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How many times have you wished you could provide input into the materials you use before it was time to buy them? Drs. Tim Burke and Timothy Goodheart share their accounts of their trips to Kerr and OralDNA, respectively. Burke says, "The visit was as much a focus group as an introduction to current and upcoming products; its hope being we would provide feedback, opinions and suggestions." Enjoy these two Townies' insights and anecdotes about their trips, and prepare yourself for future changes in products because of their insightful feedback.

January 27-29, 2011
Kerr's Sybron Training Facility, Anaheim, CA
by Tim Burke, DMD

Friday, January 27, 2011
5:30 p.m.; Reception and introductions
  • Met with guide, Tammy Morrow.
  • Finished dinner.
  • Went to bar; entertained by Dr. Howard Goldstein (HoGo) and Dr. Doug Sakurai (drstogie)
    with single-malt delicacy.
7 a.m.; Breakfast
  • Warm and beautiful morning, nice to leave ice behind.
  • Dr. Dan Quevedo (DrDan) brought winter parka for 55- degree weather.
8 a.m.; Overview
  • Senior Director of Marketing and Communications Sue Seamon gave brief introduction of Kerr's background.
  • Discussed perception of Kerr in the dental marketplace as the "old reliable brand," without innovation.
  • Proved wrong regarding perception of lack of innovation.
  • Brainstormed ideas of how to increase awareness of Kerr's innovation. Dentaltown was suggested.
  • Notes: Unfortunately, Kerr had the perception that manufacturers are often discouraged from posting, and are in some cases chastised for it. We discussed how the company might participate on the forums in a manner beneficial to all, by identifying itself as manufacturer's representatives and responding in a timely manner to questions, rather than initiating discussions about a particular product.
9 a.m.; Lecture
  • Dr. Chris Pescatore introduced SonicFill, a new handpiece-delivered composite system.
  • Notes from session: The material incorporates a rheological modifier into the resin matrix, which combines with trimodal filler particles, permitting a change in viscosity during placement through the use of sonic vibration provided by the handpiece. The handpiece is based on the Kavo ultrasonic, with the sonic waves producing a viscosity decrease of 87 percent which, combined with the high filler content, works synergistically to emulate the handling characteristics of a less highly filled resin, but without the deficits in handling and strength. The increased initial flow characteristics allow adaptation of the material into deep preparations, while allowing bulk filling to a depth of 5mm, with only 1.6 percent shrinkage!
10:45 a.m.; Hands-on session with SonicFill
  • Notes from session: Advertised as a non-sticky composite, within seconds of working with it we realized that it really doesn't stick, and the handling is as good as anything we had ever experienced. The material flows into all areas of the prep by virtue of the decreased viscosity, and within seconds firms up enough to create anatomy which remains where you place it. The main downside, by Kerr's admission, is that it only comes in three "A" shades, so you do give up something in aesthetics, but we were largely pleased that the deficit was minimal. We all agreed that this is what composites should handle like.
1:30 p.m.; Discussion
  • Mike Padilla and Eugene Qian hosted a discussion about Optibond XTR Bond/NX3
  • Glad I didn't sleep through dental materials class!
  • Notes from session: XTR's ternary solvent system (water/acetone/ethanol), GPDM monomer and pH neutral adhesive layer combine to improve penetration, handling and scope, allowing use with both light and dual-cure materials, and with a 5micron film thickness, XTR is indicated for both direct and indirect restorations.

    Another promising feature of XTR is that it provides bond strengths to rexillium or gold of greater than 30MPa when light-cured, using only a sandblaster and the adhesive; no primer is necessary. Stable bonding to zirconium is also possible via chelation of the divalent phosphate group of XTR to the tetravalent zirconium ion.

    The amine free initiator used in NX3 enables long term color stability, expanding its usefulness in anterior aesthetic restorations without fear of shade changes in the cement. Visual comparisons with competing resin cements show that NX3 is not only less opaque, but also less yellow than the others. Not surprisingly, Kerr reports that 85 percent of its sales are of the clear shade. Further, use of XTR in combination with NX3 results in an autocure of both materials, and will yield bond strengths of 41.7MPa.
3:30 p.m.; Discussion and hands-on
  • Mikhanh Pham introduced us to Vertise Flow
  • Notes from session: A self-adhering flowable composite, Vertise Flow has numerous applications including use as a base under composite restorations, a pit and fissure sealant or a filling material for small restorations and porcelain repairs. Like other Kerr composites, three types of fillers provide excellent handling and aesthetic characteristics: 30- 50micron pre-polymerized filler particles are combined with their ubiquitous 0.4micron particles, with nanoparticles filling in the spaces. She also discussed the relation of particle size to wavelength, in that considering an average wavelength of 0.5microns for visible light, any particles smaller than this will enhance the chameleon effect, which certainly makes sense, and applies to the spectrum of Kerr composites.

    With bond strengths in the mid-20s (mid-30s to porcelain), Mikhanh was questioned as to why we should not use XTR with flowable to get higher numbers, in spite of the extra steps. She did an excellent job of fending off the barbarians, and we came to the realization that there actually might be practitioners who, through circumstance or philosophy, are happy with bond strengths that a few years ago were the best around. Nearly unanimous though, was a feeling that our hygienists would love it as a sealant material, that it is absolutely a step in the right direction and, as someone mentioned, the Wright brothers didn't start by building an F-16.
Saturday, January 28, 2011
8:30 a.m.; Discussion
Greg Rome showed us a material destined to be a game changer, leaving us drooling; with others we were less-than-subtle in our skepticism. We are very fortunate that Ryan Miller and Maribelle Velasco were great sports.

What I learned throughout this trip:
  • In spite of being a large and well-established company, Kerr is no stranger to research and innovation.
  • It is fun to have input with those who actually come up with all the cool stuff we get to play with.
What Kerr learned throughout this trip:
  • How to survive and thrive on Dentaltown.
  • That when you ask a group of Townies for an opinion, you'll get one, and a half dozen more…
For more: http://www.dentaltown.com/MessageBoard/thread.aspx?s =2&f=216&t=161342&v=1
January 27-29, 2011
OralDNA Lab Headquarters, Nashville, TN
by Tim Goodheart DDS, FAGD

5 p.m.; Cocktail reception
  • Learned OralDNA's goal is to "Advance Wellness Through Salivary Diagnostics."
5:30 p.m.; Tour of lab
  • Tour guide: Mark Mackellar, VP of lab operations
  • Showed steps of specimen processing and testing, from beginning to end.
  • Attention to detail ensures no outside DNA contaminates a sample.
  • Impressed with equipment and processes. Makes me think of the TV show CSI!
7 p.m.; Overview
  • Robert Walker, VP and GM of OralDNA.
  • Learned about OralDNA's origins and business vision.
Friday, January 14, 2011
8:30 a.m.; Presentation and Q & A – "OralDNA Labs Scientific Overview"
  • Thomas Nabors, DDS, co-founder and Chief Dental Officer of OralDNA spoke regarding the current thought processes and data regarding periodontal disease, inflammation, rationale for testing and how salivary testing can potentially enhance both treatment and outcome.
  • Notes from session:
    Specific tests offered by OralDNA:
    My PerioPath, samples patient saliva for the 13 most common-known periodontal pathogens, giving not only identification, but also the actual load levels of each!

    My PerioID PST, tests for a specific patient genotype for IL-1. Patients positive for this genotype are at increased risk for more severe periodontal disease due to a genetically exaggerated immune response.

    OraRisk HPV, specific to viral DNA, tests not only for whether HPV is present in the oral cavity but also the genetic type and associated risks with the specific type.
10 a.m.; Presentation and Q & A – "The Clinical Applications of Salivary Diagnostics"
  • Dr. Doug Thompson, a general practitioner from Detroit spoke about how these tests have influenced his practice and he provided his own personal story about how he has incorporated the salivary tests into his practice and treatment protocols.
  • Great to hear about the test from a practicing clinician.
1 p.m.; Presentation and Q & A – "Oral HPV and Its Impact in the Oral Cavity"
  • Dr. Ronald McGlennan, OralDNA's medical director
  • Notes: This is a new frontier for dentists. Most of us aren't all that familiar with incorporating any type of lab tests or results into the thinking, plans and treatment of our patients. It will be for each dentist to decide if or how such testing might be used in practice but I can't help but think that technology such as that offered by OralDNA, is a preview of the future and one that I think most dentists would do well to explore and understand.

    OralDNA has the distinction of meeting requirements and standards of both CLIA (Clinical Laboratory Improvement Amendments) and CAP (College of American Pathologists), neither of which are at all easy to obtain.
3:45 p.m.; Closing remarks

6:30 p.m.; Dinner and drinks at Merchant House

Thoughts regarding trip:
Extremely impressive!

OralDNA was gracious to us with a well-planned agenda and we were given plenty of time and opportunity to ask questions and talk with people from all parts of the company, from directors to management to marketing!

Lab takes its commitment in promoting wellness and health in patients very seriously.

This is hopefully the first of many Townie trips to product creators and manufacturer's headquarters. It is a win-win when Townies can learn about the products they use every day and companies can benefit from the input of wet-fingered clinicians, all using the influential power of the Dentaltown discussions. Keep your eyes peeled for more focus groups like these!
Author Bios
Dr. Burke graduated from Farleigh Dickinson University Dental School in 1986, where he also pursued graduate study in Human Anatomy prior to joining his father's practice in Allentown, Pennsylvania where he has remained.
A 10 year volunteer with Donated Dental Services of Pennsylvania, he is also a founding member of the Empire State Academy of Cosmetic Dentistry and has served the AACD on both the Ethics and Affiliate Relations committees, and is currently a member of the AACD Affiliate Relations Task Force.

Prior to attending dental school Dr. Tim Goodheart worked for five years in the clinical microbiology field, then attended the University of Missouri Kansas City School of Dentistry. He completed a general practice residency at the Kansas City Veterans Affairs Medical Center. Since that time he has been in general practice in Raytown, Missouri. He is a member of the AGD and ADA. He completed his fellowship in the AGD in 2008.
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