How Technology Integrates into Clinical

Dentistry and “the philosophy”

DEXIS/ICON/Low Stress Bulk Fill Composite

The Philosophy

My fundamental philosophy:Getting teeth to their 85th birthday and then beyond!

The initial placement of traditional restorative dentistry is often NOT the end of treatment, but more than likely

the beginning of a long cascade of traumatic care

Recall exam of a 20 year old with high Caries rate

18 and 19: What to Do?

Contrast…the results:

E2/E1ICON ICON

Application of a resin material engineered to penetrate and fill the sub-surface pore system of an incipient caries lesion to

strengthen, stabilize and limit the lesion’s progression as well as mask visible white spots

ICON

End the “Wait and See” Approach

•Instead of taking a “wait and see” approach, Icon can arrest the progress of early enamel lesions up to the first third of dentin –without unnecessary loss of healthy tooth structure!

IS NOT radio-opaque due to the fact that the material would NOT infiltrate

Takes about 20 minutes per tooth Billing is 150-200$ and my pitch is…no drilling is best and we

follow yearly on x-rays 47 research articles show far less caries after placement

than NOT placing Dam or Isolite are highly recommended especially in lower

posterior If contacts are tight…orthodontic separator may be required

prior to therapy

ICON

Fast, simple treatment in one visit … with no drilling!

Proximal Treatment

The affected teeth are slightly separated with included dental wedges.

The surface of the lesion is etched with a 15% HCL gel. This opens the pore system of the lesion body for 2 minutes.

Steps 3 and 4

Icon Infiltrate, the resin is then applied onto the lesion body for 3 minutes. The extremely high penetration coefficient of the Icon resin enables it to penetrate into the lesion pores and this is why it’s not radio-opaque

The pore system is then air dried and then additionally air dried with the ethanol supplied for 30 seconds

Excess material is removed via floss and the material is light cured. The Icon Infiltrate is then applied a second time for one minute and again the excess removed followed by a final light cure.

Total treatment time per lesion: about 20 minutes

18M….etch for 2 minutes by twisting the handle.. Then rinse

Drying for 30 seconds with ICON DRY, simply insert the syringe and turn the handle to allow

the ethanol to dry the area further

Resin infiltration…3 minutes, remove, floss, light cure, reinsert a new infiltration for 1

minute and same sequence

Asymptomatic lesionsHistory of cariesWhat are your options?How do you determine what is the best option for the patient?

His other sideTo Drill or not to Drill

The Magnifier and Contrast

D2/E2

Restore ICON

After completing #31MO with low stress bulk fill technique, #30 has an ICON placed

with Isolite isolation

Dexis highlights• Plus screen or overview screen , 4th icon from left,

shows photos and xrays• Pins , is the little black thing, double click the image

and pin to hold it there• This screen allows you to have everything open at one

time• Move xrays, then hit home and they go back to their

original • If you want to change location hit new tooth number• Sun hits enhancements• Sun…then invert for caries, tartar• Sun relief….z for zoom s for spotlight

• Sun and color…shows changes, this is all about variations in density

• Text box is too draw, type a note• Right click to remove drawing• Measure tool, click density to evaluate bone• With file, you can reconfirm length and then more

accurate• All features on Dexis can be used on panorexs• Under measure, angle for canted teeth maybe to see

progress with ortho• Pencil writes letter, templates on letter Rauf and

others

CariVu• 2 sizes…large and small, arms are deeper, based on size of

teeth.• Wipe down with caviwipe and not the camera…autoclave

the heads in statum for 3 mintues• Heads are 195$ a piece• Infared light goes through healthy tissue and does NOT go

through unhealthy 5995$• Icon next to Dexis name• Icon turns it on and when in holder goes off• You can select the tooth number on the chart or freeze it

and choose the arrow and save or simply tooth number… squeeze first, then squeeze a second time to activate

• Squeeze button to freeze it