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Bioactive materials: A new approach to dental care

Repair with ACTIVA BioACTIVE-RESTORATIVE. (Photo: Dr. Robert Lowe, Provided by Sulzer Mixpac)
Larry Clark, FIADFE, CAED, and Fredrick M. Berk, BA, FIADFE, Pulpdent Corp.

Larry Clark, FIADFE, CAED, and Fredrick M. Berk, BA, FIADFE, Pulpdent Corp.

Mon. 18 July 2016

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Today’s new and innovative technologies hold a great potential to improve oral health and advance dental care. One of those budding technologies is evident in the ACTIVA BioACTIVE product range (Pulpdent, USA). As part of a new class of esthetic, bioactive restorative dental materials, it offers an alternative to traditional composite restoratives and delivers direct benefits to dentists and patients.

Bioactive materials are “smart,” moisture-friendly and dynamic. By responding to ambient conditions in the mouth, they play an active role in the oral environment[1] and stimulate formation of a layer of protective, apatite-like crystal deposits at the material-tooth interface[2] that forms a natural bond between the material and living tissue.[3] This natural protective remineralization process knits the restoration and the tooth together. A crystalized connective layer penetrates and fills micro-gaps, seals margins, guards against recurrent caries and prevents the staining associated with microleakage and failure.

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ACTIVA BioACTIVE materials are the first dental restoratives with a bioactive resin matrix, shock-absorbing resin component and reactive glass fillers designed to mimic the physical and chemical properties of natural teeth. ACTIVA responds to pH cycles in the mouth with release and recharge of calcium, phosphate and fluoride.

ACTIVA BioACTIVE products resist fracture and chipping at the margins[4–6] while maintaining the high compressive and tensile strength[7] and wear resistance[8,9] required of an esthetic restorative resin. It can be used for all patients and contains no Bisphenol A, no Bis-GMA and no BPA derivatives.

Over a period of five to seven years, failure may become visible at the marginal interface between the cement or restorative material and the tooth. Some materials are soluble and wash out at the margins, others are brittle and chip, and still others do not adapt intimately to tooth structure and form gaps, allowing microleakage to undermine the integrity of the restoration. These problems are compounded by constant acid attacks, the solubility and degradation of bonding agents and the incompatibility of the materials with the soft tissues, all leading to a proliferation of restoration failure[10–14] (Figs. 1, 2).

ACTIVA BioACTIVE-RESTORATIVE solves the problem of microleakage as the primary cause of restoration failure.[15–17] As flowable/injectable materials, they easily adapt to irregular tooth surfaces and exhibit wear resistance comparable to traditional composites.

The Mixpac Colibri mixing tip (Sulzer Mixpac, Switzerland) mixes the base and catalyst of the two-component material, prevents air bubbles with the 360-degree fully turnable and bendable needle and allows for precise placement of material, even in post holes and hard-to-reach areas. Placing the Mixpac Colibri mixing tip along the wall at the floor of the cavity, allowing the restorative material to flow ahead of the needle, and keeping it submerged in the material at all times ensures intimate adaptation with tooth structure and a gap-free restoration (Fig. 3).

ACTIVA BioACTIVE-CEMENT stimulates continuous formation of calcium and phosphate crystals that strengthen the surrounding dentition and ensure marginal integrity (Fig. 4). This crystalline seal is virtually insoluble and friendly to surrounding tissues. These unique chemical and physical properties provide a durable, long-lasting seal for crown and bridge placements fabricated with both traditional and newer materials.

ACTIVA BioACTIVE-CEMENT has self-etching, self-adhesive properties and is both light-curing and self-curing. Its syringe delivery system in combination with the Mixpac Colibri mixing tip provides an easy and simplified cementation procedure.

After more than three years of clinical use and more than 25 published studies, ACTIVA BioACTIVE materials have been validated and proven successful. A one-year Clinical Performance Report from The Dental Advisor awarded ACTIVA its highest 5-plus rating (+++++) and a 98 percent approval rating.[20]

A 36-month recall visit of an early ACTIVA placement looked like newly placed. This provides further clinical proof of the material’s ability to penetrate and integrate with tooth structure and form a positive seal against microleakage.

Note: This article was published in Dental Tribune U.S. Edition, Vol. 11, No. 6, June 2016 issue. A list of references is available from the publisher on request.

 

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