ACTIVA KIDS and ACTIVA Presto Restoration
By Carla Cohn DMD
Children should learn to practice oral hygiene from an early age, and pediatric dentists are specially trained to treat little ones and educate their parents on oral health care. Caries can develop as the primary teeth first begin to erupt, and maintaining healthy primary dentition is important for the growth and development of the arch and the emotional well-being of the child.
This 5-year-old did not benefit from early oral care and had multiple caries lesions. Considering the young age, high caries risk, and the uncertainty of compliance with follow up appointments, I wanted to restore all the teeth in one visit and seal teeth that were non-cavitated and caries-free. One quadrant is shown in this case study. The caries lesion on tooth J (65) is cavitated and will be prepared, restored and sealed. Tooth I (64) is non carious and will be sealed (Figure 1).
I chose Pulpdent’s ACTIVA KIDS Bioactive Restorative and ACTIVA Presto because I have seen excellent clinical results over time with these bioactive materials. Continuous release of calcium, phosphate, and fluoride from these materials are beneficial in the fight against decay long into the future. Ease of use and the ability to work quickly were important in this case, and all restorations were completed under general anesthesia in one appointment. There were wear facets on the occlusal surfaces of the molars, so it is important to use a material that will have some flexibility and resistance to fracture. The innovative composition of ACTIVA KIDS includes a rubberized-resin component that absorbs forces and would be an ideal filling material for this case. ACTIVA Presto shares similar properties and was convenient to use as an occlusal surface sealant.
Tooth J (65) was prepared with a coarse tapered high-speed diamond bur allowing for some minor mechanical retention by incorporating minimal undercut in preparation. The occlusal surface of tooth I (64) was also lightly abraded with a diamond bur (Figure 2). The preparations were selectively etched with phosphoric acid, rinsed, and lightly dried (Figure 3). Bonding agent was applied to the entire occlusal surfaces of both teeth, air thinned, and light cured (Figure 4).
Tooth J (65) was bulk filled with ACTIVA KIDS. For this fast injection technique, place the dispensing tip at the floor of the preparation, and extrude the material without removing the tip until the preparation is completely filled (Figure 5). I like to do some minor manipulation of the filling material with hand instruments to create anatomy and to ensure the material is flush with the surface of the preparation and no air is trapped in the material. ACTIVA KIDS is dual cure, is ideal for bulk filling, and cures with all lights. A thin topcoat of ACTIVA Presto was then placed as a sealant on the entire occlusal surface of teeth I and J (64 and 65) (Figure 6). Figure 7 shows the final clinical situation.
Dr. Carla Cohn, DMD, graduated from the Faculty of Dentistry at the University of Manitoba in 1991. She furthered her education, completing a post graduate internship in Children’s Dentistry at Health Science Centre, Children’s Hospital. Dr. Cohn regularly attends continuing education programs to stay current in the latest advances in modern dentistry. While practicing at Kids Dental, Carla continues to support “hospital dentistry” – treating children under general anesthetic in the operating room.