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Inside Dentistry
March 2023
Volume 19, Issue 3

Exceeding Patient Expectations With Bioceramic Cements and More

Ceramir® by Directa Dental helps improve the quality of dentistry

Todd Snyder, DDS

Quality dentistry is important, and Todd Snyder, DDS, does not believe in allowing external forces to dictate how he practices. Although Snyder has been a longtime proponent of the fee-for-service model to avoid the influence of third-party payers, when another external force—the COVID-19 pandemic—presented new obstacles, Snyder doubled down by creating Legion, an organization that helps dentists remove frustrations and become more successful in business. "One of the funnest things for me is to watch someone literally change his or her mindset and become more successful," he says.

Legion's goal is to strengthen and empower dentists by giving them the systems, skills, tools, and training that they never received in school so that they can achieve greater financial success in both business and life. "I have dentists who were pulling their hair out thinking that their only choices were to accept insurance plans or to lose all of their patients," Snyder says. "When we help them turn the corner and discover new options, their mindset changes, and they believe that they can do anything. As an educator for 28 years, I have helped plenty of dentists improve their ability to place fillings, but helping them change their career path to improve not only their own lives but also those of their patients is so impactful."

At Snyder's private practice in Laguna Niguel, California, he has found that patients can perceive the difference in the quality of care that he provides, so they choose to spend out of pocket. He describes the practice as "high-end cosmetics but also high-end quality dentistry." Snyder uses the products that he believes will keep his patients the healthiest; therefore, for more than a decade, he has used Ceramir® cements and resins, which have been acquired by Directa Dental. This line of materials utilizes nanotechnology to deliver unique properties. Ceramir® Protect LC Syringe is a light-cure, resin-modified bioceramic pulp protectant for direct and indirect pulp capping, and Ceramir® Restore QuickCap is a resin-free and self-curing bioceramic restorative material. The line also includes Ceramir® Bioceramic Implant Cement QuikCap, Ceramir® Crown & Bridge QuikCap, and more.

According to Snyder, these products immediately appealed to his desire to provide the best care. "I loved glass ionomers, and these were even better," he says. "They were basically the first cements that, like glass ionomers, could help remineralize tooth structure and strengthen it while also growing hydroxyapatite and self-sealing with no histologic change to the pulpal tissue." The materials feature a high alkaline pH level that creates a hostile environment for bacteria, which is conducive to healing and protects against hypersensitivity. "All of these factors make Ceramir like a unicorn—almost too good to be true," Snyder says. "The research behind the materials is phenomenal. Clinical studies usually find at least some failures or problems, but with Ceramir, very reputable researchers have found no failures or sensitivity."

Of course, very few treatments of any kind are able to last forever; however, Snyder sees benefits from Ceramir in that regard as well. "All restorations leak and fail with time," he says. "But if I am using a better product with the ability to fight off caries, to seal itself, and to strengthen the tooth, then I am giving the patient a much better long-term prognosis. Should a restoration ever come off or fail, the hope is that we would be able to just remove the old cement, apply fresh cement, and put the restoration back into place. Instead of finding decay and the eventual need for a root canal, the remaining tooth structure would be strong because the material interacted with it, so we would just need to replace the cement like replacing worn-out tires or old shoes."

Although Snyder is typically wary of products that are advertised as efficient because that is not his priority, he notes that the Ceramir line is also very easy to use. "I am usually the dentist who places numerous layers of composite and spends extensive time figuring out the occlusion and going through all of the steps," he says. "I do everything to the nth degree, so for me to utilize a product that is quick and easy, it had better be phenomenal and do exactly what it is supposed to do. Ceramir does that. When used correctly and in the right places, the material is amazing."

With their unique chemistries, the numerous Ceramir products allow dentists to have a bioactive material for most restorative situations. For example, Ceramir Bioceramic Implant Cement QuickCap is a 100% resin-free and tissue-friendly permanent implant cement. "I do not believe that any one material can do everything," Snyder says. "Crown-and-bridge cementation, for example, requires a mechanically retentive preparation because it does not involve adhesion. When cementing a solid ceramic restoration with Ceramir Crown & Bridge cement instead of an adhesive resin cement, you need to be sure that you have adequate reduction and thickness for the ceramic to derive its strength. For veneers, onlays, or large cuspal replacements that require adhesive retention, Ceramir is not indicated. However, for cementing implant crowns, I have used Ceramir for cases in which the margins run to the gumline, and I have never seen stronger gingival health around any type of implant crown. Again, there was no histologic change. I have even put it in a Class V subgingivally, and it performed amazingly."

Every product is subject to some level of technique sensitivity, and Snyder cautions that Ceramir must be utilized according to the manufacturer's instructions. When it is, the material exhibits the "unicorn-like" properties that he describes, so it is the type of material that can help dentists meet and exceed the expectations of patients who pay for their treatment out of pocket. With materials like this at his disposal, Snyder is as strong as ever in his convictions. He even recently opened a second office in Las Vegas, Nevada, with both a dental chair and a training facility. "I am pushing and expanding and growing," he says. "I am helping dentists to do what they think they cannot do by ridding them of their self-limiting beliefs. Eventually, I hope to have an impact on patient awareness regarding the benefits of fee-for-service models, which will help the entire profession. That is a lofty goal, but it is good to have lofty goals."

Key Points

• Ceramir Protect LC Syringe’s significant release of calcium on moist tooth surfaces promotes the formation of hydroxyapatite as well as tertiary dentin, leading to safe pulp protection.

• By combining a conventional glass ionomer with the Ceramir technology, Ceramir Restore QuickCap offers a tissue-friendly bioactive restorative material.

• Ceramir Bioceramic Implant Cement is a 100% resin-free and tissue-friendly permanent cement for implant-supported restorations.

For more information, contact:
Ceramir by Directa Dental • 800-537-8765

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