After trying out the product in his practice, here are some thoughts about BISCO's TheraBase from John Flucke, DDS.
One of the best things about practicing in the environment today is the incredible progress in the product development cycle. Not too long ago, I was reading an article about the human quest for knowledge, and one of the things the article stated was that medical knowledge doubles every 18 months. Of course, that expansion isn’t simply knowledge about the body and its processes. That remarkable accumulation of knowledge also considers the research and development cycle of medicines and other products used to treat conditions and improve human quality of life.
The field and profession of dentistry is no different. I am so grateful for the efforts put forth by the engineers and chemists whose work allows us to provide amazing results for our patients that were unheard of even 10 years ago. I don’t know whether the profession really understands what happens in the background to develop a new product. The scientists who work with chemistry on a molecular level are responsible for some of the most game-changing products in the industry, but we rarely think about them as we are using a new material.
Over my career, I’ve been incredibly lucky to get to do some amazing things, but more importantly, I’ve gotten to meet some amazing people. When I say “amazing,” I mean just that. People who understand the chemistry of a human tooth and the materials that bond to it and/or heal it are the backbone of what we do. One of those people is the man who started BISCO, Inc, Byoung Suh, PhD, MS. He is a research chemist who believes his company is not successful unless his customers, dental professionals, are successful.
I met Dr Suh at an event that was held to bring speakers and writers up to speed on some of the newest ideas BISCO was working on. I was introduced to him before the event, and we exchanged a few pleasantries. However, once the event started and Dr Suh began to discuss some of BISCO’s research products, I almost immediately had one of those “holy cow” moments. There were a lot of my friends in the room, and as the presentation continued, we began to exchange knowing glances with one another. In a room full of smart people, this gentleman was the smartest one there. I don’t even think second place was close.
I’m telling you that story for the simple reason that when Dr Suh’s company, BISCO, puts a product on the market, you can be assured it is well tested and flat out works. He would not allow anything else. One of BISCO’s latest products, TheraBase, is something I am excited to tell you about.
Throughout my career, there have always been calcium-containing materials, but there have frequently been drawbacks to them. In the old days, we would sometimes place it in deeper areas of the prep, then wait for it to harden before placing the restorative material over it. In those cases, it worked but was not efficient.
TheraBase is an exciting material that offers some definite advantages for both the doctor and the patient. As far as efficiency, no one wants to wait any longer than necessary, especially during a dental procedure. Trying to keep an area isolated and dry is a challenge in the best of circumstances, and waiting for something to set can be akin to watching paint dry. Because TheraBase is dual cured, it can be placed, light cured, and the restorative process can continue.
The material is self-adhesive, which eliminates the etching and bonding process prior to placement. There are also some practitioners who would prefer to avoid placing acid etch on very thin dentin in close proximity to the pulp. The self-adhesive aspect eliminates that.
Because it is dual cure, a layer can be placed, cured, and then the restorative process can continue. One of the problems with a material that is set only by chemistry is that if the base material is not fully set before material placement, you run the risk of the base material being displaced, as the restorative is packed against it. This isn’t a concern with TheraBase. The material also contains the molecule, MDP, which ensures a reliable and optimal dentin bond.
For me, a dual-cure material is a bit of the Holy Grail when it comes to placement. No matter how good the curing light and how good the access, there is always a risk of an area of material not being fully cured from the light. A dual-cure material eliminates those concerns. The clinician can be confident that the material sets, even without the light. TheraBase can be placed with confidence, as you can be assured it will always set.
Another benefit of the material for larger or deeper applications is its compressive strength. Sometimes a base or liner needs to be placed in a thicker application. If the material lacks compressive strength, it can fracture under a well-done restoration. This can lead to a restoration that is initially sensitivity free, but then develops pain to pressure over time as the base material fractures under the restoration. This creates points of flexure in the restoration, which drives pressure differentials across the dentinal tubules. Trying to diagnose the source of a restoration that was pain free but developed pain to pressure over time can be frustrating, to say the least, as the practitioner tries to determine the source of the problem.
It is also comforting to be able to clearly see a base material on a radiograph. TheraBase is radiopaque and can be easily seen when radiographs are taken. This is a tremendous help during routine examinations. Trying to determine whether a radiolucent area is pathology or simply a restorative material can lead to difficult diagnoses. The ability to clearly see the material on a bitewing makes diagnosis much easier and makes exams more efficient.
TheraBase releases calcium and fluoride, and it generates an alkaline pH in minutes.* Research shows that an alkaline pH promotes pulp vitality.1
TheraBase is an incredible product that takes the best elements clinicians are looking for and combines them into a single, reliable, and easy-to-use product. TheraBase is a product you should have in your bag of tricks. I’m confident it will perform well for you. It certainly has for me.
1. Okabe T, Sakamoto M, Takeuchi H, Matsushima K. Effects of pH on mineralization ability of human dental pulp cells. J Endod. 2006;32(3):198-201. doi:10.1016/j.joen.2005.10.041
* Data on file. BISCO, Inc.