Bioactive Bulk Fill Puts Life Into Restorations
Inside Dentistry provides the latest in endodontics, implantology, periodontics, and more, with in-depth articles, expert videos, and top industry insights.
December 1, 2020
Volume 16, Issue 12, December 2020
Page(s): p. 54
Composites have a long history of being inert materials that are placed into preparations to simply fill the space. However, bioactive composite materials are breathing new life into restorations, providing added value by integrating and interacting with the tooth structure.
One of the latest entries into this field is Parkell Dental Products' Predicta® Bioactive Bulk, a dual-cure, bulk-fill resin composite that stimulates mineral apatite formation. The material releases beneficial ions (ie, calcium, phosphate, and fluoride) that trigger the formation of a protective layer of mineral apatite, which is the defining requirement of a bioactive material. In addition, the material's ability to recharge fluoride ions results in a unique combination of physical and chemical properties. Predicta Bioactive Bulk is dimensionally stable and provides excellent strength, time-efficient handling, and optical characteristics close to those of natural teeth.
In a recent episode of Product Talk, Jason Olitsky, DMD, AAACD, discussed the benefits of bioactivity and his use of Predicta Bioactive Bulk. "Bioactive composite wasn't a category that entered into my thought process until I was connected with Parkell," he says. "I decided this was something that I needed to check out because I didn't know a lot about it. So, I spent about 40 hours researching bioactive materials. At the end of the day, it makes sense. Why are we treating teeth with inert substances when we could be treating them with restorations that are working with the hard tissue to create more positive situations in the oral environment."
The ability to bulk fill direct composites in the posterior region instead of performing incremental placement is another advantage. Predicta Bioactive Bulk features a thixotropic viscosity for consistent placement and adaptation; however, a low viscosity version is available for those who prefer a more flowable material.
"Implementing incremental placement takes forever," Olitsky says. "And it increases the chances for voids and failures where there is incomplete layering. I am a big fan of bulk fill. It not only speeds things up but also reduces the chances for failure."
When restoring a deep proximal box, there's often a concern about postoperative sensitivity due to uncured composite against the tooth structure. A dual-cure material such as Predicta Bioactive Bulk offers an unlimited depth of cure, which helps to alleviate that concern.
"There aren't a lot of materials available like this," Olitsky says. "This is my first experience with a dual-cure resin material for restoration. I love the concept, because I know that there are a lot of failures related to incomplete curing, especially at the bottom of boxes or where secondary caries occurs. With Predicta Bioactive Bulk, I can place one whole increment right up to the top. I know that this material starts self-curing from the bottom up. Then, I can light-cure from the top down. In the end, I have a monolithic restoration that is cured from top to bottom. This gives me that peace of mind."
Olitsky notes that in his practice, he typically prefers to place an exact amount of composite for the anatomy and occlusion. "With Predicta Bioactive Bulk, however, it works differently. I overfill it slightly and then carve it in. At first, I wasn't sure I would like that, but I wanted to test the possibilities. And it produced a nice polish."
In the end, Olitsky says he was pleasantly surprised with the esthetics. "My practice is really concerned with esthetics. Even though Parkell doesn't spend a lot of time highlighting the esthetics of Predicta Bioactive Bulk, I know my patients will be pleased with these results."
Jason Olitsky, DMD, is an accredited member of the American Academy of Cosmetic Dentistry and the program director for Clinical Mastery Series. He maintains a private practice in Ponte Vedra Beach, Florida.
