with your dentist hat on, it’s
doubly frustrating because it’s the patient that loses in the
process. The patient is totally ignorant as to what’s going
on. When you consider that there is somewhere around 100
brands of bonding agents out there now, and you’ve only
got a small handful that are really non-compromising ones,
that’s disconcerting.
Every time I’ve lectured over the last year, I share with
dentists that there are two products that have a greater
influence on the quality of your resin restorations than
any other two products, simply based on what you choose
to purchase. One of those is your bonding agent, and the
second is your curing light. There are a number of quality
composites out there, and there are a number of different
matrix systems and the like, but, everything else being equal,
the two factors that have the greatest impact on the quality
of your restorations is the quality of your adhesive and
the quality of your curing light. For posterior composites,
you’ve got to have a curing light that will deliver around
15 to 16 joules entirely into the floor of your Class II box.
You get on a first or second molar with one of these light
guides that has the bend it in, and you just can’t direct
that light directly down into those Class II boxes. So when
I’m lecturing to dentists, I share with them that if you are
using a compromising adhesive down on the gingival floor
of that Class II box, or if you are using a light that just can’t
illuminate the gingival floor of a Class II box then, yes,
there is a much higher potential for recurrent decay in the
next two to three years under that area. It’s sad to say that
our patients, when we notify them of such, just look up at
us and say, “Well, doc, don’t worry, I just have soft teeth.” It
Fluoride Release — One Week
Day 1 Day 2 Day 3 Day 4 Day 5 Day 6 Day 7
• UltraCem - (Ultradent)
• Fuji PLUS - (GC America)
Courtesy of Ultradent Products Inc.
Interview with Dr. Dan Fischer39