By Dr. Eyal Simchi
The ten-year-old patient had multiple carious teeth, both anterior and posterior. He had a high level of caries risk due to poor home care and diet.
Decay is removed and tooth is prepared. There is an extended preparation to cover decalcified areas.
Tooth #7 had MLF decay including decalcification along the cervical third of the tooth. The patient was anesthetized with 1cc of Septocaine 4% (Articaine HCI w/Epi) 1:100,000 and the tooth was isolated with a rubber dam. The decay was excavated with a high speed diamond bur (Microdont 2136) and refined with low speed round carbides. The preparation was rinsed before application of a universal self-priming dental adhesive (Prime & Bond Elect, Dentsply). After bonding, the tooth was fitted with a Bioclear Matrix (I use small anterior #A-103 in most cases) to help contour the restoration. The preparation was bulk filled with ACTIVA BioACTIVE-RESTORATIVE and light cured from both sides (Valo light, Ultradent).
The preparation is bulk filled with ACTIVA BioACTIVE-RESTORATIVE (Pulpdent) and slightly overfilled.
The restoration was polished using fine diamonds and finished with a carbide bur. The final restoration blends well and polishes beautifully.
Shows initial finishing and polishing.
Final restoration with ACTIVA BioACTIVE-RESTORATIVE.
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.
By Dr. Arthur Volker
Following caries removal and toileting of the preparation (Figures 1 and 2), the ACTIVA BioACTIVE-BASE/LINER is placed directly over the deepest dentinal areas in increments of 2mm (Figure 3). Each layer is subsequently light cured.
Figure 1. Pre-operative view demonstrating gross caries. Patient had been experiencing pain at #11.
Figure 2. Preparation showing extent of caries and pulpal involvement.
Figure 3. Placement of ACTIVA BioACTIVE-BASE/LINER over pulpal area.
The tooth is etched, bonded, and then restored via a combination of flowable and micro-filled with composite.
Figure 4. Five month post-operative view. The patient reports no pain or discomfort.
About Dr. Arthur Volker
An experienced clinician and educator, Dr. Volker graduated from Colombia University’s School of Dental and Oral Surgery, and completed a General Practice Residency at the New York Hospital of Queens. He is an attending clinician at Coler-Goldwater Specialty Hospital and Nursing Facility and serves as Vice-Chairman of the hospital’s Graduate Medical Education Committee. Dr. Volker was the recipient of the esteemed Fellowship Award from the Academy of General Dentistry, where he serves as the Academy’s Vice President of Queens, and is Chairman of the New Dentist Committee.