January 3, 2017

Pulpdent Celebrates 70 Years of Dental Innovation

PULPDENT Corporation enters its eighth decade as the world leader in esthetic bioactive restorative dental materials and the company’s mission of saving teeth and promoting good health date back even further.

Pulpdent 70th AnniversaryBy the time he was eleven years old, Harold Berk had found his calling: dentistry. Years later he told his family that as a young boy he “wanted to fix children’s teeth.”

Born in 1917 to a family of Eastern European immigrants, Dr. Berk’s studies brought him to the Forsyth Dental Infirmary in Boston, MA where he conducted research on the use of calcium hydroxide in vital pulp therapy. In 1947 Dr. Berk started a company to manufacture and market his recently developed Pulpdent Paste, a premixed calcium hydroxide paste still used by dentists worldwide today. The company was eventually called PULPDENT Corporation in honor of Dr. Berk’s original product.

From the beginning, Pulpdent was guided by Dr. Berk’s “mission to save teeth and … help my patients live in comfort and smile with confidence.” In the 1970s, Dr. Berk’s three sons, Ken, Fred and Don, took over management and operations of the company. Dr. Berk continued to serve as a consultant while maintaining a busy dental practice and teaching at Tufts Dental School.

Dr. Berk understood nature’s healing powers and saw it as his responsibility “to create an environment that is favorable for the natural healing process.” Dr. Berk’s sons explored new ways to develop dental products that mimicked nature and supported oral health. A series of innovations over a period of fifteen years culminated in 2013 with Pulpdent’s launch of ACTIVA BioACTIVE, a dental filling material that behaves much like natural teeth. The material is “bioactive” meaning it stimulates the formation of apatite (the building blocks of teeth), chemically bonds to teeth and helps seal them against decay. ACTIVA BioACTIVE has received many awards, including top performance ratings from The Dental Advisor in 2016.

Pulpdent’s offices and manufacturing facilities are based outside of Boston, MA, just a few miles from where Dr. Berk practiced and taught dentistry. Two of Dr. Berk’s grandchildren, Lewis and Leah Berk, recently joined the company, ensuring it will remain family run for another generation.

Pulpdent celebrates its 70th anniversary this year with renewed commitment to product innovation, clinical education and patient-centered care. To commemorate this milestone, Pulpdent has launched Heroic Dentistry, a clinical case series that showcases clinicians who combine innovation and compassion to deliver life-changing results for their patients, which will be featured on the Pulpdent website.

Do you have a Heroic Dentistry case to share? Send your story to feedback@pulpdent.com.

January 3, 2017

Heroic Dentistry: Severe Autism, Rampant Caries and Strip Crowns

By Raymond Kimsey, D.M.D.

The Heroic Dentistry series celebrates oral health care providers who, like PULPDENT founder Dr. Harold Berk, have made it their mission to save teeth and help patients live in comfort and smile with confidence.   

Special needs patients often present unique challenges for the practitioner. This was the case with Daniel, who was 19 years old when he was referred to our office.

Daniel suffers from severe autism and its associated lack of speech, and he is further compromised by a seizure disorder.  His mother has had great difficulty finding a dentist who could treat him. When he was younger, he could be restrained for treatment, but now as a strong young man, physical restraint is neither desirable nor possible.  His mother was hopeful that I would be able to sedate him and treat his needs.

Daniel had no ability to communicate with me and was completely uncooperative.  With patience I was able to get a brief look in his mouth, which revealed severe caries. His mother confirmed that there was a lot of apple juice in his diet, and so one of the causes was obvious. We had a long discussion about diet as a major caries risk factor.

Figure 1

Figure 1: Shows rampant caries.

Considering these obstacles, I now had to devise a treatment plan. I would have to treat him as quickly as possible, for an affordable cost, with a material that would withstand stress and not contribute to rapid recurrent marginal caries. From my experience using strip crowns in primary dentition, I knew that they offered a fast, single appointment option that could both reduce cost and the risks of extensive anesthesia. I had to plan so that I could complete the treatment in one visit. Thinking ahead, I quickly made an upper anterior alginate impression.

Using the study model, I prepared and trimmed four strip crowns in advance of Daniel’s visit. On treatment day, I placed an IV with some difficulty and sedated him with midazolam. Even with IV sedation, I knew that I wouldn’t have much time.  The caries was very deep, but there were no exposures, so I removed the decay, treated the dentin with Pulpdent Desensitizer, placed a bonding agent, and filled the strip crown forms with ACTIVA BioACTIVE-RESTORATIVE

Figure 2

Figure 2: Decay is removed and teeth prepared for restoration.

Figure 3

Figure 3: Strip crowns were prepared in advance using a study model. The strip crowns are then filled with ACTIVA-BioACTIVE-RESTORATIVE, placed and light cured (not shown).

Why Activa? I have been using Activa for the past two years and knew that it would be the solution for several reasons. It is esthetic, durable, and its bioactive properties and marginal integrity are more resistant to recurrent caries than any other product. It is high strength, dual cure, and it flows nicely, so it is easy to fill and apply the strip crowns. The actual treatment time was remarkably fast for treating such severe disease. Daniels’s mother was simply delighted with the outcome.

Figure 4

Figure 4: Shows the final result with teeth restored with ACTIVA BioACTIVE-RESTORATIVE.

Daniel returned for a follow up the next week, and upon seeing me walk into the room, he began to smile! Although he could not express it verbally, he knew how much I had helped him. With proper planning, this seemingly impossible case had a gratifying outcome for both the patient and his family, and for me as well.

About Dr. Raymond Kimsey
Dr. Kimsey served on the staff of Miami Children’s Hospital for twenty years and maintains a private practice in Coral Gables, Florida. His specialties include implantology, anesthesia and IV sedation, and management of dental phobic patients and those with mental or physical developmental defects. He has made numerous humanitarian trips to provide dental care in remote areas of the Dominican Republic.

December 12, 2016

ACTIVA is “Revolutionary” – Dr. Howard Glazer

ACTIVA BioACTIVE RestorativeDr. Howard Glazer has dedicated the past four decades to the field of dentistry. This clinician, educator and former AGD President has evaluated many products over the years and describes ACTIVA BioACTIVE-RESTORATIVE as “revolutionary” in a recent interview with Compendium.  “With ACTIVA, we have the ability to treat the tooth from within” says Dr. Glazer, explaining that “ACTIVA is the first esthetic restorative to not only give us fluoride release and recharge, but also calcium and phosphate, which are the building blocks of tooth structure. This brings strength to the restoration and allows me to truly restore a tooth, not just repair it.” Click here to read the interview.

November 14, 2016

ACTIVA™ User Shares His Experience

Dr. John Herzog of Danvers, MA has been practicing dentistry for over 30 years. During that time he has used many different dental restoratives, from amalgams and traditional composites to bioactive materials. ACTIVA™ has become his product of choice for direct restorations because it is easy to place, contour and polish.

In this interview Dr. Herzog explains how he is using ACTIVA in his dental practice.

 

Dr. John Herzog

About Dr. John Herzog
Dr. John Herzog was born and raised in Beverly, MA. He attended St. John’s Preparatory School, Holy Cross College, and Columbia University School of Dental Medicine. He then completed a one-year General Practice Residency at St. Luke’s/Roosevelt Hospital in New York City before returning home to the North Shore in 1984. In addition to his dedication to his patients, Dr. Herzog is dedicated to his profession. He has served organized dentistry in many capacities, including as Chair of the North Shore District and as General Chair of the Yankee Dental Congress, the third largest dental meeting in the country. Dr. Herzog is a member of the American College of Dentists and the International College of Dentists, organizations that invite members based upon their commitment to organized dentistry and ethical dental practice.

October 13, 2016

Heroic Dentistry: Strip Crowns for Leigh

By Eyal Simchi, D.M.D.

The Heroic Dentistry series celebrates oral health care providers who, like PULPDENT founder Dr. Harold Berk, have made it their mission to save teeth and help patients live in comfort and smile with confidence.   

The AAPD recommends children establish a dental home by age one so that they become accustomed to seeing a dentist and their parents can be educated about hygiene and prevention. These early appointments can help overcome fear and avoid serious problems down the road as seen in this case.

Leigh was 3 years old when he first came to my office with failed restorations and rampant caries (Figure 1). He had come from overseas where both he and his mother had bad experiences with dentists and developed severe dental-phobia. His mother was delighted to see that her children did not scream during treatment in our office.

Figure 1

Figure 1. Child presents with failed composite restorations and rampant caries.

Especially when working on children, it is important to remember that each tooth is attached to a person. Leigh was apprehensive and needed significant dental work completed quickly and without causing trauma. My goal in creating a treatment plan is to relieve discomfort, reduce dental disease and secondary decay, and restore function and esthetics, all in one visit.

We have seen the disadvantages of conventional composite strip crowns: degradation of the bond, recurrent decay that may lead to pulpal involvement, and fracture and chipping. Zirconia crowns have been a great addition to our restorative tool box, but they are labor intensive, require aggressive tooth reduction, and take more time. The aggressive prep requires anesthesia, which can contribute to the child’s anxiety, especially when applied to the sensitive maxillary anterior region.

A strip crown technique using ACTIVA BioACTIVE-RESTORATIVE requires fewer steps, takes less time, provides a better seal against secondary caries, and provides a more durable and fracture-resistant restoration. First I trim and pre-fit Nowak strip crowns so they are even with the sulcus (Figure 2). Because the prep in these cases is usually quite minimal, I typically do not need local anesthetic. I prep the teeth with a #4 or #6 round bur, slowly removing decay with short light touches. Incisal reduction is usually unnecessary, and I avoid it whenever possible. If needed, I use a very fine diamond to refine, shape and open contacts. I only work 2-3 seconds at a time and keep a 2×2 gauze under the teeth for children who are uncomfortable with the water spray and suction. Figure 3 shows the final prep.

Figure 2

Figure 2. Strip crowns are trimmed and pre-fitted. (Taken from a different case.)

Figure 3

Figure 3. Shows prepared maxillary anteriors. (Taken from a different case.)

I apply a self-etching bonding agent, light cure, and fill the strip crowns with ACTIVA BioACTIVE-RESTORATIVE. I usually seat the central incisor crowns first, light cure, and then the laterals. I remove the strip crowns with an explorer, and there is very little finishing required. I use Sof-Lex disks (3M) for the incisal and a fluted carbide at the gingival margin if necessary.

This case took less than 20 minutes and looks great (Figure 4). Leigh is pleased with his smile and asked if we could fix more teeth. No anesthesia, no tears, and a happy child looking forward to his next visit to the dentist.

Figure 4

Figure 4. Finished case. No anesthesia, no tears.

About Dr. Eyal Simchi
Dr. Simchi is a board certified pediatric dentist in private practice in Elmwood Park, NJ. As one of ten children and with five of his own, he is well suited for his chosen specialty.

Do you have a Heroic Dentistry story to share? Please send materials to feedback@pulpdent.com.