It has always been a boon to dentists when technology from another field benefits their practice and their patients. The CEREC AC from Sirona is a great example, using a camera to capture a high-resolution surface map of a tooth eliminating the need for traditional impression material. Now advances in space technology has the potential to redefine our ability to diagnose and treat our patients. I first heard of this device from a friend of mine who has more knowledge about aerospace science in his little finger than I have about the entire field of dentistry. The Scint-X scintillator is a device that converts x-rays into visible light. It works in similar way as a film panoramic x-ray: The x-rays strike an intensifying screen, emitting fluorescent light which exposes the film. The idea is to reduce the amount of radiation needed for the given scan, but the resolution is diminished as a result of scatter. The Scint-X works in a similar way, but the difference is that it  uses MEMS technology (micro-electro-mechanical system), similar to that accelerometer in that fancy iPhone you have. In other words, “SUPER TINY”. This scintillator is constructed by Nanospace using the same facility that made an entire satellite propulsion system that was only 55 x 43.5mm in size. By shrinking the scintillator down to such a small size, it dramatically improves the resolution, potentially better than 5 microns. Put that in a Galileos Cone Beam CT, and you might even be able to take your digital impressions with an extraoral scan. (Sirona...give these guys a call...) For a complete summary of the technology, jump over to SpaceDaily for the article.

Now more than ever, we are able to deliver better care through better diagnostics and increased precision.

I had a friend forward this article to me from Discovery News. Eric Bland talks about a new gel used to repair teeth that is so amazing, “Dentists could soon hang up their drill.” He goes on to say that “The new gel or thin film could eliminate the need to fill painful cavities or drill deep into the root canal of an infected tooth.” There are other sensationalized comments, but those are my favorites. Without trying to sound controversial, the article completely misses the mark on what the aim of the original research had been. I think there was a moment there that I forgot I was reading Discovery News, and thought I clicked a link to the Enquirer. If you look at the original research article, there is no mention of treating decay at all. The article discusses a concept in dentistry called “pulpal regeneration”. Basically, if a cavity gets to deep and allows bacteria to enter into the nerve of the tooth, the current standard of care requires completely sterilizing the internal part of the tooth to prevent proliferation of the bacteria. This process also kills the pulpal cells of the tooth. The research on PGA-alpha-MSH looked at a way to try to regenerate those cells to keep the tooth alive. What they are looking at is to end root canals by regrowing your own cells. So will dentists hang up their drills? Not from this stuff. It doesn’t prevent decay, and it certainly doesn’t grow mineralized enamel structure back. It also doesn’t preclude the use of the drill to replace defective fillings or crowns. Further, if a filling is painful while it is being worked on, my recommendation would be to ask for more numbing, or go somewhere else. It’s 2010. We should be able to make our patients comfortable.   So it seems that Discovery News is in need of a Dental News Correspondent who can convey accurate information to properly educate people rather than distort and sensationalize. I’m available. Just throwing that out there.  

Unlike traditional halogen bulbs, the everLight features twelve separate LED lights.

I don't mean to rant, but beyond oil spills, budget crisis issues, and Lindsay Lohan's need for rehab, there is an issue that hits a bit closer to home for me. It is known to everyone that if you hit your son or daughter, child protective services can be called in to take them away from you. This seems obvious to most people. It is a horrible act. Anyone blessed enough to have a child, and yet treat them this way, does not deserve to be a parent. But what about the rest of it? Like verbally belittling them, rather than verbally encouraging your kids? Can child protective services be called for you making your child feel stupid or inadequate? And how about teeth? I'm not talking about the occasional cavity. That happens to everyone. I'm talking about the child that has massive, infected decay in permanent molars, has been in pain for three weeks, and then the parents flake on the emergency appointment. When they actually do come in, there is an attitude that they "just don't have time for this." When will you have time, when it spreads to their eye?   Healthy living is today, more than ever, associated with good teeth and good oral health. If a parent neglects basic dental care for their kids, much less let a painful, infected molar get out of control, should someone not step in as an advocate for that child? It just seems more obvious to me than arm bruises caused from "falling down the stairs". I'd love to hear any thoughts or feedback in the comment section below.

Traditionally after you have taken that impression of a crown prepartion, and everything looks ok, your assistant hands you a lab slip sometime later in the day to fill out. Depending on how busy the day is, it might not get filled out until the next day. Then you have to wait for either the lab delivery person to show up, or the UPS guy, or the FedEx driver, to show up to grab the package. At this point, you have no idea whether or not the box will be smashed, or sit in a hot truck in a parking lot warping the impression, much less get lost altogether. With the iTero, I didnt worry about any of that. After you do the scans for a particular patient, the top menu screen allows you to set your lab, as well as every other detail that shows up on your regular lab prescription slip. There is even a place to make specific notes to the lab technician. Then.... press send. Thats it. All the info of the prescription and the scans get sent to Cadent for processing, and eventually to the lab. Done. That's it. Go home. Two weeks later, the case will arrive on your doorstep. Next Episode: The models.  

Cadent iTero Episode 2: The scan Perhaps one of the easiest things about bringing the iTero into our office was having to explain to patients what this machine does. First, its high tech. Most patients will appreciate that progressive stance on using the latest technology. Second, I haven’t had a single person complain that they really loved using the goop more than simply taking a series of “pictures” of the teeth. I think the hardest thing to learn was how to hold the camera to do the scans in the first place. The camera is a bit heavy the first time you pick it up, but our trainer quickly showed us how to balance it properly. The machine has a preset number of scans that it wants you to take, and prompts you each time in a computer voice. Once you get to know the order, you can move along pretty fast, starting with the arch opposing your crown prep. So all in all, how long did the scans take? For me the first few times I was taking over 3 minutes. Definitely longer than a traditional impression, but not by much depending on the material you would use. So how many scans did it take to top the learning curve? AKA… how many cases should you plan on doing with the trainer before you would feel comfortable to do this all on your own? About 3. It just isn’t that hard. Next Episode: Sending the case to the lab… with no packaging.      

In the last few years we have heard about many new materials that are being considered for bone grafting, from bone morphogenetic protein, to actual wood. Now researchers at North Carolina State University have figured out a way to use aluminum steel foam as a scaffold to build bone. Lighter than aluminum, the idea seems to be that the material doesn't resorb, and other bone grafting materials usually do. The composite foam would remain to help strengthen the surrounding bone to provide better stability for dental implants. Keep your eye on Dentalcompare for the latest in news and new products. Hopefully, these futuristic products will be available soon.

This last week I got a chance to preview the in my practice. If you haven't heard of this machine, welcome to the new world of digital dentistry. The iTero performs an extremely high resolution 3-D scan of teeth, and from that scan can create models to fabricate study models, inlays, onlays, crowns or bridges. At its heart, it does away with the impression material, and all the problems that go with it: no more gagging, no more bubbles, no more retakes, no more distortion. In coming blog posts, I'll let you know what I think of the process itself. On the front end, Cadent was very professional with arranging the delivery. My staff was given a heads up so workflow was not affected. The machine arrived in a box just short of the size of a refrigerator since the unit is mostly pre-assembled. There were a few odds and ends to install, like the monitor, and camera. It also comes with a wireless router that they plug into your network. In the future, this will server as an access point to the internet to either the digital impression. It also allows them to connect to your iTero so if you need tech support or help with an impression, they can drive your machine from their home office on the east coast. Cadent also sent some brochures and a CD with information to help you market your new toy. Our trainer took around 20 minutes total to get the machine up and running before we were able to take our first digital impression. Next blog: Our first case.

Green tea is historically been known to have broad health benefits, much due to its anti-oxidant properties. In 2006, Cabrera, et al wrote a nice, albeit, exhaustive review of green tea. Working down to the molecular level, they dissect every component, from caffeine, to minerals, to antioxidants. They cover the historical uses of green tea, including use of the plant for headaches, digestion, depression, detoxification, and to simply prolong life. Under rigorous research, it is now known to protect against heart disease, periodontal disease, tooth decay, diabetes, and even oral cancer. It turns out the article itself is also effective against insomnia. What still remained to be discovered, though, was just how green tea did all these things, especially with cancer… until now. Dr. Cheng from the National Chung Hsing University in Taiwan has done some research into the effects of green tea on cancer cells. The problem with most cancers is that the immune system stops being able to fight against it. Your immune cells are programmed to seek out and destroy cancer cells that might crop up in your body. If those cancer cells become resistant to the immune cells trying to take them out, then a tumor can grow and spread. Dr. Cheng figured out that an anti-oxidant from green tea, epigallocatechin-3 gallate (EGCG), is able to stop this resistance, making immune cells better at fighting off the spread of cancer. Another study done by Dr. Ohga at the University of Hokkaido in Japan also showed that this same anti-oxidant can inhibit development of blood vessels that feed tumor cells. If you cut off their blood supply, the tumors can’t grow. So what does it all mean? Green Tea helps to prevent cancer in multiple ways, and unlike other hocus pocus remedies such as Echinacea, real science is proving the stuff actually works