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Practice Profile

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Brett E. Gilbert, DDS

Brett E. Gilbert, DDS

Combining clinical excellence and compassion What can you tell us about your background? I was born and raised in Baltimore, Maryland. I attended college, dental school, and my postgraduate endodontic residency at the University...

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Randy Garland, DDS

Randy Garland, DDS

Exceeding expectations What can you tell us about your background?
I grew up in southern Orange County and earned a bachelor’s degree in biology at San Diego State University in 1983. There I met my future wife, Kim, at the...

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Scott A. Norton, DMD, MSD

Scott A. Norton, DMD, MSD

Focus on family, patients, friends, growth, and community What can you tell us about your background? For as long as I can remember, I wanted to make people smile. I always loved getting the class laughing in grade school. Looking back, I am sure...

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Clinical Articles

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Management of a tooth with a large internal resorption defect

Management of a tooth with a large internal resorption defect

Dr. Robert Slosberg facilitates accurate mapping and obturation of the resportive defect with CBCT imaging Abstract
A patient presented with advanced internal root resorption of tooth No. 9. The prominent location of this tooth...

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Pulpal diagnosis of teeth presenting with condensing osteitis prior to endodontic treatment — a retrospective study

Pulpal diagnosis of teeth presenting with condensing osteitis prior to endodontic treatment — a retrospective study

Drs. Brian Shaughnessy, Margaret Jones, Ricardo Caicedo, Joseph Morelli, Stephen Clark, and Ms. Jennifer Osborne review the occurrence of teeth presenting with condensing osteitis and their associated pulpal diagnosis over a 2-year period. Introduction Read More...

GuttaCore® system: a step forward in the evolution of endodontics

GuttaCore® system: a step forward in the evolution of endodontics

Dr. Andrei Zoryan dispels some of the common myths surrounding carrier-based obturation Carrier-based gutta percha Carrier-based obturation (such as Thermafil®, GT® obturator, ProTaper® obturator [Dentsply Tulsa Dental Specialties]) is one...

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Practice Management

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Effortless, fun, and profitable endodontics

Effortless, fun, and profitable endodontics

In part 2 of his series, Dr. Ace Goerig suggests ways to reduce stress in the practice Almost all endodontists could be completely out of debt and on the way to financial freedom within 5 to 7 years if they only knew the secret. But the secret is...

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Life after root canal — it’s not just about having enough money

Life after root canal — it’s not just about having enough money

Dr. Robert Fleisher ruminates on how to prepare for retirement There are so many articles about everything that you become pretty much overwhelmed and can never expect to read them all. So you pick and choose. You like to learn about the latest and...

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Superior customer service

Superior customer service

Dr. Roger Levin presents the 10 top ways to help create a perfect dental team With the changes brought on by the economy, top companies are bringing in the best resources they can find to evaluate where their organizations stand. They want to know...

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discus_lobby

Since 1989, Discus has been regarded as both the pioneer and global leader in teeth whitening. The Discus flagship product, NiteWhite, was developed by company founders Dr. Bill Dorfman and Robert Hayman, who sold cases of syringes directly to US dentists out of a small Los Angeles office with the aid of a small team of high-energy, enthusiastic sales reps. Over the years, Discus enhanced its whitening portfolio to include a full offering of both chairside (Zoom!, BriteSmile, Dash) and take-home (NiteWhite, DayWhite, Whitespeed) options for dentists and their patients.

Over the next few years, the company expanded beyond whitening to launch a line of impression materials (Splash, Precision) restorative materials (FLASHlite, Matrixx, Cabrio) and oral hygiene products (BreathRx, Fluoridex). The following decade in Discus’ history was defined by bold, sexy marketing campaigns and a direct sales model that fostered close relationships between Discus and its customers. This customer-centric model, coupled with aggressive and daring promotions, positioned Discus as the veritable “gold-standard” of marketing in dentistry.

By 2004, Discus gained a loyal customer base of over 50,000 North American dentists, direct operations in Canada, the UK, Germany, Benelux, France, Spain, Australia, and New Zealand, and a global presence through distributors in over 90 more countries. In an effort to offer global clients more than esthetic solutions, Discus explored entry into an entirely new area to the Company—endodontics. The goal was to develop something unique and effective that would truly make an impact on the endodontic community. The company wanted a system that offered both the dentist and their patients a better and more effective treatment method, and a system that put patient safety first.

The Birth of SMART Endodontics
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LightSpeed Technology, Inc. – A Truly Different Approach to the Root
In the late 1980s and early 1990s, a uniquely designed endodontic instrument prototype was developed and tested at the University of Texas Health Science Center at San Antonio. The original concept came from a desire to create an endodontic instrument that could outperform conventionally designed K-type stainless steel instruments. This work eventually led to the creation of LightSpeed. “The concept behind LightSpeed was to design an instrument that could navigate the extreme curves of root canals, similar to a plumber’s roto-rooter,” explains Dr. E. Steve Senia, co-inventor of LightSpeed. After evaluating the results of many hours of testing and becoming motivated by the positive feedback received from dentists testing LightSpeed, Dr. Senia, his son Steven Senia, and Dr. William Wildey teamed up to form their own company, LightSpeed Technology Inc., in 1993. Over the next 13 years, LightSpeed Technology, Inc. (LTI) utilized an intimate, training-driven model to grow into a multimillion dollar business with direct sales in the US and distributors in over 25 countries.

Dental Power, Inc. – Thinking from the Bottom Up
Around the same time, Dr. John Schoeffel, a Harvard-trained endodontist and practicing clinician in Dana Point, Ca, was employing a similar, small-business, event-driven approach to his own company, Dental Power, Inc. (DPI). What caught the attention of Discus Dental was a unique and seemingly backwards irrigation device. “I originally designed the EndoVac as a device to deliver sodium hypochlorite to full working length without the possibility of apical ejection,” explains Schoeffel.
EndoVac was a perfect fit for Discus Dental. The Company had already identified LTI for its revolutionary instrumentation and obturation products; now they had found a product and a company that quite literally could turn the field of endodontic irrigation upside down through its unparalleled safety feature. 

In June 2006, both companies were acquired by Discus and the creation of the SMART Endodontics was in full swing. It was now time to ignite the Discus marketing machine, leverage the company’s strong direct-selling model and vast international dealer network to introduce these products to Discus’ broad base of customers.

LightSpeedLSX – Biologically Optimal Instrumentation
The LightSpeedLSX instrument was designed with two goals in mind: (1) completely debride the apical third while preserving as much tooth structure as possible and, (2) do so in a safe manner by practically eliminating the dentist’s fear of instrument breakage. “Shaping a canal merely to prepare it for obturation is backwards thinking,” explains Wildey. “Excessive removal of coronal tooth structure can dramatically weaken a tooth. Because the LSX is non-tapered and only cuts at the tip, we can mechanically remove more bacteria in the apical third, yet sacrifice less overall tooth structure. LSX’s small cutting surface provides incredible tactile feedback. I always know where LSX is cutting the canal. For decades, the studies have told us that we need to prepare canals to much larger apical sizes to achieve complete cleaning. Most rotary systems don’t provide larger sizes that are flexible enough. With LightSpeedLSX I don’t have to worry about transporting or ledging, not to mention physical fatigue from having to hand file to larger sizes.”

This philosophy is one that seems to be gaining momentum these days. “At Penn, we teach all of our endo post-docs the importance of treating root canals with biologically acceptable root canal preparations,” explains Dr. Syngcuk Kim, endodontist and Professor and Chair of the Department of Endodontics at the University of Pennsylvania. “Preserving healthy tooth structure and respecting what nature created is fundamental in all our teachings. An instrument that helps accomplish this is a key part of our endodontic armamentarium.”

In terms of safety, the unique features of the LSX instrument are best described by an on-going study at Creighton Dental School, where the faculty has been teaching dental students the LightSpeed technique for roughly 10 years. A study conducted with the previous version of LightSpeed (LS1) showed a remarkably low irretrievable breakage rate of 1.3%. Since Creighton converted from LS1 to LSX in 2005, they continued monitoring instrument breakage. Out of 3,100 canals treated by junior and senior dental students using the LightSpeedLSX with the new safety release feature, the breakage rate dropped from 1.3% to only 0.37%—a reduction of approximately 72%.

While irretrievable breakage has not yet been completely eliminated, 0.37% is enough to instill confidence in LSX users. But the news gets even better--the same Creighton study showed that 75% of irretrievable instrument fragments could be bypassed and filled to length. This result is a factor of the unique LSX spade-shaped blade, which can leave ample room for bypassing on either side. This means that the chance of leaving a short fragment in the root without being able to bypass it is approximately 1 in 1,000.

EndoVac – Complete Microbial Control at Working Length
Complete microbial control was a concept communicated by Dr. Martin Trope, endodontist and former Professor Emeritus for the Department of Endodontics at the University of North Carolina, Chapel Hill. “Achieving maximal microbial control is the critical step for success in endodontics,” explains Trope. “Anything less compromises the case from the start, thereby decreasing the likelihood of long-term success. The concept is quite simple: if you control the microbes, you control the case. Today, new technologies can help us ensure that we can achieve microbial control from orifice to apex. We expect that these technologies will dramatically increase success rates in our field.”

With the EndoVac, there is no positive-pressure delivery of irrigant inside the root canal itself. Irrigants are drawn into the canal through a MacroCannula that evacuates gross debris, and the smaller debris is drawn through a MicroCannula placed at full working length. The MicroCannula is a true engineering and manufacturing phenomenon. Within the last 0.7 mm of the MicroCannula tip are 12 laser-drilled holes, each 100 mm in diameter. It is through these suctioning holes that liquid EDTA, sodium hypochlorite, or other irrigants are drawn down and evacuated safely away.

“All positive pressure [needle] irrigation systems can eject irrigants through the apical termination and also fail to circulate irrigant in the critical last few millimeters. Thus, micro-organisms and their by-products remain in the most critical apical area of the canal,” explains Schoeffel. “In 2009, Desai (JOE 2009, pgs 545-549) demonstrated that the safety features I developed were effective, while Nielsen (JOE 2007, pgs 611-615) and Hockett (JOE 2008, pgs 1374-1377) demonstrated significantly superior canal cleanliness and 100% biological control.”

SimpliFill & HotShot – Complex Obturation Made Simple
For obturation, Discus offers SimpliFill—available in both gutta-percha and Resilon—as the ideal apical plug obclip_image333tura tor for LSX preparations. The 5-mm SimpliFill Apical Plug fits into an LSX preparation like a cork in a wine bottle. When pushed to length, hydraulic forces push sealer into lateral canals, and with a few simple twists, the carrier is removed leaving the apical plug securely in place. “Many endodontists tell me that up to 40% of their caseload is retreatment,” comments Steven Senia. “Their biggest complaint is having to drill through the plastic or metal that is left behind with other carrier-based systems. The nice thing about SimpliFill is that the carrier is completely removed leaving only the gutta percha or Resilon behind.”

To finish the case, Discus introduced the HotShot cordless backfill obturation device to the endodontic community. This product became the ideal solution for back-filling behind the 5-mm length SimpliFill Apical Plug. HotShot has been a huge hit as it couples the clinical benefits of warm backfill with the freedom of a cordless design.

The Next Generation of Products

The products at the core of the SMART Endodontics portfolio—LightSpeed, EndoVac and SimpliFill—remain. But, just as Discus expanded to get into endodontics in 2006, the company expanded within endodontics in order to offer a more complete solution to their customers.

“LightSpeedLSX is the most flexible rotary NiTi instrument in the world and the most effective at cleaning the apical third, especially in curved canals,” says Senia. “Though the traditional classic LightSpeed technique was successfully used by thousands of dentists for many years, we’ve known that eventually we’d need to respond to customer demands and offer a crown-down alternative.” After over 3 years of development and multiple rounds of prototypes, Discus launched the LightSpeedCRX™ (C stands for coronal) and LightSpeedMRX™ (M stands for mid-root) instruments in mid-2009. Clinicians appreciate the CRX because it eliminates the number of instruments needed during a typical coronal flaring procedure; because of its tapered shape, one CRX does the work of three Gates-Glidden drills. The benefit of MRX is that it creates a smooth, funnel-like shape through the mid-root, leaving the tough-to-reach apical third for LSX. This is a very unique approach, as each instrument type (CRX, MRX and LSX) is designed and optimized to clean and shape its specific third of the canal.

At the same time Discus introduced CRX and MRX to the endodontic community, the company also released the HotShot’s sister product—the HotTip. This cordless device offers an alternative for doctors using a warm vertical compaction technique, and is also an ideal tool for eliminating voids during the incremental backfill process utilizing HotShot.

“What we’ve got here is a product line that puts patients first, improves outcomes, protects clinicians, and provides support,” says Vice President of Global Marketing Jennifer McNally. “Irretrievable broken instruments, irrigation accidents, and poor fills are concerns that all doctors have to some extent. We take pride in offering a system that can be easier, safer, and more worry-free for our customers.”

Going the Extra Mile – The SMART Endodontics Mentor Program

Regardless of the education format, the science behind the SMART Endodontics platform remains compelling. “We take pride in the fact that our products are backed with an abundance of practical clinical research,” says Steven Senia. It’s helpful from a sales perspective to have some “big names” on the lecture circuit, but it is Discus’ intent to offer a dedicated group of knowledgeable clinicians who use these products every day to provide assistance to dentists learning these new techniques and new ways of thinking. So what Discus has done is leverage a core group of users to expand its training and support reach.


Discus “Mentors” teach small, private continuing education (CE) courses often in their own offices. When doctors are making a major purchase that has significant practice management implications, they prefer to speak to a wet-fingered dentist actually using the product. “We’ve learned two important lessons as we’ve hosted CE courses over the years: (1) doctors prefer to talk to other doctors before, during, and after the purchase, and (2) bigger is not better,” says Senia. In a smaller group setting, participating doctors are able to receive the one-on-one attention they often need to gain understanding and confidence in these new techniques. It also allows them to establish a close relationship with the mentor, one they can turn to later if they need additional help.

The Discus SMART Endodontics Mentor program begins with two courses offering a total of 11 CE units. The first three units are completed as a series of online webinars from the comfort of one’s own home or office. The advantage of this approach is that a participant can proceed at his or her own pace and view the material again if necessary. It also gives one a sense of the philosophies that support SMART Endodontics so they will better know if it is the right system for them before investing more time, effort, and money. The next eight units are mostly hands-on experience with the techniques and equipment, and are taken at one of many locations around North America. “Our biggest competitor is inertia,” says Senia. “Change introduces uncertainty and this program can provide the skills and confidence to help eliminate that uncertainty.”

In 2010, Discus will hold over 120 small hands-on courses. In fact, they plan to host courses every other week at their corporate headquarters in Culver City. “Whether you’re from Southern California or not, we’d love to invite every doctor to come out to LA so we can show you around the office and welcome you to the Discus family,” says CEO Steve Semmelmayer.


Looking Toward the Future

The SMART Endodontics product line is making a global impact, and can now be found in over 30 countries worldwide. In 2009 alone, Discus launched the entire portfolio through its direct operations in Australia, and also through dealers in Colombia, Costa Rica, Hungary, Greece, Saudi Arabia, Egypt, Turkey, Jordan, the United Arab Emirates, Indonesia, Malaysia, and the Philippines. “At the end of the day, our number one priority is patient safety,” says Discus founder Dr. Bill Dorfman. “Every patient who sits in a dental chair for a root canal is entitled to receive the best care available, and since 2006, we’ve incorporated this belief into our corporate mission. It’s been over 3 years since Discus introduced Smart Endodontics to the world, and yet upon second glance, it feels like we’re just getting started.”

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Latest News

Research has shown that irrigants are more effective when they are electro-mechanically activated.

Acoustic streaming and cavitation have been proven to significantly enhance cleaning of difficult anatomy. Studies have shown that low frequency (Sonic) oscillation (160-190Hz) was not sufficient to create acoustic streaming or cavitation within the canal space.

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