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KEEPING YOU ON THE PULSE OF YOUR MARKETING SOLUTIONS. MedMarkâ&#x20AC;&#x2122;s key areas of expertise are distinctive to our company and critical to our companyâ&#x20AC;&#x2122;s long-term growth. For our company, the most value is added by employee dedication, the production of high quality products, and the distribution of exceptional services. We build on our core competencies, utilizing skills that combine to strengthen value chains and increase competitive advantages. This leads to creating synergies among all units of operation, enabling us to become more productive and work cohesively as a team to accomplish great things.

2014

CONTACT S Headquartered in Scottsdale, Arizona, MedMark is a privately-held company delivering innovative marketing strategies and enriched programs that increase professional dentistry development. This development provides dentists with improved knowledge and skills, so that their performance will better serve others. At MedMark, we practice our profession with integrity, honesty, and innovation as we address the needs of our clients. Our team members demonstrate concern for the interests and well-being of each other, and we foster cultural diversity and pluralistic values.

Mission Statement Our mission is to be the leading interactive marketing and advertising company excelling in the production of high-quality dental publications and custom media to promote the educational advancement of the US dental profession. We strive to maximize our core competencies and to promote excellence in endodontic, implant, orthodontic and other specialized areas of dentistry, promoting clinical growth, industry change, and technological advancement.

Our Team

Our Publications

Lisa Moler CEO/Publisher lmoler@medmarkaz.com

MedMarkâ&#x20AC;&#x2122;s highly respected dental publication brands represent our

Mali Schantz-Feld Managing Editor mali@medmarkaz.com

deep understanding of the dental industry, evolving trends, and emerging technologies. Endodontic Practice US,

Kay FernĂĄndez Assistant Editor kay@medmarkaz.com

Implant Practice US, and Orthodontic Practice US provide a full range of clinical, continuing education, practice

Mandi Gross Editorial Assistant Mandi@medmarkaz.com

management, and technology articles written by the worldâ&#x20AC;&#x2122;s leading specialists.

Adrienne Good Operations/Client Relations Mgr agood@medmarkaz.com Michelle Manning Director of Sales michelle@medmarkaz.com Drew Thornley National Sales Representative drew@medmarkaz.com

endopracticeus.com

Scott Olason Web Designer Scott@medmarkaz.com

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January 2014 Damon Forum January 15 – 18 ICOI Winter Symposium January 16-18 February 2014 1st International Quintessence Symposium February 7-8 Chicago Midwinter Meeting February 20 – 22 March 2014 Academy of Osseointegration March 6 – 8

From th e P u b li s Lisa Mol her er - CEO/Pub

lisher

De ar Re ad er s:

Af te r 25 ye ar s of pu bl is hi ng /m ar ke tin g an ha ve re al ize d d ov er 8 ye ar th at se rv in g s in th e de nt th e de nt al in al co m m un ity du st ry ha s ne ,I In no va tio n an ve r be en m or d te ch no lo gy e exci tin g th an ab ou nd, an d it is th to da y. e ev ol ut io n is ch an ge is ha pp en in g fa st m or e like a re , as cl in ic ia ns vo lu tio n. Po si ar e se ar ch in tiv e m ater ia ls , an g fo r st ate- of d eq ui pm en t -th e- ar t pr oc to ex pa nd th ed ur es , ei r tre at m en t H er e at M ed op tio ns an d M ar k, ou r sp of fe r be tte r pa ec ia lty pu bl ic tie nt ca re. at io ns , En do se ar ch gl ob al do nt ic, Im pl an t, ly fo r re le va nt an d O rth od on to pi cs , au th or tic Pr ac tic e s, op in io ns , co te ch no lo gy to nt in ui ng ed uc pr ov id e ou r re at io n, ca se st ad er s w ith a ud ie s, an d m ix of ed uc at sp ec ia lty pr ac io na l to pi cs ta tit io ne r au di en rg eted sp ec ifi ce. ca lly fo r ou r Re al izi ng th at ou r re ad er s ar e lo ng on te ch ar e in ve rs at ile no lo gy an d sh fo rm at s — co or t on tim e, ou m bi ni ng th e r pu bl ic at io ns be st th at pr in of fe r. Fo r ou r t pu bl ic at io ns ad ve rti se rs , an d th e In te rn w e co nt in ue to ex pa nd ou et ha ve to ed ge w ay s to r e- m ed ia op re ac h ou r sp po rtu ni tie s an ec ia lty au di en d of fe r cu tti ng ce th ro ug h in no va tiv e, hi gh qu al ity cu stom O ur st af f, ed pa ck ag es . ito ria l te am, an d in vo lve d an d kn ow le dg ho w ou r pu bl ea bl e Ed ito ria ic at io ns co nt in ue to gr ow l Bo ar d ar e pr in si ze an d sc ou d of ar e th ril le d to op e. sh ar e th e ne W e ar e co ns w op po rtu ni tie ta nt ly pr og re ss in g an d s th at aw ai t de th er e is an yt hi ng th at I ca nt al pr of es si on n do pe rs on al al s w ith ev er ly to as si st yo y is su e. If he si ta te to le u w ith yo ur co t m e kn ow. M m pa ny go al s, y am az in g te pl ea se do n’t am an d I ap pr ec ia te yo ur co nt in ue d su pp or Al l th e be st, t!

april 2014 American Association of Orthodontists (AAO) April 25-29 American Academy of Endodontists (AAE) April 30 – May 3, 2014 May 2014 California Dental Association meeting May 15 – 17 august 2014 ICOI Aug 21-23 septeMber 2014 AAOMS September 8-13 American Academy of Periodontolgy (AAP) September 19 – 22 OctOber 2014 ADA October 9 – 12 nOveMber 2014 AAID November 5-8 Greater New York Dental Meeting November 28 – December 3 DeceMber 2014 AAOMS Implant December 4-7, 2014

or F ro m t h e E d itEditor naging

Mali Schantz-Feld - Ma De ar Re ade rs:

and del vin g me ask ing que stio ns ’s pub lica tion s kee ps ark dM Me for ial tor Ma nag ing the edi US , and End odo ntic Ort hod ont ic Pra ctic e Imp lan t Pra ctic e US , of rs ade Re rs! we ava ilab le, and our for ans st cur ren t info rm atio n and hun ger for the mo dge wle kno for st ion ers , Pra ctic e US thir and enr ich the pra ctit — art icle s tha t nou rish t ugh tho for d foo e tea m stri ves to pro vid pra ctic es. the ir tea ms , and the ir iew ed art me nts and pee r rev s for our var iou s dep hor aut new for rch s We con tinu ally sea cal l or wri te to dis cus spe cia list s — Ple ase our esteem ed den tal To s. icle of w art kno CE us and clin ica l rs – ple ase let ert ise. To our adv ert ise ring you r clin ica l exp ut the pos sib iliti es of sha nt to offe r art icle s abo r pro duc ts and wh o wa you ed ent lem imp e hav a han ds- on the pra ctit ion ers wh o p-B y-S tep, tha t giv es our new col um n, Ste out eck Ch e. car tal imp rov ing den ts in act ion. per spe ctiv e of pro duc hon ore d to be ark fam ily, and we are erie nce for the Me dM exp g rnin lea a is day Eve ry acr oss the U.S . inv ited into off ice s all Be st reg ard s,

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implant

PROMOTING

EXCE

Top ten tips

Access cavities and canal location Dr. Tony Druttman

Results of retreated root canals with a methacrylate resin-based sealer Drs. Osvaldo Zmener and Cornelis H. Pameijer

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Endodontic Practice US is a highly regarded endodontic publication. EPUS is a bi-monthly publication that provides US clinicians with access to the most intriguing clinical cases and articles in the endodontic field.

Circulation & Frequency

Published 6 times per year and mails to 7,500 endodontists and GPs who are regularly performing endodontic techniques.

100% endodontic-focused publication

Number 1 advertising medium for companies looking to promote to endodontists and GPs with an interest in endodontics Continuing education articles and peer-reviewed clinical case studies

Reaching endodontists and GPs performing endodontic techniques

“What separates Endodontic Practice US is the team’s search for the truth, challenge to the status quo, and developing a family that believes, ‘All for one and one for all.’ EP leaves no one behind. They teach the leaders of the future. It takes a village, and EP’s got it. Please consider that reading EP may be your fastest track to finding the dental practice of your dreams. ” John West, DDS, MSD

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Established as one of the leading endodontic clinical journals in the United States

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Product Profiles If you are launching a to describe the release Practice Profiles Nominate one of your article.

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March/April 2013 – Vol 6 No 2

Aribex acquired by the KaVo Group

Top ten tips

Access cavities and canal location Dr. Tony Druttman

Results of retreated root canals with a methacrylate resin-based sealer Drs. Osvaldo Zmener and Cornelis H. Pameijer

Maxillary premolars with three canals Drs. Keith Plain, Stephen Clark, Ricardo Caicedo, and Joseph Morelli

Practice proﬁle Dr. Wyatt Simons Involved and impactful

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PROMOTING

ENDODONTICS

New instruments for root canal negotiation and preparation

Top ten tips

Drs. Peet van der Vyver and Casper Jonker

Magnification and illumination Dr. Tony Druttman

Long-term treatment of root fractures

n November 2012, Aribex, a worldwide leader in portable and handheld X-ray products, was acquired by the KaVo Group, an affiliation of leading global dental equipment brands. Aribex, best known for the NOMAD™ handheld and portable X-ray systems, will continue to be the center of excellence for the portable X-ray business. Handheld and portable X-ray systems are the fastest growing segment in intraoral Xray systems, and Aribex’s innovative products are supported by strong patents, intellectual property, and a robust new product pipeline. Aribex NOMAD X-ray systems are now used in clinical, remote, and mobile facilities throughout the world, from professional offices to humanitarian missions. The NOMAD significantly decreases costs 54 Endodontic practice

and provides hundreds of safe, high-quality images on a single battery charge. “We are thrilled to be joining forces with the KaVo Group, a world class dental organization that shares common values and a passion for future success. The KaVo Group combines over 500 years of dental experience with leading global brands and will certainly bolster Aribex’s ability to further accelerate the adoption of handheld X-ray technology,” says Ken Kaufman, President of Aribex. The KaVo Group consists of marketleading brands such as KaVo, Gendex, DEXIS®, i-CAT®, Instrumentarium, SOREDEX, Pelton & Crane, and Marus. With the acquisition of Aribex, the KaVo Group will reinforce its global imaging

footprint and commitment to marketleading innovation. “We enthusiastically welcome the Aribex team and look forward to further acceleration and expansion of the portable X-ray market,” says Henk van Duijnhoven, Senior Vice President, Dental. “The synergies across our platform are immense from integrated R&D, advances in workflow, technology integration, and a passion to advance the quality of care that our health care providers deliver. We also share a passion for serving our dealer partners with excellence.” EP

CBCT within endodontics: an introduction

Drs. Jozef Mincík and Marián Tulenko

Dr. Navid Saberi

Corporate profile Coltene: Growth helps fund innovation

Practice profile Dr. John R. Hughes

ORTHOPHOS® XG 3D

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• Visualize canal anatomy prior to treatment • MARS for better diagnosis around metal • Easy patient positioning

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Aribex, the leader in portable X-ray technology, joins the KaVo Group’s portfolio of dental brands

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This information was provided by the KaVo Group.

Volume 6 Number 1

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CASE REPORT

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Exclusive custom packages available upon request. All rates quoted are net. 15% additional positioning charge added to all premium positions inside publication. This includes pages opposite Table of Contents and any specific page requests for placement at any time. All premium positions must commit to a 1-year contract, which is noncancellable.

Figure 6: Working length X-ray showing three separate canals 9A

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ts and

for that They t. nding

S, MSD

Figure 10: A 1-year follow-up X-ray reveals healthy periapical tissue

files allowed for rapid preparation of a glide path while minimizing hand fatigue. The preparation of a glide path reduces change to the natural curvature of the canal with subsequent mechanical shaping of the canal by reciprocation (Bertutti, et al., 2012). The GuttaCore carrier based obturation technique allows for the movement of warm gutta percha three-dimensionally into all areas of the properly shaped root canal system (Gutmann, 2011). A meticulous assessment of multiple angled radiographs, the use of magnification, illumination, adequate access cavity preparation, and the awareness of possible anatomic variations can aid the clinician in the treatment of multi-rooted maxillary second premolars. EP REfEREncEs Berutti E, Paolino DS, Chiandussi G, et al. Root canal anatomy preservation of WaveOne reciprocating files with or without glide path. J Endod. 2012;38:101-104. Cantatore G, Berutti E, Castellucci A. Missed anatomy: frequency and clinical impact. Endod Topics. 2009;15:3-31. Gutmann JL. The future of root canal obturation. Dent Today. 2011;30(11):128,130-1. Holland GR, Walton RE. Diagnosis and treatment planning. In: Torabinejad M, Walton RE, eds. Endodontics Principles and Practice, 4th ed. St. Louis, MO: Saunders Elsevier; 2009:68-93. Kartal N, Özçelik B, Çimilli H. Root canal morphology of maxillary premolars. J Endod. 1998;24(6):417-419. Kirkevang LL, Horsted-Bindslev P. Technical aspects oftreatment in relation to treatment outcome. Endod Topics. 2002;2:89-102. Pecora JD, Sousa Neto MD, Saquy PC, Woelfel JB. In vitro study of root canal anatomy of maxillary second premolars. Braz Dent J. 1992;3:81-85. Schilder H. Cleaning and shaping the root canal. Dent Clin North Am. 1974;18:269-96. Sieraski SM, Taylor GN, Kohn RA. Identification and endodontic management of three-canalled maxillary premolars. J Endod. 1989;15(1):29-32. Vier-Pelisser FV, Dummer PMH, Bryant S, Marca C, So´ MVR, Figueiredo JAP. The anatomy of the root canal system of three-rooted maxillary premolars analyzed using high-resolution computed tomography. Int Endod J. 2010;43:356-362. Yoshioka T, Villegas JC, Kobayashi C, Suda H. Radiographic evaluation of root canal multiplicity in mandibular first premolar. J Endod. 2004;30:73-74.

No 4

24 Endodontic practice

Volume 6 Number 3

EXCELLENCE

ENDODONTICS

Top ten tips

Endorsed article reprints are available to contributing key opinion leaders (KOLs) and clients interested in supplementing their own marketing needs.

Tip irrigation in endodontics Dr. Tony Druttman

Ultrasonics in orthograde endodontics

Dr. Sanjeev Bhanderi

ProTaper Next: a clinical study Dr. Edmond Koyess

Editorial Added Value

atures,

to either side of the canal wall. Figure 8 that all symptoms had subsided. Following shows the pulp chamber after all canals anesthesia and rubber dam application, were obturated. The access cavity was the temporary filling was removed. The etched and restored with Spectrum® SDR® canals were flooded with 17% EDTA and agitated with the EndoActivator to remove and TPH® spectrum composite (Dentsply), the calcium hydroxide dressing. The canals and the patient was referred back to were gauged with a size 25 K-file (Dentsply his dentist for an overlay to protect the Maillefer), and it was snug at the apex of cusps. A follow-up X-ray at 1 year revealed ® all three canals. The GuttaCore (Dentsply radiographically healthy periradicular tissues (Figure 10), and the patient was Tulsa Dental Specialties) size 25 verifier reminded that a coronal restoration with file was placed in each canal to verify easy cuspal coverage would be needed. placement and passage of the GuttaCore obturator. The canals were irrigated with 3% sodium hypochlorite, the irrigant Discussion agitated, and then the canals dried. Three rooted premolars are a challenge to ® A small amount of AH Plus sealer identify and treat, and a lack of knowledge of the internal anatomy of maxillary (Dentsply) was placed with a paper point premolars with three root canals may lead in the coronal third of the mesiobuccal to failure of root canal treatment (Viercanal; a paper point trimmed to orifice Pelisser, et al., 2010). When the two buccal level was placed in the distobuccal canal, canals arise from a common narrow canal, and then, the GuttaCore obturator was access is restricted to each canal, and this placed in the dedicated heating oven, and gives rise to an S-shaped canal curvature the mesiobuccal canal was obturated. The (Sieraski, Taylor, Kohn, 1989). Modifying obturator was sectioned off at orifice level the access to a T-shape and troughing the using a Thermacut® bur (Dentsply Maillefer) buccal overhang of dentin allow straightline and then a Machtou plugger (Dentsply access to the buccal canals. Maillefer) used to apply condensation The Start-X 1 and 3 ultrasonic pressure to the obturator at orifice level. The tips (Dentsply) facilitate this step with excess gutta percha over the distobuccal conservative removal of dentin in the orifice was removed by engaging the narrow confines of the premolar pulp paper point with a size 40 Hedstroem file chamber, and the non-end cutting tip of (Dentsply Maillefer) and removing it from the Start-X 1 ultrasonic tip helps to leave the canal, thereby allowing easy placement the pulp chamber floor map intact and of the subsequent GuttaCore obturator in reduces the risk of perforating the pulp the distobuccal canal. floor. The occlusal can also be reduced to The distobuccal and palatal canals facilitate visibility and access, and to the were obturated in the same manner as articles • management advice practice profiles technology reviews orifices of the • canals. described for the first canal, but the•handle The PathFiles series of2013 nickel-titanium of the carrier was removed by bending it August/September – Vol 6

PROMOTING

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Figure 8: View of pulp chamber after obturation

Figures 9A, 9B and 9C: The different angled postoperative X-rays; note the S-shaped curvature of the DB root and material adaptation to the canal walls

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Figure 7: EndoActivator (Dentsply) in use for agitation of irrigants

Corporate profile

Practice profile

TDO Software

Dr. Anthony Horalek

Extend your reach and participate in one of our added-value programs. Corporate Profiles Feature your company in a 3-4 page article, exclusive position—only one per issue. Product Profiles If you are launching a new product, our full-page product profile is perfect to describe the release in detail. Practice Profiles Nominate one of your KOLs, and his/her office will be presented in a feature article. Industry News Use a full page of added-value editorial to let readers know what is new with your company.

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DIARY

lllllllllllllllllllllll OF EVENTS llllllllllllllllllllllllllllllllllllllllllllllllllll

Endodontic Techniques for Safe & Predictable Results Dr. Barry Lee Musikant & Dr. Allan S. Deutsch January 11-12, 2013 March 1-2, 2013 South Hackensack, NJ www.essentialseminars.org

Southwest Dental Conference January 17-19, 2013 Dallas, TX www.swdentalconf.org

Ultradent Cancún 2013 Dr. John Flucke & Shannon Pace Brinker January 27-February 1, 2013 Cancún, Mexico www.ultradent.com

Yankee Dental Congress January 30-February 3, 2013 Boston, MA www.yankeedental.com

Current Scientific Evidence in Endodontic Therapy Troy McGrew February 8, 2013 Showshoe, WV www.tulsadentalspecialties.com

Volume 6 Number 1

“Endo-Practice is an inspirational journal. Each article leaves the reader with a level of care, expertise, spirit and passion to elevate their delivery of care at a higher level. Patients benefit! Overall, one walks away from each issue, with superior clinical focus.” Louis E. Rossman D.M.D. Pres-Elect, the Foundation of the Amer. Assoc. of Endododntists Diplomate, American Board of Endodontics

endopracticeus.com

Chicago Dental Society Midwinter Meeting February 21-23, 2013 Chicago, IL www.cds.org/mwm

The 81st Annual Nation’s Capital Dental Meeting March 7-9, 2013 Washington, DC www.dcdental.org/capmeet.asp

UDA Convention February 28-March 1, 2013 Salt Lake City, UT www.uda.org/convention.php

Big Apple Dental Meeting March 13-14, 2013 Mahwah, NJ bigappledentalmeeting.us

Current Scientific Evidence in Endodontic Therapy Dr. Sergio Kutter March 2, 2013 Portland, OR www.tulsadentalspecialties.com

ADEA Annual Session & Exhibition March 16-19, 2013 Seattle, WA www.adea.org/Secondary. aspx?id=13859

Pacific Dental Conference March 7-9, 2013 Vancouver, BC www.pdconf.com/cms2013

The 101st Thomas P. Hinman Dental Meeting March 21-23, 2013 Atlanta, GA www.hinman.org

Star of the South Dental Meeting March 7-9, 2013 Houston, TX www.starofthesouth.org

Endodontic practice 53

Endodontic Practice US

clinical articles • management advice • practice profiles • technology reviews

INDUSTRY NEWS s • technology reviews January/February 2013 – Vol 6 No 1

Implant Practice US is dedicated to the fastest-growing sector in dental treatment. It contains high-quality practical continuing education and case studies aimed at keeping clinicians up to date with all the latest issues and challenges facing implantology.

Circulation & Frequency

Published 6 times per year and mails to 10,000 specialists who are placing and restoring implants.

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100% implant-focused publication Reaching top US implant dentists including oral surgeons, periodontists, prosthodontists, and GPs placing implants Established as a highly regarded clinical journal in implant dentistry

Extend yo

“Implant Practice US, contains quality articles that are timely with clinical relevance to both the specialist and general practitioner. Additionally, the print quality and paper used sets this publication at the top of dental publications ”

Gregori M. Kurtzman, DDS, MAGD, FPFA, FACD, FADI, DICOI, DADIA

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March/April 2013 – Vol 6 No 2

August/September 2013 – Vol 6 No 4

PROMOTING EXCELLENCE IN IMPLANTOLOGY

ROXOLID® FOR ALL THREE INNOVATIONS

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Preventing the dreaded black triangle during implant placement in the esthetic zone: part 1 Dr. Scott M. Blyer

Practice profile

Dr. Coury Staadecker

Corporate profile Henry Schein Dental Surgical Solutions

Corporate profile Straumann

Minimally invasive crestal approach technique for sinus elevation ■ ■ ■

Trabecular Metal™ implants from orthopedics to dental implantology

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Drs. Ziv Mazor, Andreas Ioannou, Narayan Venkataraman, George Kotsakis, and Udatta Kher

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Designed to increase your treatment options and help to increase patient acceptance of implant therapy.

Dr. Nikos Donos

Dr. Suheil M. Boutros

Dr. David Feinerman

The evolution and advancement of dental implants Drs. Robert J. Miller and Randi J. Korn

Treatment planning of implants in the esthetic zone: part three Drs. Sajid Jivraj, Mamaly Reshad, and Winston Chee

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CASE STUDY

Incorporating state-of-the-art and science to provide stability and excellent esthetic results in implant dentistry

Dr. Robert C. Vogel illustrates how a patient with limited buccal bone and interradicular space benefitted from a narrow diameter implant

ncorporating the latest developments in implant dentistry into practice may result in increased security and less aggressive surgical techniques with long-term stability and excellent esthetics. The case below illustrates the use of a Straumann® Roxolid® narrow diameter implant with improved strength* and osseointegration with prosthetic flexibility through the use of a CAD/CAM zirconia abutment. Limited buccal bone and interradicular space necessitated the use of a narrow diameter implant such as the Straumann Bone Level Ø3.3mm Roxolid Implant. The biologic advantage of a platform shift allows for maintenance of crestal bone levels and maintenance of the soft tissue. The strength of this implant (titanium alloyed with zirconium) allows for increased thickness of the abutment at the level of connection resulting in the ability to use a CAD/CAM all zirconia abutment not previously feasible with other small diameter implants. The use of a zirconia abutment in the case presented here addresses the high esthetic demands of a patient with a high smile line, thin tissue type, and high scalloped architecture. Combining the

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Figure 1: Healthy 18-year-old female with congenitally missing lateral incisor. Orthodontics was necessary to correct severe root convergence of adjacent teeth

Figure 2: Temporary abutment and provisional restoration in place 6 weeks after implant placement for “provisional guided tissue conditioning”

Figure 3: Esthetic evaluation of provisional restoration 3 weeks after insertion Figures 4A and 4B: Straumann® CAD/CAD zirconia abutment for Bone Level Ø3.3mm Roxolid® Implant

Figure 5: Abutment and lithium disilacate (IPS e.max®) crown ready for delivery shown on Bone Level NC (Narrow CrossFit®) analog Robert Vogel, DDS, graduated from the Columbia University School of Dental and Oral Surgery in New York City, New York; upon graduation, he completed a combined residency program in Miami, Florida at Jackson Memorial Hospital, Mount Sinai Medical Center, and Miami Children’s Hospital. He maintains a full-time private practice in implant prosthetics and reconstructive dentistry in Palm Beach Gardens, clinical Florida. articles • management advice • practice profiles • technology reviews He works closely as a team member with several specialists providing implant-based comprehensive Figure 7: Final restoration in place 2013 – Vol 6 January/February treatment, as well as conducting clinical trials and providing clinical advice to the dental attachment and implant fields. Dr. Vogel has developed and collaborated SLActive® surface for reduced healing on the development of several prosthetic components and techniques currently in use in implant dentistry. He times with a narrow diameter for decreased lectures internationally on implant dentistry, focusing on grafting needs, along with a platform shift simplification, confidence, and predictability of implant design, all allow for more conservative prosthetics through ideal treatment planning and team interaction. Dr. Vogel continues to publish scientific treatment in the difficult esthetic situation. articles on implant dentistry, and is a Fellow of the The ability to incorporate these biologic International Team for Implantology (ITI).

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Figure 6: Delivery of final abutment to 35Ncm

Figure 8: Twenty-six-month post-op radiograph noting no change in bone levels and stable implant/abutment connection

No 1

and mechanical advantages with an all

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zirconia CAD/CAM abutment allows for precise angulation, emergence, and margin placement with an esthetic advantage over titanium or gold abutments. IP *Norm ASTM F67 (states minimum tensile strength of annealed titanium); data on file.

16 Implant practice

Volume 6 Number 3

The Most Efficient Clinical Workflow in Dentistry

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i-CAT® FLX — the latest advancement in Cone Beam 3D For greater flexibility in scanning, planning, and treatment i-CAT award-winning cone beam 3D dental imaging has already gained a wide reputation for image quality, patient safety, and smooth workflow. In the field of implantology, 3D scanning helps to increase surgical predictability and facilitate precise implant placement. i-CAT scans show true anatomy in full 3D volume and high-resolution individual slices for accurate measurement of bone thickness and alveolar nerve location. With the precise data gathered from viewing an i-CAT scan and utilizing proprietary software tools, clinicians can map an entire course of treatment from surgical placement of the implant and abutment, all the way to final restoration. Practitioners can obtain a more thorough analysis of bone structure and tooth orientation, and as a result, treat patients with greater confidence. Developed on the foundation of i-CAT excellence, the new i-CAT FLX cone beam 3D system offers a range of innovative features for greater clarity, easeof-use, and control. Practitioners can take advantage of these dynamic tools: • Visual iQuity™ advanced image technology delivers i-CAT’s clearest 3D and 2D images • Full dentition 3D imaging at a dose lower than a 2D Panoramic X-ray with QuickScan+* • Ergonomic Stability System (ESS) offers seated positioning, robust head stability, and adjustable seating controls to minimize patient movement and reduce the need for retakes. The unit is also wheelchair accessible • i-Collimator electronically adjusts the field-of-view to limit radiation only to the area of scanning interest. • The i-CAT FLX offers a lower radiation dose than a panoramic X-ray • i-PAN™ produces traditional 2D panoramic images SmartScan STUDIO also works toward more clinical control by providing an easy, customizable solution for a more guided, controlled workflow in the dental practice. With its easy-to-use, touchscreen interface, and integrated acquisition system, SmartScan STUDIO offers step48 Implant practice

by-step guidance, allowing the clinician to select the appropriate scan for each patient at the lowest acceptable radiation dose. In addition to all of the clinical advantages, the small footprint of the i-CAT FLX also allows it to fit easily and seamlessly into any practice. Of course, the i-CAT FLX also includes Tx STUDIO™ technology that is an integral part of all i-CAT cone beam 3D systems, which are known for their clinical and dose control, as well as the fastest workflow. Tx STUDIO leverages the best in anatomy imaging software and cone beam 3D technology that benefits a gamut of specialties, from diagnostics to implant and orthodontic treatment planning. Using the software in conjunction with scans, practitioners can virtually place single or multiple implants from an extensive implant library that takes the guesswork out of planning, and also conveniently order surgical guides from all leading surgical guide providers through the Tx STUDIO software. These software tools facilitate communication with other clinicians, and help dentists educate patients about their dental conditions, improving the possibility of case acceptance.

i-CAT continues to revolutionize 3D dental and maxillofacial radiography, with the launch of the new i-CAT FLX. IP About Imaging Sciences International Since 1992, Imaging Sciences International has been an innovator in advanced dental imaging, specifically with i-CAT cone beam technology. i-CAT solutions have been installed in more than 3,000 sites around the world. Imaging Sciences offers highly specialized service and support through the i-CAT Network and continuing education through the 3D Imaging Institute, the only entity of its kind dedicated to helping dentists and specialists use the latest in cone beam technology. * Data on file. Based on the number of scan options currently available at time of printing. For more information on the i-CAT FLX or other i-CAT products, visit: http://www.i-cat.com/ This information was provided by Imaging Sciences International.

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ORTHODONTICS

Incorporating TADsupported Haas expansion into everyday practice

BioDigital Orthodontics: Diagnopeutics with SureSmile technology: part 3

Drs. Ryan K. Tamburrino and Shalin R. Shah

Dr. Rohit C.L. Sachdeva

Figure 12: Post-orthodontic view of the patient’s smile after debonding

Figures 13 and 14: Immediate post-orthodontic TruDenta Scans demonstrate that the patient achieved significantly lessened anterior prematurity

Figure 15: Following an initial equilibration, a force analysis was performed

A new regimen of Phase I care applied to potential maxillary canine impactions Dr. John Hayes

or headaches, and an incredibly positive experience with her treatment.

Corporate proﬁle

Conclusion

Ormco

Figures 16 and 17: After the initial equilibration, a TruDenta scan was also performed while the patient was clenching

drugs or needles. Many dental practices offering the TruDenta pathway to care — including orthodontic practices — have reported that, within a 10- to 12-week period, their patients experienced lifealtering relief from their chronic pain. Additionally, it now gives us the ability to properly balance our finished orthodontic

cases like never before. The combination of SureSmile virtual diagnostic and robotic treatment, and TruDenta force value detailing finally gives us the tools to perfectly finish our cases for maximum stomatognathic function and stability. It’s a dream that has finally become a reality. OP

RefeRences 1. Junge D. Oral Sensorimotor Function. Medico Dental Media International, Inc.: 1998. 2. Sessle BJ. Mechanisms of oral somatosensory and motor functions and their clinical correlates. J Oral Rehabil. 2006;33(4):243-261. 3. Okeson JP. Management of Temporomandibular Disorders and Occlusion. 6th ed. St. Louis, Mo: Mosby; 2008. 4. US News Health. Headache. US News and World Report. 2006. http://health.usnews.com/healthconditions/brain-health/headache. Accessed July 3, 2012.

5. Adults. National Institute of Dental and Craniofacial Research Web site. http://www.nidcr.nih.gov/ DataStatistics/ByPopulation/Adults. Accessed December 7, 2012. 6. Migraine. National Headache Foundation Web site. http://www.headaches.org/education/Headache_Topic_ Sheets/Migraine. Accessed July 3, 2012. 7. Ostler GL. Building professional referral relationships with physicians. Dental Economics. 2012. http://www.dentaleconomics.com/articles/print/ volume-96/issue-12/features/building-professionalreferral-relationships-with-physicians.html. Accessed July 3, 2012.

8. Sardella A, Demarosi F, Lodi G, Canegallo L, Rimondini L, Carrassi A. Accuracy of referrals to a specialist oral medicine unit by general medical and dental practitioners and the educational implications. J Dent Educ. 2007;71(4):487-491.

*Data on file.

With the acceptance and incorporation of a comprehensive assessment and treatment system, orthodontic practices have the opportunity to expand the scope of services they provide to patients looking to resolve the TMJ/D and head pain issues associated with dental force related problems. The proprietary TruDenta system, which incorporates assessment devices and therapeutic technology derived from sports medicine, uniquely empowers orthodontists to offer a proven, long-term solution and customized pathway to care for DMSMD-related conditions. Treating patients with TruDenta is straightforward; treatments are simple, quick, effective, painless, and require no

Practice proﬁle Dr. Mark Reynolds

Learn more on page

14 Orthodontic practice

Objective: The purpose of this pilot study was to evaluate a new regimen of Phase I care applied to potential maxillary canine impactions. Materials and Methods: The data were drawn from the Williamsport Orthodontic Study, which is part of the University of Pennsylvania, School of Dental Medicine, Orthodontic Department’s practice-based research network (PBRN). Ten cases were evaluated (20 canine impactions), all of which underwent a new regimen of “Phase I only” care. All patients were diagnosed as maxillary deficient based on Harmony criteria and also based on the center of alveolar crest (CAC) measurement technique, both of which were previously reported. Results: A new regimen of Phase I care may be helpful for potential canine impactions. Conclusions: Early Phase I diagnosis and RPE correction of maxillary transverse deficiency, by way of Harmony criteria and the CAC measurement technique, may be helpful for potential maxillary canine impactions. More study is recommended with control and treatment groups matched for maxillary deficiency determined by Harmony criteria and measured by the CAC technique.

ORTHODONTICS

John L. Hayes, DMD, MBA, received an AB and MBA from the University of Michigan. After graduating from the Boston University H. M. Goldman School of Dental Medicine, he completed his orthodontic residency at the University of Pennsylvania where he is a Clinical Associate in the Department of Orthodontics. Dr. Hayes is on the Editorial Review Board of Orthodontic Practice US. He continues to research and lecture on the advantages of early interceptive treatment and on the etiology of malocclusions. Dr. Hayes is in private practice in Pennsylvania, with his wife, Sharon, who is also an orthodontist.

The molar to molar corrector Dr. Bill Dischinger

BioDigital Orthodontics: part 2 Dr. Rohit C.L. Sachdeva Figure 1

Upper airway obstruction - poor function becomes poor form Dr. Bradford Edgren

Avoiding employment claims and lawsuits Eilene Verret and Gibson Pratt Figure 2

Figure 3

measurement.1-8 However, even with early detection, prevention of impacted canines has been uncertain. The extraction of primary canines has been recommended.7, 9-11 However, extraction has not been a significant advantage over no extraction.12 The supplemental use of space gaining cervical pull headgear has been shown to be more effective than primary canine extraction alone.12 Maxillary expansion for space gaining for prevention may not be warranted if the maxilla is deemed sufficient by some criteria. It should be fair to say that the particular criteria used to diagnose a deficient maxilla will determine whether or not a maxillary deficiency is deemed to exist. Accordingly, there can easily be disagreement regarding the need for

maxillary transverse treatment.13-17 The purpose of this pilot study was to evaluate a new regimen of Phase I care applied to potential maxillary canine impactions. This manuscript suggests a new method of diagnosis of a transverse deficient maxilla. Specific treatment is then directed in a new regimen of Phase I care to normalize the maxilla and gain intra-arch Harmony.

44 Orthodontic practice

10. TruDenta. http://www.trudenta.com. Accessed January 22, 2013.

EXCELLENCE

Abstract

Helpful intervention for potentially impacted canines is problematical. Most researchers recommend early detection by way of palpation and/or films and/or dental cast

• PROMOTING

Dr. John Hayes outlines a study of canine impactions to evaluate a regimen of Phase I care

Introduction

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9. Dentists: Doctors of Oral Health. American Dental Association Web site. http://www.ada.org/4504.aspx. Accessed July 3, 2012.

A new regimen of Phase I care applied to potential maxillary canine impactions

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•

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Figure 12: Post-orthodontic view of the patient’s smile after debonding

March/April 2013 – Vol 4 No 2

RESEARCH

• Faster clinical workflow with Ortho template and “Quick Shot” mode • Unprecedented image clarity with ASTRA for 2D images • Automatic positioning for 2D pan

PROMOTING Figure 11: View of the post-orthodontic radiograph following treatment with three prescription wires

clinical articles • management advice • practice profiles • technology reviews

Orthodontic Practice US

CLINICAL

3D imaging for lower dose than a 2D panoramic * is not magic …it’s

May/June 2013 – Vol 4 No 3

Practice profile Dr. Juan-Carlos Quintero

Materials and methods

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The “Phase I only treatment–no braces” Williamsport Orthodontic Study (WOS) provided the patients. The WOS is part of the University of Pennsylvania School of Dental Medicine, Orthodontic Department’s practice based research network (PBRN).13 The WOS was a 10-year retrospective and Volume 4 Number 3

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Figures 8A-8D: A. Evaluation of global position of the VTM against the frontal facial photograph and the (B) lateral cephalogram. C and D. Bite registration of the VTM is validated against the respective intraoral photographs

Table 3: SVTME Matrix demonstrating the range of model registrations that can be performed to. These registrations may be used as communication aids and also to evaluate treatment response and doctor performance

very difficult to objectively assess measured tooth displacement by clinical inspection. Using simulations to move teeth to a target and acquiring measures about specific points and fixed references provides a reliable method to measure displacement. An example of this is shown in Figures 9F and 9G.

to detect subtle discrepancies in the malocclusion using the following principles: i. Dynamic visualization: It must be noted that the 3D images are displayed on a 2D flat screen. Therefore, to develop a 3D visual sense of the model, it is imperative that it is viewed from multiple perspectives so that the hidden features are recognized. An example demonstrating the detection of a subtle rotation in patient K.S. is shown in Figure 9. ii. Feature facilitated diagnosis: Because of the artificial lighting and difficulty in sensing 3D morphology on the teeth, it is important to reduce the feature sets to simple points or line-based landmarks for ease of evaluation. This is shown in Figure 9E. iii. Simulation guided diagnosis: It is

Comparative and predictive analysis/ communication In the virtual world, the ability to register different models by best fit registration allows the doctor to evaluate treatment outcomes effectively as well as readily. Table 3 shows the matrix of the various possibilities of model registration included in the SVTME methodology. Figure 11A demonstrates the original planned treatment for patient K.S.1 (the Virtual Diagnostic Simulation superimposed on the Virtual

Figures 9A-9G: A. Lower occlusal photograph of patient K.S. Note the rotation on the LR 2 cannot be identified. B. Also, it is not visible on the VTM when visualized from a perspective similar to that of the photograph. C. It is difficult to visualize the rotation on the LR2 with a closeup view D. when the perspective of the VTM is changed (Dynamic Visualization), the ML rotation on the LR2 is seen. E. By displaying the feature (Feature Facilitated Diagnosis) points (in this situation the incisal edges), the rotation becomes very obvious. F. The magnitude of rotation can be measured by calculating the amount of displacement required to correct the position of the tooth which is G. 14 degrees (Simulation Guided Diagnosis)

Figure 10: SureSmile has many additional tools to aid the orthodontist in diagnosis. A. Features such as the marginal ridges are automatically identified for viewing B. The electronic articulating paper can be used to identify the interarch contact relationships

Diagnostic Model). Progress in care can be evaluated by superimposing the Virtual Diagnostic Model (VDM) to the Virtual Therapeutic Model (VTM). The VDM to VTM registration finds great use in understanding how well the reactive segments have been managed (Figure 11B). Furthermore, it provides an invaluable visual aid to communicate with the patients and the referring doctor regarding treatment progress. Displacement values (Figures 11C and 11D) or resolution of the ABO discrepancy index are useful measures to provide a semi-qualitative analysis to assess treatment progress (Figure 11E). The virtual diagnostic 12-DGAC-142, Visionary Cover Banner OP FA.pdf 1 12/20/12 2:43 PM simulation (VDS) can also be registered to the VTM, and this is useful to the clinician in assessing how close his clinical articles • management advice • practice profiles • te initial treatment goals are adhered January/Febr to during the course of treatment and if any mid-course corrections in

ORTHOPHOS XG 3D The right solution for your diagnostic needs.

22 Orthodontic practice

Orthodontic Practice US

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Figures 7A-7C: A. Checklist for evaluating the Virtual Therapeutic Model (VTM) for patient K.S. B and C. As one goes through the checklist, matched images are displayed for the doctor to evaluate

Volume 4 Number 2

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Implantologists

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Editorial Added Value

Orthodontists will benefit from highquality pan and ceph images for optimized therapy planning.

will enjoy instantly viewable 3D volumetric images for revealing and measuring canal shapes, depths and anatomies.

will appreciate the seamless clinical workflow from initial diagnostics, to treatment planning, to ordering surgical guides and final implant placement.

General Practitioners will achieve greater diagnostic accuracy for routine cases.

ORTHOPHOS XG 3D

BioDigital Orthodontics: Planning care with SureSmile technology: part I

“With my Sirona 3D unit, I can see the anatomy of canals, calcification, extent of resorption, fractures, and sizes of periapical radiolucencies, all of which influence treatment plans for my patients. Combine that with the metal artifact reduction software that reduces distortions from metal objects, my treatment process is a lot less stressful. My patients benefit from the technology and my referrals appreciate the value.” ~ Dr. Kathryn Stuart, Endodontist - Fishers, Indiana

Dr. Rohit C.L. Sachdeva

Complete Clinical Orthodontics: treatment mechanics: part 1

The advantages of 2D & 3D in one comprehensive unit ORTHOPHOS XG 3D is a hybrid system that provides clinical workflow advantages, along with the lowest possible effective dose for the patient. Its 3D function provides diagnostic accuracy when you need it most: for implants, surgical procedures and volumetric imaging of the jaws, sinuses and other dental anatomy.

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Figure 1: Simulated canal injected with ink

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“Orthodontic Practice US provides orthodontic clinicians with a publication that has the most current topics presented in a clear and inviting format with unsurpassed graphics and illustrations that make it a delight to read and will ultimately benefit our patients.”

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Hector’s story Dr. Mark Reynolds tells about the many people involved in bringing this novel case to its happy conclusion

he first time I heard anything about Hector was from my dentist who knew both his family and him. She had referred them to our chapter of Smile for a Lifetime and suggested that he apply. When his application arrived, I was somewhat prepared, but shocked to see both the complexity of his case and his passion and heart. Hector has agenesis, the absence of permanent teeth, and is missing 10 teeth. When a primary tooth would fall out, there was nothing to replace it. This left him with many gaps, oddly shaped teeth, and holes where teeth were absent. And while he was definitely self-conscious about his smile, he didn’t act like a victim or have any less passion for life. “When the dentist told my mom the first time that I had agenesis, it was in my presence. I felt so sad that I cried all the way back home. I was 7 years old and did not understand why that was happening to me. I prayed for months asking God to let my teeth grow,” said Hector on his application. Although Hector definitely had significant need, our board initially declined his application due to the complexity of his case. We knew we could put braces on him, but he needed so much more to make his smile. We used the next quarter to investigate resources and to determine what we could provide to him beyond the braces. After meeting Hector face to face, we learned that he is missing 14 of his permanent teeth, and several of the teeth that he does have are either small or misshapen. Our initial treatment plan was to close the gaps in his upper arch mesially, to the extent possible with his undersized teeth, and replace his missing premolars with four implants. His mandibular arch required not only the replacement of his premolars but also his central incisors. I met with Dr. Luis Benitez, a local periodontist. He was excited about the case. He mentioned to me that he had wanted to get involved in some pro bono work but found it difficult to identify where he could use his specialized skills. Hector provided him with a need within his 52 Orthodontic practice

specialty as well as a significant challenge. Amazingly, Dr. Benitez worked with Astra Tech, and they graciously agreed to provide all 10 of the implants that Hector will need once we are able to position his existing teeth properly. In addition, Dr. Ed Martinez, a prosthodontist, and the lab that he works with, have volunteered their services to restore the implants as teeth once a proper time for healing has passed. By the time Hector is finished, he will have received more than $50,000 in dental care, but I am confident his smile will look like a million bucks! “Now I am grown,” says Hector, “but I still believe in miracles. I believe that people like you are used by God to make those miracles, and make this possible with people like me. Currently, I am in a relationship, and I would like to be and feel more comfortable and confident with myself.” It has been amazing to see Hector’s smile change, but more significant is the change I have seen in him. When he first came to my office, his mother brought many pictures of him throughout his childhood. What started as a happy, smiling boy quickly turned into a child who smiled without showing his teeth, and the twinkle in his eye slowly disappeared as he grew older. Even with only the initial alignment of his teeth, that twinkle has returned. Hector has graduated from high school and is in the dental assisting program at our local community college. He plans to continue to hygiene school and possibly pursue dental school. He married a wonderful girl and has many, many reasons to show off the smile that is constantly improving. Smile for a Lifetime offers a wonderful structure to provide care to those in our community who really need it but are without the resources to make things happen on their own. Cases like Hector’s have also provided a way to work with other dental professionals for the good of a common patient. By the time we reach the end of Hector’s treatment, at least six dental professionals will have worked together on this case. We have truly

banded together, and the results are visibly life-changing.

Dr. Luis M. Benitez, periodontist, tells his chapter of Hector’s story Partial anodontia or oligodontia is a condition characterized by the partial absence of certain permanent teeth, which could include one or both of the jaw bones. As a consequence of having undeveloped teeth, these patients frequently suffer from malpositioned teeth and underdeveloped bone where the tooth is supposed to erupt. The latter is mainly due to the lack of “bone stimulus” during the tooth bud development. Since this condition is frequently diagnosed during childhood, it becomes imminent to involve several dental specialists who will focus not only on tooth alignment, but also in the adequate tooth replacement. Following orthodontic treatment, the missing teeth need to be replaced in order to maintain the arch integrity and a balanced bite during adulthood. As a periodontist, my involvement requires the reassessment of the bone of the empty spaces to determine what kind of treatment best suits the patient’s condition to replace his teeth. I have evaluated Hector, and he will require some bone regeneration to accept dental dental implants, which are considered the gold standard in these cases. I will donate the regenerative materials and the time involved to deliver the implants that were donated by Astra Tech. Once the implants heal, Dr. Ed Martinez will be the one in charge of restoring the implants with crowns as the final restoration. OP

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Publication Departments Continuing Education – Peer-reviewed educational articles on a wide variety of pertinent, timely topics, offer 2 hours of CE per article. Paid subscribers who obtain a passing score on the accompanying quiz receive a certificate of completion. Clinical Articles – Peer-reviewed clinical articles cover new techniques, technologies, and products. Detailed case reports with large clinical images walk the reader through the steps of successful cases. Corporate Profiles – In-depth features focus on what makes dental manufacturers and technology companies unique and successful. This four-page section provides readers with interesting insights on the history, innovations, and product offerings from the industry’s leading companies. Exclusive position—only one per issue. Practice Profile – Nominate one of your key opinion leaders (KOLs) to share his/her success story, career and practice-building experience, inspirations, favorite products and systems, and some personal insights on the future of his/her profession. Industry News – A full page of added-value editorial to let readers know about your milestones, promotions, new products, and new technologies. Practice Management – Marketing and management specialists from around the world share their knowledge and insights on the best ways to make a practice stand out, provide the highest quality treatment and service to patients, and elevate staff relationships and performance. Technology – This section provides a forum for in-depth explanations of practice-changing products/technologies and their uses. Product Profile – Detailed information on new product launches, expanded product lines, and upcoming innovations. Educator Profile (Orthodontic only) – Today’s KOLs interview and/or write about their mentors and the impacts they’ve had on the profession. Laboratory Link (Orthodontic and Implant only) – A new department written by leading laboratory technicians explaining lab procedures, how to improve communication between the lab and the clinician, and providing insights and tips for better clinical outcomes. Abstracts (Endodontic and Orthodontic only) – Presents abstracts from the world’s mostread and referenced research and clinical dental journals. Diary – Timely listing of CE, hands-on, and practice management courses offered around the country. This is a free service provided in all journals and on our websites. Materials and Equipment – Product press releases printed free of charge in all journals and on our websites. Step-by-Step - Illustrate your product or service in full detail, with step-by-step instruction on how it works and performs.

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echnology reviews

ANTOLOGY

Incorporating

3D imaging for lower dose than a 2D panoramic* is not magic… it’s

/June 2013 – Vol 6 No 3

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and science to provide stability and excellent esthetic results in implant dentistry Dr. Robert C. Vogel

Practice profile

Dr. Bao-Thy Grant

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Millennium Dental Technologies, Inc.

*Data on file.

Corporate profile

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Learn more on page

Learn more at Sirona3D.com

• management advice • practice profiles • technology reviews state-of-the-art

Top ten tips

CBCT within endodontics: an introduction Dr. Navid Saberi

fund innovation

Practice profile Dr. John R. Hughes

Departments

BERS EARN 24 CATION CREDITS

ORTHOPHOS® XG 3D

• Visualize canal anatomy prior to treatment • MARS for better diagnosis around metal • Easy patient positioning

Dr. Tony Druttman

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endodontic

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trade shows

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implant

2014 Media Planning Guide Here is a look at the 2014 Dental Trade Shows as they relate to our publication schedule. Please contact a MedMark representative for any additional questions at 480.621.89 55 or 866.579.9496.

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15720 N. GREENWAY HAYDEN LOOP #9 SCOTTSDALE, ARIZONA 85260 480.621.8955 | 866.579.9496 | FAX 480.629.4002 www.MedMarkAZ.com