Helping Patients Keep Their Teeth for a Lifetime

About 10 years ago, Miyasaki rejoined Miyasaki Dental in Sacramento, California, as his father was preparing for retirement, and he brought that same philosophy with him: providing comprehensive health in a minimally invasive manner. "We are a longtime family practice, so we work on great-grandchildren, great-grandparents, and every generation in between," he says. "Treating these families for multiple generations has given me a true appreciation of what good dental health can provide and what poor dental health can cause."

According to Miyasaki, listening to patients is the key to providing the best care. He believes that patients are empowered to make better decisions about their health when the dentist understands their desires. "We are fortunate to be able to spend the time to learn our patients' concerns, determine their needs, and offer them options," he says.

Currently, one of the best options that Miyasaki has found is Vista Apex's RE-GEN^™ line of bioactive materials, which includes a flowable composite, a pit and fissure sealant, and what Vista Apex calls the world's first bioactive universal and self-etch adhesives. "RE-GEN represents the next generation of restorative materials," he says. "Our philosophy is to treat the whole patient—not just the decay. We often say that we are trying to help our patients keep their teeth for a lifetime, so we need to employ treatments that conserve tooth structure and help our patients with their long-term health."

Restorations using RE-GEN products are osteogenic, antimicrobial, biocompatible, and BPA-free. The bioactive ingredient in the materials is Bioglass 45S5, which attracts and exchanges bioactive ions such as calcium phosphate and fluoride. These ions neutralize the environment's pH and provide broad antimicrobial effects that promote healing and the prevention of caries.

"Most children eat candy and do not brush their teeth well or floss regularly, so they invariably get cavities in between the teeth that need to be filled," Miyasaki says. "Oftentimes, those fillings need to be replaced a few years later because of recurrent decay, and eventually, this can lead to the need for a crown, a root canal, or extraction. We have been searching for ways to prevent that decay or at least to make the initial filling last longer, and that is what excites us about RE-GEN. We can use the RE-GEN Pit & Fissure Sealant, and then if we need to do a composite restoration, we can use the RE-GEN Flowable Composite for that as well."

Continuous pH buffering helps prevent erosion and secondary decay, and the bioregenerative nature of RE-GEN helps close marginal gaps, preserving marginal integrity. "The research shows that this creates more of an alkaline environment, which allows for remineralization and prevents the formation of bacterial colonies around the margins of our restorations," Miyasaki says.

RE-GEN Flowable Composite Liner is formulated to deliver a unique combination of thickness and flow in a material with excellent compressive strength (357 MPa) and a high level of radiopacity. The RE-GEN universal and self-etch adhesives, which also incorporate bioglass, provide consistent results and exceptional bonding while virtually eliminating postoperative sensitivity. "We can place the bioglass material right into the dentinal tubules where it will help the tooth heal," Miyasaki says. "Using the adhesive and flowable composite together offers strong prevention against secondary decay."

When Miyasaki discusses the RE-GEN materials with his patients as part of his patient-centric process, several have mentioned that they would have been willing to pay extra for such impressive bioactive capabilities. Miyasaki emphasizes that his priority is their long-term health. "Patients love that we can give them a better chance to keep their teeth for life," he says. "Do I want to place restorations that will lead my patients down the path of possible extraction because of recurrent decay, or do I want to place restorations that will lead them down the path to dental health because of their regenerative properties? I invite my colleagues to look into the RE-GEN line from Vista Apex. If we can break that typical life cycle of a tooth that ends in extraction, and we can promote the regeneration of healthy teeth, then we are going to help our patients keep their teeth for a lifetime."

• Construct longer-lasting restorations that reduce the incidence of restorative failure and sensitivity.

• Bioglass attracts and exchanges bioactive ions (Ca2+, PO43-, F-) with the oral environment.

• Continuous pH buffering helps prevent erosion and secondary decay.

• The bioregenerative nature of RE-GEN helps close marginal gaps, preserving marginal integrity.