Dr. Delfín Barquero

	Bioactive dental materials are changing the existing paradigms of restorative dentistry.

	Treatments that would normally require multiple visits can be completed in just one appointment with materials like ACTIVA BioACTIVE-RESTORATIVE. Such was the case for a female cancer patient in her early 60s who was referred to our practice with nine posterior teeth requiring restorations.

	The patient had been diagnosed with squamous cell carcinoma, a common form of skin cancer, and needed to have all dental restorations completed before undergoing radiation therapy. Xerostomia is a typical side effect of radiation therapy and the lack of saliva can lead to further decay. Root caries resulting from Xerostomia are often visible several months after radiation therapy, and materials that promote remineralization help protect already compromised teeth. It was not clear whether the patient would be able to maintain adequate oral hygiene during her radiation treatment.  

	Not wishing to risk the patient’s oral health, I chose ACTIVA BioACTIVE-RESTORATIVE because the material supports the natural remineralization process and keeps the margins intact with apatite formation at the material-tooth interface and a non-soluble seal.

	The flowable characteristics of ACTIVA BioACTIVE, allowed me to complete each posterior restoration in eight minutes after the placement of a rubber dam. The material adapted easily to the tooth and produced no bubbles or voids.

	Continue to the next page to see the case study.

	Technically, the procedure was very efficient.  After the placement of rubber dam, the amalgam restorations (

      Fig. 1: Failed amalgam restoration.   Fig. 2: Amalgam and decay are removed and tooth is prepared 

	The enamel was etched for 20 seconds with Select HV from BISCO (

), and ALL-BOND UNIVERSAL (BISCO) was applied (

Fig. 3: Enamel etched for 20 seconds with Select HV.                                           Fig. 4: ALL-BOND UNIVERSAL applied.           

	ACTIVA BioACTIVE-RESTORATIVE was placed (

) and, thanks to its dual cure capability, I did not have to worry about depth of cure in deep cavities. Figure 6 shows the completed restoration.

   Fig. 5: Placement of ACTIVA BioACTIVE-RESTORATIVE.                                               Fig. 6: Final restoration.                            

	The same procedure was followed for the remaining eight restorations. Figure 7 shows several posterior teeth prepared for restoration and enamel etched with Select HV (BISCO) for 20 seconds (

). Figure 9 shows the final restorations.

Fig. 7 Amalgam and decay are removed and tooth is prepared with ACTIVA BioACTIVE-RESTORATIVE. Fig. 8: Enamel etched for 20 seconds with Select HV 

	I chose ACTIVA BioACTIVE because the material releases and recharges fluoride, calcium and phosphate ions, and contains a rubberized component that resists fracture and chipping. ACTIVA BioACTIVE participates in an ionic exchange that is pH sensitive and supersaturates the saliva and pellicle during low pH cycles. As the pH rises, these minerals are available to form a layer of apatite on the tooth surface, supporting the natural mineralization process.

	The patient was pleased with the esthetics and impressed that all nine restorations were placed in a single appointment. She had been concerned about the possibility of infection resulting from untreated dental caries and wanted to complete the restorations before starting radiation therapy.   

Articles

A practitioner shares how he used ACTIVE BioACTIVE to complete nine restorations in one single appointment.