Testing the Tools September 2025

Your Neck and Shoulders Will Thank You

ErgoPrism Air Loupes 4th Gen (5×)

Lumadent

lumadent.com

I would argue that, second to communication, the most difficult and important habit or skill to learn in any profession (and dentistry in particular) is posture ergonomics. I have been wearing loupes since the days of wax-ups in my dental school preclinical lab and started with a 2.5× magnification set of Designs for Vision Buddy Hollys that boasted a declination angle of 25 degrees. If you rewatch “The Fugitive” with Harrison Ford, you will notice that he was wearing the same style. As you can guess from the movie reference, the loupes were great and functional at the time but are no longer cutting edge. In pursuit of something better, I upgraded to the SurgiTel® EVK 3.5× with exchangeable working length front lenses and an increased declination angle of 35 degrees. While definitely a positive change with a wide field of view, I still found myself leaning more than I wanted. My newest set, the Lumadent ErgoPrism Air through-the-lens loupes, have an angle that is about 50 degrees using an angled mirror system that truly allows for an upright seating position. The other interesting function is that you can alter your working length by simply twisting the lenses to bring your depth up or down by about five inches. I chose a 5× magnification, though Lumadent offers a range from 3.5× to 8×. Weighing in at about 38 grams, they are very lightweight and not as front heavy as I expected despite the size and projection of the optic apparatus from the frame and lens. They are heavy enough that you do need to wear a head strap to secure them, but it is not physically straining to hold your head position. When I first received my set, the measurement for my interpupillary distance was not perfect, which lead to headaches. I can’t say enough about how pleasant it was to work with the company’s support team, and, a couple weeks after my video conference repair consult, my loupes were adjusted to meet my needs. If you purchase Lumadent’s light kit to go with the loupes, it has a convenient on/ off touch button that mounts to the frame as well as the button on the battery. While altering my posture from leaning to sitting directly upright took some getting used to and required a stubborn commitment, my neck and shoulder muscles have definitely benefited.

Upgrade Your Periosteal Elevator

Orban Knife

Karl Schumacher

karlschumacher.com

When I learned how to gain entry to a surgical site with a flap for an implant or an extraction and socket preservation, the instrument put in my hand was a molt periosteal. While that is a great and practical choice, I no longer consider it my favorite. Instead, I prefer using an Orban periodontal knife because it not only can lift, but the angled approach also makes it easier to engage underneath and leverage against tissue, which requires less force from me. This more delicate, but equally strong, separation of periosteum and gingiva from bone is also aided by the double-sided blade that is sharp enough to cut while also being dull enough not to accidentally slice. I typically still employ an ovoid periosteal immediately after my releasing incision to open an access hole but then swap to the Orban for sliding along the periosteum to release and lift. My brand preference for an Orban knife is Karl Schumacher because I have had great and long-lasting results from its products, but most surgical instrument manufacturers carry this style. If you are searching for an upgrade to your standard periosteal elevator, look to an Orban periodontal knife for an easily controllable and quickly effective blade to create a conservative surgical access.

Add Some Regenerative Abilities to Your Perio Arsenal

Emdogain®

Straumann®

straumann.com

As a general dentist in a small town, I am engaged in an extensive mixture of procedures, from restorative to surgical and everything in between. One area in which I believe myself to be lacking is regenerative therapies. I have always offered socket preservation for extraction sites but have not branched into other augmentation therapies until recently. As my practice has developed and we have begun to focus our hygiene team on more comprehensive periodontal diagnoses, I have begun looking into ways to treat soft- and hard-tissue defects other than just scaling and root-planing. A periodontist friend who is also a regenerative therapy lecturer recommended I try Emdogain® from Straumann®. This product has been on the market for more than 20 years and has extensive literature to back up its success aiding in periodontal attachment regrowth. Emdogain can be used in situations around teeth and implants such as gingival recession, infrabony defects and furcation-involved vertical bone loss. It is a mixture of naturally occurring enamel matrix proteins that forms an extracellular matrix in the presence of tooth structure, and it stimulates angiogenesis and downregulates inflammatory processes while also having an antibacterial effect. The presence of Emdogain also significantly helps to decrease postoperative pain during surgical management of the aforementioned problems. Procedurally, you begin by gaining access to the site, with or without a flap, and thoroughly clean the defect of everything you can find except bone and tooth. The site must then be treated for two minutes with PrefGel®, a Straumann-developed ethylenediaminetetraacetic acid formula that removes the subgingival biofilm and smear layer from the tooth, aids in hemostasis, and encourages attachment of the Emdogain proteins. Next, rinse the PrefGel entirely from the site with sterile saline, and dry it with air or sterile gauze. Lastly, inject or place the Emdogain to fill the defect up to the level of the surrounding bone. Both PrefGel and Emdogain are loaded into a syringe with bendable delivery tips for easy placement into any site. If possible, cover the site and Emdogain gel with a membrane to maintain placement of the proteins, but this may not be necessary if soft-tissue closure can be gained with suturing or manual pressure. I currently do not have long-term results to brag about with this product, but I am thankful for a straightforward delivery and system that promises consistent regenerative capabilities.

Ross Isbell, DMD, MBA, currently practices in Gadsden, Alabama, with his father, Gordon Isbell, DMD, MAGD. He attended the University of Alabama at Birmingham (UAB) School of Dentistry and completed a general practice residency at UAB Hospital. Isbell has confirmed to AGD that he has not received any remuneration from the manufacturers of the products reviewed or their affiliates for the past three years. All reviews are the opinions of the author and are not shared or endorsed by AGD Impact or AGD. To comment on this article, email impact@agd.org.