January 24, 2019

Direct from the Operatory: Embrace Pit & Fissure Sealant

by Dr. Josh Wren 

A 7-year-old male patient came to my clinic for a 6-month recall examination and cleaning. We had placed two occlusal-lingual resin restorations one year earlier to repair carious lesions on teeth # A and J. There was organic debris present in all pit and fissures of the fully erupted 6-year molars (Figure 1), but not in the primary teeth. When questioned, the caregiver stated that the patient brushes his teeth with no parental supervision and had brushed just before coming to this exam. 

Figure 1. Organic or food debris is often found on examination of first permanent molars despite good hygiene for other teeth.

All first permanent molars were free of decay, and after consent was obtained, the patient was prepared for sealants on all the permanent molars. The Isolite device was chosen for its ability to treat opposing molars simultaneously. A thorough air-water blast was used to assess if a fissurotomy was indicated or if we should proceed with a non-abraded sealant procedure. 

Thorough cleaning and air-water blast were not sufficient to remove the organic debris from the permanent molars, so I chose a 330 bur to lightly prepare each groove (Figure 2).

Figure 2. Shows preparation of all grooves in a lower left first permanent molar after gentle removal of debris using a 330 bur.

This technique requires only a gentle approach to round the deep grooves, not the normal preparation for a cavity. After preparation, 37% phosphoric acid was applied to the enamel for 20 seconds, rinsed, and lightly dried, removing all surface water, but not desiccating the tooth. Embrace WetBond Pit and Fissure Sealant was applied to the grooves and cured for 20 seconds (Figure 3).

Figure 3. 37% phosphoric acid was applied for 20 seconds, rinsed and lightly dried, and then Embrace WetBond Pit and Fissure Sealant was applied and cured.

An explorer examination was performed to check the margins and attempt to remove the sealant from the tooth-sealant interface. No detectable margin was present (Figure 4). 

Figure 4. Final result. Smooth margins of Embrace sealant are undetectable with an explorer.

About Dr. Josh Wren
Dr. Josh Wren is a board-certified pediatric dentist who founded Wren Pediatric Dentistry in 2007 in Brandon, Mississippi. He is an online and live speaker for Dentaltown where he also serves as the moderator of the pediatric dental forum. Dr. Wren is the Mississippi Representative to the Southeastern Society of Pediatric Dentistry. He founded Pediatric Dental Seminars to educate dentists on all topics related to pediatric dentistry.

January 23, 2019

Pulpdent 2019 Trade Show Calendar

Pulpdent will be an exhibitor at the following trade shows this year:

  • NDC Dental Forum | January 14-16
  • Yankee Dental Congress | January 31 – February 2 | Booth 1411
  • Chicago MidWinter Meeting |February 21-23 | Booth 3211
  • Pacific Dental Conference | March 7-9 | Booth 57
  • IDS Koln, Germany | March 10-17 | Hall 10.1, Aisle J, Stand 031
  • Townie Meeting | March 20-23 | Booth 310
  • Hinman Dental Meeting | March 21-23 | Booth 1435
  • Greater Long Island Meeting (GLIDM) | April 2-3 | Booth 39
  • NOHC | April 15-17
  • Michigan Dental Association Annual Session | May 1-4 | Booth 46
  • South Carolina Dental Association Annual Session | May 2-5 | Booth 77
  • Texas Dental Association Meeting | May 2-4 | Booth 830
  • Ontario Dental Association Annual Spring Meeting | May 9-11 | Booth 421
  • CDA Anaheim | May 16-18 | Booth 1532
  • North Carolina Dental Society Annual Session | May 16-19 | Booth 28
  • AAPD Chicago | May 23-26
  • JDQ Montreal | May 27-28 | Booth 1827
  • ADHA | June 21-23 | Booth 322
  • Florida National Dental Meeting (FNDC) | June 27-29 | Booth 720
  • AGD Meeting | July 18-20
  • Georgia Dental Association Convention & Expo | July 25-26 | Booth 104
  • ADA San Francisco | September 5-7 | Booth 2138
  • Canadian Dental Hygiene Association National Conference | October 3-5
  • NNOHA | October 13-16
  • ASDA | October 23-26
  • Greater New York Dental Meeting | December 1-4

For more information on trade shows where Pulpdent will be an exhibitor, please contact sales@pulpdent.com.

January 10, 2018

Heroic Dentistry: Crowns for a Cancer Survivor

By Jack D Griffin, DMD

Patients undergoing cancer treatment face a variety of oral health challenges, including xerostomia. Without sufficient saliva to neutralize acids and support the natural remineralization process, patients suffering from dry mouth can be more susceptible to the acids that cause tooth decay.

Such was the case of a 78-year-old female cancer survivor who presented at my office with rampant root surface decay (Figure 1). She had undergone radiation and several rounds of chemotherapy over a five year period and had been cancer-free for over a year by the time of our appointment.

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The chances of recurrent decay with traditional bonding and composites are high, so my first step was to thoroughly remove caries with the help of caries indicator (Figure 2). After the decay was removed, I followed a total etch protocol and built up the crown preparations using ACTIVA BioACTIVE-RESTORATIVE (Figure 3). I chose ACTIVA because of its strength, bioactive capabilities, and aesthetics.

Figure 1: Shows difficult restorative case with rampant, post radiation, root surface decay

Figure 2: Shows thorough caries removal with the help of caries indicator.

Figure 3: After a total etch protocol the crown preparations were built up using ACTIVA BioACTIVE-RESTORATIVE.

The preparations for the individual indirect restorations were subgingival in most places. Choosing the right materials, in this case a hydrophilic and biocompatible cement, would be important for long-term success. ACTIVA BioACTIVE-CEMENT is not only moisture-friendly, and biocompatible, but also strong, aesthetic, self-adhesive, and dual-cure. This bioactive luting material releases and recharges fluoride, phosphate, and calcium, and participates in an ionic exchange that promotes an environment of tissue health.

Figure 4: Shows preparations for individual indirect restorations. Most of these preparations are sub-gingival.

Seven monolithic zirconia restorations were made, tried in, and cemented at the same time with ACTIVA BioACTIVE-CEMENT (Figures 5-7). The ACTIVA BioACTIVE-CEMENT was easy to clean up. Figure 8 shows the final restoration.

Figure 5: Monolithic zirconia restorations were made, tried in, and cemented with ACTIVA BioACTIVE-CEMENT.

Figure 6: ACTIVA BioACTIVE-CEMENT is dispensed into the crown.

Figure 7: All restorations were cemented at the same time and the cement cleaned up easily.

Figure 8: Shows final restoration. I have found that thorough decay removal with bioactive core buildups and cement results in excellent tissue tolerance and long-term prognosis.

New bioactive, self-adhesive cements such as ACTIVA BioACTIVE offer a promising alternative to traditional resin cements. I have found that thorough decay removal followed by core build-up and cementation using bioactive materials results in excellent tissue health and long-term prognosis.  With comparable strength, aesthetics, and durability to traditional dual cure resin cements, ACTIVA has the important benefit of ionic release that may aid in tooth repair. All of this while being very easy to clean up. It may be time to rethink traditional, dual cure, self-adhesive cementation for better patient care.

About Dr. Jack D Griffin
Dr. Jack D Griffin is one of the most honored and awarded dentists in the country. Jack is one of a hand-full of dentists awarded by his peers Diplomat status with the American Board of Aesthetic Dentistry (ABAD), accreditation with the American Academy of Cosmetic Dentistry (AACD), and Mastership in the Academy of General Dentistry (AGD). Jack graduated dental school from Southern Illinois University, where he received student dentistry awards and then went on to complete a general dentistry residency at the University of Louisville in Kentucky, with an emphasis in advanced dental care in restorative dentistry, emergency care, implants, oral surgery, and special patient care. Dr. Griffin began his dental practice in Eureka in 1988.

December 18, 2018

Direct from the Operatory: Bulk Filling with ACTIVA BioACTIVE-RESTORATIVE

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.

December 5, 2018

Direct from the Operatory: ACTIVA BioACTIVE-BASE/LINER

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.

November 29, 2018

Christie Bailey Joins Pulpdent Team

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.