MIcHAEl b. MIllEr, D.D.S. – President/Editor-in-chief InGrID r. cASTEllAnOS, c.D. – Vice President/Publisher EDITOrIAl TEAM: David l. baird, D.D.S., bellevue, WA; robert W. baker, Jr., D.M.D, Ithaca, nY; Joel H. berg, D.D.S., M.S., Seattle, WA; nathan S. birnbaum, D.D.S., Wellesley, MA; Alan A. boghosian, D.D.S., chicago, Il; Mitch A. conditt, D.D.S., Fort Worth, TX; Gerald E. Denehy, D.D.S., M.S., Iowa city, IA; Marvin A. Fier, D.D.S., Pomona, nY; Daniel Fortin, D.M.D., M.S., Montreal, canada; George A. Freedman, D.D.S., Toronto, Ont., canada; Jack D. Griffin, Jr., D.M.D., Eureka, MO; David S. Hornbrook, D.D.S., San Diego, cA; ronald D. Jackson, D.D.S., Middleburg, VA; Mark E. Jensen, D.D.S., Ph.D., Slidell, lA; Thomas P. Keogh, M.D., D.D.S., navarra, Spain; Timothy F. Kosinski, M.S., D.D.S., bingham Farms, MI; Hannu O. laamanen, D.D.S., M.S., Turku, Finland; Paul landman, D.D.S., chicago, Il; clarence c. lindquist, D.D.S., Washington, D.c.; Edward lynch, M.A., b.D.Sc., Ph.D., coventry, uK; Hans Malmstrom, D.D.S., rochester, nY; Sandesh Mayekar, M.D.S., Mumbai, India; Steven McGowan, c.D.T., Seattle, WA; Michael K. McGuire, D.D.S., Houston, TX; carlos Muñoz, D.D.S., M.S., buffalo, nY; christopher Pescatore, D.M.D., Danville, cA; Stephen D. Poss, D.D.S., brentwood, Tn; robert G. ritter, D.M.D., Juniper, Fl; Andrew T. Shannon, D.D.S., Vancouver, bc, canada; liviu Steier, D.M.D., Mayen, Germany; Franklin Tay, b.D.Sc.(Hons), Ph.D., Augusta, GA; Marcos A. Vargas, D.D.S., M.S., Iowa city, IA; charles Wakefield, D.D.S., Dallas, TX; Thomas G. Wilson, Jr., D.D.S., Dallas, TX; David Winkler, D.D.S., Windsor berks, England. A publication member of the American Association of Dental Editors The Ratings DESENSiTiZERS — officE The information source for esthetic dentistry OcTObEr 2013 nuMbEr 246 27 th Anniversary REAliTy Gluma PowerGel iNTRoDucTioN/MANufAcTuRER’S clAiMS There are a few iconic brand names in the dental world and Gluma certainly has to be among the standard-bearers. As the first commercial product con- taining glutaraldehyde and HEMA, the original Gluma Desensitizer made its initial appearance in The Ratings in 1992 as a component of the Gluma dental adhesive, but then it ushered in the new Desensitizers section in 1996 and became our perennial #1 and 5 Star recipient in 2002. This lofty status has been largely due to its sterling lab test results as well as its long-standing clinical performance. PowerGel aims to stay faithful to its legacy by mimicking the chemistry of the original version, but in a gel to improve on its application control, making it safer to use near soft tissue. It also has a green color so you can see where you place it. It can be presumably placed without any agitation, which should also help keeping it off the marginal gingiva. coMpoSiTioN Glutaraldehyde, HEMA, pyrogenic silicic acid and water. ph 3.7 ViScoSiTy The gel itself is indeed very thick and non-runny. All evaluators except one thought it was about right, while the lone holdout considered it to be too thick. One evaluator noted it stayed where he applied it. oDoR Most (73%) evaluators thought it was not really noticeable, while the other 27% found it to be strong. One evaluator noted it was not as strong as the original version. coloR Green. MANufAcTuRER Heraeus www.heraeus-kulzer-us.com pRicES Assortment $146.36/4g/4.4ml ($33.26/ml) ShElf lifE 2 years (4.5) 1 RAVES & RANTS + Gel allows you to control its application + Green color gives it extra visibility – Directions don’t even mention use under direct restorations – Rinsing adds an extra step
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th REAliTy · taining glutaraldehyde and HEMA, the original Gluma Desensitizer made its initial appearance in The Ratings in 1992 as a component of the Gluma dental adhesive, but
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MIcHAEl b. MIllEr, D.D.S. – President/Editor-in-chief InGrID r. cASTEllAnOS, c.D. – Vice President/Publisher
EDITOrIAl TEAM: David l. baird, D.D.S., bellevue, WA; robert W. baker, Jr., D.M.D, Ithaca, nY; Joel H. berg, D.D.S., M.S., Seattle, WA; nathan S. birnbaum, D.D.S., Wellesley, MA; Alan A. boghosian, D.D.S.,
chicago, Il; Mitch A. conditt, D.D.S., Fort Worth, TX; Gerald E. Denehy, D.D.S., M.S., Iowa city, IA; Marvin A. Fier, D.D.S., Pomona, nY; Daniel Fortin, D.M.D., M.S., Montreal, canada; George A. Freedman, D.D.S.,
Toronto, Ont., canada; Jack D. Griffin, Jr., D.M.D., Eureka, MO; David S. Hornbrook, D.D.S., San Diego, cA; ronald D. Jackson, D.D.S., Middleburg, VA; Mark E. Jensen, D.D.S., Ph.D., Slidell, lA; Thomas P. Keogh,
M.D., D.D.S., navarra, Spain; Timothy F. Kosinski, M.S., D.D.S., bingham Farms, MI; Hannu O. laamanen, D.D.S., M.S., Turku, Finland; Paul landman, D.D.S., chicago, Il; clarence c. lindquist, D.D.S., Washington,
D.c.; Edward lynch, M.A., b.D.Sc., Ph.D., coventry, uK; Hans Malmstrom, D.D.S., rochester, nY; Sandesh Mayekar, M.D.S., Mumbai, India; Steven McGowan, c.D.T., Seattle, WA; Michael K. McGuire, D.D.S., Houston,
TX; carlos Muñoz, D.D.S., M.S., buffalo, nY; christopher Pescatore, D.M.D., Danville, cA; Stephen D. Poss, D.D.S., brentwood, Tn; robert G. ritter, D.M.D., Juniper, Fl; Andrew T. Shannon, D.D.S., Vancouver, bc,
canada; liviu Steier, D.M.D., Mayen, Germany; Franklin Tay, b.D.Sc.(Hons), Ph.D., Augusta, GA; Marcos A. Vargas, D.D.S., M.S., Iowa city, IA; charles Wakefield, D.D.S., Dallas, TX; Thomas G. Wilson, Jr., D.D.S.,
Dallas, TX; David Winkler, D.D.S., Windsor berks, England.
A publication member of theAmerican Association of Dental Editors
The Ratings DESENSiTiZERS — officE
T h e i n f o r m a t i o n s o u r c e f o r e s t h e t i c d e n t i s t r y
O c T O b E r 2 0 1 3 n u M b E r 2 4 6
2 7 t h A n n i v e r s a r y
REAliTy
Gluma PowerGeliNTRoDucTioN/MANufAcTuRER’S clAiMS
There are a few iconic brand names in the dental world and Gluma certainly
has to be among the standard-bearers. As the first commercial product con-
taining glutaraldehyde and HEMA, the original Gluma Desensitizer made its
initial appearance in The Ratings in 1992 as a component of the Gluma dental
adhesive, but then it ushered in the new Desensitizers section in 1996 and
became our perennial #1 and 5 Star recipient in 2002. This lofty status has
been largely due to its sterling lab test results as well as its long-standing
clinical performance.
PowerGel aims to stay faithful to its legacy by mimicking the chemistry of the
original version, but in a gel to improve on its application control, making it
safer to use near soft tissue. It also has a green color so you can see where
you place it. It can be presumably placed without any agitation, which should
also help keeping it off the marginal gingiva.
coMpoSiTioN
Glutaraldehyde, HEMA, pyrogenic silicic acid and water.
ph
3.7
ViScoSiTy
The gel itself is indeed very thick and non-runny. All evaluators except one
thought it was about right, while the lone holdout considered it to be too
thick. One evaluator noted it stayed where he applied it.
oDoR
Most (73%) evaluators thought it was not really noticeable, while the other
27% found it to be strong. One evaluator noted it was not as strong as the
Tuberculin-like syringes on which you mount a black
plastic tip with an applicator tip-like end on it. This type
of tip is a curious selection since, as noted previously,
the gel is supposed to be applied and left in place with-
out any agitation. You are also warned to keep the gel
away from the soft tissue. With these issues, a simple,
small gauge metal tip would have been preferred.
nevertheless, the plastic tip comes straight and is easy
to bend, but won’t retain a right angle — it rebounds to
about 115 degrees. And one evaluator liked the applica-
tor-like end on the plastic tip.
uSE
One major difference between PowerGel and its lega-
cy namesake is the fact that PowerGel must be rinsed
off before applying your bonding agent or cementing
your crown, whereas the original version is typically
not rinsed off.
Due to its viscosity, there is a tendency to dispense a
thicker layer than is needed — all you need is a very thin
coat. When you are judicious in the amount you apply, the
lime green color becomes very subtle. You can still see it,
but bold it’s not. Allow it to dwell for 30-60 seconds.
After cleaning the tooth or prep, rinse but don’t overdry
— our bond strength tests indicate applying it to a moist
(not wet) tooth was best, even though it does contain
water. Then rinse with a vigorous air-water spray and
leave the tooth in the optimal manner to maximize the
performance of your bonding agent, assuming you are
using it under a restoration.
All evaluators found it to be easy to apply, with 46% of
the evaluators allowing it to dwell on the tooth for 30
seconds, 18% used 45 seconds, and 36% hedged their
bets with 60 seconds. One evaluator noted that it wasn’t
easy dispensing the gel at first and then there was con-
tinued flow even after application.
The rinsing step, unnecessary with most other desensi-
tizers, was not an issue with most (82%) evaluators,
while the other 18% felt it was a nuisance. One evalua-
tor reported that if you are desensitizing a cervical lesion
and the patient is not anesthetized, then rinsing can be
painful if the desensitization is not effective.
EffEcT oN BoND STRENGTh
none.
EffEcTiVENESS
under restorations placed with etch/rinse adhesives
All evaluators except one reported it worked all the time,
while the lone holdout found it worked some of the time.
One evaluator noted that it worked all the time in reduc-
ing if not totally eliminating sensitivity.
Note: The directions do not even mention using it under
direct restorations, although this application is stated on
the manufacturer’s site.
cervical areas
Slightly more than half (55%) of the evaluators reported
it worked some of the time, while the other 45% found it
worked all the time.
pAckAGiNG
The syringes are secured in a white plastic tray with a
clear plastic cover, all of which are inside a typical card-
board box that was not sealed in any manner and only
has product identification on the front, which also
includes the expiration date. The label on the syringes
includes the expiration date as well.
One evaluator needed more syringe tips. Another evalua-
tor noted the white plastic tray securing the contents
was obviously from another product since about one-
third of it is empty. This means the tray and box could
have been substantially smaller. Still another evaluator
noted that some syringes had a flaky yellow powder
around its orifice when the cap was removed.
DiREcTioNS
Small, multi-language booklet that is fairly straightfor-
ward and easy to follow, although there is a directive to
use a rubber dam for treating root sensitivity and seating
crowns. While we understand a rubber dam in these situ-
ations may be optimal, we also know that virtually no cli-
nician will use one for these applications. no other isola-
tion method was even mentioned.
There is also a plastic-laminated, illustrated technique
card, but the lack of any words describing the illustrations
makes them less relevant, confusing and more difficult to
follow. Interestingly, this card shows isolation with either
a rubber dam or cotton rolls, while the aforementioned
paper booklet only tells you to use a rubber dam.
As noted under Effectiveness, using it under a direct
composite like the original version is not even men-
tioned, although the manufacturer’s site lists that appli-
cation as an indication. These directions only state it
should be used for cervical sensitivity and under indirec-
tion restorations. Therefore, there are no instructions for
the application steps prior to placing a direct restoration.
2
3
STRENGThS Easy to use and reasonably effective for
use under restorations and for cervical lesions. Gel formu-
la is easy to see and control since it is not runny. chemistry
is time-tested and proven. Does not affect bond strength.
Odor not as bad as competing products.
WEAkNESSES Doesn’t always work. rinsing it off is an
additional step. Directions do not even mention using it
under direct restorations. Applicator tip is somewhat large,
especially when you are trying to keep it off the gingiva.
One evaluator had difficulty in starting the flow of materi-
al out of the syringe and then difficulty in stemming the
flow after dispensing.
BoTToM liNE
Despite the extra rinsing step, the gel consistency and syringe dispensing give it a step up on the competition.
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