“It’s like having an additional assistant without obstructing the view.”
“Excellent for veneer preparation and placement.”
“Provides the best lip protection during in-office bleaching.”
“Opens the patient’s mouth and protects the lips.”
“Provide a youth size for pediatric patients.”
Description
OptraGate is a single-use, latex-free lip and cheek retractor that provides increased visibility and accessibility during dental procedures. It is highly flexible and elastic in all directions of movement for patient comfort and assists in keeping the patient’s mouth open. The device has a small inner plastic ring that is positioned in the area of the buccal vestibule, while the larger outer ring remains outside the mouth. The elastic component between the two rings is about 35 mm and it retracts the upper and lower lips for easy access to the oral cavity. OptraGate is indicated for a variety of applications including restorative procedures, tooth whitening and photography and is available in two sizes, small and regular. The retractors are individually wrapped for single use and packaged in an assortment box containing 40 each of the small and regular sizes. Twenty-five consultants evaluated OptraGate in more than 350 clinical applications. This product received a 97% rating.
Product Features
The available sizes and ease of placement were rated as good, while the resistance to tearing and quality of isolation were rated as excellent. The elastic has no odor or taste and does not irritate dental tissues when placed properly. OptraGate is ideal for protection of the lips, eliminating interference from the lips, and providing excellent isolation for anterior esthetic treatment. The flexible nature of the retractor encourages mouth opening, yet allows complete closure for checking occlusion. Placement of OptraGate can be accomplished quickly with no patient discomfort, although a few patients requested that the device be removed when it was in position for an extended period of time. Eighty-eight percent of consultants would recommend OptraGate and rated it equivalent to or better than their current retraction methods, while 74% would switch to it.
Clinical Tips
Lubricate the patient’s lips to ease placement of the retractor.
Place folded gauze between the retractor and the lips for greater patient comfort.
Editors’ Note: Following our evaluation, Ivoclar Vivadent announced it will be launching a pedodontic size, OptraGate Jr., in October 2005.
LUMINEERS are leucite-reinforced, pressed ceramic veneers. Minimal to no tooth reduction is needed to accommodate these restorations of as little as 0.2 mm of thickness. When traditional tooth preparation is utilized, the same Cerinate ceramic is used. Resin cement such as Ultra-Bond Plus with Tenure MPB (Multi-Purpose Bonding System) is recommended for cementation of LUMINEERS. This product received a 96% clinical rating.
Clinical Evaluation Protocol
Two hundred sixty-nine restorations were placed in 61 patients. These included 39 anterior crowns, 228 veneers and one onlay (Figure 1).
Fifty-four of the 228 veneers were placed on teeth prepared using the minimal reduction technique. Twelve veneers were placed on unprepared teeth. One veneer was placed on an existing ceramic-metal crown where the facial ceramic had fractured (Figure 2).
Restorations ranged in age from one to four years (Figure 3).
Restorations were fabricated by Nellmar Laboratory, Ann Arbor, MI.
LUMINEERS were bonded with Ultra-Bond Plus with Tenure MPB.
Restorations were evaluated on a 1-5 scale: 1 = poor, 2 = fair, 3 = good, 4 = very good, 5 = excellent .
Clinical Observations
Resistance to Fracture During the four-year clinical evaluation of LUMINEERS, five patients experienced chips or fractures of their restorations, including six anterior veneers and one premolar of traditional thickness (Figure 4). Six restorations were replaced and one was polished. All fractures occurred during the first year of placement. Three anterior veneers of minimal preparation and one veneer of traditional preparation debonded and were recemented.
Esthetics LUMINEERS continue to provide excellent esthetics and vitality after four years in service. The life-like appearance and gloss have been maintained from the time of insertion. Of the 269 restorations placed, nine restorations on two patients exhibited surface stain which was readily removed with a ceramic polishing system (Figure 4). The stain has not returned.
Resistance to Marginal Discoloration No microleakage was reported in 99% of LUMINEERS (Figure 4). During the first year in service, two anterior veneers experienced black marginal staining and were replaced. No additional microleakage has occurred.
Wear Resistance No visible wear was noted on any of the LUMINEERS (Figure 4). No wear of opposing dentition was attributed to the ceramic.
Conclusions
After four years in service, LUMINEERS have maintained surface texture, gloss, and life-like appearance noted at placement. Proper case selection is critical when determining the best preparation design. Minimal preparation is best suited for undersized teeth or those with spaces, thus allowing proper thickness of the ceramic and preventing a bulky appearance. Traditional preparation is required with teeth that are crowded, malposed or darkly stained. Using both the minimal preparation and traditional preparation techniques, LUMINEERS has demonstrated excellent esthetics.
CLEARFIL S3 BOND is a 7th-generation bonding system that includes the primer and adhesive in one bottle. This light-cured material is water-based and self-etching. The material must be applied to the tooth for 20 seconds. Strong air and high-volume suction are utilized to evaporate the solvent, and then CLEARFIL S3 BOND is light-cured for 10 seconds. Refrigeration is recommended for overnight or long-term storage. CLEARFIL S3 BOND is available in a kit containing a 4-ml bottle, disposable brush tips, brush tip handle, and accessories. Sixteen editors evaluated CLEARFIL S3 BOND during a six-week period. This product received a 92% clinical rating.
Editors’ Observations
Manufacturer’s Instructions The technique guides are well illustrated with a clear, simple description of each indication for use. Abbreviated directions are also provided on the side of the bottle for quick reference.
Completeness of Kit The bottle is small, well-balanced and easy to open. Consultants found the directions printed on the bottle to be an excellent addition. Disposable brushes and a sterilizable handle are provided. Disposable fiber-tipped applicators would be preferred.
Ease of Dispensing/Ease of Use CLEARFIL S3 BOND has a medium viscosity and is easily dispensed in a controlled volume. The slight yellow color is easy to see, indicating that all surfaces have been covered. The CLEARFIL S3 BOND system is very simple to use and requires a short application time.
Viscosity The viscosity allows for controlled dispensing and coating of all surfaces; however, it is more difficult to disperse with air.
Initial Postoperative Sensitivity No sensitivity was reported during the six-week evaluation period of CLEARFIL S3 BOND.
Ease of Matrix Band Removal The bond strength data is exceptional; however, consultants found it very difficult to remove the metal matrix band after placement of the composite.
Bond Strength to Tooth Structure, MPa
Enamel
Dentin
CLEARFIL S3 BOND
28
23
Clinical Tips
Use an instrument such as a spoon excavator to remove cured adhesive from the internal aspect of the matrix band before composite placement.
Use a phosphoric acid etchant on uncut enamel
Editors’ Note: The original evaluation was published in THE DENTAL ADVISOR, Vol. 22, No. 8, October 2005.
