GC America Inc. is very pleased to announce the publication of the Journal of Dental Research Article, Managing Our Older Population: The Challenges Ahead, cowritten by Mr. Makoto Nakao, Chairman and CEO of GC International.
To read the article, click here.
Duration: 1.04 h
Presenter: Dr Ron Kaminer
About the webinar:
A mainstay procedure in any dental office is the single crown. Yet despite our successes and failures many of us continue to do things the same way we have done for years. This CE webinar will break down the single crown and outline and modernize the steps and procedures needed to be ultimately successful.
Upon completion of this CE webinar, the student will have covered
1. Core build ups and post and cores: Current materials for optimal success
2. How to achieve a perfect impression every time
3. Material choice for single units
4. Clarifying cementation confusion
See below for a 2.5 minute excerpt of the webinar
Click here to view the full length on-demand webinar
About Dr Kaminer
Dr Ron Kaminer is a 1990 graduate from SUNY at Buffalo School of Dental Medicine. He maintains two practices, one in Hewlett, NY and one in Oceanside, NY. Dr Kaminer is an international expert in the field of Dental lasers and has lectured on Lasers and minimally invasive Dentistry nationally and internationally. He is Director of the Masters of Laser training program in New York, and is a clinical consultant and lecturer for numerous companies, including, Ultradent, Lares, GC America, AMD Lasers , Camsight, Nu Calm and Smile Reminder. Dr. Kaminer maintains a teaching appointment at Peninsula General Hospital in Far Rockaway , NY. He is also a clinical instructor with the International College of Laser Education. He has authored numerous articles on Dental lasers and minimally invasive Dentistry. He is a member of the Academy of Laser Dentistry, Academy of General Dentistry, International College of Facial Esthetic, and American Dental Association. He lives in Hewlett, NY with is wife Jackie and three children, Josh, Erika and Matt.
Duration: 1:10 h
Presenter: Dr Robert Lowe
Most indirect dental restorations are luted to preparations using one of four types of dental cements:
1) Glass Ionomer Cements
2) Resin Modified Ionomer Cements
3) Resin Cements which require the use of total etch technique and dentin adhesives on the tooth structure prior to the luting process
4) Self Etching Resin Cements
Improved properties in this last category of cements including, improvements in self cure mode and bonding to zirconia, will be discussed. It is important to note that no cement will perform to its utmost clinically without an adequate preparation that includes good resistance and retention form.
In this CE webinar, Dr. Lowe will discuss clinical techniques and protocols for indirect cementation of both provisional and definitive restorations. Provisional cementation will be discussed as an integral part of the indirect delivery process for preparation protection and tissue management. The student will come away from this webinar with a more thorough understanding of the cementation process and which cements perform the best when coupled with the variety of restorative materials, both all ceramic and metal based, that are currently available.
Click here to watch the webinar free of charge
About Dr Lowe
Dr. Robert A. Lowe graduated magna cum laude from Loyola University School of Dentistry in 1982 and was an Assistant Professor in Operative Dentistry until its closure in 1993. Since January of 2000, Dr. Lowe has been in private practice in Charlotte, North Carolina. Dr. Lowe lectures internationally and publishes in well-known dental journals on esthetic and restorative dentistry.
He is a clinical evaluator of materials and products with many prominent dental manufacturers. Dr. Lowe received fellowships in the AGD, ICD, ADI, ACD, and received the 2004 Gordon Christensen Outstanding Lecturers Award at the Chicago Midwinter Meeting. In 2005, he was awarded Diplomat status on the American Board of Aesthetic Dentistry.
GC America believes in the importance of informing dentists about the evidence available on Minimally Invasive Dentistry topics so they can make scientifically sound choices in the treatment of their patients. In the research-clinical application jigsaw puzzle, it is essential to make all the pieces fit in order to see the whole picture.
Systematic review with meta-analysis
AIM: To quantitatively appraise the current evidence regarding the caries-prevention effect of resin-modified glass ionomer cement (RM-GIC) fissure sealants in comparison to that of resin-based fissure sealants.
METHODS: 8 Anglophone databases and 2 Lusophone databases were searched until 15 April 2009, using a pre- determined search strategy. Clinical trials were considered for inclusion if their titles/abstracts were relevant to the topic, published in English, Portuguese or Spanish and had a two-arm longitudinal study design. The outcome measure of the caries-preventive effect was caries absence on sealed teeth. Two reviewers independently extracted data from the accepted articles in order to complete a 2×2 table for meta-analysis. The unit of interest was the tooth, and the number of caries-free teeth (n) at the end of each time interval (6, 12 and 24 months) was compared against the total number of evaluated teeth (N).
STATISTICS: Datasets were assessed for their clinical and methodological heterogeneity, following Cochrane guidelines, and only homogeneous datasets were combined for meta-analysis, using a random effects model (RevMan 4.2). Differences in the caries-preventive effect were computed on the basis of the combined Relative Risk (RR) with 95% confidence interval (CI).
RESULTS: Of the 212 articles identified, only 6 trials were included. From these, 19 separate datasets were extracted. For the pooled data, equivalent caries-preventive effects were observed at 6 months (RR= 0.98, 95% CI 0.95- 1.00; p = 0.08); 12 months (RR=1.00, 95% CI 0.96-1.04, p = 0.99) and 24 months (RR=1.01, 95% CI 0.84-1.21, p = 0.91). The 36-month data (not pooled) favored resin-based sealants (RR 0.93, 95% CI 0.88-0.97, p = 0.002).
CONCLUSIONS: This meta-analysis found no conclusive evidence that either material was superior to the other in preventing dental caries.
European Archives of Paediatric Dentistry, official journal of the European Academy of Paediatric Dentistry (2010) Volume: 11, Issue: 1, Pages: 18-25
The academic perspective: Dr Steffen Mickenautsch, University of the Witwatersrand, South Africa
What were the main reasons for reviewing this particular area of dental materials?
Steffen Mickenautsch: Resin is still considered to be the material of choice, worldwide, to caries-protect pits and fissures. This begs the question: Why? Is this so because we have overwhelming scientific evidence for its preference? Or overwhelming evidence in the sense that it sweeps any other possible materials asunder? Or is it just because of tradition, because we do not know the merits of other materials, or finally simply: because we have been told so in dental school? It is always interesting (and beneficial to the heart and mind) to find out the truth of things and that is why we embarked on an intensive systematic review programme that also included the comparison of the caries preventive effect between resin-based and resin-modified glass ionomer cement (RM-GIC) based fissure sealants.
What criteria did the articles you selected meet and why is this important?
Steffen Mickenautsch: We aimed to identify all evidence to this topic from all different sources, corners of the world and from as many languages as possible. We did that in a systematic format and from what we found we selected studies that were relevant, i.e. compared the two types of material with each other. Then these studies needed to have been randomized in some way. Randomization assures that patients whose teeth were sealed with either resin or RM-GIC do not substantially differ, thus are comparable. Studies who do not use randomization, cannot tell whether any observed results, e.g. that one material performed better than the other, were due to the material and not due to other factors (like one group of patients may simply had better oral hygiene or used fluoride and thus had less caries activity than the other, regardless what materials was used).
What should the general dental practitioner understand about this particular review?
Steffen Mickenautsch: The general dentist in her/his daily dental practice should have the knowledge that there is simply no scientific evidence that says that resin protects pits and fissures better against caries than RM-GIC.
How should general dentists apply the conclusion of this review to their daily practise of dentistry?
Steffen Mickenautsch: The application of this knowledge would be that if a dentist finds resin not to be a favorable choice to use as fissure sealant, perhaps for reasons of moisture control, material handling, material availability, costs, a personal reason, or reason stated by the patient etc., then RM-GIC can provide a good alternative.
How does this review contribute to the body of evidence on this topic in dentistry?
Steffen Mickenautsch: This is the very first quantitative systematic review and thus offers the best source of current scientific evidence to this topic. It’s the best, simply because: it first and foremost employed a comprehensive systematic sweep through all possible scientific and non-scientific sources of evidence available to answer a particular question. From everything that we found, we selected the best evidence in line with commonly accepted criteria and then we quantified this evidence, using meta-analysis, in order to provide a precise and well weighted answer to whether resin is better than RM-GIC in preventing caries or not. The result showed that it’s not.
Is more evidence needed on this topic? If so, what gaps are there in the research that has been done thus far on it?
Steffen Mickenautsch: From an academic point of view there is always need for more evidence – even just for the purpose to confirm the current state of evidence. It is recommended that future studies to this topic should report in much more detail on their randomization methods, which would remove any last academic shred of doubt. Our team is committed to continuously update current systematic review evidence – to this topic perhaps in about 2-3 years’ time. For now the current evidence from our systematic review is as good as it can get.
Clinician comments: Dr Geoff Knight, private dentist based in Australia
For how long have you been using glass ionomer cements in practice – and what motivated your decision to use them in the first place?
Geoff Knight: I met Dr Jurgen Eberlein at a dental seminar in Melbourne in the late 1970s. He was then with ESPE and gave me some samples of Ketac Fill to use in my practice. I was concerned about the recurrent caries I was seeing with composite resin and was impressed with the anti caries properties, low interface stress and ease of handling and I found myself using it for more and more clinical applications.
What is your preferred protocol for fissure sealing and what materials do you prefer to use for this?
Geoff Knight: I fissure seal with auto-cure glass ionomer cement because the material has relatively good wear resistance, releases abundant fluoride to convert carbonated apatite into fluorapatite and is a semi permeable to enable phosphate and calcium ions in towards the enamel and hydrogen ions to move outwards. Furthermore when the GIC is placed on the enamel surface it has a low pH that dissolves the outer surface of carbonated apatite enamel crystals so as to enable the formation of fluorapatite crystals after the GIC sets and the pH returns to neutral.
I am unaware of any tooth that I sealed with auto-cure glass ionomer cement ever developing a carious lesion beneath the seal. My current gem is Colgate Neutra fluor 5000 plus tooth paste. When patients brush without rinsing twice daily it prevents caries and significantly improves periodontal health.
Before reading the meta-analysis, what was your opinion of resin-modified glass ionomer cements versus resin-based materials as fissure sealants?
Geoff Knight: Resin fissure sealants prevent carbonated apatite from maturing into fluorapatite and have no place in MID. Resin modified glass ionomer cements enable the transfer of carbonated apatite into fluorapatite but do not wear as well as auto-cure GICs.
As a busy clinician, how do you keep yourself updated on developments in clinical evidence in dentistry, particularly in MID?
Geoff Knight: Read the literature, use Google and look at focused resources such as Dental Outlook here in Australia.
Systematic reviews reveal the continued evolution of dental materials
Results from a recent systematic review suggest high-viscosity glass-ionomer cement (GIC) as safe and economical long-term tooth restorative system in conventional stress bearing Class I and in non-stress bearing Class II and Class V situation. High-viscosity GIC may also be acceptable in Class II stress bearing situations, as long as the isthmus is less than half of the intercuspal distance as stated in the manufacturer’s instruction of use.
Systematic reviews, often including meta-analysis as statistical method, provide the highest form of clinical knowledge in terms of achieving internal validity of results. One systematic review appraised the current clinical evidence regarding the use of high-viscosity GIC for longterm Class I, II and V tooth restorations placed in permanent teeth (1). This systematic review included 14 clinical studies, providing a total of 27 separate study results and concluded as follows:
These results show that high-viscosity GIC is not inferior in comparison to traditional amalgam restorations under similar clinical conditions. In addition, two further systematic reviews revealed the following evidence:
* Tooth margins of single-surface GIC restorations in permanent teeth had significantly less carious lesions after 6 years than on amalgam restorations (2)
* A significantly higher fluoride release (p<0.05) of GIC than from compomers (3)
Further advances have revealed that a resin coating over a GIC restoration may increase its fracture toughness (4) and reduce microleakage (5). This resin layer may also not completely hinder the fluoride release activated by the GIC and thus its external anti-cariogenic effects within the oral cavity (6).
Scientific journal articles for further reading:
1. Systematic review of clinical trials by Mickenautsch et al., Clinical Oral Investigation 2010; v14:pp233-240.
2. Systematic review of clinical trials by Mickenautsch et al., European Journal of Paediatric Dentistry 2009; v10: pp41-46.
3. Systematic review of trials by Oliveira et al., Journal of Minimum Intervention in Dentistry 2010; v3: p23 – abstract 023.
4. Investigation of dental materials by Bagheri et al., American Journal of Dentistry 2010; v23: pp142-146.
5. Investigation of dental materials by Magni et al., Journal of Dentistry 2008; v36: pp885-891.
6. Investigation of dental materials by Mazzaoui et al., Dental Materials 2000; v16: pp166-171.
Duration: 58 minutes
Presenter: Dr Lee Ann Brady
This CE webinar will look at the current options for bonding and cementation of indirect restorations. With so many choices today it can be confusing. Simple decision points will be presented to know when to use conventional cementation or a true bonding protocol. We will also look at the current choices in materials and which clinical situations they are best for.
View a short excerpt of the tutorial here or click the image below to watch the full tutorial free of charge!
About Dr Brady
Dr. Brady earned her D.M.D. degree from the University Of Florida College Of Dentistry. She has worked in a variety of practice models from small fee-for-service offices to large insurance-dependent practices, as an associate and as a practice owner.
She was invited to join the Pankey Institute in 2005 as their first female resident faculty member and was promoted to Clinical Director within a year, and held this position until November of 2008. She was asked by Dr. Frank Spear in September of 2008 to join him in the formation of Spear Education and the expansion of his curriculum. As the Executive VP of Clinical Education at Spear Education, she managed the development and delivery of all programs in addition to her teaching responsibilities until June of 2011. In 2010 she was recognized by Dental Products Reportas one of the “Top 25 Women Dentists in the U.S.” in the category of dental educators. She is on the editorial board of Inside Dentistry, DentalTown magazine and The Journal of Cosmetic Dentistry. Dr. Brady is a Guest Presenter at The Pankey Institute and teaches Continuing Education for the University of Florida College of Dentistry and University of Minnesota.
She has published articles in General Dentistry, Dentistry Today, Seattle Study Club Journal, Oral Health Journal (Canada), DentistryIQ, Women Dentist Journal, Inside Dentistry, DentalTown Magazine, Journal of Cosmetic Dentistry Dental Practice Report, Private Dentistry (UK), Journal of Dental Technology, and other print and web publications. Dr. Brady is a frequent presenter at local, state, national and international dental meetings such as the ADA Annual Session, AACD Annual Meeting, Thomas P. Hinman Dental Meeting, Chicago Midwinter Meeting, Yankee Dental Congress and Florida National Dental Congress.
Being a lifelong learner, Dr. Brady dedicates countless hours to studying and understanding occlusion, restorative dentistry and dental materials performance. She enjoys researching and teaching these clinical disciplines as well as patient communications, case acceptance and team development. She is passionate about solving complex cases, understanding the needs and concerns of her patients, facilitating the success of colleagues, and helping dentists find balance in their lives.
GC America is proud to have created a library of online, on demand webinars by leading experts on a range of dental topics which is accessible to dental professionals who are looking to broaden their skills, improve their product techniques while earning CE credits.
If you would like to enhance your knowledge, or that of your team members, on the topic of minimally invasive techniques, we recommend the following 1 hour webinar presented by Daniel Ward, DDS. The presentation title is Less is More – Incorporating Minimally Invasive Techniques into your Office Treatment Protocols and can be streamed online at no cost, worth 1 CE Credit.
During the webinar Dr. Ward discusses:
About the presenter
Dr Daniel H Ward is an Assistant Clinical Professor at The Ohio State University and in private practice in Columbus, Ohio. He has lectured at the Post-Graduate Program in Esthetic Dentistry at the University of Minnesota, SUNY Buffalo, UMKC, and the University of Florida and served as chief examiner. He is a fellow in the American College of Dentists, fellow of the American Society for Dental Aesthetics, and a fellow in the Academy of General Dentistry.
Dr Ward has lectured throughout the world. He has published numerous articles about smile design, posterior composites, glass ionomer materials and digital dental photography. He has developed an innovative computerized method of smile design called the RED Proportion. An innovative pioneer, Dr Ward combines theory with practical real world experience.
About MI Paste and MI Paste Plus
MI Paste and MI Paste Plus by GC America are the only products for professional use containing the active ingredient RECALDENT™ (CPP-ACP), a special milk-derived protein that has a unique ability to release bio-available calcium and phosphate (and fluoride in MI Paste Plus) to tooth surfaces. Since their introduction to the dental market, MI Paste and MI Paste Plus have become essential products in many dental practices who are focused on preventive care and minimum intervention dentistry.
MI Paste Plus offers the same benefits of MI Paste, but is enhanced with a patented form of fluoride (900 ppm). Both products are safe and easy-to-use both in office and at-home and are both available in five delicious flavors: melon, mint, strawberry, tutti-frutti and vanilla.
To view the on-demand webinar at no cost, simply click this link:
Less is More – Incorporating Minimally Invasive Techniques into your Office Treatment Protocols
“If you want to heal a tooth the best thing you can give it is calcium and phosphate in a very specific concentration, with a little bit of fluoride. And when you do that, you super saturate the mouth with calcium phosphate, which helps restore the mineral balance. The only product that does that is MI Paste.” Dr Brian Nový, 2009 Winner of ADA Adult Preventive Care Practice of the Year.
MI Paste and MI Paste Plus by GC America are the only products for professional use containing the active ingredient RECALDENT™ (CPP-ACP), a special milk-derived protein that has a unique ability to release bio-available calcium and phosphate (and fluoride in MI Paste Plus) to tooth surfaces. Since their introduction to the dental market, MI Paste and MI Paste Plus have become essential products in many dental practices who are focused on preventive care and minimum intervention dentistry.
MI Paste Plus offers the same benefits of MI Paste, but is enhanced with a patented form of fluoride (900 ppm). Both products are safe and easy-to-use both in office and at-home and are both available in five delicious flavors: melon, mint, strawberry, tutti-frutti and vanilla.
Choose MI Paste and MI Paste Plus with RECALDENT™ (CPP-ACP):
A recent webinar recorded by Dr. Dan Ward DDS outlines the benefits of using MI Paste and MI Paste Plus in managing caries in high risk patients. He provides an overview on the active ingredient, CPP-ACP. He also talks through his recommended protocol for the most effective results. Watch the webinar here: http://www.vivalearning.com/console/playbackConsole.asp?x_moduleid=1948
Here are some comments from hygienists and dentists who have incorporated MI Paste and MI Paste Plus into their practices:
“I am amazed by the immediate relief of sensitivity. I now apply MI Paste immediately after every whitening procedure.”
Dr Jeff Blank, Rock Hill, SC
“MI Paste Plus is far and away the most effective treatment out there for generalized dentinal hypersensitivity.”
Dr. Brian Nový, Assistant Professor, Department of Restorative Dentistry, Loma Linda University School of Dentistry
“I personally treated my teeth using etchant for two 20 second intervals, followed by MI Paste in a tray at nighttime for 2 – 3 weeks. Very happy with the results!”
Dr Stephanie M. Benton
“I have had beautiful results using MI Paste… This patient’s teeth were first etched and she then used MI Paste twice daily in a tray for three months. Before starting the third month with MI Paste, she first used Whitestrips for two weeks. Both the patient and I are incredibly happy!”
Dr Ivan A. Serdar
“As a clinician MI Varnish is a must! When applying MI Varnish to the teeth, the flowability and maneuvering of the brush was excellent. This is the best applicator brush I’ve used. Adherence was no problem at all. When choosing a fluoride varnish, I take several things into consideration. It is not just how the product works for me as a clinician. Equally important is how the patient reacts to the product. Patient compliance and acceptance will not only make a huge difference in my job but it also helps to determine the out come of the use of the product. MI Varnish has the greatest acceptance rate of any product I have ever used. Patients love that it is not gummy, runny or leave you with a bad taste in your mouth.”
Noel Brandon Kelsch, RDHAP
MI Varnish by GC America with RECALDENT™ (CPP-ACP) enhances enamel acid resistance and boosts salivary fluoride levels. This product remains on the teeth longer than other fluoride varnishes and contains high levels of fluoride and calcium released in the oral cavity. The difference is in the RECALDENT™ (CPP-ACP), which makes MI Varnish a natural and unique choice for your patients. Casein phosphopeptides (CPP) naturally occurs in milk casein; Amorphous Calcium Phosphate (ACP), which is found in the RECALDENT™, is also the source of calcium and phosphate. In the oral cavity, CPP binds to oral surfaces such as teeth, dentin, oral mucosa and biofilm. Calcium and phosphate ions are the building blocks for healthy teeth and MI Varnish delivers bioavailable calcium and phosphate ions into the saliva.
The features of MI Varnish include:
In a recent video recorded by Dr Dan Ward DDS, he provides an introduction to this product and its exceptional properties thanks to the active ingredient of CPP-ACP. He discusses the instructions for use that ensure the best results for patients.
We also highly recommend this short video technique tutorial that guides you through all the steps of the treatment protocol using MI Varnish. The video is available on demand, so you can watch it whenever you have a few minutes. Click here
Here are some comments from hygienists and dentists who have incorporated MI Varnish into their practices:
“Nice consistency, great brush, great material, goes on smooth and with one easy layer. MI Varnish flows very nice, not too thick and not too watery. It sticks to the brush very well and does not drip from the brush as you take it from container to tooth. As to the color of the MI Varnish, patients loved it, moms could not see it, kids are not bothered by the color.” – Lance Kisby, DMD, Division Chief of Dentistry & Program Director of the Pediatric Dentistry Residency, Nemours Hospital for Children
“MI Varnish goes on very smooth and creamy. The taste is very mild.”- Mark L. Cannon, DDS, Pediatric Dentist
“The viscosity of MI Varnish was perfect. It flowed easily over the tooth surfaces and interproximally. More importantly, my patients loved the flavor and the consistency.”- Sheri B. Doniger, DDS
“In treating hypersensitive teeth, MI Varnish was excellent. More than one coat could easily be applied.” – Lory Laughter, RDH, BS
“RECALDENT™ (CPP-ACP) technology has transformed my practice! I use MI Varnish™ and MI Paste™ because RECALDENT™ (CPP-ACP) technology offers a natural and unique system for releasing bioavailable calcium, phosphate and fluoride into the saliva. MI Varnish™ and MI Paste™ are an essential part of my practice.”- Dr Pamela Maragliano-Muniz, Salem, MA
At GC America we understand the demands on dentists as well as the importance of continued education. Refining your restorative techniques and strategies takes time and practice. This is why we have made available a large number of on-demand learning sessions, accessible online for learning on the go.
The following two online classes will be of particular interest to dentists who are wanting to improve their knowledge and skills in minimally invasive dentistry as well as creating natural esthetics with your restorations.
Presenter: Dr. Daniel Ward, DDS
Duration: 64 minutes
Released: 4/16/14
CE Credits: 1 CEU (Home Study)
Watch the On-demand Class Now
Cost: no charge
It has long been said that “Dentistry begets Dentistry.” In other words the more treatment you do, the more treatment you will need to do in the future. This CE webinar will acquaint you with conservative and minimally invasive techniques to treat your patients.
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Presenter: Dr. Frank Milnar
Released: 2/11/14
CE Credits: 1 CEU (Home Study)
Watch the On-demand Class Now
Duration: 51 minutes
Cost: no charge
Developing treatment strategies for restoration of anterior maxillary dentition can be challenging. When faced with such cases, a detailed diagnosis and thorough understanding is required to ensure that the most appropriate materials and techniques are considered. In this CE webinar, you will learn how to improve your skills and confidence using a new generation of composites that utilize minimal invasive concepts. Minimally invasive concepts originates from the “inside out”.
About EQUIA
Featured in both online classes is the new restorative system by GC called EQUIA.
EQUIA restorations are based on glass ionomer technology and are known for being aesthetic and translucent, high-performing and economical. EQUIA is the first to combine quick and easy handling with perfect physical and incomparably aesthetic properties.
The advantages of using EQUIA are:
To find out more about EQUIA visit this page
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