Monthly Archives: June 2018

Bioactive Composites for the Clinician and Patient

Dentist and educator Dr. Robert Lowe has published a new eBook called Bioactive Composites for the Clinician and Patient.

Download Free eBook by Dr. Robert Lowe

Dr. Lowe addresses the importance of patient education, saying that the dentists “have to get better at explaining the disease process of dental caries (decay) and the restorative options that best fit the needs of each patient.

According to Dr. Lowe, “the majority of today’s dental restoratives are designed merely to occupy space” but bioactive filling materials like ACTIVA BioACTIVE “participate in an ionic exchange of calcium, phosphate, and fluoride that helps neutralize acid attack and supports the natural remineralization process.” Through this ionic exchange, the bioactive material becomes integrated into the tooth and helps create a protective seal.

Dr. Lowe shares best practices on how dentists can discuss treatment options and new technologies like bioactive fillings with their patients.

The eBook features a series of clinical cases, including:

  • Minimally invasive restorations
  • Bulk fillings
  • Root caries restorations
  • Pediatric dentistry
  • Geriatric dentistry

Dr. Lowe provides step-by-step instructions on how to use ACTIVA BioACTIVE-RESTORATIVE in these different clinical situations to ensure better patient outcomes. The cases involve patients of all ages, and Dr. Lowe notes that ACTIVA BioACTIVE addresses many of the challenges associated with both pediatric and geriatric patients. 

About Robert A. Lowe, DDS
Robert A. Lowe, DDS, received his Doctor of Dental Surgery degree from Loyola University School of Dentistry. After completing his residency, Dr. Lowe went into private practice and began to pursue another passion: clinical teaching. While running his own practice, Dr. Lowe served as a Clinical Professor in Restorative Dentistry at Loyola University School of Dentistry until its closure in 1993. In 2000, he relocated to Charlotte, NC.

Heroic Dentistry: Asperger’s Syndrome and Special Care with ACTIVA

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.

Rachel has been diagnosed with Asperger’s Syndrome and was referred to me for comprehensive dental care. She has acute anxiety around dental treatment, which can escalate into a panic attack. We faced the challenge of allaying her fears, keeping her calm, while operating smoothly and uneventfully.

Rachel was experiencing considerable discomfort. Her lower left second molar (#18) had extensive caries and appeared hopeless, but she was still young, and I wanted to try and salvage this tooth for her (Figure 1). Endodontic treatment on her first molar (#19) had been performed successfully at another office, but she had not returned to her dentist to have the tooth restored.

Figure 1. Shows extensive caries in lower left second molar (#18).

I would have to complete this case in one visit. Proper isolation would be imperative. My treatment plan was to excavate the second molar (Figure 2), isolate the area, quickly build up the entire distal-lingual wall, and proceed with root canal treatment. The wall would allow me to place a rubber dam with a good seal, contain the irrigating fluids within the confines of the tooth, and then use the wall as part of the final restoration.

Figure 2. Second molar after caries removal.

Controlling hemorrhaging from the gingiva is critical for these procedures. Placement of retraction cord treated (Figure 3) with ferric sulfate can stop bleeding, but the challenge is to prevent contamination and bleeding when building up the wall. For this reason, I selected ACTIVA Bioactive-Restorative. It is easy to control the flow and placement of ACTIVA through the bendable metal cannula, and this technique eliminates the use of hand instruments that could disturb the gingiva and cause bleeding.

Figure 3. Shows retraction cord in place.

I placed a thick layer of Teflon tape over the pulpal floor to facilitate access to the pulp chamber (Figure 4), and I built up the distal-lingual wall with ACTIVA (Figure 5). I could now place a well-sealed rubber dam and perform endodontic treatment on #18 (figure 6). After debriding the pulp (Figure 7) and obturating the canals (Figure 8), I completed the restoration with ACTIVA (Figure 9).

Figure 4. Teflon covers pulpal floor before building up distal-lingual wall.

Figure 5. Distal-lingual wall built up and margins sealed with ACTIVA.

Figure 6. Shows pulpal access, ACTIVA walls, and rubber dam in place.

Figure 7. After debriding pulp.

Figure 8. Canals are obturated.

Figure 9. Final ACTIVA restoration.

Using ACTIVA I could accomplish all this in one appointment with a material that provides an excellent foundation for a future crown and will be more resistant to recurrent caries at the margins.

About Dr. Raymond Kimsey
Dr. Kimsey is in private practice in Coral Gables, Florida. His specialties include implantology, anesthesia and IV sedation, and management of patients with mental and physical developmental defects.