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mIchael b. mIller, D.D.S. – President/editor-in-chief IngrID r. caSTellanOS, c.D. – Vice President/Publisher

eDITOrIal Team: David l. baird, D.D.S., bellevue, Wa; robert W. baker, Jr., D.m.D, Ithaca, nY; Joel h. berg, D.D.S., m.S., Seattle, Wa; nathan S. birnbaum, D.D.S., Wellesley, ma; alan a. boghosian, D.D.S.,

chicago, Il; mitch a. conditt, D.D.S., Fort Worth, TX; gerald e. Denehy, D.D.S., m.S., Iowa city, Ia; marvin a. Fier, D.D.S., Pomona, nY; Daniel Fortin, D.m.D., m.S., montreal, canada; george a. Freedman, D.D.S.,

Toronto, Ont., canada; Jack D. griffin, Jr., D.m.D., eureka, mO; David S. hornbrook, D.D.S., San Diego, ca; mark e. Jensen, D.D.S., Ph.D., Slidell, la; Thomas P. Keogh, m.D., D.D.S., navarra, Spain; Timothy F.

Kosinski, m.S., D.D.S., bingham Farms, mI; hannu O. laamanen, D.D.S., m.S., Turku, Finland; Paul landman, D.D.S., chicago, Il; clarence c. lindquist, D.D.S., Washington, D.c.; edward lynch, m.a., b.D.Sc.,

Ph.D., coventry, uK; hans malmstrom, D.D.S., rochester, nY; Sandesh mayekar, m.D.S., mumbai, India; Steven mcgowan, c.D.T., Seattle, Wa; michael K. mcguire, D.D.S., houston, TX; carlos muñoz, D.D.S., m.S.,

buffalo, nY; christopher Pescatore, D.m.D., Danville, ca; Stephen D. Poss, D.D.S., brentwood, Tn; robert g. ritter, D.m.D., Juniper, Fl; andrew T. Shannon, D.D.S., Vancouver, bc, canada; liviu Steier, D.m.D.,

mayen, germany; Franklin Tay, b.D.Sc.(hons), Ph.D., augusta, ga; marcos a. Vargas, D.D.S., m.S., Iowa city, Ia; charles Wakefield, D.D.S., Dallas, TX; Thomas g. Wilson, Jr., D.D.S., Dallas, TX; David Winkler,

D.D.S., Windsor berks, england.

A publication member of theAmerican Association of Dental Editors

eZ StentAD Surgical

www.ad-surgical.com

PRIcEKit$145.00Pilot Surgical Drill$45.00

Thermoplastic surgical template for implants that claims

to allow you to “fabricate an accurate surgical guide in

minutes — no more time consuming lab work using a vac-

uum former!” The kits come in a small, white plastic box

with a flip top. Inside are five eZ Stents nicely organized

in a clear plastic tray.

The actual stents come in two styles: titanium guide pin

channel in the center (called Single-Tooth Set) or at one

end (called Free-end Set). The thermoplastic section is a

white plate measuring 45mm in length for the Free-end

and 40mm for the Single-Tooth. both versions have a

thickness of 3mm. also included in the kit are five guide

pins, a 2.4mm drill for the model, and a glass bowl for

heating and softening the stent in hot water. The actual

pilot surgical drill, which is available in short and long ver-

sions, needs to be purchased a la carte.

To use, prepare a study model with the drill from the

kit, aiming for an ideal angulation for the implant.

Insert a guide pin into this prepared channel. Then fill

the glass bowl partially with water and heat it above

140 degrees F/60 degrees c. Place the template into

the hot water for about one minute — it should turn

transparent and malleable.

Then remove the template from the water, slide the guide

pin into the titanium channel, place it over the adjacent

teeth, and mold the softened plastic to them. note that

the thermoplastic material will be sticky, so you should

form it against the teeth without using gloves. Once the

thermoplastic material has cooled and turned back to

being rigid and opaque, remove and cold sterilize.

During the surgical appointment, place the template intra-

orally and confirm its positioning and angulation radi-

ographically. Then use the aforementioned pilot drill,

which is inserted in the guide pin channel, to make the ini-

tial preparation in the exposed ridge.

In our preliminary clinical evaluation, eZ Stent proved to

be fairly simple to use and can totally eliminate having to

use a lab for straightforward cases. even in more compli-

cated situations where a lab-fabricated stent may be more

applicable, eZ Stent can come to the rescue if the lab fails

to deliver the case by the surgery appointment and/or the

stent doesn’t fit adequately.

For these reasons alone, it appears having an eZ Stent kit

on hand would be a smart decision for your practice pro-

ductivity and peace of mind.

FirstLook

T h e i n f o r m a t i o n s o u r c e f o r e s t h e t i c d e n t i s t r y

m a r c h 2 0 1 3 n u m b e r 2 4 0

2 7 t h A n n i v e r s a r y

REALITY NOWMISCELLANEOUS

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With zirconia-based restorations increasing in popularity,

adhesive primers for this substrate are becoming more

prevalent. Z-bond, as the name implies, was created for

bonding to zirconia, although it is also being promoted for

bonding to alumina, precious and non-precious metal, and

ceramics. It contains pyromellitic dimethacrylate, hema,

bIS-gma, 10-mDP, and glycerol dimethacrylate in ethanol.

The ph is approximately 3.0.

To use, Danville tells you to roughen the bonding surface by

sandblasting with 50 micron aluminum oxide or with a dia-

mond, although using a diamond on the inside of an indi-

rect restoration could affect the fit if you are not very care-

ful. Then apply the Z-bond and allow it to dwell for 30 sec-

onds, followed by air drying to evaporate the ethanol sol-

vent. Then proceed with the luting or restorative process.

We performed preliminary shear bond strength tests using

discs of lava. In all tests, we sandblasted the lava disc

with conventional 50-micron aluminum oxide sand using

80 psi for 30 seconds, followed by five seconds of forceful

air-water rinse and five seconds of forceful air. The results

are as follows:

These results show that Z-bond and its main competitor,

Z-Prime Plus, basically perform on an equal basis based on

this test protocol. While the silane control also performed

reasonably well, not using any treatment at all does not

seem to be a viable treatment approach when using a con-

ventional composite or resin cement.

note: These tests were done immediately after bonding.

The effect of aging on these results remains to be seen.

The product comes in a conventional black plastic squeeze

bottle inside an equally conventional, small, unsealed

cardboard box with product identification on all sides as

well as the top. The expiration date is on the side of the

box and the bottle label, the latter of which is not mois-

ture-resistant and starts to disintegrate after even one

disinfection procedure. The coated paper directions are

simple, short, and easy to follow.

Z-bond appears to be an effective primer for zirconia and

less expensive than the competition.

Z-bondDanville Materials

www.danvillematerials.com

PRIcE$66.95/5ml ($13.39/ml)

SHELf LIfE2 years

ZIRCONIA PRIMERS

To become a member of REALITY,

please visit our Web site at www.realityesthetics.com.

Primer Bond Strength (MPa)

control (no treatment) 0

S-bond (silane control) 7.4

Z-Prime Plus 11.6

Z-bond 11.9

Do LED HeadlightsDamage Your Eyes?

There is a controversy brewing over the

safety of leD headlights. according to one

manufacturer of these products, some

headlights can produce dangerous levels of

blue light, which puts your eyes at risk. In

the april issue of REALITY NOW, we

report on the results of our tests and tell

you whether you should be worried or not.

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cS 1500 Directto uSbCarestream

www.carestreamdental.com

PRIcE$4,195.00

Includes:• Handpiece• Dental Imaging Suite

WARRAnTY1 year

ExTEnDED3 YEAR WARRAnTY:ADvAnTAgE PLAn$649note: This optional planmust be purchased at thesame time as the cameraand replaces the standardwarranty — it is nOT inaddition to it.

Intraoral camera that connects to your operatory com-

puter directly through a conventional uSb port. This

corded version gives you all the functionality of the

cordless model that we evaluated two years ago and

whose 5-Star report can be found in The Ratings:

Intraoral cameras with computers. So if the cord-

less model has already earned 5 Stars, why would any-

one want to seemingly go backwards in technology and

get tethered again with a cord?

The answer is: simplicity. While it is true that the cordless

version is very cool and convenient, pairing the camera to

the docking station through a Wi-Fi connection can be

challenging. In addition, with the proliferation of high tech

devices potentially causing interference issues for the

cordless version, a direct connection through uSb can

give you confidence that it will perform in an exemplary

manner in any treatment room that has a computer with

the imaging software installed.

The actual camera is quite similar to its cordless brethren.

It’s very lightweight (3.2oz/90.7g) and features a white,

plastic-clad triangular handle, a gray tapered center band,

and a silver-like, matte-finish front end terminating in the

round lens, which is surrounded by eight, bright white

leDs for more than adequate illumination.

The backend of the handle is where the cord inserts, but

this connection can be quickly and easily removed if you

ever need to replace either the camera or the cord. There

is a highly polished silver band that delineates the cord

connection module from the rest of the handle. The trian-

gular handle is a clever design that prevents the hand-

piece from rolling off a countertop.

The top, flat side of the handle includes the oval, matte-

like, silver shutter release, which sits smack in the middle

of the gray center band, plus two leD indicator lights. One

leD illuminates green and signifies the camera is turned

on and the other glows blue to signify there is a connec-

tion to the computer.

On the bottom of the handle in the apex of the triangle

you will find two small round buttons. The button clos-

est to the backend is the cord connection module

release (push it and the module is easily pulled off the

handle), while the button about halfway up the handle

is the power control.

The rapid uSb cord is 8.0ft/2.4m long and has a small

battery in the cable assembly that keeps the camera acti-

vated even when it’s unplugged from the computer. This

battery is a small, rectangular, white plastic module in the

cord positioned about 7.0in/17.8cm from the uSb end.

There is a battery status leD on the top of this module

that glows orange while it is charging and green when it

has a full charge, which required about four hours for the

first charging cycle, although the recommended first

charging time is 10 hours.

When you disconnect the camera from one computer,

the blue leD deactivates, while the green one blinks,

giving you a visual indicator that the battery is keeping

the camera in the ready-on status. Then, when you

plug it into the uSb port in the next room, it is ready

to roll almost instantly.

note: as noted previously, the cord with the battery is

called the rapid uSb cable. The first cord we received

with the camera was a conventional version without the

onboard battery so the instant-on feature did not work.

make sure the cord you receive has the built-in battery.

Installing the system is reasonably easy, especially

with the new “Installation Wizard DVD”. It walks the

installer through each step of the install process,

INTRAORAL CAMERAS

REALITY (ISSn#1041-8253) is an online and print information service from REALITY Publishing company, 11757 Katy Frwy., Suite 210, houston, TX 77079-1717, u.S.a.,

800-544-4999, 281-558-9101, Fax 281-493-1558. a one-year membership includes access to the online database plus nine monthly print issues of REALITY NOW. call for

membership and publication rates or access our Web site for enrollment information. Payments by check must be in u.S. funds drawn on a u.S. bank, or by Visa, mastercard,

or american express. all rights reserved. no part of REALITY or REALITY NOW may be reproduced or transmitted in any form or by any means, electronic or mechanical,

including photocopying, recording, or by any information storage and retrieval system without the written permission of the Publisher, except where permitted by law.

copyright ©2013 by REALITY Publishing company. gST #898-896-659. POSTmaSTer: Send address changes to REALITY Publishing company, 11757 Katy Frwy., Suite

210, houston, TX 77079-1752.

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no coMMERcIALIzATIon PoLIcYWe accept no advertising and are not beholden to any commercial interest. Product evaluations and ratings are intended only to guide our readers to make

wise and informed purchases. The unauthorized use of product evaluations and ratings in advertising or for any other commercial purpose is strictly forbidden.

checks that your computer meets the specs for proper

operation, and automatically configures your computer

to work with the camera.

as noted with the cordless model, the camera is stated to

have the highest resolution for still images on the market,

that being 1024 x 768. The images we captured were very

clear and allowed us and patients to see fine details. It is

also claimed to have the widest focus, which allows you to

capture full faces down to sections of teeth.

To use, you first open the software and click on patient.

choose between "new" or "find". If the patient is new

to the software, choose "new" and enter the patient's

name and other identifying information if you choose

such as date of birth, address, phone numbers, etc. If

the patient is already in the system, click "find" and

the list of patients will open. Double click on the

patient's name and a new window opens. Then, using

the taskbar of icons at the top of the screen, find "new

intraoral camera image" and double click on it. This

opens the acquisition module.

next, retrieve the camera and hold down the power but-

ton on the back until the green leD illuminates (usually

about 1-2 seconds). Then you wait for about 22 seconds

for the blue leD to illuminate, which signifies the connec-

tion between the camera and the computer has been

established. Shortly before this connection is established,

the leD illumination lights turn on.

Then you click on new intraoral image and the acquisition

module opens up. note that the handpiece has a sleep

mode that activates after about 1.5 minutes — this turns

off the leD lights and camera. however, if you placed the

handpiece on your countertop or bracket table and you

want to use it again, it awakens automatically by just pick-

ing it up. Very cool feature.

Finally, there are two icons on the right side of the win-

dow, one being a still camera and the other being a video

camera. If you forget which is which, you can hover your

cursor over each icon — the still image will state "capture'

while the video will state "record'. This makes it pretty

foolproof that you will use your intended mode.

Put the handpiece in the patient’s mouth and center it

over whatever tooth or teeth you are intending to cap-

ture or video and press the shutter about halfway to

activate the autofocus mechanism, which is almost done

in an instant. Then press the shutter all the way to cap-

ture the image, which will then appear on your monitor

at the bottom in a filmstrip-type arrangement. To take

another image, merely press the shutter again to return

to the acquisition mode.

If you are shooting a video, you need to use the red "stop"

button on the screen when you want to stop recording.

Videos appear in the filmstrip with the familiar right point-

ing arrow to differentiate them from the still images.

Other features include a notation tool as well as the usual

ones such as zoom in/out and rotate plus controls for

brightness and contrast. We found the software was more

than adequate for our needs and was quite intuitive to use.

as noted previously, even though the cord cannot match

the wireless convenience of its older sibling, its ease of use

is hard to beat. add that to the other features — one lens,

autofocus, still or video, full face to macro, and instant-on

— and this new version looks poised to join its brethren as

the most desirable intraoral camera currently available.

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