cosmetic dentistry_ beauty & science

I 11 CE article _ bioactive materials I cosmeticdentistry 1_2013 with a micro-brush and cure for 20 seconds. 4) Place composite to fill the preparation and cure as appropriate. When I use this material in the Co-Cure Technique, I just substitute it for the traditional RMGIC material that I would have used oth- erwise. _Resin-modified calcium silicates Another recent interesting product release is from Bisco and is called TheraCal LC. This light- cured bioactive material is used to seal and pro- tect the dentin-pulp complex. It is the first of a new class of internal pulpal protectant mate- rials known as resinmodified calcium silicates (RMCS). It acts as a pulp capping and liner material. Calcium hydroxide (CH) has been the “gold” stan- dard for pulp capping for many years. However, it has always had difficulties in use as a liner under RBC adhesives. In fact, despite their frequent use, the success of CH based therapies is only 30 to 50 per cent.21 It has also been shown that traditional resin- based light-cured liners have been cytotoxic to cultured odontoblast-like cells, while light-cured resinbased MTA cements presented the lowest cytopathic effects.22 Based on this, the creation of light-cured RMCS is a logical step in developing a solution for direct pulpal protection. Calcium has been shown to be crucial to the formation of apatite, dentin bridge formation and re-apatite potential of affected dentin. Additionally, alkalinity also seems to be con- tributory toward this goal. This combination in the RMCS material appears to form good, hard and thick dentin bridges and stimulates dentin pulp cells to turn into odotoblastic dentin cells.23 This type of material represents a promising new direction in direct pulp-capping clinical pro- cedures with its ability to form apatite and further contribute to the formation of new dentin. _Conclusion It is my belief that using bioactive materials in the provision of care for my patients has been paramount to the success of the care I have been providing. In this way, I have provided ways to heal the dentition, enhance the restoration and im- prove the health of my patients. I believe we are on the threshold of further bioactive material advancements and that learn- ing and incorporating these restorative materials intotheday-to-dayprovisionofcarewillcontinue to help our patients, our practices and our profes- sion._ Editorial note: A complete list of references is available fromthepublisher. Dr John C.Comisi,DDS, MAGD,has been in private practice in Ithaca,NY, since 1983.He is a graduate of Northwestern University Dental School and received his Bachelor of Science in biology at Fordham University. He is a member of theAmerican DentalAssociation and its tripartite organizations,theAcademy of General Dentistry,theAmerican Equilibration Society,the International andAmericanAssociation of Dental Research,a research associate at NewYork University Dental School and an editorial board member of Dental Products Shopper Magazine.Comisi is a Master of the Academy of General Dentistry,and holds fellowships in theAcademy of Dentistry International,theAmerican College of Dentistry, the Pierre FauchardAcademy and the International College of Dentistry.He may be contacted at jcomisi@jcomisi.com. _about the author cosmeticdentistry Fig. 16 Fig. 17