dr wender

Visited Convergent Dental maker of the Solea Laser.

This past Monday I was in Boston and visited the headquarters of Convergent Dental. I met the entire development team and the CEO, Mike Cataldo. I was very impressed. He has assembled a dedicated group of young energetic people who are working together to provide the best possible product. They are continuously making advancements both hardware and software to improve the patients experience.

Tooth Preperation

Now that I have covered the changes in filling materials,  are there any changes in the way a tooth is prepared?   The conventional way of fixing a tooth with decay is to first numb the tooth and then use a high and low speed drill to remove the affected tooth structure.

Now there has been a paradigm shift for the first time since the invention of the dental drill.  This is a dental hard and soft tissue laser that is specific for tooth structure and water.  It operates at a different wave length than all other dental lasers which only effect water.

What does this mean for you?  It means that I can now remove the enamel, dentin and decayed dentin without giving you a shot to numb the tooth.  This can be done in 95% of the cases.  This is revolutionary.  So you can come into the office, have a filling placed and then go on about your day without a numb lip and tongue.  For children this is especially important.  A child with a numb tongue and lip are likely to bite and chew on them because it has no feeling.

The laser inventors at UCSF, knew that it worked, but did not know how to bring it into the market place.  A commercial laser company based out of Boston heard about this technology and knew they could bring it to market.   So they set out to use their knowledge of making commercial lasers into the dental industry.  Unlike all the other lasers in the market which use an expensive disposable fiber optic cable to transmit the laser energy, they use the same technology used in putting the date stamp on water bottles and laser light shows.  After several prototypes they came out with a product that has many uses and easily upgradable as new and improved uses are developed.  It is all software driven at this time.  However, they continue to take the user suggestions to improve the hardware as needed.  I have never seen a company so responsive and dedicated to us, the dentist.  Not only in the hardware but the continuing training every 2 weeks we have a user webinar to discuss uses and problems that might have arisen.

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Fillings

Let us start with the simplest and most common procedure performed in the dental office-FILLINGS.

Removing the decayed or damaged tooth structure from the tooth and replacing it with a filling is the most basic procedure done by dentist all over the world.  When I started in dentistry, silver amalgams were the norm and the early white composite self curing resins for the front teeth.  The age of repairing a chipped tooth with a resin was just getting started with the invention of the Nuva light.  We thought that this was greatest.  We could now treat the enamel surface of a fractured tooth and bond on a white filling.

The silver fillings were placed into the tooth after placing a liquid varnish and sometimes if the decay was deep, a liner of calcium hydroxide.  The teeth were always sensitive to cold after the fillings.  What we now know is that the varnish did nothing and the calcium did very little.  The cold sensation was not caused by the conduction of cold through the silver filling but rather from micro leakage between the filling and the tooth.  This would reduce over time due to the oxidation of the filling to seal the margins.

The white fillings had its own set of problems caused by the shrinkage of the material as it set.  This caused micro leakage and recurrent decay.  The other problem with the early composite material was the large particle size of the fillers within the resin.  “Plucking” which is the plucking or falling out of the large particles on the surface caused microscopic craters.  These craters would pick up stain and the material would look yellow.

Over time great leaps in technology and material science were developed.  The reduction of the particle size to make the polished surface more enamel like and the greatest advancement was the discovery that the tooth structure could be totally etched and bonded.  This allowed us to bond to the inside of the tooth as well as the outer enamel.  This also stopped the micro leakage and the teeth were not sensitive after placing the fillings.  This is a very technique sensitive procedure and required more time to place the fillings and new problems to overcome.  The resulting fillings of today are a completely different animal than in days past and far superior.

Good bye “Stone Age”

The Stone Age did not end because they ran out of stones……
The Stone Age disappeared, because of technological advances.
In this blog I am going to discuss the many advances that have occurred over the past 40 years that have completely changed dentistry—-for the better.
I live and practice by the thought that when I stop learning, it is time for me to retire. To that end, I get around 50 hours of continuing education a year ( only 15 hours is required by the state board). I do this because I love learning and advancing.
With each post, I will discuss the past and the latest development in every aspect of dentistry.

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