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John Flucke, DDS, is in private practice in Lee’s Summit, Mo. He also serves as chief clinical editor and technology editor for 

® and keeps an active blog filled with thoughts and tidbits on the world of technology at blog.denticle.com.

Videos

Riva Cem Automix features SDI’s revolutionary ionglass technology. This unique blend of different sized reactive glass particles harnesses ion-release to cross-link polycarboxylic acid chains. [4 minutes]

Video Test Drive: Riva Cem Automix from SDI

Stan Goff is a Managing Editor with MJH Life Sciences, which includes Dental Products Report, Dental Practice Management, Dental Lab Products, Modern Hygienist, and Dentist's Money Digest. He has covered the dental industry since 1999 and can be reached at sgoff@mjhlifesciences.com.  

Articles

A look at the evolution of minimally invasive dentistry, and the products, technologies, and techniques behind it.

The Modern State of Minimal Dentistry

With 2025 approaching, the cloud-based dental practice management solutions company celebrates significant achievements and key milestones.

Product Innovation, Partnerships, and Increased Revenue Power Planet DDS to a Strong 2024

Josh DeVries is the CEO and co-founder of Intiveo, patient engagement software designed to empower dental practices to enhance patient experiences. He is also the co-host for The Patient Blueprint Experience podcast. For 15 years, he’s worked with healthcare professionals to improve processes and drive efficiency. Through his experience, Josh recognized there were a lot of patient communication services on the market, however none of them focused on healthcare specialists where patient communication is the most critical to their treatment's success.

CEO and co-founder of Intiveo shares his thoughts on what the dental industry can expect in the new year.

5 Trends Your Dental Practice Needs to Know in 2025

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Clinical

VITA has added new shades to its VITABLOCS CAD/CAM block, as well as introduce new eco-friendly product packaging. 

VITA Expands VITABLOCS Product Lines, Launches Eco-Friendly Packaging

The collaboration is designed to improve the experience for dental patients and to allow practices to experience growth powered by technology. 

PrestoSmile Announces Partnership with Weave Along with General Availability of its AI Technology Solution

The 16 CEU course will be held at the Institute of Advanced Dental Education Center in New Jersey.

Nash Institute to Present Full Mouth Reconstruction Course July 19-20

Infinix, equipped with the latest technology and offering both in-person lectures and over the shoulder learning as well as interactive live online and recorded learning opportunities, looks to deliver a new way of dental education.

Todd Snyder Builds New Dental Teaching Facility in Las Vegas

Joe Pelerin, DDS and his patient Jennifer discuss how the GrindRelief PRO helped eliminate jaw and shoulder pain and help her sleep through the night.

Dental Product Insights: GrindRelief PRO

Bruxism expert Joe Pelerin, DDS and his patient Jennifer discuss how the customizable GrindRelief PRO helped to eliminate her jaw and shoulder pain as well as help her sleep through the night better. [3 minutes]

Chief clinical editor and technology editor John Flucke, DDS explains the advantages electric handpieces have over air turbine handpieces.

Tips from the Technology Evangelist: The Advantages of Electric Dental Handpieces

If you're only using air driven right now, here's a little something to be aware of. Air driven handpieces don't have much torque, those turbines spin very fast, and they're powered by a very thin stream of air that comes to that handpiece and we have 35 or 40 psi.

Air doesn't have a lot of density. And when you step on your rheostat, and that handpiece spins up with that air turbine, it spins up to around 400,000 rpms. But when you actually engage bur to tooth, you'll notice that the handpiece spins down, it slows down when you engage. And the reason for that is a lack of torque. They have to spin at that really high speed, it sort of gives them a running start, if you will, so that when you put burr to tooth, you can actually accomplish something. 

An electric handpiece is totally different. An electric hand piece is driven by an electric motor. And that electric motor powers gears that run throughout the handpiece up into the head, and those gears, they don't, you know, they don't slow down when you engage tooth structure, those gears keep rotating at the same rpm. So with an electric, you dial it in at high speed 200,000 RPMs and when you actually put bur to tooth, you stay at 200,000 RPM. Stalling electric handpieces just darn near impossible. 

The other thing that gives you the vibration free aspect of things is the fact that you can actually decrease the speed if you want to. You can even go through if you want to and decrease the torque on the handpiece, although I don't find too many reasons to do that in my practice. But sometimes when finishing margins, it is really helpful to spin things down to 100,000 or 50,000 RPM, especially if you're dealing with a case in the aesthetic zone. It just allows you to be so much more precise. The handpiece continues to turn and allows you to get those margins exactly the way you want them with no chance for error because everything is consistent all the time.

Chief clinical editor and technology editor John Flucke, DDS explains the advantages electric handpieces have over air turbine handpieces. [3 Minutes]

Technique in 2 Minutes: How To Create Conservative Smile Rejuvenation On a Patient With Peg Laterals

View the article version of this technique 

This clinical example from Michael S. Morgan, DDS, demonstrates the use of Kuraray Noritake’s CLEARFIL MAJESTY ES-2 Premium composite material for direct bonding in the anterior region.

In part 4 of this 4 part series sponsored by SDI, Susan McMahon, DMD, discusses the growing popularity of over-the-counter whitening products.

Contemporary Cosmetic Dentistry – Part IV: When to Talk Whitening

Hi there, I'm Dr. Susan McMahon. I'm a clinician from Pittsburgh Pennsylvania

Lots and lots of people are asking for whitening that's just been growing like crazy. And we all know people are spending money on whitening over the counter. Lots and lots of over the counter products influences or selling whitening product. Um, you go into any, any drugstore, any Wal-mart, any Target, there's an entire shelf dedicated to whitening material.

I think it's really important that we offer that as dentists, because our patients want it, and if we don't give it to them, they're gonna look somewhere else. I also think it's really important that every time we do any cosmetic procedure, talk about any cosmetic procedure that we present whitening at that point to the patients too, because that's the time to decide whether or not they're going to whiten their teeth before we close their black triangle. Before we do direct composite veneers before we even do indirect veneers on the top whitening on the bottom. We want to kind of set the stage for the shade that we're looking for and then do our restorative on top of that.

In part 4 of this 4 part series sponsored by SDI, Susan McMahon, DMD, discusses the growing popularity of over-the-counter whitening products, and the need for dental practices to provide access to the safest and most effective whitening approaches. [2 Minutes]

In part 3 of this 4 part series sponsored by SDI, Susan McMahon, DMD, takes on the desire for longer lasting restorations, and a new composite from SDI, Stela.

Contemporary Cosmetic Dentistry – Part III: Modern Restorative Materials

Hi there, I'm Dr. Susan McMahon. I'm a clinician from Pittsburgh Pennsylvania.

So composite resin, one of the most conservative treatments we can, we can do, right. But it's also one of the most esthetic treatments that we can do.

And we've been placing composites for a very long time here, my whole career i've been using composites, and I think that statistically, long term stability of composites has been a challenge for many of us dentists. And statistically, they last between 5 and 6 years. And we want to do better than that.

And so when we are looking at composite restorations, there are several places where the composites tend to fail. They're failing in class IIs at the base of the gingival box, they're failing at the margin areas in all classes of restoration, posterior restorations, and class V restorations. So how many of us see those class V that we put in, they get that little brown stain around them, or an occlusal restoration that has that little brown stain around it, or the class II restoration, that when you take an x-ray of it, your heart sinks a little bit because you see that translucency down at the base of the box.

So I think there's some really interesting new products that are coming our way that have been developed to address those situations. So we've taken all the things that we love and learned about composite over the years. When I started in dental school, we started with self-cure composites. And with big macro filled self-cure composites, and they were just as ugly as can be, they didn't finish well, they didn't adhere well, and we've learned so much about adhesive and composite over the over my career. And I think what's really, what we could do really well with composite now is we get beautiful esthetics with composite, we get beautiful finish, we get beautiful tensile strength and compressive strength. But sometimes we still have these issues where we're not getting long term adhesion. And we're seeing the failure in our class IIs, IIIs, IVs, Vs, all of that. So as we're looking to do, maybe better with our composites, get more longevity out of them, we look, we're looking at newer products that have some a different approach, let's say.

And the Stela product by SDI is a relatively new product. And it's a self-cure composite. And I know when I heard self-cure composite, I was like, oh, that sounds like a long time ago. But in fact, it's a composite that has taken all the things that we've learned about composite, and built it into a self-cure that gives us an unlimited depth of cure.

When we think about light cured composites, there's a lot of things that we're concerned about. And one of the main things is the shrinkage, is the polymerization happening too fast. And it's pulling adhesive layers off the wall, causing micro voids in the adhesive perhaps. And that's possibly where we're getting the failure in our adhesive. So when we look at a newer product that says self-cure, it's going to start its cure layer down at the adhesive layer. And it's going to cure toward the adhesive as opposed to away from it. And it's also an unlimited depth of cure. So there's no worry about trying to layer your composite 2 mm at a time, or maybe obliquely pack it, so you don't have, you know, see factor factoring in. So these are the these are the things that I find really interesting about the Stela that it's kind of overcome some of those problems, some of those challenges, let's say with traditional composite packing.

So it's a product that is very simple to use. You prep your tooth, you get your decay out of your teeth, and it works for me really well in areas that maybe are dark, deep class II restorations, I just did a really deep class III restoration with this the other day. You clean out your decay, grab your primer, and for five seconds, give it a quick air dry and then you place your the Stela composite and it has a really nice needle tip that let you get it all the way down into the deepest areas of the cavity. You flow it in. It flows in really nicely and you can fill it up the entire way. You can fill it the whole way to the top. It's a one and a half minutes or so, initial set, and then 4 minutes till you get to polish it. So it's a 4 minute set, but during that time, it is curing with the adhesive layer and it is married to the adhesive layer. It's a gap free adhesive layer. And I think that's one of the most exciting things is that we're going to have adhesive and composite gap free in between them. So that's something I'm looking forward to seeing how it performs over time. And it's also very esthetic. So I was sort of surprised how esthetic it is. And it's just a single shade. So very, very simple.

The things that I think are really important for clinicians today, moving forward in dentistry, is that we are looking for the most conservative treatment we can do to get the results that we wan. That the more enamel we're able to keep, the better our patients are going to be long term. If we're able to do minimal prep veneers or almost no prep veneers, if we're using composites, to finesse the smile as opposed to deep cutting, indirect restorations on them. I think it's also important that we kind of minimize our inventories in our offices. The simpler things are, the better it is not just for us, our team, but for our patients we're able to do more efficient dentistry and still get incredible results.

In part 3 of this 4 part series sponsored by SDI, Susan McMahon, DMD, talks about the desire for longer lasting restorations. Dr McMahon highlights Stela, a SDI's new self-cure composite could be a an option for improved direct dentistry longevity. [6 Minutes]

In part 2 of this 4 part series sponsored by SDI, Susan McMahon, DMD, talks about decay at restoration margins, and Riva Star Aqua SDF is up for the challenge.

Contemporary Cosmetic Dentistry – Part II: Arresting Marginal Caries

People are definitely living longer, which is a great thing, right? Especially as we're all aging, it's a great thing that everyone's living longer. But because of that, people that I've restored 20 years ago, are now aging into a more mature place in their life, let's say. And oftentimes, patients that are, say in their 60s 70s 80s years old, have dentistry that might be 25 years old, and they're not always in a position to replace it at this point. They're also sometimes can be going through medical issues. And we will find that we're getting recurrent decay, root caries, because as our population ages there's just going to be more root caries, there's going to be saliva that is not as robust as it once was. And we're going to see changes in their salivary content from medicines are taking and from treatments they're having, there's just more root caries. So we're seeing I'm seeing a lot of it.

And there's a couple of things I really am excited about treating these root caries with, I like for many of these patients, I want to try to maintain their dentistry and do the best thing I can to clean up these caries, there are some really conservative things we can do to restore these patients. Hopefully let them hang on to their dentistry as long as possible and get a result that we're confident with. So I like when I have a patient that's maybe a whole mouthful of crown and bridge, even PFM crown and bridge that I put in 20, 25 years ago, and we're starting to see those little sticks under the margin or you know, actual margins where our whole explorer just kind of sinks under that margin.

I want to try to save that for them. So I am taking that, spooning that out, sometimes round buring that out, sometimes taking a laser exposing a little tissue, getting underneath that decay, and then using the Riva Aqua product to really arrest the decay inside there. Because you can't always see underneath the crown, right? You can't, you can't see the whole depth of the restoration. But you can be pretty confident when you scrub it with the Riva Star Aqua that you're going to arrest the decay, and then you use the potassium iodide because you know I'm in a cosmetic practice and my patients care about the way they look. They care about the outcome of that they care about having black teeth, so the Aqua is going to give us that dark staining when we use the SDF on that on the caries for the caries arrestent, we're gonna get black, that's what we're hoping for to get the black caries arrested solid dentin and you're gonna see some black cementum too.

So when we scrub it with the potassium iodide, it takes away most of the blackness but when you scrub it, you have to remember you've got to scrub till you see the white precipitate. If you just scrub a little bit, you're not going to get the same results. You got to scrub scrub scrub a little bit longer till that white precipitate comes and then you know it's going to be much more esthetic. And then then we cover it with you're gonna get these traditional glass Ionomer to do that, so I'm using the Riva Self-Cure on top of that. Triturate it, and use the self cure, and it's really nice restoration to help these people keep their dentistry longer, get through whatever medical treatment they might need to get through and arrest caries for them.

In part 2 of this 4 part series sponsored by SDI, Susan McMahon, DMD, discusses the growing number of older patients with decay at restoration margins, and how Riva Star Aqua, SDI's silver diamine fluoride product helps her meet this challenge. [4 Minutes]

Susan McMahon, DMD, talks about growing patient awareness of black triangles and how she likes to use Luna 2 composite from SDI when closing them.

Contemporary Cosmetic Dentistry – Part I: Closing Black Triangles

It is amazing how people are so informed about cosmetic procedures these days. People are requesting more and more and more cosmetics. I've seen it 10 times more than 5 years ago, and younger people are requesting cosmetics too, and I think a lot of that is driven by social media.

People are out there comparing themselves to influencers and celebrities and people that have really had a lot of work done. And they're coming to us to seek out cosmetic care. And it's been it's been a wild ride. People now come in the door and say I want veneers. They also come in the door really frequently and say things like, "I have black triangles in my teeth." And that's a newer phenomenon that people know what black triangles are. And we're seeing a huge uptick in clear aligner treatment. And because of that, we all know that 40% of clear aligner treatment in adults results in black triangles, so people know what they are. And they're coming in and asking us to restore them. And that's one of my favorite things to restore, because it's a really pretty easy procedure to do. And closing black triangles can be a huge WOW factor for the patient and a big practice builder too, because so many people know about them. So many people are talking about them. And once you fix it, people are out there telling them, "Look, I don't have that black space in my teeth anymore." And you can do it really easily.

There's a lot of great techniques out to do it. I know there's the clear mylar band technique, and I use a technique where we use a section matrix band, a metal section matrix band that's really simple and cost effective and beautiful results. I like to use the Luna 2 composite because it's just just a right the right opacity to close that dark triangle and the handling is so beautiful for it. Of course the finishing is nice too. And it comes with a compatible flowable. You know the Luna Flow, you get a little void on the lingual. You can just put your little bit of flow material in there. Smooth it out with a brush and give it a cure.

In part 1 of this 4 part series sponsored by SDI, Susan McMahon, DMD, talks about growing patient awareness of black triangles and how she likes to use Luna 2 composite from SDI when closing them, a service she and her patients love. [3 Minutes]

Cosmetic Dentistry

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