continuum - aesthetic dental studio plus articleson marketing,technology, finance,leadership...
TRANSCRIPT
Aurum Ceramic / Classic - Specializing in Comprehensive Aesthetic & Implant Dentistry
Volume 23, Issue 2 • Spring/Summer, 2010
The ScienceBehind Lithium
Disilicate:
Do YouSell
Flowers?
ImmediateDentures
PlusArticles on
Marketing, Technology,Finance, Leadership
and more!Dentistry courtesy of Dr. Art Mowery.
Restorations fabricated by Aurum Ceramic/Classic.
Today’s Surprisingly Versatile,Esthetic & Durable
Metal-Free Alternative
ContinuumDENTAL LABORATORIESCLASSICCLASSIC//ERAMICERAMIC ™
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CONTENTSIn the News — Aurum Ceramic/Classic’s Continuing EducationPrograms
Advanced Esthetics — The ScienceBehind Lithium DisilicateGeorge W. Tysowsky
Hot Topics — Do You Sell Flowers?Dr. Louis Malcmacher
Dentures —Immediate DenturesGary Wakelam
Pictorial Profile —Gordon Chee
Olympic Smiles —The Vancouver 2010 Winter OlympicGames Mouthguard ProgramDr. Mark Parhar
Technique Tip — The Cadent iTeroDigital Impression SystemImplementing Digital Technologyinto the PracticeTrish Jones
Innovative Implant SolutionsDr. Nathalie Bouchard
Appliance Therapy — Treatment ofClass II Division 1 MalocclusionCases (Part 2)Dr. Walt Pfitzinger
Orthodontics — Protocol forCleaning Orthodontic Pliers Prior toSterilization
© Aurum Ceramic Dental Laboratories Co. (2010). Reproduction of this work in whole or in part, by any means whatsoever,is strictly prohibited without the express written consent of Aurum Ceramic Dental Laboratories Co.
AURUM CERAMIC DENTAL LABORATORIES
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VICTORIA 1928 OAK BAY AVENUE, VICTORIA, BC V8R 1C9 (250) 595-2314 TOLL FREE 1-800-663-6364
KELOWNA #10, 1710 ELLIS STREET, KELOWNA, BC V1Y 2B5 (250) 762-3022 TOLL FREE 1-800-667-4146
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AURUM/CLASSIC DENTAL LABORATORIES
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Except where specifically stated otherwise, views expressed in this newsletter are the opinions of the individual contributors and do not reflect the views of Aurum CeramicDental Laboratories or Classic Dental Laboratories. Offers contained in this newsletter are not valid where prohibited by provincial regulation.
CONTINUUM IS PUBLISHED BY:
E-mail: [email protected]
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IN THE NEWS
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Visit our Website at: www.aurumgroup.com
The Aurum Ceramic/Classic Continuing Education Department
TOLL FREE 1-800-363-3989E-mail at [email protected]
Take Advantage ofAurum Ceramic/Classic’s ExtensiveContinuing Education Programs
The following are a sampling of the Clinicians that are available tospeak in conjunction with Dental Societies or Study Clubs:
For courses in your area, please visit the “Upcoming Courses”List on the What’s New Index.
For information on our entire Speaker and Course line-up, visitour “Continuing Education” section off the Education Index.
For complete details, visit our website atwww.aurumgroup.com
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Dr. Louis Malcmacher“The Hottest Topics inDentistry: Minimal andNo Prep VeneersHands-On Workshop”
Dr. Ronald Jackson“Esthetic RestorativeExcellence withInlays/Onlays andMetal Free Crowns”
Sherry Blair“Practice Essentials -Top Four PatientCare Systems”
Dr. Mark Duncan“Bread and ButterDentistry – and why itis the future of a cut-ting edge practice.”
Dr. Duane Keller“The Perio ProtectMethod”
Dr. Walt Pfitzinger“Minor ToothMovement forChildren and Adults”
Dr. Chuck Flume“Smile Design/BiteDemonstration/Occlusion”
Dr. Lorne Lavine“New TechnologyUpdates”
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ADVANCED ESTHETICS
Dentists and laboratory technicianstoday require materials that offeroutstanding esthetics, high
strength and efficient productivity.Historically, dentistry also has alwaysbeen faced with the challenge of findingways to combine two incompatiblematerials in a synergistic way, whetherthat combination is metal with metal-ceramic or zirconia with zirconia layeringceramic. Simultaneously, dental practicesand dental laboratories increasingly areseeking ways to realize the wonderfulopportunities presented by CAD/CAMand digital fabrication techniques thatoffer the benefits of consistency in theproduction of a restoration and expandedmaterial options.
To satisfy these requirements, lithiumdisilicate glass ceramic represents amaterial like no other available in thedental industry. What’s more, lithiumdisilicate has the present and futurepotential to provide new options forimproving patient care.
For the dentist, lithium disilicate is ahighly esthetic, high strength materialthat can be conventionally cemented oradhesively bonded.1 In terms of dealingwith incompatible restorations, lithiumdisilicate offers a unique solution with itsability to offer a full contour restorationfabricated from one high strengthceramic, thereby eliminating this chal-lenge. What’s more, it is a material thatcan be used in all areas of the mouthwhen specific considerations areaccounted for. For laboratory ceramists,the versatility and performance of lithi-um disilicate enable them to optimizetheir productivity when fabricatingrestorations using this material, sinceeither lost-wax pressing or CAD/CAMmilling fabrication techniques can beused. In particular, the Ivoclar Vivadentlithium disilicate materials (IPS e.max®
Press and IPS e.max® CAD) maximize
The Science BehindLithium Disilicate:
these benefits for laboratories anddentists.
What Is Lithium Disilicate?Glass ceramics are categorized accord-ing to their chemical compositionand/or application.2 Lithium disilicate isamong the best known and most widelyused types of glass ceramics. The IPSe.max lithium disilicate, for example, iscomposed of quartz, lithium dioxide,phosphor oxide, alumina, potassiumoxide, and other components. Overall,this composition yields a highly thermalshock resistant glass ceramic due to thelow thermal expansion that results whenit is processed. This type of resistantglass ceramic can be processed usingeither well-known lost-wax hot pressingtechniques or state-of-the-art CAD/CAMmilling procedures.
The pressable lithium disilicate (IPSe.max Press) is produced according to aunique bulk casting production processin order to create the ingots. Thisinvolves a continuous manufacturingprocess based on glass technology(melting, cooling, simultaneousnucleation of two different crystals, andgrowth of crystals) that is constantlyoptimized in order to prevent the forma-tion of defects (eg, pores, pigments).The microstructure of the pressablelithium disilicate material consists ofapproximately 70% needle-like lithiumdisilicate crystals that are embedded in
a glassy matrix. These crystals measureapproximately 3 um to 6 um in length.Polyvalent ions that are dissolved in theglass are utilized to provide the desiredcolour to the lithium disilicate material.These colour-releasing ions are homoge-neously distributed in the single-phasematerial, thereby eliminating colourpigment imperfections in the micro-structure. Machineable lithium disilicateblocks are manufactured according to asimilar process, but only partial crystal-lization is achieved in order to ensurethat the blocks can be milled fast in acrystalline intermediate phase (blue,translucent state). The partial crystalliza-tion process leads to the formation oflithium metasilicate crystals, which areresponsible for the material’s processingproperties, relatively high strength, andgood edge stability. It is after the millingprocedure and the restorations are firedthat they reach their fully crystallizedstate and their desired high strength.The microstructure of partially crystal-lized IPS e.max CAD lithium disilicateconsists of 40% platelet-shaped lithiummetasilicate crystals embedded in aglassy phase. These crystals range inlength from 0.2 to 1.0 um. Post-crystal-lization microstructure of IPS e.maxCAD lithium disilicate material consistsof 70% fine-grain lithium disilicatecrystals embedded in a glassy matrix.
Today’s Surprisingly Versatile, Esthetic &Durable Metal-Free Alternative
George W. Tysowsky, DDS, MPH,Vice President, Ivoclar Vivadent
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Similar to the pressable lithium disili-cate, the millable IPS e.max CAD blocksare coloured using colouring ions.However, the colouring elementsdemonstrate a different oxidation stateduring the crystalline intermediatephase than in the fully crystallized state.As a result, the blocks exhibit a bluecolour. The material achieves its desiredtooth colour and opacity when thelithium metasilicate is transformed intolithium disilicate (during the post-millingfiring process).
Physical & Clinical Properties ofLithium DisilicateAt Ivoclar Vivadent, we believe lithiumdisilicate is now the best restorativematerial available today for single unitindirect restorations. Ivoclar Vivadent’slithium disilicate material — particularlyIPS e.max Press and IPS e.max CAD —has been in clinical trials for the last 4years with adhesive and self-adhesive/conventional cementation, and theresults have been very positive. Wecontinue to complete both in vivo and invitro testing to enhance the material’sperformance and maximize its useclinically.
These tests have included mechani-cal testing of strength using static loadwith a universal testing machine; sub-critical eccentric loading using a chew-ing simulator (Willytec); and a long-timecyclic loading with a chewing simulator(eGa). The results of these tests demon-strate that:• To ensure maximum success usingthe lithium disilicate material, it isimportant to consider the minimumthickness of the lithium disilicateframe
• The inside of the crown should NOTbe sandblasted
• Regardless of the in vitro test isperformed, in comparison to variousrestorative dental material for crowns(eg, leucite glass ceramic, metalceramic, zirconia), the lithiumdisilicate material demonstratessuperior results
This is because the strength of theceramic material in contact with oppos-ing teeth, to fulfill masticatory functions,is about 100 MPa for veneering material,and about 160 MPa for leucite glassceramic. However, for the pressed lithi-um disilicate (IPS e.max Press LT andHT), the strength is in the range of 360MPa to 400 MPa in its final anatomi-cal shaped crown form.
Properties of IPS e.max Press
The pressable lithium disilicate materialis indicated for inlays, onlays, thinveneers, veneers, partial crowns,anterior and posterior crowns, 3-unitanterior bridges, 3-unit premolarbridges, telescope primary crowns, andimplant superstructures.3,4,5 In somecases, minimal tooth preparation isdesired (e.g., thin veneers), and IPSe.max lithium disilicate enables labora-tories to press restorations as thin as0.3 mm while still ensuring strength of400 MPa. If sufficient space is available(eg, retrusion of a tooth), no preparationis required.
Properties of IPS e.max CAD
Indications for the machineable lithiumdisilicate material are inlays, onlays,veneers, partial crowns, anterior andposterior crowns, telescope primarycrowns, and implant superstructures.For a posterior crown fabricated to fullcontour using CAD methods, lithiumdisilicate offers 360 MPa of strengththrough the entire restoration. As aresult, restorations demonstrate a“monolithic” strength unlike any othermetal-free restoration.
Overall, these materials demonstratespecific advantages to dentists andpatients, including higher edge strengthvs. traditional glass ceramic materials(ie, can be finished thinner withoutchipping); low viscosity of heated ingotenables pressing to very thin dimension(ie, enabling minimal prep or no-prepveneers); and chameleon effect due tohigher translucency.
ConclusionAt Ivoclar Vivadent, we see lithiumdisilicate emerging as the restorativematerial of choice for single unit indirectrestorations. Further, we believe thattrends that have begun in NorthAmerica are starting to have an impactin other economies around the world.Lithium disilicate increasingly is beingintegrated into the North American andWestern European dental practice as anesthetic, high strength option for singleunit dentistry, whether for anterior orposterior restorations. As technologycontinues to expand in Asia and develop-ing nations, these markets are likely toembrace the same benefits from lithiumdisilicate that North American dentistsand laboratories are experiencing today.
References
1. Fabianelli A, Goracci C, Bertelli E, Davidson CL, FerrariM. A clinical trial of Empress II porcelain inlays luted-to vital teeth with a dual-curing adhesive system anda self-curing resin cement. J Adhes Dent. 2006 Dec;8(6):427-31.
2. Denry IL. Recent advances in ceramics for dentistry.Crit Rev Oral Biol Med. 1996; 7(2):134-143.
3. Sorensen JA, Cruz M, Mito WT, Raffeiner O, MeredithHR, Foser HP. A clinical investigation on three-unitfixed partial dentures fabricated with a lithiumdisilicate glass-ceramic. Pract Periodontics AesthetDent. 1999 Jan-Feb; 11(1):95-106.
4. Höland W, Schweiger M, Frank M, Rheinberger V. Acomparison of the microstructure and properties ofthe IPS Empress 2 and the IPS Empress glass-ceramics. J Biomed Mater Res. 2000; 53(4):297-303.
5. Kheradmandan S, Koutayas SO, Bernhard M, StrubJR. Fracture strength of four different types ofanterior 3-unit bridges after thermo-mechanicalfatigue in the dual-axis chewing simulator. J OralRehabil. 2001 Apr; 28(4):361-9.
George W. Tysowsky, DDS, MPH serves as VicePresident of Technology for Ivoclar Vivadent, Inc.In this capacity, Dr. Tysowsky is responsible forResearch & Development activities for all NorthAmerican operations. He also serves as a ClinicalAssistant Professor at the State University of NewYork at Buffalo, School of Dental Medicine, and isa Fellow of the American College of Dentistry.
Dr. Tysowsky earned a DDS degree from theUniversity of Minnesota, School of Dentistry, anda Masters of Public Health from Minnesota’sSchool of Public Health. He also completed aGeneral Practice Residency at St. Francis MedicalCenter/University of Connecticut. Dr. Tysowskyhas published and lectured extensively throughoutNorth America and Europe on the application ofcontemporary materials.
IPS e.max offers:• Monolithic crowns (one materialthroughout the entire restoration)
• More durable results than layeredzirconia restorations
• Outstanding esthetics
• Conventionally cementable restorations
• Efficiently produced restorations,providing rapid turnaround
• Ability to fabricate a digitallycustomized restoration
IPS e.max® from Aurum Ceramic/Classic
Call our Advanced Esthetic Hotlines TOLL FREECalgary Edmonton Saskatoon Vancouver Victoria Kelowna Vernon Ottawa Toronto
1-800-661-1169 1-800-661-2745 1-800-665 8815 1-800-663-1721 1-800-663-6364 1-800-667-4146 1-800-663-5413 1-800-267-7040 1-800-268-4294
DENTAL LABORATORIESCLASSICCLASSIC//ERAMICERAMIC ™
Dentistry courtesy of Dr. Art Mowery.Restorations fabricated byAurum Ceramic/Classic.
Strength.Durability.Esthetics.
Aurum Ceramic/Classic Dental Laboratories recommends the Strength, Durability and Esthetics of
l i th ium dis i l i catee.max®
IPS
©2010 Aurum Ceramic/Classic Dental Laboratories. IPS emax is a registered trademark of Ivoclar Vivadent.
Revolutionizing the way all-ceramiccrowns are crafted, Aurum Ceramic/Classic and IPS e.max® unite the latest inCAD/CAM processing and pressingtechnologies with a high performancelithium disilicate glass ceramic.
Our digitally equilibrated occlusion,contacts and beautifully consistent
anatomy virtually eliminate theneed for chair side adjustments.
The result – an incredibly precise,and cost-effective, solution for singleanterior and posterior all-ceramiccrowns. No other laboratory can matchAurum Ceramic/Classic in making themost of your IPS e.max® restorations.
www.aurumgroup.com
Combining all the best of polyether ...• Excellent flow properties andresilience.
• Extremely hydrophilic. Lowestachievable contact angle (less than10° after 1 second).
• Long intraoral working time.
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... With all the best of A-silicone:• Dimensionally accurate, high tensile strength.
• Short curing time.
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Contact our customer service department today for more information or to place your order:
PHONE: 1.800.661.9567 FAX: 1.800.361.5088 EMAIL: [email protected]
ADDRESS: 115-17th Avenue S.W., Calgary, AB T2S 0A1
www.aurumgroup.com
Distributed by
A Canadian Group of Companies
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HOT TOPICS
Dr. Louis Malcmacher
Do You SellFlowers?
albums and up on our office walls. What Iwant to hear from the patient when I walkinto the room is for them to point to a pic-ture on the wall and say, “Hey, can you dothat for me?” The answer obviously is.“Sure I can do that for you”. That isbasically my treatment presentation. Youneed to plant seeds in patients minds as towhat you can accomplish for them. Withelective esthetic dentistry, beautiful smileson the walls are much more effectivethan flowers.
One of the most important lessons Ilearned from Fred Joyal, the marketinggenius behind 1800DENTIST andwww.goaskfred.com, is that you need tomarket the services that you performspecifically in your office, not promote thedental services that you refer out. If youdon’t do implants, then having that as aheadline in your practice newsletter proba-bly is not prudent. If you don’t sell flowers,then stop promoting them in your office —or start selling flowers.
We can certainly learn a lot from otherhealthcare practitioners in the health andfacial esthetic industry. Now that we areproviding Botox and dermal fillers in ouroffice and training dentists how to do theseprocedures, we have gotten very involvedwith other esthetic healthcare profession-als. They have taught us how to trulyinspire and motivate the patients who arelooking for these treatments to go aheadwith a combination of soft tissue and hardtissue esthetics. If you go into any medicalspa, dermatologist or plastic surgeon’soffice, you won’t see pictures of flowers ontheir walls. You will see big pictures ofbeautiful faces! As a matter of fact, if yougo into any florist’s shop, you will not seebig beautiful smiles on the wall becausethat is not what they sell. They sell flowers,you don’t!
The walls in your office should tell thestory of what you are trying to sell. It isthe best way to help motivate people toaccept whatever services you provide. Yousell health, wellness, oral hygiene preven-tion, esthetics, implants, laser procedures(with a Powerlase AT laserwww.laresdental.com) and life changingtreatment for people. Your office walls, ifthey could talk, would tell some incredible
stories about what you have accomplishedfor people over your career as a dentist.Let your walls publicize and educate peopleabout the great treatment options we nowhave in dentistry to make them look good,feel good, and improve the quality oftheir lives.
When I walk into many dentaloffices, sometimes I feel that theyare selling big bouquets of flow-
ers. Other times, I am sure that they areselling a condo or a house on the beach. Inother dental offices, I could swear that it iseither an art gallery or they are trying tosell paintings or knock-offs of famous artpieces. I was sure that one dentist that Iwent to visit was a farmer, because in hiswaiting room he had beautiful picturesof fruit.
Why would I think that dentists are sell-ing flowers, condos, homes on the beach,art, and fruit? Because when I, and theirpatients, walk into their offices, there arebig pictures of these items on the walls ofthe waiting room and treatment rooms.Well, here is my big question to those den-tists. If you are notselling flowers or fruit, then why in theworld do you have these things on yourwalls? Most businesses that you go intothat actually sell something have beautifulpictures of whatever they are selling up onthe walls. Dentists, for some strange rea-son, all of a sudden want to hide from theirpatients what they can do, and indeed, maybe more comfortable selling flowers totheir patients.
Like it or not, we are all selling some-thing. What is your core business? It isdelivering dental services to your patientsand creating health, wellness and beautifulsmiles. What you should have on yourwalls are big pictures of happy people withbeautiful smiles because that is exactlywhat will help motivate your patients toaccept treatment. Before and after picturesof smiles with Aurum Cristal Veneers (visitwww.aurumgroup.com for details), totalfacial esthetics with Botox and dermalfillers or other cosmetic results that youhave done should immediately take theplace of anything else on your office walls.Why, because that is what you are lookingto provide to your patients and indeed, thatis what they are looking to receivefrom you.
The strong effect of before and afterpictures can not be discounted in showingpatients what you can do for them. For aslong as I can remember, we have hadbefore and after pictures of smiles in
Louis Malcmacher DDS MAGD is a practicinggeneral dentist and an internationally knownlecturer, author, and dental consultant known forhis comprehensive and entertaining style. Anevaluator for Clinicians Reports, Dr. Malcmacheris president of the American Academy of FacialEsthetics. You can contact him at 440 892-1810or email [email protected]. His website iswww.commonsensedentistry.com where you canfind information about his lecture schedule andBotox and dermal filler live patient hands-ontraining schedule, audio cd’s, download hisresource list, and and sign up for a free monthlye-newsletter.
Plan to Attend:“Hottest Topics inDentistry”with Dr. Louis Malcmacher
Vancouver, BC, October 29, 2010in conjunction with University of British Columbia
Edmonton, AB, April 29, 2011in conjunction with Edmonton & DistrictDental Society
“Minimally Invasive andNo Prep Veneers”,Concepts and DesignHands On Workshop
Ottawa, ON, October 22, 2010
For more information or courses in your area,check out “Upcoming Courses” off the NEWS& EVENTS Menu at www.aurumgroup.com orcontact theAurum Ceramic/Classic DentalLaboratories Continuing Education Departmentat 1-800-363-3989 oremail: [email protected].
Dates subject to change. Please call toconfirm course dates.
9
DENTURES
• Cheek and lip support are maintained(instant effect on appearance).
• Patient able to chew food and maintainproper nutrition during healing process.
• Adaptation easier (especially in upperfront teeth) as able to mimic natural toothposition in jaws.
Since each patient’s healing period andability to accommodate an immediatedenture varies, the feeling of being“comfortable” will be different. For the firstweek, the denture remains stable and
reasonably retained. After this, as resorption occurs, the imme-diate denture is often relined on one or more occasions with asoft liner to help cushion the hard denture base against thehealing extraction sites. If both upper and lower immediatedentures are being prepared, it is recommended that both befabricated at the same time. This ensures that cosmetic or biteirregularities that existed in the natural teeth will not interferewith tooth positioning in the new immediate denture.
During the healing process, the patient may becomecomfortable with the appearance of the teeth and may not wanta change. However, depending on the amount of resorptionthat occurs, the anteriors may need to be lengthened or thevertical slightly increased in the final denture.
Most patients who are facingextraction as the final step to fulldentures want to make the move
to dentures as quickly and conveniently aspossible. Yet, the procedure commonlyinvolves an initial surgical appointmentfollowed by at least three – six months toallow healing of the ridges before beginningto construct the final dentures. After that,impressions must be taken; dentures craft-ed, tried in and adjusted; and the definitivedenture completed, all of which takes timeand delays completion of treatment.
An all-acrylic “Immediate Denture” can ease the transitionfrom natural dentition to dentures (either for single or doublearch treatment) during this period by allowing the patient to“keep their teeth” while their gums are healing. Fabricatedprior to removal of the patient’s remaining teeth and deliveredimmediately after, they usually require only one short impres-sion appointment before extraction and one appointment forplacement of the dentures. Immediate dentures can even becreated as partial dentures that will only replace certain teeth.
Even more important, Immediate Dentures may assist inresolving many clinical problems:• The splinting action of the denture may help reduce the painand swelling that can occur after oral surgery.
• Gums tend to heal to the shape of the dentures.
Immediate DenturesGary Wakelam, RDT, CDT
Both Include:
Immediate Denture Reline onImmediate Denture
Plus:
A Final Definitive Denture(either NaturalLook or AE Denture depending on Package chosen)
• Single or double arch treatment. Can even be createdas partials to replace certain teeth.
• Requires no healing period between extractions andplacement of dentures.
• Allows patient to “keep their teeth” during healingperiod after extractions.
• Usually requires only one surgical appointment.
• Cheek and lip support maintained (instant effect onappearance).
• Serves as splint to reduce pain and swelling after oralsurgery.
• Allows natural tooth position to be duplicated oraltered as required.
• Permits test period for changes in tooth positionbefore definitive dentures are made.
• Performs as spare/emergency denture after definitivedentures delivered (especially convenient duringrelines).
Call Today and askabout our NaturalLookand AdvancedEsthetic ImmediateDenture Packages!
For more information and pricing,call your closest
Aurum Ceramic/Classic laboratory TOLL FREE.(See Page 2 for locations and contact information)
All for an economical flat rate price!
PICTORIAL PROFILE
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“This female patient originally came to us with a desire toimprove her smile. She had a really interesting clinicalsituation in that she still had her 6-3 baby canine on theleft side, which had resulted in her adult canine (tooth #2-3) being pushed back towards her palate. Her left lateralwas also a noticeably tiny peg lateral.
We presented a number of treatment options to her,beginning with the extraction of the baby canine and theuse of fixed orthodontics to move her remaining dentitioninto a more pleasing alignment. The second option was toextract both her baby and adult canines and replace themwith a single crown on an implant. The patient did notwant either of these options. Instead, she initially chose toproceed with extraction of both 6-3 and 2-3 canines andthe placement of a three-unit bridge from 2-2 to 2-4. As thepeg lateral at 2-2 was too small to support a bridge, thepreparation was extended to include 2-1 and a four-unitbridge was accepted. As our discussions continued, she
mentioned the large old stained composite she had on 1-2and inquired about veneering this tooth. As we consideredher smile, we also decided to veneer 1-1 as well to assist inmatching the shape and colour of the various restorations.After extraction, a temporary bridge was placed to allowthe gums to heal with a nice ovate pontic site at 2-3.
The Aurum Ceramic/Classic AE (Advanced Esthetic)Team crafted a beautiful four unit Contessa® Bridge (2-1to 2-4) and IPS Empress Esthetic veneers on 1-1 and 1-2.The shade match between Empress, Contessa and theremaining natural dentition was superb. Everything fitperfectly with the Cadent iTero impression system andlooked wonderful. The patient was absolutely thrilled withthe final result, as evidenced by the big smile in her finalFull Face photograph.”
Gordon Chee, DDS
Full Face Before.
Close-up of pre-operative smile. Retracted pre-operative smile.
Initial situation – upper arch. Shade selection.
Preparations and stumpf shade selection. Upper arch preparations. Cadent iTero scan of area of upper arch.
Full face After.
Restorations fabricated by Aurum Ceramic/Classic.
Dr. Gordon Chee completedhis dental degree at theUniversity of Alberta in 2000,and began practicing generaland cosmetic dentistry inVancouver. Originally fromLethbridge, he returned to
Alberta, joining the Aesthetic DentalStudio in Calgary in February 2006. Dr.Chee has completed a number of coursesat the Las Vegas Institute for Advanced
Dental Studies (LVI) including AdvancedFunctional Aesthetics; AdvancedAdhesive Aesthetic Dentistry; OcclusionI and II; Neuromuscular Implants I;Sleep Breathing Disorders; Comprehen-sive Aesthetic Reconstruction; ScanInterpretation; and Coronoplasty andCase Finishing. He has completed theD.O.C.S. Conscious Sedation programand is an Invisalign and PPM preferredprovider.
Dr. Chee has appeared on a variety ofmedia outlets including CTV News,Global TV News, and National Post forthe Velscope Oral Cancer Device; GlobalTV News for the Cadent Itero DigitalImpression Scanner; and Canwest NewsService, Canada.com, LifestylesMagazine and Best Health Magazine forAesthetic Dentistry.
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Cadent iTero scan of preparations.
Upper arch after placement of bridge and veneers. Close-up of new smile.
Retracted restored smile.
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OLYMPIC SMILES
The Vancouver 2010Winter Olympic GamesMouthguard Program Dr. Mark Parhar
The Vancouver2010 WinterOlympic Games
brought approximately2,600 athletes from 82nations to Vancouver/Whistler. Both the
Olympic and Paralympic Games wereorganized by the Vancouver OrganizingCommittee (VANOC). The VANOCMedical goal was to deliver excellentmedical and health care services forathletes and team officials, Olympic andParalympic family and workforce. Tofacilitate this a Polyclinic was builtwithin the athletes villages at Whistlerand Vancouver. A Polyclinic is a multi-service medical center, which providesservices in sports medicine, emergencycare, imaging, physiotherapy, labora-tory, pharmacy, and dentistry. In pastOlympics, dentistry has been a well-utilized service and is usually one of thebusiest medical services during theOlympic games. The goal for thesegames was to provide urgent dental carefor athletes, which included examina-tions, radiographs, basic restorativedentistry, extractions, and endodontictreatment. In addition, there wereseveral programs offered as part of thetotal dental service, including a dentalscreening program, oral cancer aware-ness program, oral health education,and a mouthguard program.
Sport-related orofacial traumaticinjuries occur frequently among variouskinds of sports activities. The OlympicWinter Games includes many sportsthat would be considered medium tohigh risk for traumatic dental injuriessuch as ice hockey, snowboarding, shorttrack speed skating, aerial ski jumping,freestyle skiing, alpine skiing, luge,skeleton and bobsleigh. The dental liter-ature supports the use of mouthguardsin reducing sports-related injuries to theorofacial area. A recent meta-analysis(Knack 2007) indicated that the overallrisk of orofacial injury is 1.6 - 1.9 timeshigher when a mouthguard is not worn,
compared to wearing a mouthguard. Thegoal of the Olympic mouthguard programwas to increase awareness of the impor-tance of mouthguard use and providecustom-made pressure laminated mouth-guards for the Olympic athletes.
The Olympic National Teams wereinformed prior to the Winter Gamesabout the availability of dental services,including the mouthguard program.When athletes had dental visits, theywere routinely asked, as part of theirdental examination, which sport theyparticipated in and if they currently useda mouthguard. If an athlete did not use amouthguard, the benefits were explained,and in most cases, the athlete elected tohave a mouthguard fabricated.
The process started with an excellentupper impression at the Polyclinic dentalclinic, which was then sent to SpaceMaintainers Laboratories for the fabrica-tion of a custom made pressure-laminatedSports-flex mouthguard. Each mouth-guard was fabricated using 2 laminatedlayers of EVA, each 3 mm in thickness.This allowed for increased stability, bettercontrol of thickness, and less dimensionalchange. The goal was to provide a wellfitting mouthguard that was comfortable,had minimal effect on breathing andspeech, and was 3 – 4 mm in thicknessfor optimal protection.
The Sports-flex mouthguards werecompleted within 2 days and the athletewas seen for a final delivery where the
mouthguard was tried in for comfort andretention. Minor adjustments were madechairside as needed. The occlusalsurface of the mouthguard was gentlyheated with a flame and placed into theathlete’s mouth. The athlete was theninstructed to gently bite down normallyand hold that position for 30 seconds.This step ensured a balanced occlusion.The mouthguard was rinsed with coldwater and the occlusion checked again.Home care instructions were given to theathlete prior to dismissal, along with acase for storing the mouthguard.
In surveying many of the athletesafter their dental visits, the athletes werevery grateful for the mouthguard andcommented routinely how comfortablethe mouthguards felt. Overall, the mouth-guard program was a huge success withthe number of mouthguards fabricatedexceeding that of any previous OlympicWinter Games. With the support andsponsorship of Space MaintainersLaboratories, the program successfullysupplied 149 custom-made pressurelaminated Sports-flex mouthguards forthe various athletes during the OlympicWinter Games.
Dr. Parhar completed his undergraduate degreein the Honors Biochemistry program at theUniversity of British Columbia and went on toreceive his Dental degree from the UBC Faculty ofDentistry in 1997. He is a member of theAcademy of Sport Dentistry, InternationalAssociation of Dental Traumatology, AmericanAssociation of Endodontics, and CanadianAcademy of Endodontics. Dr. Parhar has been theteam dentist for the Vancouver Giants of theWestern Hockey League since 2001 and has beenactively involved in sports dentistry. In 2006, hewas the Director of Dental Services for the WorldJunior Ice Hockey Championship and in 2007 hecoordinated the dental coverage for theMasterCard Memorial Cup. He is currently aResident in the Graduate Endodontic SpecialtyProgram at the University of British Columbia.Dr. Parhar was the Co-Manager of DentalServices for VANOC Medical Services during theVancouver 2010 Olympic Winter Games.
13
The Olympic Winter Games includes many sports that would beconsidered medium to high risk for traumatic dental injuriessuch as ice hockey, snowboarding, short track speed skating,
aerial ski jumping, freestyle skiing, alpine skiing, luge, skeletonand bobsleigh.
Offer your patients a beautiful,broader smile with
The D-LX™ Archwire System
Expand Your Treatment Options While BroadeningSmilesBased on the belief that a smile is optimized by an arch formthat displays well-positioned anterior teeth, the first and secondbicuspids, and the mesiobuccal surface of the first molars, thisbroader form archwire helps prevent dark corners in theposterior of the mouth thus presenting a wide smile.
A Wide Range of Proven Benefits• Lower costs from reduced inventory requirements – univer-sal shape allows for use in both the upper and lower arches.
• Posts and micro-stops not mandated with archwire –customize to your treatment preference with crimpablehooks and micro-stops.†
• Promote hygiene with autoclavable single packs.
• Easy to manage inventory with clearly labeledindividual packs and colour-coded boxes.
† For hook and micro-stop options, please contact yourlocal Cerum Ortho Organizers representative.
ORGANIZERS®
PLACE YOUR ORDER TODAY! PHONE: 1.800.661.9567FAX: 1.800.361.5088EMAIL: [email protected]: 115-17th Avenue S.W., Calgary, AB T2S 0A1INTERNET: www.aurumgroup.com
For more information or to place your order,contact our customer service department fromanywhere across Canada by:
D-LX Archwires combined with low-friction brackets like OrthoOrganizers® Carriere LX® Self-Ligating Brackets offer more non-extraction treatment options. The Carriere LX® incorporates many ofthe properties of the ideal ligation system:• It is very resistant to any inadvertent loss of ligation.
• It exhibits low friction between bracket and archwire.
• It facilitates quick & easy insertion and removal of the archwire.
• Innovative design of the bracket allows good oral hygiene.
The Perfect Complement forThe Carriere LX® Self-LigatingBracket
15
TECHNIQUE TIP
The Cadent iTero DigitalImpression System
Trish Jones, RDH, BSKey Accounts Manager, Aurum Ceramic @ LVI
Exciting, new dental technology isopening up new techniques andtreatment modalities, making
dentistry more simple, efficient, costeffective and kinder to the patient.
One area that has exploded involvesdigital impressions. Over the past fewyears, several systems have come on themarket. As a laboratory committed toadvancing the cause of Digital Dentistry,we support intraoral scanning systems ingeneral, however, we feel the CadentiTero Impression System is the currentmarket leader.
What makes this system so special?And why would a laboratory be so inter-ested? From our standpoint, if we canproduce a crown with superior fit, con-tacts and occlusion, and reduce remakes,it is a win-win situation for all partiesinvolved.
Let’s recap what digital impressionsare all about. The Cadent iTero allowsthe dentist to take electronic impressionsintraorally. Once the digital impression iscaptured, the scans are sent electronical-ly to Cadent where polyurethane modelsare fabricated and sent to the laboratory.Then the laboratory fabricates therequested dental restorations and returnsthe case back to the dental office. Insome cases, if CAD/CAM technology isused, fabrication of the restorations canactually begin before models even arriveat the laboratory!
Here are a few key points coveringwhat makes the Cadent iTero technologydifferent and superior, in our opinion, towhat is on the market:• The iTero consists of a mobile cart thathouses a computer, a 19 inch displaymonitor, a small air compressor andregulator, and a wireless foot pedal.
• The computer is set up for wirelessconnection, and has a wireless mouseand a built-in sealed keyboard so it iseasily disinfected.
• The handheld scanner utilizes adisposable sleeve for each patient.
• The handheld scanner itself has airthat flows through the scanner to pre-vent fogging while capturing images.
• While visually, the hand piece mayappear large and cumbersome, it iseasy to maneuver intraorally withexperience and it can act as a cheek ortongue retractor at the same time. Abonus with this scanning device: youcan touch the teeth for stability.
• It captures images using the “parallelconfocal” technique. No other digitalimpression system on the market usesthis technique. The iTero captures animage in focus in a 13.5 mm field ofdepth by using 100,000 points of laserlight at 300 focal depths of tooth struc-ture. So what does that really mean? Itmeans NO POWDER! The iTero doesnot need to use powder to reflect thelight back. The iTero scans in colour,so it is able to capture both supragingi-val and subgingival preparations. Thetrue benefit is the scanner scans within15 microns of what is in the patient’smouth. The milling deviation of themodel is 2 microns. Therefore, itcreates a near exact replica. There arelittle to no adjustments to restorationsfabricated on an iTero model, and thefit is incredibly precise.
• Models are milled out by a 5 axis-milling machine from blocks of aproprietary polyurethane material. Thegreat thing about the models is they donot break or shrink. The die model is
Implementing Digital Technology into the Practice
also the solid model - so it eliminatesthe prior requirement for 2 models(one to check fit for margins on thedie and one to check contacts on asolid). It is “two models in one”.
• The Cadent iTero can be used forsingle units, smile designs, or fullmouth reconstruction. Full archmodels can be milled.
• There is no question that patients findscanning a lot more comfortable thantraditional impression taking, plusthey love that your office is truly stateof the art.
If you are looking to invest in a piece oftechnology that is both affordable andhas an outstanding return on investment,consider the Cadent iTero. It reduceschairtime, reduces remakes, speeds upturnaround time from the laboratory andcan bring new patients into your office!
Cadent iTero wand in use intraorally. A full arch can be scanned, whether it is asingle or multiple units.
Hereʼs one doctorʼs experience withCadent iTero:“The two dentists and four certified dental assistantsin our office were trained on the Cadent Itero onMarch 17, 2010. Handling the scanner wand wasawkward at first - but with persistence and persever-ance both dentists and dental assistants are nowroutinely enjoying digital impression taking.
We have completed 50 units in 3 weeks and theresults are excellent concerning marginal fit, proximalcontact and the occlusion. We have had zero remakesand would recommend for everyone to ‘go digital’.”
Dr. Dana Bailey
16
INNOVATIVE IMPLANT SOLUTIONS
“This patient was referred to my clinic fora major cosmetic and functional recon-struction of her smile. Her crown workhad been completed 20 years ago. Today,the porcelain is broken, worn and dis-coloured. As a result, the patient was veryuncomfortable and embarrassed by hersmile. In addition, she was a heavy bruxerand suffered from a variety of neuromus-cular problems as evidenced by a numberof symptoms: pain in her neck, noise inher joints, dizziness and numbness at thetips of her fingers.
I did a complete analysis of her muscu-lar activity with the K-7 and found therewas a lot of muscular fatigue. At thetomogram, the patient showed significantartrosis in her right condyle. Her verticaldimension was also incorrect. I took aMyobite with the TENS and the K-7 andused it to develop a treatment plan tocorrect her occlusion and esthetics.
The Aurum Ceramic/Classic ImplantTeam fabricated fixed upper and lowerorthotics correcting the esthetic and thebite. I then replaced the missing teeth(#’s 14-15-21-24-25-37-34-45-46) with 8BioHorizon implants after completingbone augmentation throughout themouth.
During the healing process, I saw thepatient several times to adjust the occlu-sion on her orthotics with the TENS andthe K-7. The objective was to eliminateher symptoms (neck pain, the numbnessof her fingers and the noise in her joints)and stabilize the bite. These adjustmentscontinued until she was free of symptomsand stable for at least 3 months.
To complete the esthetic design of thefinal crowns, I used a computer programcalled “Dental GPS”, deciding on theshape, width and length of the finalcrowns. The Aurum Ceramic/Classic
Full face before restoration. Close-up of pre-operative smile.
Retracted close-up of initial situation. Panoramic view of the case before.
Implant Team then used this virtualmock-up to create her new smile. In addi-tion, this program allowed the patient tosee what the final results would be.Aurum Ceramic/Classic used the exactmeasurements given on the GPS to fabri-cate the IPS Empress Esthetic crowns.The crowns were cemented in place.Micro adjustments of the occlusion withthe TENS and the K-7 were made at thatinitial placement appointment and twoother times at subsequent one monthrecall appointments. The patient is verycomfortable and extremely pleased withthe overall results.
The changes in her bite reallyimproved the position of her head andreleased considerably the tension in herneck. She doesn’t feel she bruxes anylonger and is also very happy with thefinal esthetics.
Dr. Nathalie Bouchard gradu-ated from the University ofMontreal in Dentistry in1985. She completed a multi-disciplinary residency fromMcGill University at the
Jewish General Hospital in 1986. Herpassion for surgery lead her to com-plete a full program in implant surgery,advanced bone grafting and pros-thetics at the Canadian ImplantologyInstitute and to become an ICOI Fellow.She attended many courses around the
Restorations fabricated by Aurum Ceramic/Classic.
Panoramic view of the bone grafting with bone blocs technique. Full face with the temporary crowns.
Full face with the final crowns.
Retracted After - Teeth together with new vertical dimension immediatelyafter cementation.
Panoramic view of the final case with BioHorizon implants.
Close-up of new smile.
world in implantology with Dr. CarlMisch, Dr. Pat Allen, Dr. Vasos, Dr.Steigman in Germany and many others.She also became a neuromuscular den-tist by completing the program at theLas Vegas Institute of Advanced DentalStudies. Dr. Bouchard has completedseveral courses at the Las VegasInstitute for Advanced Dental Studies(LVI) including Advanced Anterior andOcclusion I, Comprehensive FunctionalAesthetics, Comprehensive AestheticReconstruction, Full Mouth
Reconstruction, MasteringNeuromuscular Occlusion,Neuromuscular Coronoplasty and CaseFinishing, Advanced Interpretation andDiagnosis, and Core II AdvanceAdhesive Aesthetic Dentistry.
Dr. Bouchard is in private practice inSaint-Lambert, Quebec with a greatemphasis on neuromuscular, cosmeticand implant dentistry. She is an activemember of the ICOI, ACE, and otherorganizations.
17
A perfect fit... for strength, precision and esthetics
www.aurumgroup.com
DENTAL LABORATORIESCLASSICCLASSIC//ERAMICERAMIC ™
The practice of implantology is full of challenges. Impossibletime constraints. Incorrect angulation. Implants placed toodeep sub-gingivally. Obsolete systems. Now, you caneliminate many of these with AurumTek Custom ZirconiaAbutments, designed and milled exclusively in-house atAurum Ceramic/Classic.
The Natural Beauty of Shaded Zirconia
• Full palette of shades available for seamless transitionbetween abutment and crown.
• Perfect emergence profiles for optimal soft tissue supportand margin placement.
Created with the Latest Advancements in DigitalTechnologies
• Abutments and crowns custom designed fromyour fixture level impression.
• Milled with CAD/CAM technology for virtuallyperfect fit and easy seating.
• Customized height, width, margin and angulation.
• Restore even large full arch or full mouthreconstruction cases with perfect confidence.
Combined with the Strength of Titanium
• Titanium base allows metal-to-metal connectionbetween screw and abutment.
• Prevents fracturing (stresses from torquing screwfocused on titanium versus zirconia).
Fast and Versatile
• Can be fabricated in as little as two days in-lab,depending on clinical situation.
• Compatible with a wide variety of implantsystems.
• Custom fabricated Zirconia or Titaniumabutments also available.
Look to Aurum Ceramic/Classic forexceptionally fast, accurate and beautifulAurumTek Custom Milled ZirconiaAbutments.
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CALL YOUR CLOSEST AURUM CERAMIC/CLASSIC LABORATORY TOLL FREE FOR FREE PICK-UP
Toronto1-800-268-4294
Calgary1-800-661-1169
Edmonton1-800-661-2745
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Vancouver1-800-663-1721
Victoria1-800-663-6364
Kelowna1-800-667-4146
Vernon1-800-663-5413
Ottawa1-800-267-7040
Super Strong and Esthetic for Demanding Posterior Applications
• Monolithic all-zirconia crowns & bridges.
• Occlusal reduction as little as 0.5 mm all that’s required.
• Hard sintered for unsurpassed final flexural strength (1100MPa).
• Virtually unbreakable, even with severe bruxers and grinders.
• CAD/CAM milled for virtually perfect contacts, fit and easyseating.
• Use your digital impression files – or normal impressions andmodels.
• Translucent zirconia. Far more esthetic than metal occlusion orfull-cast crowns.
• Wide range of shades available. Glazed to a smooth, plaqueresistant surface.
• Conventional cementation.
Look to Aurum Ceramic/Classic for exceptionally strong,esthetic and economical Opalite Crowns & Bridges. Call yourclosest Aurum Ceramic/Classic laboratory TOLL FREE.
DENTAL LABORATORIESCLASSICCLASSIC//ERAMICERAMIC ™
CALL TOLL FREE
Toronto1-800-268-4294
Calgary1-800-661-1169
Edmonton1-800-661-2745
Saskatoon1-800-665-8815
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Victoria1-800-663-6364
Kelowna1-800-667-4146
Vernon1-800-663-5413
Ottawa1-800-267-7040
www.aurumgroup.com
APPLIANCE THERAPY
Walt Pfitzinger, DDS, MS
In Part 1 of this two part series on thetreatment of Class II Division 1 casesthat show no lower arch crowding, I
listed the diagnostic criteria that need tobe met before considering the followingscenario regarding treatment withfunctional appliances, in this case, theBionator (For more information on theBionator, please call your closest SpaceMaintainers Laboratories Canada loca-tion TOLL FREE). Please review thesediagnostic criteria, as listed again inEXHIBIT 1, before starting any cases.
The case study is an 8 1/2 year oldfemale who exhibits a full step Class IImalocclusion with a 14 mm over jet anddeep overbite (Figure 1 and 2). Whilethe age of 8 1/2 may seem to be a bitearly to start treatment, I felt that byreducing the amount of overjet early wewould decrease the chance of accidentalinjury to the upper incisors. The initialappliance placed was a transverse screw
20
appliance (Schwartz) designed to widenthe maxilla and at the same time retract(tip back) the maxillary anterior teeth(Figure 3). The results of 5 months ofwear with the appliance are shown inFigure 4. The patient has worn theappliance full time with weekly adjust-ments of the screw. Note that themaxilla has gone from a “V” shape to arounded out arch form and in doing so,the overjet has been reduced to 9 mm.Figure 5a and 5b show the occlusionafter the Schwartz appliance. Note in 5athat the lingual cusps of the maxillaryposterior teeth occlude with the buccalcusps of the mandibular posterior teeth.However, when the patient shifts themandible forward into a Class I relation-ship, the molars occlude in a normalcusp to fossa relationship.
The second appliance used in thispatient was a Bionator designed to openthe bite and position the mandible for-
ward and is shown in Figure 6. The con-struction bite is taken with the mandibleshifted forward so that when the appli-ance is worn the lower incisors areopposite the upper incisors. Channelsare cut into the posterior acrylic toallow the posterior teeth to erupt, whichhas a net effect of opening the bite. Thisappliance is worn only in the evening(after dinner) and at night when sleep-ing. Physiologists report that mostgrowth hormone is released during thefirst few hours of sleep making this thecritical time for appliance wear.
Figures 7a and 7b show the resultsafter 11 months of Bionator wear. Thepatient is in a Class I molar relationshipand both overbite and overjet have beenreduced. The photographs were takenat age 10 years 3 months. Note that thepatient is still in the mixed dentition. Atthis point the Class II correction iscompleted. Although we always caution
Treatment of Class II Division 1Malocclusion Cases (Part 2)
Figure 1- Pretreatment Age 8 1/2. Figure 2 - Pretreatment Cephalometric x-ray Age 8 1/2.
Figure 3 - Initial Transverse Appliance. Figure 4 - Before and After Transverse Appliance.
21Figure 7a and 7b - After Functional Appliance.
EXHIBIT 1
Diagnostic Criteria
• Class II Division 1 cases with deepbites and a moderate to severeoverjet.
• Cases that exhibit a retrognathicmandible as opposed to a prog-nathic maxilla.
• Cases that exhibit counterclock-wise or horizontal growth.
• Cases that exhibit generally goodarch form with no crowding in themandibular arch.
• Patients that we believe will becooperative (no day time wear isrequired).
• Cases that are actively growing(ideally treatment takes place dur-ing the pubertal growth spurt).
For more information or courses in yourarea, check out “Upcoming Courses” offthe NEWS & EVENTS Menu atwww.aurumgroup.com or contact theAurum Ceramic/Classic DentalLaboratories Continuing EducationDepartment at 1-800-363-3989 oremail: [email protected].
Dates subject to change. Please call toconfirm course dates.
Figure 5a and 5b - Intraoral Photos After Transverse Appliance.
Figure 6 - Bionator Appliance.
parents that the child will need fixedappliances when the permanent denti-tion is fully erupted, in this particularcase the patient did not have any fixedtreatment.
In summary, I have presented a casethat responded well to removable appli-ances. My experience is that when careis taken to select the right cases forfunctional appliances, the results areexcellent as long as patient cooperationis obtained. Not demanding full timewear with the functional appliance helpsto insure that cooperation.
Physiologists report that most growth hormone is releasedduring the first few hours of sleep
making this the critical time for appliance wear.
with Space Maintainers’Extended Warranty Program.
CALL TOLL FREE
LABORATORIES CANADA
It’s a dangerous world out there for Orthodontic Appliances!Now, you can do something about it. Protect your patient’s newlyfabricated appliances against loss or irreparable damage. SpaceMaintainers’ Extended Warranty Program* covers them for ONEFULL CALENDAR YEAR from their date of delivery!For a small fee per appliance, you can protect all of your
appliances against:• Loss• Damage Beyond Repair• BreakageAll remade to original prescription at no additional charge formaterials or labour!
Ask your closest Space Maintainers Laboratory about howto register your office under the Extended Warranty Program today.
We Can’t Stop the Accidents!
We Can DoSomethingabout theDamage...
* All Space Maintainers cases are guaranteed against defects in materials and workmanship for 90 days per routine at no charge.
ORTHODONTICS
Protocol for Cleaning OrthodonticPliers Prior to Sterilization
To keep your sterilizer in goodworking condition, follow theseeasy steps every other day:
• Spray 409®* or Fantastik®** ona paper towel or clean cloth andwipe down the inside and out-side of the unit.
• For tough stains on inside ofunit, use a teflon pad or stain-less steel with 409®* orFantastik®**.
• Please Note: All product recom-mendations are products avail-able from Dentronix with theexception of 409®* andFantastik®**. To maintainsterilizer performance werecommend annual servicingand proper maintenance.
* Formula 409 is a registered trademark ofClorox Company
** Fantastik is a registered trademark ofS.C. Johnson & Son, Inc.
Dental Sterilizers do not run at temperatures high enough to damage Orthodontic Pliers. Rust andcorrosion are actually caused by harmful minerals and chemicals that come into contact with theseinstruments. The heat generated by sterilization then accelerates the damage. Following these easysteps can help prolong the life of your valuable instruments and protect your investment:
Ultrasonically clean or hand scrub instruments in abiodegradable / no rinse solution(Recommended product: DMP-US Plus Ultrasonic CleaningSolution; a highly concentrated, no rinse formula that requiresno distilled water and has a strong rust inhibitor). Do not useenzymatic cleaning solutions, as they will corrode your pliers.• Add 1/2 fl.oz. (15 ml) of MPUS Plus per gallon of tap water.• Change cleaning solution daily for best results.
Let instruments drip dry or pat dry with a clean paperor shop towel.Wipe mouth mirrors dry with a clean paper or shop towel toavoid spotting, or shake off excess moisture as they sit onracks.• Do not rinse. Harmful minerals found in tap water can leaverust spots on your pliers.
• Use clean towels to dry instruments prior to sterilization.• Detergent residue from towels can stain your instruments.
Lubricate hinged instruments weekly with a siliconelubricant(Recommended products: DSL16 Multi-Purpose SiliconeLubricant or DSY20 Syringe).• Lubricate between Ultrasonic Cleaning and Dry HeatSterilization.
• Do not use oil-based lubricants as they are unable to with-stand most sterilization temperatures and may “gum-up” inthe hinges of your instruments as well as the sterilizerchamber.
Sterilize in a Dry Heat Sterilizer(Recommended product: DDS 7000*).• Do not use autoclaves (steam under pressure). Autoclaveswill rust and dull orthodontic pliers.
• Do not use chemclaves (chemical under pressure) as theycan dull orthodontic pliers.
Keep YourSterilizer Clean
ORGANIZERS®
Contact our customer servicedepartment to place your order:
PHONE: 1.800.661.9567FAX: 1.800.361.5088
EMAIL: [email protected]
Clean for five (5) minutes in a small capacityUltrasonic Cleaner or twelve (12) minutes in a largecapacity Ultrasonic Cleaner(Recommended product: DDUS60/DDUS60R).
Create perfect smiles for yourpatients with our exclusive options:
• NaturalTemps® MilledProvisionals:A whole New Concept in Temporaries.
• Opalite™ All-Zirconia Crownsand Bridges: Super Strong andEsthetic for Demanding PosteriorApplications.
• Aurum‘s Cristal® Veneers:Ultra Thin – Ultra Conservative –Ultra Beautiful.
• Contessa® Zirconia: Superiormilled zirconia strength – pressed orlayered ceramic esthetics.
• Easi-ACCES™ Implant Bridges:Harmonized esthetics and function.
• AurumTek™ Milled CustomImplant Abutments: A perfect fit –for strength, precision and a full paletteof shades.
A Beautiful Smile!
DENTAL LABORATORIESCLASSICCLASSIC//ERAMICERAMIC ™
LABORATORIES CANADA
From advanced smile design to exacting fullmouth reconstruction; superbly craftedimplant-based restorations, dentures andcast partials to leading edge orthodonticappliances; Aurum Ceramic/Classic andSpace Maintainers deliver beautiful smiles...on every case... every time!
Always the Perfect Accessory... Exclusively from Aurum Ceramic/Classic
Visit us at www.aurumgroup.comCALL YOUR CLOSEST AURUM CERAMIC/CLASSIC LABORATORY TOLL FREE FOR FREE PICK-UP
Toronto1-800-268-4294
Calgary1-800-661-1169
Edmonton1-800-661-2745
Saskatoon1-800-665-8815
Vancouver1-800-663-1721
Victoria1-800-663-6364
Kelowna1-800-667-4146
Vernon1-800-663-5413
Ottawa1-800-267-7040