Wednesday, March 31, 2010

The erosive potential of jawbreakers, a type of hard candy

The erosive potential of jawbreakers, a type of hard candy

International Journal of Dental Hygiene

Published Online: 19 Mar 2010

Int J Dent Hygiene
DOI: 10.1111/j.1601-5037.2010.00450.x
Brand HS, Gambon DL, van Dop LF, van Liere LE, Veerman ECI.


Objectives: To explore the consumption pattern of a specific type of acidic solid candy, the so-called jawbreakers, by primary school children and determine the erosive potential of this type of candy in vivo.

Methods: A questionnaire about jawbreaker consumption was distributed among 10–12 year-old-children (n = 302). Subsequently, 19 healthy volunteers tested four different jawbreakers in vivo. Whole saliva was collected 5 min before, 3 min during and 11 min after consumption. Salivary flow rate and pH were determined.

Results: Two-thirds of the children reported a history of jawbreaker consumption, 18% during the last week. More than half of the children estimated their average time for consumption of one jawbreaker to be more than 15 min. In vivo, the jawbreakers induced 8.6–13.9-fold increase in salivary flow rate. Sucking on sour, jumbo and strawberry jawbreakers induced a drop in salivary pH to values below pH 5.5. During consumption of fireball jawbreakers, the intra-oral pH hardly changed.

Conclusions: Jawbreakers are frequently used by children, who keep this candy in their mouth for a long time. Jawbreakers differ considerable in erosive potential, with sour and jumbo jawbreakers > strawberry jawbreaker >> fireball jawbreaker. This information is of use for dental hygienists counselling juvenile patients with dental erosion.

Tuesday, March 30, 2010

Hydroxyapatite nanorods as novel fillers for improving the properties of dental adhesives: Synthesis and application

Dental Materials
Volume 26, Issue 5, Pages 471-482 (May 2010)

Mehdi Sadat-Shojaia, Mohammad AtaiaCorresponding Author Informationemail address, Azizollah Nodehia, Leila Nasiri Khanlarb
Received 18 July 2009; received in revised form 3 October 2009; accepted 9 January 2010.


This study evaluates the hypothesis that the incorporation of fibrous hydroxyapatite nanoparticles with high crystallinity and high aspect ratio, synthesized by hydrothermal method, into an experimental ethanol-based one-bottle dentin adhesive, improves the mechanical properties of the adhesive layer, and accordingly increases the bond strength to dentin.
Hydroxyapatite nanorods were synthesized using a simple hydrothermal procedure. First, the HPO42-containing solution was added drop-wise into the Ca2+-containing solution while the molar ratio of Ca/P was adjusted at 1.67. The HAp precursor was then treated hydrothermally at 200°C for 60h. The resulting powder was characterized using XRD, FTIR, SEM, TEM, and EDXA. The synthesized HAp nanorods were added to an experimental one-bottle dentin adhesive followed by the characterization of the filled adhesive. The diametral tensile strength, flexural strength, flexural modulus, and the microshear bond strength to the dentin of human premolars of seven adhesive systems containing different nanorod contents were evaluated. The distribution of the filler was determined using EDX-mapping. The depth of cure was also evaluated using scraping technique. Moreover, after microshear testing, the fracture cross-section was observed using SEM to determine the mode of failure involved. The colloidal stability was studied using a separation analyzer and also zeta potential measurement. Data were analyzed using one-way analysis of variance followed by the Tukey test.
The results confirmed the high purity, high crystallinity, and high aspect ratio of synthesized HAp nanorods. The diametral tensile strength of nanorod containing adhesive system appeared to increase when 0.2–0.5wt.% HAp nanorods were incorporated (p<0.05). A similar trend was observed in the flexural test providing higher flexural strength at filler contents of 0.2–0.5wt.% while flexural modulus remained unchanged. The highest microshear bond strength was also obtained at 0.2wt.% filler content (p<0.05). The improved properties of the new adhesive system might be due to the high crystallinity and high aspect ratio of the nanorods. SEM observation of debonded surfaces revealed that most specimens showed an adhesive failure from the adhesive–dentin interface. Energy dispersive X-ray (EDX) mapping confirmed the uniform distribution of nanorods in the adhesive matrix. The colloidal stability studies indicated that synthesized hydroxyapatite nanorods have high colloidal stability in the dental adhesive solution. Indeed, the nanorods are well dispersed and protected from aggregation by their high surface charge confirmed by zeta potential measurement.
Hydroxyapatite-based composites have shown promising bioactivity. However, the knowledge about the influence of the nano-sized HAp on the properties of the dental materials, especially dentin bonding adhesives, is yet insufficient. The nanorod containing adhesive system presented here might be considered to have practical applications in dental clinics.

Monday, March 29, 2010

Effect of primer treatment on bonding of resin cements to zirconia ceramic

Dental Materials
Volume 26, Issue 5, Pages 426-432 (May 2010)

Effect of primer treatment on bonding of resin cements to zirconia ceramic

Shuzo KitayamaabCorresponding Author Informationemail address, Toru Nikaidoa, Rena Takahashia, Lei Zhua, Masaomi Ikedac, Richard M. Foxtond, Alireza Sadrb, Junji Tagamiab

Received 4 March 2008; received in revised form 8 July 2009; accepted 5 November 2009.

To evaluate and compare bond strengths of different primers and resin cements to silica-based and zirconia ceramics.

Silica-based and zirconia ceramic specimens were ground flat with #600-grit SiC paper. The ceramic surfaces were airborne-particle abraded and then divided into 11 groups of seven each: untreated (control); and conditioned with one of the six primers in combination with a resin cement from the same manufacturer as follows: Bistite II/Tokuso Ceramic Primer, Linkmax/GC Ceramic Primer, RelyX ARC/RelyX Ceramic Primer, Panavia F 2.0/Clearfil Ceramic Primer, and Resicem/Shofu Porcelain Primer and Resicem/AZ Primer. Stainless steel rods were bonded to the ceramic surfaces using one of the five resin cements. After 24-h water storage, the tensile bond strengths were tested using a universal testing machine and failure modes were examined.

Conditioning with primers containing a silane coupling agent (all the primers except AZ Primer) significantly enhanced bond strengths of resin cements to silica-based ceramic. For zirconia ceramic, Resicem/AZ Primer exhibited significantly higher bond strength than the other groups except Panavia F 2.0/Clearfil Ceramic Primer. The predominant failure mode of the groups conditioned with primers containing a phosphonic acid monomer (AZ Primer) or a phosphate ester monomer (Clearfil Ceramic Primer and Tokuso Ceramic Primer) was cohesive failure in cements whereas that with the other primers was adhesive failure at the zirconia surfaces.

The use of primers containing a silane coupling agent improved resin bonding to silica-based ceramic. On the other hand, the use of primers containing a phosphonic acid monomer or a phosphate ester monomer improved resin bonding to zirconia ceramic.

Saturday, March 27, 2010

Robot in Japanese Dental School

This information came courtesy of my buddy Paul Feuerstein.

Hanako, a robot designed in Japan, has a mouthful of sensors that let her realistically react to the pokings and proddings of dentists in training.

Friday, March 26, 2010

Barodontalgia: what have we learned in the past decade?

Since I scuba dive and fly frequently I thought this article abstract was quite interesting. MJ
Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology and Endodontology
Volume 109, Issue 4, Pages e65-e69 (April 2010)

Barodontalgia: what have we learned in the past decade?

Yehuda Zadik, DMD, MHACorresponding Author Informationemail address

This article reviews the current knowledge regarding barodontalgia, a barometric pressure–related oral (dental and other) pain. Contemporary classification, prevalence, and incidence, features, etiology, and diagnosis of this entity are presented regarding flight and diving conditions. Summarizing the past decade data, three-fourths of episodes were described as severe, sharp, and localized pain. Barodontalgia affects 11.9% of divers and 11.0% of military aircrews with a rate of 5 episodes/1,000 flight-years. Upper and lower dentitions were affected equally in flight, but more upper than lower dentition were affected in diving. The most prevalent etiologic pathologies for in-flight dental pain were faulty dental restorations (including dental barotrauma) and dental caries without pulp involvement (29.2%), necrotic pulp/periapical inflammation (27.8%), vital pulp pathology (13.9%), recent dental treatment (11.1%), and barosinusitis (9.7%). This review refutes 3 generally accepted conventions: According to the results, the current in-flight barodontalgia incidence is similar to the incidence in the first half of the 20th century, the weighted incidence of barodontalgia among aircrews are similar to the weighted incidence among divers, and the role of facial barotrauma in the etiology of in-flight barodontalgia is minor.

Thursday, March 25, 2010

Microleakage evaluation of core buildup composite resins with total-etch and self-etch adhesive systems.

J Contemp Dent Pract. 2010 Mar 1;11(2):E009-16.
Microleakage evaluation of core buildup composite resins with total-etch and self-etch adhesive systems.

Moosavi H, Moazzami SM, Loh S, Salari S.

AIM: Core buildup composite resins with prefabricated posts are commonly used to restore endodontically treated teeth. This study compared the sealing ability of Core Max II and Panavia F2.0 cement with total-etch and self-etch adhesive systems. METHODS AND MATERIALS: Sixty recently extracted human second premolar teeth were chosen and their crowns were cut 3 mm above the CEJ. After preparing proximal boxes (4+/-1 mm buccolingually and 3 mm occlusogingivally dimensions) and finishing root canal therapy, the teeth were randomly divided into four groups (n=15): groups 1 and 2, Core Max II without and with total-etch adhesive; groups 3 and 4, Clearfil photocore composite, A2 shade, and Panavia F2.0 cement without and with self-etch adhesive respectively. The Dentatus posts (# 2 Long) were used in canals approximately 8 mm depth. According to manufacturer guidelines, pins were cemented and cores were restored. After keeping the specimens for 24 hours at 37 degrees C and 100% humidity, they were thermally cycled for 500 cycles, sealed with nail varnish except 1 mm beyond the margins of restoration, and then immersed in a 0.5% fuschin basic for 24 hours. Samples were embedded in clear epoxy resin, sectioned mesiodistally, and observed at 20x magnification. The microleakage was assessed under stereomicroscope and the results were recorded in percentage of dye penetration to the whole path from the cavosurface margin of the proximal boxes to the end of the post. Analysis of variance and the Tukey test were used to evaluate the data (p=0.05). RESULTS: Groups 1 and 4 had the highest and the lowest values of microleakage respectively. Microleakage of Panavia F2.0 cement was lower than for Core Max II and for both cements using adhesive made the microleakage smaller than without it (p<0.05). CONCLUSION: Application of adhesive using Core Max II cement and Panavia F2.0 cement is strongly recommended to decrease microleakage. Self-etch adhesive performed better than total-etch adhesive. CLINICAL SIGNIFICANCE: With regards to microleakage, the self-etching primer displayed better sealing than that obtained with the total-etching, two-step dental adhesive.

Wednesday, March 24, 2010

BIOLASE Announces FDA 510(K) Clearance Of ILase TM Personal Laser For Dental Market

This laser was announced in Chicago but did not yet have FDA clearance.

BIOLASE Technology, Inc. (NASDAQ: BLTI), the world's leading dental laser company, today announced that it has received 510(k) clearance from the U.S. Food and Drug Administration (FDA) to market its iLase™ diode laser, the world's first personal laser for dentists and hygienists for performing a full-range of minimally invasive soft-tissue and hygiene procedures.

The iLase is the first completely self-contained, hand-held dental laser that includes the laser, user interface, battery power, and controls in a single, integrated handpiece with no foot pedals or cords attached.

BIOLASE Chief Executive Officer David M. Mulder said, "The iLase represents another milestone for BIOLASE and another example of our leadership in the global dental laser market. We call the iLase a revolutionary breakthrough because there is nothing else like it on the market. The iLase was created to be simple and intuitive and, after introducing it at the Chicago dental show last month, it has already generated global interest and demand, along with prepaid orders. We look forward to offering this to our customers in the U.S. and around the world and are on schedule to begin shipping in April."

The iLase, which is about the size of a large pen and has five watts of power, is the only dental laser controlled by a patent-pending finger switch on the laser handpiece, which uniquely eliminates the need for a foot control pedal. It also uses BIOLASE's proprietary ComfortPulse™ control that lets clinicians adjust the laser for maximum patient comfort and cutting speed.

The iLase has 10 completely pre-set soft tissue and hygiene procedures at the push of a button, including gingivectomy, troughing for crown procedures and sulcular debridement, and a procedure for cleaning between gums and teeth for the treatment of periodontal disease. Like the ezlase™, the iLase can perform a comprehensive set of 25 FDA-cleared soft tissue and hygiene procedures. For a full diode solution, the ezlase goes beyond the basic iLase with 20-minute teeth whitening and FDA-cleared pain relief functions. Beyond all diode lasers, the Waterlase® MD Turbo™ is the very best soft-tissue laser with a virtually painless "cold cut" water-based wavelength, and the Waterlase provides the substantial added benefits of virtually painless procedures on teeth and bone, periodontal procedures and much more.

Tuesday, March 23, 2010

The Formula For Making Teeth Will Soon Be Found

Each cusp of our teeth is regulated by genes which carefully control the development. A similar genetic puzzle also regulates the differentiation of our other organs and of all living organisms. A team of researchers at the Institute of Biotechnology of the University of Helsinki has developed a computer model reproducing population-level variation in complex structures like teeth and organs. The research takes a step towards the growing of correctly shaped teeth and other organs. The results were published last week in Nature, the esteemed science journal.

Academy Professor Jukka Jernvall and his team investigate the evolutionary development of mammal teeth. After over 15 years of work, the team has compiled so much data that the main aspects of a formula for making teeth are beginning to be clear. The model shows that regulation of tooth development is already well known. Teeth are a kind of "model species" for Jernvall's team, which means that the study results also tell about the development of other organs.

A mathematical model applied to the teeth of ringed seals

According to a mathematical computer model, a rather simple basic formula seems to be behind the complex gene puzzle resulting in tooth formations; the jungle of gene networks has a 'patterning kernel' regulating the variation of teeth among individuals in the same population. Also the variation of human teeth from the incisors to the molar teeth may result from a single factor regulating cell division.

The researchers tested their theoretical model, which is based on mouse tooth development, by investigating seal teeth. The Ladoga ringed seal collection of the Finnish Museum of Natural History at the University of Helsinki provided an ideal population sample for the research because dentitions are highly variable.

New teeth and organs?

The mathematical model proposed by the research team may give new kind of understanding on the formation of organisms' three-dimensional shapes: How do different levels of ontogeny function together? What factors guide the emergence of specific external features? The new research results may promote medical research, such as growing new organs.

Jernvall is known as an international pioneer in cross-disciplinary evolutionary development biology. A few years ago, the science journal Nature chose a teeth evolution work conducted by Jernvall and two post-doc researchers as one of the 15 educational topics in the field of evolutionary biology. The research published now was conducted with Jernvall's third post-doc researcher, Isaac Salazar-Ciudad. Salazar-Ciudad currently works at the Autonomous University of Barcelona in Spain.

Source: Helsingin yliopisto (University of Helsinki)

Article URL:

Monday, March 22, 2010

Orthodontists should help Iowa kids now

Iowa dentists have long complained the state does not pay them enough to cover the cost of caring for patients on Medicaid, government health insurance for the poor. So some kids go without dental care. Sometimes social workers drive foster kids across the state to the University of Iowa Hospitals and Clinics for help.

Sen. Jack Hatch of Des Moines acknowledged there may be a problem with the insurance contracts, but said it was "embarrassing" that orthodontists won't treat children.

It's especially embarrassing considering how much these health professionals earn. According to a survey by the American Dental Association, the average net income for dental specialists, which includes orthodontists, was $353,280 in 2007. lists orthodontists, along with professional athletes and motivational speakers, among the "Ten Most Overpaid Jobs in the United States" and cites the Journal of Clinical Orthodontics for salary information to back it up: "For a 35-hour week, orthodontists earn a median $374,000 a year."

Read the entire article

Saturday, March 20, 2010

Healozone Update

Here is a copy of a letter from Curozone about Kavo distribution. Click to enlarge.

Friday, March 19, 2010

Lares New Advanced Laser Hard Tissue Applications and Training

Chico, CA: March 15, 2010— Lares Research has added a third course to their advanced level training series: Advanced Laser Hard Tissue Applications Including PIPS™ (Photon Induced Photoacoustic Streaming) Endodontic Therapy and CEREC®. The two-day, hands-on course will be provided by the Montana Center for Laser Dentistry and the Arizona Center for Laser Dentistry, two premier laser training facilities.

The new Lares advanced level training course trains the user on advanced laser endodontics, and advanced fixed prosthetics utilizing CEREC® 3D technology to restore teeth that have been prepared with the laser for crowns, inlays, or overlays. Tuition is $2,995 when purchased separately, however this advanced training course (2 days) and the Total Immersion training course (2 days) can both be included in the price of a new Lares laser.

Lares will also offer optional additional in-office coaching of dentist and staff. An experienced laser clinician will come to the dental practice for one full day to coach the dentist as he or she performs a variety of laser procedures on actual patients. The clinician will also coach the staff on issues such as insurance billing, fee setting, and scheduling of laser procedures. Tuition is $4,500/day plus travel expenses (if applicable). The coaching will be provided by experienced independent clinicians not affiliated with the Arizona Center for Laser Dentistry or the Montana Center for Laser Dentistry. For more information, call 888-333-8440, extension 2050.

Thursday, March 18, 2010

Shane MacGowan FINALLY gets new teeth

He is infamous for his shabby looks and gummy smile.

But all that's in the past now for Shane MacGowan.

The Pogues singer has been spotted in Malaga with a new set of gnashers.

Read more:

Wednesday, March 17, 2010

RelyX™ Fiber Post: A new family member is welcomed

RelyX™ Fiber Post: A new family member is welcomed

New post size to complement existing line of products, ensuring reliable clinical performance

ST. PAUL, Minn. – (March 10, 2010) – As of mid-March 2010, RelyX™ Fiber Post will be available in an additional size. The new, smallest post “0”, with a coronal diameter of 1.1 mm, presents a beneficial addition to the existing portfolio. RelyX™ Fiber Post radiopacity was rated “Good” by a leading independent dental publication. RelyX™ Fiber Posts are a reliable, esthetic and convenient solution standing for predictable clinical performance.

In contrast to metal posts, root canal posts made of glass fibers embedded into a resin matrix -- such as RelyX™ Fiber Post by 3M ESPE -- offer an esthetic solution for all-ceramic restorations. Due to their high translucency and an appearance similar to that of tooth structure, RelyX™ Fiber Posts are not visible through the restoration – unlike the dark shadow often caused by metal posts – and support a natural light reflection.

However, the similarity between RelyX™ Fiber Posts and natural teeth not only exists in terms of appearance: Their mechanical properties are related as well, ensuring reliable clinical performance. Since the modulus of elasticity is in the same range as that of dentin, forces are distributed evenly within the tooth and thus, the “wedge effect” characteristic of metal posts( i.e., occurring peak forces that may lead to root fracture) is avoided. The tapered shape of RelyX™ Fiber Post further helps to conserve valuable root canal dentin.

In order to make these benefits available for all clinical situations, 3M ESPE will offer the new post size “0” in mid-March 2010. With a coronal diameter of 1.1 mm, it will complement the existing sizes of 1.9 mm, 1.6 mm and 1.3 mm diameter very well. For the required adhesive cementation of the posts, a brilliant solution is provided: RelyX™ Unicem Self-Adhesive Universal Resin Cement eliminates the need for prior etching, priming and bonding as well as the necessity to prime and silanize the post. Since the material is available with the RelyX™ Unicem Aplicap™ Elongation Tip designed to reach into the root canal, cement application from bottom to top is simplified and the risk of cement voids is virtually eliminated.

With the useful addition to the popular RelyX™ Fiber Post System, 3M ESPE makes sure that users can rely on convenience and excellent clinical performance in every situation.

For more information, visit or call 1-800-634-2249. To view a RelyX Fiber Post Espertise Operatory Technique video, visit

Tuesday, March 16, 2010

February 2010 U.S. Search Engine Rankings

Total searches were down for this period and Bing is coming up. MJ

February 2010 U.S. Search Engine Rankings

RESTON, VA, March 10, 2010 – comScore, Inc. (NASDAQ: SCOR), a leader in measuring the digital world, today released its monthly comScore qSearch analysis of the U.S. search marketplace. In February 2010, Americans conducted 14.5 billion core searches, with Google Sites accounting for 65.5 percent search market share.

February 2010 U.S. Core Search Rankings

Google Sites led the U.S. core search market in February with 65.5 percent of the searches conducted, followed by Yahoo! Sites (16.8 percent), and Microsoft Sites (11.5 percent). Ask Network captured 3.7 percent of the search market, followed by AOL LLC with 2.5 percent.

comScore Core Search Report*

February 2010 vs. January 2010

Total U.S. – Home/Work/University Locations

Source: comScore qSearch

Core Search Entity Share of Searches (%)
Jan-10 Feb-10 Point Change Feb-10 vs. Jan-10
Total Core Search 100.0% 100.0% N/A
Google Sites 65.4% 65.5% 0.1
Yahoo! Sites 17.0% 16.8% -0.2
Microsoft Sites 11.3% 11.5% 0.2
Ask Network 3.8% 3.7% -0.1
AOL LLC Network 2.5% 2.5% 0.0

* Based on the five major search engines including partner searches and cross-channel searches. Searches for mapping, local directory, and user-generated video sites that are not on the core domain of the five search engines are not included in the core search numbers.

Monday, March 15, 2010

ePocrates for WebOS and Android

Epocrates Rx beta application, you will have quick and easy access to reliable drug information. Epocrates Rx provides you with multiple clinical tools in one easy-to-use application. Please note that the clinical content will not be updated for the beta version of this application.

Saturday, March 13, 2010

Crest and Oral-B Great Canadian- Smile Survey

Read the entire article by clicking the link below:

Additional At-a-Glance Stats from the Crest and Oral-B Great Canadian
Smile Survey


- Among those who don't brush their teeth at lease twice a day, 24 per
cent say they're too tired at night and 16 per cent say they don't
have time
- 4 per cent of those who don't brush their teeth twice a day admit
they don't know how to use a toothbrush
- Among those who don't floss daily, 31 per cent say they can't be
bothered and 25 per cent say they don't have time
- 31 per cent of Canadians haven't flossed in the past six months
- Among those who don't rinse daily, 18 per cent admit they don't have
time to rinse
- Among the 26 per cent of Canadians who don't go to the dentist at
least once a year, 42 per cent say they don't go because they can't
afford it, and 29 per cent say it's because they don't have dental
- 82 per cent of Canadians rate their own overall oral health as good,
while only 62 per cent say the same

Friday, March 12, 2010

Sirona Dental Systems Presents CAD/CAM & 3D Cone Beam Seminar

Sirona Dental Systems Presents CAD/CAM & 3D Cone Beam

Top Industry Experts Slated to Speak –
Dentists Receive Complimentary Tuition, Hotel Stay, and Up to 14 CE Credits

Charlotte, NC (March 11, 2010) – Sirona Dental Systems, LLC (Nasdaq: SIRO), the company that pioneered digital impressions & dental CAD/CAM 25 years ago and the world’s leading producer of dental CAD/CAM and digital impression systems, today announced plans to hold a complimentary seminar on CAD/CAM and 3D Cone Beam technology for dentists.

Dentists are encouraged to attend the informative seminar which will take place at the Dolce Valley Forge Resort, located in Philadelphia, Pennsylvania, March 25-27th. The CAD/CAM and 3D Cone Beam Seminar includes not only complimentary tuition and CE credits, but also up to two hotel night stays, compliments of Sirona.*

“The CAD/CAM and 3D Cone Beam Seminar promises to be an educational experience that will provide dentists with the information they need to make an informed decision about incorporating in-office CAD/CAM, Cone Beam technologies, or both, into their own practices,” remarked Sirona Dental Systems President, Michael Augins. “I would highly recommend this seminar to any dentist who is seriously considering making the purchase of a CAD/CAM system and/or 3-D diagnostic tool the official start to an improved and more efficient workflow.”

Topics of discussion during the CAD/CAM and 3D Cone Beam Discovery Seminar will include:

• Success of In-Office CAD/CAM
• CAD/CAM for the General Dentist
• Clinical Efficacy of CAD/CAM Materials
• Taking Your Practice to New Heights
• Hands-On Experience with CEREC® AC
• SICAT Case Presentation
• 3D Digital Radiography – Introduction
• Cone Beam FAQs
• Integrating CEREC AC and GALILEOS
• Implant with CEREC Provisional Crowns

Sirona has also enlisted an impressive lineup of distinguished dental industry speakers for the seminars,** including:

• Gordon Christensen, DDS, MSD, PhD
• Imtiaz Manji, CEO, Scottsdale Center for Dentistry™
• Sameer Puri, DDS
• Russell Giordano, DMD, DMSc, FADM
• Dennis Fasbinder, DDS, MAGD, ABGD
• Paul Child, Jr., DMD, CDT
• Tarun Agarwal, DDS, PA
• Jay Reznick, DMD, MD
• Donald Tyndall, DDS, MSPH, PhD
• Andrew Moll, DDS

To register for the seminar, or for additional information, please call 877-526-3590 or visit

*Current CEREC owners not eligible for complimentary tuition, CE, and hotel stay for CAD/CAM event. Current GALILEOS owners not eligible for complimentary tuition, CE, and hotel stay for 3D Cone Beam event.

**Speakers subject to change without notice.

Thursday, March 11, 2010


HAUPPAUGE, NY: March 8, 2010— Mydent International has introduced two lightweight high-speed handpieces. The new DEFEND® Handpieces feature a 4-hole quick-release connection with 360-degree swivel to reduce hand fatigue, and push-button cartridge for fast and easy bur changing. One handpiece has a full head size; the other has a mini-head. Replacement turbines with ceramic bearings are available for both versions.

DEFEND handpieces combine superior intraoral access and greater visibility with strong, controlled cutting power. The lightweight design provides perfect balance for maximal ergonomics. Operation of 260,000 rpm at 32 psi and ceramic bearings provide smooth, quiet, vibration-free action. DEFEND Handpieces come with a six-month warranty.

Mydent International, home to DEFEND® infection control products, disposables, and impression material systems, provides dependable solutions for defensive healthcare. Mydent urges healthcare professionals to: DEFEND. Be smart. Be safe. For more information on Mydent International and its products, call 800-275-0020, or go to

Wednesday, March 10, 2010

SEC/Scottevest Great Customer Service

Great customer service is important no matter what industry you are in. I have purchased some Travel Clothing from SEC/Scottevest and really like their products. On my trip to the Chicago Mid Winter Dental Meeting one of the pull tabs on my TEC Shirt broke. I sent an email from Newark airport about the problem and 2 hours later when I landed in Chicago there was an email response telling me a new shirt would be sent immediately. The next day an email arrived telling me the new shirt had been shipped and included the tracking number. The shirt arrived 2 days after I returned from the meeting (the weekend got it the way). In the package was a return UPS label and bag to ship it back.

Now that is great customer service. No waiting on hold for an RMA number. Perfectly done and it was all electronic. Thanks to Scott Jordan for running a great company and Sherri for making it all happen so effortlessly.

Tuesday, March 09, 2010

iPad, Yes or No in my Apex column

The new edition of Apex is out with my article on the iPad.
Check it out

Inside the latest issue:
  • "Children entering school have on average 9 decayed teeth, three of which have pulp involvement" Dr Bella Monse in Sustainable programme invests in oral health of young children on page 12
  • "There is still no proven gold standard of disease progression" Dr Vandana Laxman in Advanced diagnostic aids in periodontics on page 4
  • "The hygienist can enjoy a longer and pain free career by practising proper posture and choosing good equipment" Keverly Sugden in Your body, your choice on page 16
  • "Effective communication is about genuinely appreciating the other person's situation" Chris Barrow in Good conversations on page 20

Monday, March 08, 2010

Medical Professionals of Tomorrow Scholarship

US Medical Supplies is a top supplier of medical supplies and mobility aids such as lift chairs, mobility scooters, stair lifts, and wheelchair lifts. As an industry leader, US Medical Supplies recognizes the importance of education and the incredible potential of tomorrow's medical professionals.

The US Medical Supplies Medical Professionals of Tomorrow Scholarship is available to full-time college students who are pursuing a course of study in a medical field. Those studying to become a doctor, nurse, physical therapist, anesthesiologist, radiologist, etc. are encouraged to apply. Our goal is to contribute to the future of the medical field by offering you financial assistance to help cover the expenses of tuition and books.

The $1,000 scholarship is being offered for the Fall 2010 semester. We look forward to reading your applications and essays and we are excited to be able to contribute to your future as well as the future of the medical industry.


  • You must be enrolled in an accredited two or four-year school
  • You must be enrolled as a full-time student
  • You must be in an educational program that is related to the medical field
  • This program is available to entering freshmen provided you have been accepted into a degree program
  • You must be a legal resident of the United States
  • You must complete the application and submit your response to the essay question by July 31, 2010
  • Your response to the essay question should be approximately 500 words in length.

How to Apply

  • Have your essay prepared prior to completing the online application.
  • Fill out our online application by clicking here. Copy and paste your essay into the field provided. Please note that we do not accept email attachments.
  • Online applications and essays must be completed by July 31, 2010.

The Essay Question

Describe a person or persons that have influenced your decision to enter your medical profession. What impact did they have, and why did you decide to enter the medical field? Please describe any other events or experiences from your past that have inspired you to become a medical professional.

Fill out our online Scholarship Application or email us if you have any questions.

Saturday, March 06, 2010

FDA Sends Letter to Novalar Regarding Promotions for OraVerse

FDA Sends Letter to Novalar Regarding Promotions for OraVerse

ROCKVILLE, Md., Feb. 2, 2010 - The FDA today posted on its website a letter sent to Novalar Pharmaceuticals regarding a patient brochure for OraVerse injection. The letter is below.

Food and Drug Administration Silver Spring, MD 20993

Laura A. Navalta Senior Vice President, Clinical and Regulatory Novalar Pharmaceuticals, Inc. 12555 High Bluff Drive, Suite 300 San Diego, CA 92130

RE: NDA #22-159
OraVerse (phentolamine mesylate) Injection
MACMIS #18185

Dear Ms. Navalta:
As part of its monitoring and surveillance program, the Division of Drug Marketing, Advertising, and Communications (DDMAC) of the U.S. Food and Drug Administration (FDA) has reviewed a direct-to-consumer (DTC) patient brochure (0128, Rev. 01/2009) for OraVerse (phentolamine mesylate) Injection (OraVerse) submitted by Novalar Pharmaceuticals, Inc. (Novalar) under cover of Form FDA 2253. The patient brochure is misleading because it omits and minimizes risks associated with the use of OraVerse, broadens the indication for OraVerse and overstates the efficacy of OraVerse. Thus, the patient brochure misbrands the drug in violation of the Federal Food, Drug, and Cosmetic Act (the Act), 21 U.S.C. 352(a) and 321(n), and FDA implementing regulations. 21 CFR 1.21(a); cf. 202.1(e)(5); (e)(6)(i), (xviii), & (e)(7)(viii).

According to the Indications and Usage section of the FDA-approved product labeling (PI):
OraVerse is indicated for reversal of the soft-tissue anesthesia, i.e., anesthesia of the lip and tongue, and the associated functional deficits resulting from an intraoral submucosal injection of a local anesthetic containing a vasoconstrictor. OraVerse is not recommended for use in children less than 6 years of age or weighing less than 15 kg (33 lbs).

OraVerse is associated with a warning and precaution regarding cardiovascular events. The most common adverse reaction with OraVerse that was greater than the control group was injection site pain. Adverse reactions, where the frequency was greater than or equal to 3% in any OraVerse dose group and was equal to or exceeded that of the control group, were tachycardia, bradycardia, injection site pain, post procedural pain, and headache.

The Pediatric Use section of the PI states that the safety, but not the efficacy, of OraVerse has been evaluated in pediatric patients under the age of 6 years old.

In clinical studies, the primary endpoint was time to normal lip sensation as measured by patient reported responses to lip palpation. The secondary endpoints included patients’ perception of altered function, sensation and appearance, and their actual functional deficits in smiling, speaking, drinking and drooling.

Omission and Minimization of Risk
Promotional materials are misleading if they fail to reveal material facts in light of representations made by the materials or with respect to consequences that may result from the use of the drug as recommended or suggested by the materials. The patient brochure presents various efficacy claims for OraVerse, but omits material risks associated with OraVerse treatment. In particular, while the “Important Safety Information” presentation in the brochure discloses that tachycardia, bradycardia, and cardiac arrhythmias may occur, it fails to disclose any other risk information for OraVerse, including the other common adverse reactions experienced with OraVerse treatment (see background section).

In addition, promotional materials are misleading if they fail to present information about risks associated with a drug with a prominence and readability reasonably comparable with the presentation of information relating to the effectiveness of the drug. The patient brochure prominently presents efficacy claims in large bolded font size and colorful text and graphics surrounded by a significant amount of white space. In contrast, risk information is presented in small black font, and in single-spaced paragraph format on the last fold of the brochure. Furthermore, while the patient brochure presents efficacy claims for OraVerse in language that is easily understandable to consumers, it presents risk information using complex medical terminology that is not likely to be comprehended by the same audience.
Therefore, the overall effect of this presentation undermines the communication of important risk information, minimizing the risks associated with OraVerse and misleadingly suggesting that OraVerse is safer than has been demonstrated.

Broadening of Indication
The patient brochure is misleading because it suggests that OraVerse is useful in a broader range of conditions or patients than has been demonstrated by substantial evidence or substantial clinical experience. Specifically, the patient brochure contains the claim, “And now the safety and effectiveness of OraVerse have been successfully demonstrated through clinical trials involving pediatric, adolescent and adult patients ages 4 through 92.” This claim misleadingly suggests that OraVerse is approved for all patients ages 4 through 92, when this is not the case. FDA is not aware of substantial evidence to support efficacy claims in patients under the age of 6 years old. According to the Indications and Usage section of the PI, OraVerse is not recommended for use in children less than 6 years of age or weighing less than 15 kg (33 lbs). Furthermore, the Pediatric Use section of the PI states, “The safety, but not the efficacy, of OraVerse has been evaluated in pediatric patients under the age of 6 years old” (emphasis added).

Overstatement of Efficacy/Minimization of Risk
Promotional materials are misleading if they suggest that a drug is more effective or safer than has been demonstrated by substantial evidence or substantial clinical experience. The patient brochure includes the following claims (bolded emphasis in original; underlined emphasis added):

“A new direction in comfort”

“Your dental professionals want you to have the most comfortable experience

“This breakthrough changes your measure of comfort by creating an easy and
expedient return to your normal activities.
These claims misleadingly overstate the efficacy of OraVerse by implying that treatment with OraVerse will provide “comfort” for dental patients. FDA is not aware of substantial evidence to support claims made in the patient brochure related to the “comfort” of patients treated with OraVerse. Moreover, these claims also minimize the risks associated with OraVerse that may prevent a patient from feeling comfortable. As stated in the PI, the most common adverse reaction with OraVerse that was greater than the control group was injection site pain. The presentations related to comfort in the patient brochure minimize this risk and misleadingly suggest that OraVerse is safer than has been demonstrated by substantial evidence or substantial clinical experience.
The patient brochure also contains the following claims (bolded emphasis in original):

“From numb to normal . . . it’s about time.”

“OraVerse™ brings you back”

“This breakthrough changes your measure of comfort by creating an easy and
expedient return to your normal activities.”

“Your return to normal”

“And that’s time you can put back in your day . . . doing what you want to do without limitations.”
The totality of this presentation is misleading because it overstates the efficacy of OraVerse by implying that the drug has a broad impact on a patient’s activities of daily living. While OraVerse’s impact on time to normal lip sensation and on patients’ perception of altered function, sensation and appearance or their actual functional deficits in smiling, speaking, drinking, or drooling, was assessed in OraVerse clinical studies, we are not aware of substantial evidence to support the broad suggestions conveyed by the above claims (i.e., that patients will be able to return to “normal,” engage in “normal” activities without limitations and have time to “put back in [their] day” after treatment with OraVerse). Moreover, the common adverse reactions patients may experience with OraVerse could all impact a patient’s ability to return to “normal” and engage in “normal” activities without limitations. Additionally, OraVerse is indicated only for the reversal of the soft-tissue anesthesia and not relief of pain from the dental procedure itself, which may also prevent a patient’s return to “normal” or engagement in “normal” activities without limitations.

The patient brochure also contains the claim, “And for parents, there is added peace of mind in knowing children will regain normal feeling more quickly with OraVerse.” This claim is misleading because it overstates the treatment benefit of OraVerse by implying that the drug will give parents “peace of mind” regarding the effects of reversal of soft-tissue anesthesia or other aspects related to treatment with OraVerse, when this has not been demonstrated by substantial evidence. Furthermore, this claim misleadingly suggests a safety benefit associated with the reversal of the local anesthetic when no such benefit has been evaluated or observed in clinical studies for OraVerse. This claim is particularly troubling given the misleading claim in the brochure (discussed above) that OraVerse has been shown to be safe and effective for children as young as 4 years of age.

Conclusion and Requested Action
For the reasons discussed above, the patient brochure misbrands OraVerse in violation of the Federal Food, Drug, and Cosmetic Act (the Act), 21 U.S.C. 352(a) and 321(n), and FDA implementing regulations. 21 CFR 1.21(a); cf. 202.1(e)(5); (e)(6)(i), (xviii), & (e)(7)(viii).

DDMAC requests that Novalar immediately cease the dissemination of violative promotional materials for OraVerse such as those described above. Please submit a written response to this letter on or before February 5, 2010, stating whether you intend to comply with this request, listing all promotional materials (with the 2253 submission date) for OraVerse that contain violations such as those described above, and explaining your plan for discontinuing use of such violative materials. Please direct your response to me at the Food and Drug Administration, Center for Drug Evaluation and Research, Division of Drug Marketing, Advertising, and Communications, 5901-B Ammendale Road, Beltsville, MD 20705-1266, facsimile at 301-847-8444. In all future correspondence regarding this matter, please refer to MACMIS # 18185 in addition to the NDA number. We remind you that only written communications are considered official.

The violations discussed in this letter do not necessarily constitute an exhaustive list. It is your responsibility to ensure that your promotional materials for OraVerse comply with each applicable requirement of the Act and FDA implementing regulations.

{See appended electronic signature page}
Twyla Thompson, Pharm.D. Regulatory Review Officer Division of Drug Marketing, Advertising, and Communications
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Application Submission
Submitter Name Product Name
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This is a representation of an electronic record that was signed electronically and this page is the manifestation of the electronic signature.

Friday, March 05, 2010

Whats New From Chicago Part 3

Here is the 3rd part of new and exciting products from the Chicago Mid Winter meeting.

I have been using the Kavo Diagnodnet for caries detection for what seems forever. Recently there have been some new video based fluorescence products available. Spectra from Air Techniques and Acteon's SoporoLife. The SoporoLife combines an intra-oral camera (717) and caries detection into one device. I have previously used the Sopro 717 and thought it was an excellent camera. In the very near future I hope to have both the Spectra and SoporLife in my office and will provide a full review after I put them through their paces. I did see another caries detection device from a small company called Daraza,they have a device called the FluoreCam.

Dentsply has their smart air handpiece the Stylus ATC. This is not a hybrid electric. It is a straight air driven handpiece that has a sensor attached that controls the amount of air to the turbine. It cuts much faster and with more torque then a conventional handpiece even under load. Check out this video comparison of the Stylus ATC handpiece.

Some other products to look for in the future are in office digital impression scanners. So you can take an impression and scan it right in your office. This will cut down on shipping expense and cut the fabrication time. So turn around for a crown maybe a week! A new CAD/CAM produced surgical guide machine, to make implant placement more predictable. A hybrid processed long term temporary crown that can be fabricated in your office. So another Chicago Mid Winter meeting is done. Cannot wait to see what is new next year!

Thursday, March 04, 2010

Whats New From Chicago Part 2

Chicago is where many manufacturers announce their new products for 2010. So in no particular order here are some products that caught my eye. Part 2

One of the coolest things I saw was Sirona's New Biogenic Software. A simple scan of some teeth with the Cerec AC digital impression wand easily and precisely reconstructs a patients natural occlusion based on their own teeth.

Version 3.8 of the CEREC software enables dentists to create lifelike reconstructions – even while working with completely damaged occlusal surfaces. On the basis of a single intact tooth, the program extrapolates the natural morphology of that tooth to the patient’s damaged tooth structure. CEREC 3.8 software can be used for all single-tooth restorations and for three-unit bridges.

Asepsis in the operatories is absolutley necessary and keyboards


The Cleankeys wireless keyboard is the easiest keyboard every to clean. The device is a keyboard and trackpad all built into one. One simple spray and wipe and the keyboard is clean.

You have seen me already blog about OralDNA. They released OraRisk the new DNA test for the Human Papilloma Virus (HPV). HPV is a leading cause of oral cancer. A simple saliva test can now access the risk level if a patient is carrying the HPV. There are other saliva tests for periodontal disease.

Wednesday, March 03, 2010

What was new at the Chicago Mid Winter Meeting Part 1

Chicago is where many manufacturers announce their new products for 2010. So in no particular order here are some products that caught my eye.

Lets start with imaging and more in the next few days.

Cone Beam goes High Definition – Introducing the GXCB-500 HD

My buddy John Flucke is talking about the new Gendex GXCB-500HD. Building on its award-winning 3D design, Gendex is pleased to introduce the GXCB-500 HD Medium Field of View Cone Beam system, featuring an advanced High Definition sensor for precise i-CAT®-powered 3D scans and detailed 2D pan images. Along with High Definition, the GXCB-500 HD offers scan flexibility, fast workflow, and integration capabilities. As a result, clinicians can select 3D scans and traditional 2D pans, choose scan sizes specifically designed to work with targeted procedures, and blend technologies for a wide variety of treatment options.

Dexco showed an all in one hand held the ADX 4000 Digital Radiography System. You have an xray head, sensor and viewer all in one. This system does not have FDA approval. This would be a good system for missionary work or a satellite office.

Video Dental Concepts was selling 2 sensors for under $8000. These are USB sensors. No software but should integrate with any of your imaging software.

Lester Dine was showing a small camera that produces very good intra-oral photos. For $695 Lester Dine had a complete photography package using a Pentex Optio W80. This is a 12 Megapixel camera with mirrors, retractors and carrying case and 2GB memory card and reader.
The images I saw were excellent and the camera is waterproof and shock proof. This makes it perfect for the dental operatory. Take it from someone who has dropped his camera. Check out the video.

Tuesday, March 02, 2010

Goodbye Healzone

Update: This has been confirmed!

I am a big fan of ozone use for dental treatment and think its a great modality when used for its intended purposes. Kavo has for years been waiting for FDA approval for their Healzone unit. The Healzone has been available for the rest of the world.

A rumor I heard from multiple sources (including a Kavo representative) is that the Healzone will no longer be available world wide because of low sales and no FDA approval. The biggest problem with the device was trying to get a good seal so that the unit would dispense the ozone. There are other ozone machines on the market but none are as nicely built and none have FDA approval. Too bad about the Healzone but ozone therapy has been around for decades and it has a small but very devote following in dentistry.

Monday, March 01, 2010

What Is New From the Chicago Midwinter Meeting.

After 3 very long days the Chicago Mid Winter Meeting is over. Lots of stuff to go over and can't wait to update everyone on all the cool stuff I saw over the next few days.

So until I can get through everything here is something new from Biolase.
The iLase is a handheld 5 watt diode laser similar to the Discus Styla. The iLase is currently not available as it is awaiting FDA approval. Officially the cost is supposed to be less then $8000 but I heard rumors of a cost of $3000. Time will tell if the rumor is correct.

In the mean time check out the video