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.

Pulpdent Corporation is pleased to welcome Christie Bailey in the position of Manager of Professional Relations and International Sales.

Christie Bailey uses a combination of strategy, data analysis and creative problem-solving to identify customer needs and deliver thoughtful resolutions. She is responsible for overseeing Pulpdent’s KOL network and international sales development. Prior to Pulpdent, Christie worked for PDT, Inc. (Paradise Dental Technologies), where she was successful in branding, high level marketing strategy and global sales leadership.

Christie will work closely with Larry Clark, Director of Clinical Affairs and Marketing at Pulpdent, who comments that “in the nearly three years I have known Christie, she has proven herself to one of the most professional and personable individuals I have met in my career. Very genuine and very smart, she listens and learns. Christie has been a bright light for many. I’m truly excited to have her as part of our Pulpdent team.”

Christie holds a BA in Psychology, with a minor in English Language & Literature from the University of Montana, where she was involved in founding a non-profit health collaborative. She is passionate about health and wellness and studied Yoga and holistic healing in India.

About PULPDENT® Corporation 
PULPDENT® Corporation is a family-owned dental research, manufacturing company and leader in bioactive dental materials. ACTIVA BioACTIVE™, developed by PULPDENT, is a bioactive restorative material that behaves much like natural teeth and stimulates the formation of apatite (the building blocks of teeth), chemically bonds to teeth and helps protect against decay. PULPDENT celebrates its 70th anniversary this year with continued commitment to product innovation, clinical education and patient-centered care. To stay updated on bioactivity and learn about the Heroic Dentistry Series, which demonstrates ACTIVA’s unprecedented capabilities, visit the Pulpdent blog.

By Amber Auger RDH, MPH

When it comes to preventing tooth decay, dental sealants play a primary role. The pits and fissures of the teeth account for 80% to 90% of the total caries in permanent teeth and 44% in primary teeth.¹ Selecting a sealant material that has proper integration with the tooth will prevent open margins, chipping, and the need for resealing. The goal of prevention is to preserve the enamel of the tooth, without having to re-treat.

Sealant Longevity
The effectiveness of the sealant is directly related to how long the sealant is retained in the mouth.² While most resin-based materials have a high retention rate, they can be challenging to use in the moist environment. Additionally, most resin-based pit and fissure sealants contain Bis-GMA, which is not moisture tolerant.² Therefore, selecting a sealant material that is hydrophilic (moisture-tolerant) will provide the optimal retention.

Retention Rates
Researchers estimate that 5% to 10% of sealants require repair or replacement annually.¹ This poses a concern for patients that do not have the resources to be evaluated yearly, as a compromised sealant could increase the risk of chipping and microleakage. Therefore, selecting a sealant material that is long lasting and integrates with the tooth is essential to the prevention of tooth decay. When Embrace Wetbond Pit & Fissure Sealant was tested, studies demonstrated that 95% of the sealants maintained uniform marginal integrity and 100% of the teeth were caries-free 2 years after the initial placement.²

Effectiveness of Embrace WetBond Pit & Fissure Sealant
The main objective of a sealant is to protect the deep grooves and fissures from tooth decay. The traditional sealant contains Bis-GMA and requires a totally dry enamel surface, which is virtually impossible when working with pediatric patients. Embrace WetBond Pit & Fissure Sealant is a unique, moisture-tolerant resin-based sealant that contains no Bis-GMA and no Bisphenol A.² Embrace is wet-bonding, tooth-integrating, provides better retention, a superior marginal seal, and increased fluoride release.³

Incorporating preventive materials that are designed to work in the moist oral environment, with superior integration, moisture-tolerance, and fluoride release is critical for providing the highest quality of care. Avoiding retreatments will not only preserve the enamel but also provide greater patient trust in the provider. Embrace Pit & Fissure Sealant is designed to work with the natural oral environment to preserve enamel and promote oral health.

1. Sreedevi A, Mohamed S. Sealants, Pit and Fissure. [Updated 2017 Oct 5]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2018 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK448116/
2. Prasanna Kumar Bhat, Sapna Konde, Sunil N. Raj, and Narayan Chandra Kumar. Moisture-tolerant resin-based sealant: A boon. Contemp Clin Dent. 2013 Jul-Sep; 4(3): 343–348. doi: 10.4103/0976-237X.118394
3. Bhat PK, Konde S, Raj SN, Kumar NC. Moisture-tolerant resin-based sealant: A boon. Contemporary Clinical Dentistry. 2013;4(3):343-348. doi:10.4103/0976-237X.118394
   

About Amber Auger, RDH, MPH
Amber Auger, RDH, MPH, is a hygienist with experience in multiple clinical settings, including facilities abroad. Amber obtained a master’s degree in public health from the University of New England and a bachelor’s in dental hygiene from the University of New Haven. She holds a part-time position at an elite dental office in Boston, and is chief of clinical technology for Jameson Management. Amber Auger is a key opinion leader for several dental companies, speaker and published author, and can be contacted at amberaugerrdh.com.

by  Dr. Susan McMahon

The patient is a healthy, 28-year-old woman with a very low caries rate. She has had staining in the pits and fissures of posterior molars for many years (Figure 1) and has recently begun to experience sensitivity in her upper left molars.

Figure 1. Shows staining in the pits and fissures of posterior molars

Visual inspection revealed staining in the pits and fissures of the upper left first and second molars. Traditionally, a clinical exam with a sharp explorer would be performed. Recent findings from light-microscopic studies have confirmed that using a sharp dental probe for occlusal caries detection causes enamel defects. Therefore, dental probing should be considered as an inappropriate procedure and should be replaced by a meticulous visual inspection.¹ The CamX Triton (Air Techniques) uses fluorescence to evaluate and calibrate demineralization and decay. In Figure 2 the numerical value (1.6) and color coding indicate incipient enamel caries (blue) with deep enamel caries (red).   The deep enamel decay was removed with a disposable #330 carbide bur (Microcopy) and the surrounding incipient enamel decay was prepared with a Fissurotomy Bur (SS White).

Figure 2. The CamX Triton (Air Techniques) uses fluorescence to evaluate and calibrate demineralization and decay. The numerical value (1.6) and color coding indicate incipient enamel caries (blue) with deep enamel caries (red).

The preps were cleaned and rinsed with Consepsis (Ultradent). The enamel was etched with 37% Phosphoric Acid, rinsed and lightly dried and then the adhesive was applied and cured. Placement of ACTIVA BioACTIVE-RESTORATIVE was easy and precise with the bendable applicator tip (Figure 3). The applicator tip was used to carry and drag the material for anatomic placement and very little finishing was needed.

Figure 3. After caries removal, selective etching of enamel and bonding, placement of ACTIVA BioACTIVE-RESTORATIVE is easy and precise with the bendable tip.

Figure 4 shows the final restoration, which is esthetic, very conservative, durable and releases ions.

Figure 4. Final restoration with ACTIVA BioACTIVE-RESTORATIVE.

About Dr. Susan McMahon
Dr McMahon, an University of Pittsburgh School of Dental Medicine graduate, is in private practice in Pittsburgh and at University Dental Professionals in Chicago. She is an accredited member of the American Academy of Cosmetic Dentistry, the American Society for Dental Aesthetics, and a fellow in the International Academy of Dental Facial Esthetics. She is the Director of Product Evaluation for Catapult Education and a member of Catapult Speaker’s Bureau. She can be reached at 412.298.2734 or drsusan@wowinsmile.com.

By Karen Comisi CDA, RDA, FADAA

As Treatment Coordinator at Dental Care with a Difference®, PC, I had the opportunity to present treatment options to patients and answer their questions. After reviewing their restorative needs I would ask what they knew about filling materials. I quickly discovered most patients have no idea what materials are used in their mouth and why. Then I would ask if I could share some really interesting information about the materials we used at our practice.

Most of our patients either had composite restorations or knew someone who did. I explained most dental offices use traditional tooth-colored composites, and they attach this filling material to the tooth using a bonding agent. Put simply, a plastic filling is affixed to the tooth with an adhesive. After a while the adhesive breaks down, leaving teeth vulnerable to acid attack.

I said that our office uses bioactive filling materials, like ACTIVA BioACTIVE, that are ion-releasing and provide teeth withthe minerals they need to become stronger. I would then mention some of the other benefits of bioactive restoratives, including:

• reduced sensitivity
• marginal integrity which keeps the bacteria out
• resistance to fracture and chipping
• reduced wear
• excellent esthetics
• shorter appointment times because it can be bulked filled

Taking the time to educate your patients about the materials going in their mouths will set you apart from the other offices in your community. An educated patient is also a wonderful referral source.

About Karen L Comisi, RDA, CDA, FAADA
Over the past 33 years, Karen Comisi has held almost every staff position in the dental office, with the exception of dentist and dental hygienist. She has been an orthodontic dental assistant, oral surgeon dental assistant, general dentist assistant, front desk and insurance coordinator, office manager, CFO, Co-Founder of Dental Care with a Difference, PC and currently Co-Founder and CFO of Sleep Focused Solutions, Inc.  She is one of the first licensed, registered dental assistants in New York State and is a founding member and Treasurer of the Southern Tier Dental Assistants Society. Karen is a DANB Certified Dental Assistant, a member of the American Dental Assistants Association, the American Association of Dental Office Managers, the Office for Safety & Asepsis Procedures (OSAP), and The American Academy for Oral Systemic Health (AAOSH).