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Resin Veneer Cements—The Clinical Differences
Gordon’s Clinical Bottom Line: Veneers must be cemented with resin cements to provide adequate bond to tooth structure and optimum strength. However, the pre-polymerization color of resin cements sometimes varies significantly from the post-polymerization color, causing a displeasing and irreversible esthetic appearance. CR research has identified several veneer cements that demonstrate many of the ideal characteristics desired. Providing ceramic veneer restorations has increased dramatically during the past five years as patient’s demand for esthetic dentistry has risen. The popularity of “thin veneers” continues as manufacturers advertise directly to the public and simplified techniques make the procedure more predictable. However, dental clinicians are still challenged with accurately matching adjacent teeth, masking stains and discolored enamel, and selecting and properly using a resin cement for bonding veneers. This article will address the accuracy of try-in pastes for shade matching, color change on polymerization, color change of polymerized cement over time, color differences between light-cured and dual-cured veneer cements, CR survey results, and clinical tips for ceramic veneer cementation.
Patient desiring esthetic enhancement and treatment of occlusal disease
Completed ceramic veneers using proper cement choice and ceramic thickness
FPhotos provided by a CR Product Evaluator
Continued on page 2
Illuminating the Field: Top LED Headlamps for 2009
Gordon’s Clinical Bottom Line: Dental operatory lights are excellent, but they are seldom aimed at the right location. Historically, dental headlamps have been hot halogen headbands or loupe attachments plugged into the wall. An impressive array of bright, lightweight LED headlamps now available provide excellent lighting of your operating field, improving vision and increasing clinical quality. The LED DayLite and Solaris provided the most desirable overall features in CR research. In an earlier report (Jan. 2007), we felt LED headlamps promised to revolutionize intraoral illumination. Today, the latest models have lived up to expectations and show significant improvements in constant power output, higher intensity, well-defined spots, and truer color. To many clinicians, intraoral lighting provided by LED headlamps is as important as the loupes they wear for magnification. Intraoral illumination has become the next major advancement after magnification, and combining the two gives the practitioner greater satisfaction through enhanced visualization. Headlamps direct light parallel to the line of vision providing optimum illumination by minimizing shadows and reducing the need to frequently adjust the chair light. With such an impact, it is important to analyze and compare some of the best headlamps for 2009. Continued on page 3
Antibiotics in Dentistry: What to Use and When to Use It
Gordon’s Clinical Bottom Line: Why do you prescribe certain antibiotics? When should you provide any antibiotics and for what clinical situations? Are there more adequate antibiotics than those you commonly use? Based on current research, most frequent use, and international data, CR staff and Evaluators have provided useful guidelines on antibiotics for use in your practice. Penicillin VK and Amoxicillin are the most prescribed antibiotics for oral conditions requiring antibiotic coverage. Antibiotics are vitally important in the adjunctive management of dental, oral, and facial infections. They do not replace the need for eliminating the foci (etiology) of infection! However, when used properly, they can shorten its duration and lessen associated risks. Antibiotics are also necessary to prevent the joint and heart sequelae to high-risk patients by bacteremias associated with certain dental procedures. Since a previous Clinicians Report (Feb. 2008) has already reviewed this topic and presented suggested situations in which prophylactic antibiotics are recommended, this aspect of antibiotic therapy will not be covered here.
Submandibular space Infratemporal space abscess abscess with neck extension, with orbital extension, abscessed tooth #31 abscessed tooth #1
This article identifies why and which drugs, doses, and durations you should prescribe. Continued on page 4
Evaluators Reports and Clinical Tips
The Little Dental Drug Booklet: Indispensable, fast, and easy drug reference booklet (Page 3)
A Publication of CR Foundation™ 3707 North Canyon Road, Building 7, Provo, UT 84604 • 801-226-2121 • www.cliniciansreport.org
• A dry working field is necessary. . etchant. and hemostatic compounds must be controlled to avoid staining of margins and color changes of the restoration. etchant. try-in paste. catalyst. etchant. and Insure Lite demonstrated the best overall combination of cost. try-in paste. includes Excellent– cement. silane Includes cement. tested characteristics. polymerized cements. • 98% of clinicians would recommend it to a colleague. Clearfil Esthetic Resin Cement. catalyst. At one week. adhesive. catalyst for 2 viscosities Good Dual Cure Clearfil Esthetic Resin Cement Excellent– Excellent– Medium– Includes cement. all cements demonstrated only slight differences in color. – 68% of clinicians who noticed a change in color observed it six months or later. 2. • 60% of clinicians are using try-in paste prior to veneer cementation. Avoid desiccating the teeth. silane. try-in paste. and accuracy in color.53 $26. Good try-in paste. bonding resin. Overall Grade Cost Color Match No Color Change No Color Change Flow under Number per ml* to Try-in Pastes on Polymerization† over Time‡ Pressure of Colors Other Features and Kit Contents Excellent– Good Good Excellent– Good Excellent– Good Excellent Excellent– Good Good Excellent– Good Excellent Excellent Excellent– Good Excellent– Good Good Excellent– Good Light Cure Excellent– Medium– Good High Low– Excellent Medium Medium– Excellent High Excellent Excellent Excellent Excellent High Medium– High Low– Medium Medium– High Composite try-in paste. detectable through test ceramic veneers.15 $19. Accolade PV. try-in paste. silane.52 $64. The low film thickness of the veneer cement in a clinical application minimizes the overall effect of the color on the veneer. Choice 2 Veneer Cement. polymerized veneer cement at one week. silane. includes cement. silane Includes cement. catalyst for two viscosities Includes cement. adhesive. • Glutaraldehyde desensitizers can be used after etching to prevent chromogenic bacterial staining.83 Excellent Excellent Good Excellent Light-Cure with Dual-Cure Option Excellent– Excellent Low Good Excellent– Excellent– Medium Good Good Low– Good Excellent Medium Excellent Good High 7 7 5 8 Color modifiers for chairside adjustment. adhesive. CR Conclusions: Try-in pastes can assist the clinician in obtaining only a general idea of the effects of the veneer cement and should not be used as a predictor of final shading. adhesive. try-in paste. adhesive. Consideration should be given to the differences in thickness and the choice of material for the veneers. try-in pastes sold separately Amine-free initiator system. At one week. 3. silane Includes cement. increasing the thickness of the veneer did not overcome the change in color caused 4. duo-link/biscem Includes cement. Color change of uncured veneer cement 2. and 1.88 Excellent Excellent Excellent High 6 Den-Mat Holdings bond enhancer Good *Based on refill syringe cost †May be clinically insignificant ‡Initial data at one week.6 mm. Clearfil Esthetic Resin Cement.) 5. Dual-cure and light-cure veneer cements performed equally well upon immediate polymerization and after storage for one week. etchant. try-in paste. includes Excellent cement. and Calibra Esthetic Resin Cement demonstrated the least change in color at one week. Clinical Tips FPhotos on page 1 provided by Tyler Lasseigne DDS • Use appropriate try-in pastes/gels to evaluate the effect on the veneers. long-term color change of veneer cements 4. Calibra Esthetic Resin Cement. try-in pastes sold separately Good Color modifiers for chairside adjustment. try-in paste. adhesive. and all cements tested were acceptable. $23.38 6 5 11 12 4 6 7 Excellent Excellent Excellent Excellent– Good Pre-Market Excellent– Good Excellent– Good $41. • Dual-cure cements are desirable for use with inlays.57 $35. use of an isolation technique is recommended (such as cheek retractors or OptraGate by Ivoclar Vivadent).3 mm. 12 Resin Cements Indicated for Final Cementation of Veneers Product Company Accolade PV Danville Materials Calibra Esthetic Resin Cement Dentsply Caulk Choice 2 Veneer Cement Bisco Grandio Flow Veneer Voco Mojo Veneer Cement Pentron Clinical RelyX Veneer Cement 3M ESPE Variolink Veneer Ivoclar Vivadent Insure Cosmedent Insure Lite Cosmedent NX3 (Nexus 3rd Generation) Kerr Vitique DMG America –––––– Results ––––––– –––––––– Tests ––––––– All of the following cements are recommended by the manufacturer for veneer cementation. and dual-cured cements. Excellent– $54. shade A2).70 Excellent 5 Excellent Kuraray Good Good High silane Ultra-Bond Plus Includes cement. – 44% reported their patient being aware of the change. All the try-in pastes demonstrated differences in color from the polymerized veneer cement. Color change over time of the least overall color change upon immediate polymerization with in-vitro testing. adhesive. Shade 1M2) of three thicknesses (0. • Trial cure a sample of the cement and compare it to the try-in pastes/gels and uncured cement prior to use. 6. etchant. activator.21 Premarket $44. In the majority of the tested veneer cements. separate try-in paste for both Excellent– light cure and dual cure.Clinicians Report Page 2 • No color change on polymerization • No color change over time • Multiple color choices • Accurate try-in paste/gels to cured cement • Viscosity options May 2009 Resin Veneer Cements—The Clinical Differences (Continued from page 1) CR Laboratory Tests and Results Desired Characteristics of Veneer Cements • Radiopaque or radiolucent • Lower cost • Easy removal of excess cured cement • Low film thickness • Long working time • Insoluble/no microleakage A total of 972 fine-particle feldspar ceramic block samples (Vident Vitabloc Mark II. 0.0 mm) were cemented to 3. Measurements were recorded for the following: 1. try-in paste. Ultra-Bond Plus. a majority of the cements demonstrated a slightly lighter change in value (lightness/darkness). • View under natural lighting conditions and show proposed effect and restorations to patient. Calibra Esthetic Resin Cement demonstrated the 3. • Avoid relying on shaded veneer cements to correct severe color discrepancies or sub-standard lab fabrication of ceramic veneers. Ultra-Bond Plus was the most accurate. etchant.53 $49. Color differences between light-cured by immediate polymerization or color change at one week. All cements performed well and can be used successfully to cement veneers. • 71% of clinicians reported the color of the try-in paste matched the cured cement. onlays. silane Includes cement. • Thickness of veneer and type of veneer material influences the overall shade. saliva. silane Includes cement. six month results will be reported in a future issue §Average for NX3 light/dual cured Results from Survey of CR Evaluators • RelyX Veneer (3M ESPE) and Variolink Veneer (Ivoclar Vivadent) are the most commonly used cements for veneer cementation. adhesive. liquid strip $21. Choice 2 (‡A future report will provide results on Veneer Cement. • 16% of clinicians observed a change in color of the ceramic veneer restoration after a period of time in the oral cavity. silane. • 95% of clinicians are satisfied with their choice of veneer cement. includes cement. All samples were cemented under equal pressure. try-in paste. etchant.68 $34. under ceramic veneer restorations. The color change upon initial polymerization was not visibly to polymerized veneer cement. and some all-ceramic crowns.91§ $39. Color match of try-in pastes to 1.0 mm thick composite stumps (Septodont N’Durance. • Contamination by blood. etchant.
spot size. endo. †Includes: color. • Headlamps are essential for oral surgery. Hudson. color. PhD. practice-oriented suggestions. and spot edge sharpness Cost BrasselerVE Light Infinity Ultra LED DayLite LED Headlight Lumis II Odyssey LED OptiStar 4 Radiant Headlight Ray Solaris Zeon Apollo Advantages • Greater visual acuity: Operator can see details that are difficult to visualize with conventional chair light. • White light: LEDs produces more accurate tissue colors than halogen chair lights. revealing significant growth potential for this helpful clinical adjunct. and Easy Drug Reference Booklet This 88-page pocket-sized booklet is updated yearly and designed as a quick reference for the drugs most commonly used in dental practice. • Limited battery life: 17% noted inadequate battery life and the need to turn off light between procedures to conserve battery power. All brands tested performed well and were clinically useful. stable output.lexi. • 86% use their headlamp in conjunction with the chair light. especially when loupes are removed between procedures. intensity. focused spot. or any procedure that is difficult to adequately illuminate. Indispensable. DDS Lexi-Comp 1100 Terex Rd. 2 batteries) Solaris 29 g Excellent Optional $845 Excellent Good 1 year Excellent PeriOptix Excellent–Good (inc. • Cost • Dangling cord: The cord from the battery pack can be difficult to position and is easily snagged. but lack the intensity. • Maintenance: 64% of users have experienced some type of problem. Current models show significant improvements in intensity. • Consumer LED headlamps may be adequate for emergency treatment. Jacobsen. although a faint blue hue is still evident from some models. 2 batteries) $25 Lumis II 40 g $550 Good–Fair Excellent Excellent No 6 months Good Lumisoptic Good–Fair OptiStar 4 40 g Good $695 Good Fair No Lifetime Good OptiVision Industries Good–Fair (inc. LED DayLite (Designs for Vision) and Solaris (PeriOptix) had the best overall combination of features. The main disadvantages continue to be the cost and the clinical adjustment to having more equipment mounted on the head. eliminating tether to countertop power supply. including: • Anxiety/Sedation • Oral Soft Tissue Problems • Pain Management • Infections • Prophylactic Antibiotic Coverage • Tobacco Cessation The Little Dental Drug Booklet by Peter L. • Less than one third of survey respondents currently use headlamps. • Portable: Small light mounts on loupes and battery pack is worn at belt. 60% of users indicated compatibility with loupes was the most important factor in headlamp choice. quick use • Easy to read and well organized • Provides common abbreviations • Inexpensive Disadvantage: Augments but does not replace a drug reference book or website . 2 batteries) *Many companies offer additional models not included in this study. 67% rated the light quality as excellent. and spot quality. Clinical Observations and Tips • All headlamps tested could be attached to most loupe designs with custom or universal mounts. One section covers specific medical situations and the appropriate medications to be used. and mounting options of professional models. Advantages: • Excellent resource and references including useful internet websites • Portable size for convenient.com/lddb $8. a section on prescription writing. 100% rated it excellent or good and worthy of trial by colleagues. • Frequent aiming adjustment: Headlamp is easily bumped. implants. Fast. CR Conclusions: LED headlamps are a logical adjunct to loupes and provide greater visual acuity which enhances treatment and reduces stress due to poor illumination. 2 batteries) $75 Radiant Headlight 31 g $1095 Excellent–Good Excellent–Good Excellent–Good Yes 1 year Excellent–Good Q-Optics Excellent–Good BrasselerVE Light 28 g $1095 Excellent–Good Excellent–Good Good Yes 1 year Excellent–Good Brasseler Excellent–Good Infinity Ultra 34 g $995 Excellent Excellent–Good Good Yes 1 year Excellent–Good Sheervision Good LED Headlight 28 g $995 Excellent–Good Excellent–Good Good Yes 1 year Excellent–Good Salvin Excellent–Good Ray 42 g $595 Good Excellent–Good Excellent Yes Lifetime Excellent–Good High Q Dental Good–Fair Zeon Apollo 24 g $895 Good Good Fair Yes 1 year Excellent–Good Orascoptic Excellent Odyssey LED 31 g Good Optional $845 Good–Fair Excellent 3 years Good SurgiTel Excellent–Good (inc.95 Each CR Conclusions: 96% of 25 CR Evaluators stated they would purchase The Little Dental Drug Booklet. 70% of users felt a headlamp was essential. • Durability: 89% rated durability as good to excellent.Clinicians Report Page 3 May 2009 Illuminating the Field: Top LED Headlamps for 2009 (Continued from page 1) LED Headlamp Comparison Product* Company Weight Illumination Minimal Glare Orange (loupe mount) Quality† Battery Power (in patient’s eyes) Filter Warranty Overall Grade LED DayLite 41 g Excellent $995 Excellent–Good Excellent Yes Lifetime Excellent Designs for Vision Good–Fair (inc. and prescription requirements. OH 44236 866-397-3433 • www. and 55% have used the warranty. It contains practical. Disadvantages • Weight: User must become accustomed to the extra weight on the loupes and nose or headband.
al. The earlier the referral to an oral surgeon. and 4) early referral of spreading infections. Characteristics of a local infection: • Periapical abscess confined to bone • Percussive tenderness • Chronic fistula • Gingival swelling • Local pericoronal infection without lymph node tenderness or swelling See table for treatment recommendations. BID = twice a day. JADA 130(9):1341. ©2009 This Report or portions thereof may not be duplicated without permission of CR Foundation. factual data. P. P. valuable classic. JADA 131(11):1600. sub-mandibular. the practical guide for dentists. et. Chong.A.B. (2) Less expensive. Your results may differ from CR Evaluators or other researchers on any product because of differences in preferences. and environments. T. non-profit education and research organization which uses a unique volunteer structure to produce objective.e. and temporalis). submasseteric. It is imperative that the incision be done through the periosteum at the level of the apex (use a pointed mosquito for blunt dissection following mucosal incision) and a drain be sutured to keep the wound open for drainage. TID = three times a day Good References 1. masticator (such as pterygomandibular. and (3) Basic science laboratory research. and Nhu. . See www.. Epstein. To Extract or Not A tooth is not worth a life. Use QD or BID dosing schedule to maximize patient compliance. Over 400 clinical field evaluators are located throughout the world and 40 full-time employees work at the institute. eliminating the foci of infection (extraction) is the best course of action. Spreading Infections Determine the nature of an infection and whether it is localized or spreading. incision and drainage may be warranted. Fazio. reprinted by permission Augmentin 875mg BID x 10 days Spreading Infection Debridement* Types of Spreading Infections • Cellulitis • Sinusitis • Brain abscess • Facial fistulization • Retropharyngeal space • Distant seeding *Debridement: surgical removal of devitalized lacerated or contaminated tissue or purulence (i. Antibiotic use in dentistry. Caution patient not to drink alcohol (antabuse effect). CR Foundation™ is a tax-exempt. plus GST Canada subscriptions. Pen VK and Amoxicillin are the most commonly prescribed antibiotics and are the first choice for odontogenic infections. etc.. 2000. Although Penicillin VK (or generic) is empirically the first choice for this type of odontogenic infection.B. Other examples of wrongful use include faulty dosing (too low a dose or too long a duration).S. batches of products. D. If deep. In either case. 1999. The ultimate cheat sheets. I&D) †When to add Metronidazole: If no improvement of spreading infection is evident after 48 hours of initial regimen. Most Commonly Prescribed Antibiotics • Pen VK 500 mg QID x 7–10 days • Amoxicillin 875 mg BID x 7–10 days CR Conclusions: Effective treatment of odontogenic infection includes: 1) differentiating local vs. To Prescribe or Not See list of Cases Requiring Antibiotics at right.cliniciansreport. 2007. and improper combinations of antibiotics. Dental therapeutic indications for the newer long-acting macrolide antibiotics. patient compliance increases from 42% to 70% by twice-a-day dosing with Amoxicillin 875mg. Pediatric Doses Antibiotic lbs to kg Cases Requiring Antibiotics • Implant surgery • Purulent pulpitis for RCT (Root Canal Therapy) • ANUG (Acute Necrotizing Ulcerative Gingivitis) • Pericoronitis • Third molar impaction surgery (elective and controversial) • Apicoectomy in presence of infection • Mucosal graft • Socket preservation (elective and controversial) • Odontogenic infections (see box above) • SBE prophylaxis • Prosthetic joint prophylaxis (as indicated) • Immuno-suppressed patient Dose 25 lbs 12 kg Amoxil/Trimox 40mg/kg/day in divided 50 lbs 23 kg (Amoxicillin) BID or TID doses Augmentin 45mg/kg/day in divided 75 lbs 35 kg (Amoxicillin-Clavulanate) BID doses Zithromax 12mg/kg/day QD for 5 100 lbs 47 kg (Azithromycin) days Cleocin 20mg/kg/day in divided 125 lbs 59 kg (Clindamycin) TID doses QD = every day. Antibiotic Therapy in Treatment of Odontogenic Infections Treatment dictated by determination of local vs.. I&D is indicated if drainage by extraction was not accomplished.T. 3. Fang. CR conducts research at three levels: (1) Multiple-user field evaluations. Single issue $8 each. anatomic spaces are involved and infection is not responding to treatment. 5. S. paraphryngeal. A survey of antibiotic use in dentistry. See table for treatment recommendations. JADA 138(4):458. The evidence base for the efficacy of antibiotic prophylaxis in dental practice. then add metronidzole (Flagyl). Annual English language subscription $95 worldwide. techniques. canine. A product must meet at least one of the following standards to be reported in this publication: (1) Innovative and new on the market. 1997. Moore. see above references.. L. spreading infection.. ADA Council on Scientific Affairs. and Menhall.. Assess Degree of Infection Localized Infection Treatment of Localized Infection Non-Penicillin Allergic Amoxicillin 875mg BID x 7 days Penicillin Allergic Azithromycin Z-pak #1 as directed Tri-pak #1 as directed Clindamycin 300mg TID x 7 days Debridement* Treatment of Spreading Infection Non-Penicillin Allergic Penicillin Allergic Clindamycin 300mg TID x 7 days Azithromycin Z-pak #1 as directed Add Metronidzole (Flagyl) 500 mg TID if necessary. R. 2008 edition. spreading infection. For additional information. wrong choice of antibiotic (organisms not sensitive). “Clinical Success is the Final Test” Products evaluated by CR Foundation™ (CR™) and reported in Gordon J. the better. All proceeds are used to support the work of CR Foundation™.Clinicians Report Page 4 May 2009 Antibiotics in Dentistry: What to Use and When to Use It (Continued from page 1) Localized vs.† ©The Ultimate Cheat Sheets™ 2008.C.L. J.) • Skin erythema • Trismus • Systemic involvement (such as fever and/or malaise) • Sinus infection • Presence of a draining fistula through the skin Some spreading infections have the potential to close the airway or extend to the brain. Extraction. 4. 2. 2) eliminating the foci. or (4) Superior to others in its broad classification.e.org for non-English subscriptions. (3) Unrecognized. Inappropriate use of antibiotics can lead to resistant microorganisms. A spreading infection is more likely to require the help of a specialist such as an oral and maxillofacial surgeon. (2) Controlled long-term clinical research. When to Incise and Drain (I&D) I&D is indicated if swelling has been present for more than 48 hours since a purulent exudate is likely present with or without a palpable fluctuance. Christensen CLINICIANS REPORT™ have been selected on the basis of merit from hundreds of products under evaluation. vestibular. RCT. Characteristics of a spreading infection: • Swelling or tenderness of an anatomic space defined by muscle boundaries (i. 3) appropriate antibiotic(s) as indicated. but meets the use standards. JADA 128(5):648. Lockhart. Extractions and other surgeries in healthy patients where there is no infection or the cause of infection is removed do not always require antibiotics.
CE Self-Instructional Test—May 2009 Check the box next to the most correct answer 1. Cement shade Ì D. At one week. 3. endodontics. malaise. photocopy this page and list requested information. Incise thru periosteum. This is a self-instructional program. A headlamp purchased at a local camping store works just as well as a dental headlamp. Once adjusted to match your loupes. In a patient with a localized infection who is allergic to Penicillin. Which of the following characteristics of veneer cements are desirable? Ì A. place and suture drain Ì C. For additional participants. (AGD# ____________________________________________) Annual Enrollment Fee for 2009. Trismus Ì B. Short working time Ì B.org or by calling 888-272-2345.) Ì C. Ì D.cliniciansreport. and when access is difficult. All of the above 2. High intensity Ì D. Eliminate the foci of infection Ì B. a headlamp never needs adjustment again. Systemic involvement (fever. 3707 N Canyon Rd. 12 hours 8. Few shadows Ì C. Ì B. Stable output power Ì C. except: Ì A. Tooth shade before/after prep Ì B. Flagyl (metronidzole) is indicated if the infection does not respond by: Ì A. Truer color Ì B.Clinicians Report Page 5 May 2009 CE Self-Instructional Test—May 2009 Earn Up to 11 Credit Hours. Color change upon initial polymerization was visibly much darker on all cements. 48 hours Ì D. Prescribe appropriate antibiotic Ì E. Tetracycline 10. Which of the following statements about headlamps is true? Ì A. Color change upon polymerization 4. Provo UT 84604 or Fax 888-353-2121 Call 888-272-2345 now to sign up for the Clinicians Report 2009 CE Self-Instructional program! . Tests for each issue of Clinicians Report will be available online at www. etc. Name ____________________________________________________________________________ Address___________________________________________________________________________ City _____________________________________________________________________________ Email __________________________________________________ Phone __________________________________________________ State ___________ ZIP __________________________________ Ì Please send my tests results directly to the Academy of General Dentistry. All of the above Print Participant Information. Bldg 7. 1 week Ì B. The chair light is no longer useful once you have a headlamp. Ì C. Headlamps are particularly useful for surgical procedures. Lighter weight 5. Which of the following is not related to the results for veneer cements? Ì A. The majority of the cements demonstrated a slightly lighter change in value at one week. Current LED headlamps have improved in the following ways. all cements demonstrated only slight differences in color. Augmentin Ì D. No color change over time Ì D. Ì B. which antibiotic would be a good alternative? Ì A. Which of the following needs to be considered for proper use and cementation of ceramic veneers? Ì A. Which of the following is not an advantage of LED headlamps? Ì A. High cost Ì C. Ì C. Well-defined spot Ì D. Flagyl Ì B. Limited battery life Ì B. Dual-cure and light-cure cements tested equally well Ì D. ________ (Signature Required) Payment Method: Ì Visa Ì MC Ì AMEX Ì Discover Ì Check (Payable to CR Foundation™) Send your test answers and enrollment fee to: Clinicians Report. Select one: Ì $44 Clinicians Report Subscriber Ì $66 non-subscriber Ì Already enrolled Cardholder’s Signature____________________________________________________ Exp. CR Foundation is an ADA CERP recognized provider and an AGD approved PACE program provider. Complete the Test. Which of the following is not a characteristic of a spreading infection: Ì A. 5 days Ì C. Periapical abscess Ì D. Ceramic material and thickness Ì C. More accurate color 6. Sinus infection 9. To treat an infection: Ì A. Receive 1 credit hour for successful completion of each month’s test (January 2009 through November 2009). 7. Clindamycin Ì C. Place and suture drain Ì D.
2009 Friday Williamsburg Marriott New York City. Academy of General Dentistry Approved PACE Program Provider FAGD/MAGD credit 1/2006 to 12/2009 CR Foundation™ is an ADA CERP recognized provider January 15 and 16. and Paul* for a fast-paced. including: • The latest clinical findings on zirconia-based restorations • The best resin cements and their most appropriate uses • Conventional implants vs. Child Jr. New York September 2. and techniques in all areas of dentistry. • Compare the major resin-based composite techniques and materials. hype • Many other timely topics *and other CR staff Gordon J. Nevada October 30. Virginia July 31..org Boston. participants will be able to: • Identify and discuss the most important new concepts. Christensen. 2009 Wednesday New York Marriott Marquis For more information or to register for a course. • Discuss the status of zirconiabased restorations. • Describe clinical protocol for patients on bisphosphonates. devices. • Identify the most appropriate pediatric restorative materials and techniques. Williamsburg. CDT Register Today! Upcoming Course Locations Lake Tahoe. PhD Rella Christensen. Rella. small diameter implants • The easiest and best implant abutments • Comparing endodontic sealers • Is “cone-beam” radiography here? • Foolproof impressions for fixed and removable prosthodontics • Comparing resin restorative techniques and materials • New surgical and medical concepts • How do fluoride varnishes compare to 5000ppm fluoride? • Cutting off and through zirconia-based restorations • Digital impressions • High-tech—practical vs. MSD. Nevada June 19.cliniciansreport. • Describe the best impression procedures for fixed and removable prosthodontics. information-packed course highlighting the best dental products and techniques for 2009. Massachusetts October 16. Utah Las Vegas. materials. • Select the most appropriate preventive materials and techniques for your practice. • Select which high-tech concepts you want in your practice. 2009 Friday Hyatt Regency Lake Tahoe At the completion of this course. DDS. 2009 Friday Hilton Boston/Woburn Ski and Learn CR Dentistry Update® in Park City.2009 Presented by:* Join Gordon. PhD Paul L. Course features at least 25 topics. DMD. • Compare conventional diameter and small diameter implants for your practice. 2010 . 2009 Friday Venetian Resort–Hotel–Casino at the CE Information—6 CE credits available. call 1-888-334-3200 or visit www. • Many other concepts important to dental practice in 2009.
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