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Dr Wig shows the use of ACTIVA BioACTIVE-RESTORATIVE composite. (Photograph: DTI)
0 Comments Aug 29, 2017 | News Europe

Live at FDI: Hands-on demonstration of ACTIVA BioACTIVE-RESTORATIVE

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Bioactive materials are moisture-friendly and promote the natural remineralisation process through the continuous release and recharge of essential minerals. ACTIVA BioACTIVE-RESTORATIVE composite, manufactured by US company Pulpdent, is the first bioactive restorative composite with the natural aesthetic and physical properties of composites while delivering all the advantages of glass ionomers. These features set ACTIVA apart from all other products, since the restorative material releases calcium, phosphate and fluoride, chemically bonds to teeth and seals against microleakage.

Dental Tribune International Online interviewed Dr Rumpa Wig at FDI 2017 about her experience using bioactive dental materials. Wig has been using ACTIVA clinically for more than three years. She is an international educator and opinion leader for prominent global companies, and has given keynote presentations and workshops on topics in restorative and aesthetic dentistry throughout the world. She is based in Bhopal, India and focuses mainly on aesthetic, restorative and minimally invasive dentistry in her private practice.

Dr Wig, we enjoyed your demonstration on ACTIVA BioACTIVE-RESTORATIVE. Could you please briefly explain what bioactive dental materials are and elaborate on the advantages of the bioactive properties of this material compared with others?
It has been almost 50 years since the concept of bioactivity was introduced. Bioactive dental materials play a dynamic role in the oral environment because they reduce sensitivity, marginal leakage and caries. Clinically, these bioactive materials are very simple and easy to use. The most important thing is that the bioactive dental materials remain active. All that is needed to kick-start the bioactive chemistry is a little bit of water, because they then transport this water and deliver minerals that are beneficial to the tooth structure. Moreover, bioactive dental materials stimulate biomineralisation and form chemical bonds that help to seal the tooth and thereby prevent microleakage.

Studies indicate that bonding agents are not needed when applying ACTIVA. Can you explain the effect of ACTIVA in this regard?
The main cause of failure in composite restorations is the degradation of the bonding agent at the adhesive–dentine interface. ACTIVA contains a bioactive ionic resin that chemically bonds to the tooth structure through ionisation and ionic interaction. This ionic exchange binds the resin to the tooth, forming a strong resin–hydroxyapatite complex and a positive seal against microleakage. The ionic exchange between the acid groups of ionic resin and tooth structure occurs at a molecular level. Since ACTIVA is directly absorbed within the tooth, a bonding agent is not needed in most cases, and the weak link of the adhesive–dentine interface is eliminated.

You said in your presentation that bioactive restorations release and recharge more calcium, phosphate and fluoride than traditional materials do, maximising the potential for remineralisation. What are the clinical implications of this?
Clinically, bioactive restorations are a gift for the tooth. Finally, the tooth has a restorative it can relate to, nature-wise, and that delivers the minerals the tooth needs. ACTIVA has a bioactive and biomimetic function. During low-pH demineralisation cycles, ACTIVA releases more phosphate ions. These ions reside in the pellicle layer or saliva. When there is an increase in the pH in the oral cavity, these phosphate ions are readily available to interact with calcium and fluoride ions. This facilitates the diffusion of calcium, phosphate and fluoride, even after the material has been cured. The ionic components are always bioavailable.

You have used ACTIVA for several years now. What has your experience been with three-year-recall patients, Class II restorations, core build-ups, cervical lesions and carious crown margins?
Yes, I have been using ACTIVA BioACTIVE-RESTORATIVE in my private practice since April 2014 and all types of Class II, Class I, root surface caries, core build-ups and a few not-so-simple restorative situations have been treated. I am still very happy with the results, as are my patients. The cases look great at recall visits, without chipping, staining or marginal leakage.

I have been using the ACTIVA cements since April 2016. In my opinion, the cements are an out-and-out winner. In terms of clinical significance, these types of calcium- and phosphate-containing bioactive materials can improve the marginal stability of the material–tooth interface and lead to good predictability. The natural remineralisation process knits the restoration and the tooth together and penetrates and fills micro-gaps.

The stamp technique is a new method for placing large composite restorations in the case of Class I cavities and erosively damaged teeth. Why is ACTIVA BioACTIVE-RESTORATIVE suitable for this technique?
It has the perfect consistency and flow characteristics, and the bioactive properties of the material provide the teeth with essential minerals that stimulate the natural remineralisation process. Once the stamp is ready, the restoration is built up with ACTIVA, then immediately coated with a thin layer of petroleum jelly. Then, a PTFE strip is placed on the surface, and the stamp is pressed on to the correct place and light-cured. The PTFE prevents the stamp from sticking to ACTIVA. The immediate result duplicates the original surface anatomy of the tooth. After the removal of any excess, the ACTIVA restoration does not require further finishing. This enables dentists to replicate the natural anatomy with utmost precision.

Your demonstration of the use of ACTIVA gave the impression that it is very simple to use. How easy is this material to apply, and is it similar to placing other composites?
Yes, it is delightfully simple to use ACTIVA in routine clinical dentistry, as the chairside time does not exceed 6–7 minutes. One just etches the tooth for 10–15 seconds, rinses it off, lightly dries it to remove surface water, but not desiccate the tooth, which naturally contains structural water, and then places ACTIVA. In retentive preparations, no bonding agent is necessary. In non-retentive reparations, a bonding agent is recommended. A traditional Class II composite restoration is technique-sensitive and can take 45–60 minutes, with multiple steps, requiring a high level of precision to be performed correctly. ACTIVA is much faster, easier to use and very reliable.

More information on ACTIVA is available at www.pulpdent.com.

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