Bio-Active Basics- What you need to know

Dr. Milnar was invited to Pulpdent Corporation, a leading manufacturer of Bio-Active dental products on 7/26/19. Pulpdent’s headquarters are in Watertown, Massachusetts. Dr. Milnar was invited because of his reputation as an educator and key opinion leader in the dental profession. He met with Larry Clark, the director of Clinical Affairs and Marketing. Also, included was Leah Berk. She is Media and Marketing Manager at Pulpdent and Christie Bailey, Manager of Professional Relations & International Sales Dr. Milnar also met with the chemists who created Bio-Active dental products.

Pulpdent is a family owned and operated dental research and manufacturing company established in 1947 and committed to its founding principles of education, prevention and proactive dental care so that people can live healthier and more productive lives. Pulpdent’s research and product development is directed toward unlocking nature’s healing powers with bioactive materials that mimic the physical and chemical properties of tooth structure, behave favorably in the moist oral environment, and maximize the potential for remineralization. Pulpdent products are manufactured in Watertown, Massachusetts, USA in compliance with the company’s Quality System and all regulatory requirements. Each year they renew their commitment to investing in research and new technologies, earning the trust of the profession, inspiring clinicians with new ideas and materials, and providing the leadership to accomplish these objectives.

Bioactive materials are changing restorative dentistry. Materials marketed as ‘bioactive’ serve to solve a long-standing problem in dentistry — giving teeth what they want.

Materials are a fascinating, ever-changing, ever-improving facet of restorative dentistry. For more than 100 years, amalgam fillings have been commonplace. And while they’re still in use (albeit, not as often), the introduction of resin composites seemed to correct what amalgam left to be desired — a mercury-free material that also was tooth-colored. Bioactive materials serve to improve materials even further. Bioactive materials help clinicians transition from a repair model to a prevention model. Composite restorations fail due to microleakage and the degradation of the adhesive layer. This usually appears as staining at the margins. Bioactive materials have a great potential to seal against microleakage and slow or prevent the progression of secondary caries under restorations. This is a great benefit to the patient and results in longer-lasting restorations and preservation of tooth structure. Bioactive products like ACTIVA BioACTIVE provide the esthetics, strength and wear resistance of composites, and release and recharge calcium, phosphate and fluoride, while promoting a healthier dentin interface over time.” Materials marketed as “bioactive” serve to solve a long-standing problem in dentistry — giving teeth what they want.

Very simply, if you think about what a tooth really wants states Dr. Milnar. You think about the disease process itself, Bacteria in dental plaque feed on sugar and release acids that demineralize the tooth, which can lead to cavitated lesions. After removing the affected tooth structure, dentists should consider what material would be best suited to restore what is lost. Caries and the trauma to the tooth associated with removing it can be injurious to the tooth. Bioactive materials can be a way to not only restore the cavity but help provide a mechanism for healing, health and improved function.

Bioactive materials help stimulate the natural remineralization process. In the presence of saliva, they elicit a biological response that forms a layer of apatite and a natural bond between the material and the tooth. Pulpdent’s research focuses on developing bioactive materials that imitate the physical and chemical properties of teeth, help neutralize conditions that cause dental caries, and maximize the potential for remineralization.

How was Pulpdent’s ACTIVA™ BioACTIVE developed?

ACTIVA™ BioACTIVE was developed over the course of almost 20 years. The mouth is a wet environment, but traditional dental resins are hydrophobic. Pulpdent had a different idea and developed resin materials that are moisture tolerant and work favorably in the moist oral environment.

Pulpdent looked at provisional materials and saw that acrylics and bisacrylics were brittle. They recognized that there was a need for more fracture-resistant materials. They synthesized a new molecule, which we patented, by splicing a synthetic rubber molecule into a diurethane dimethacrylate molecule. Studies consistently show that the addition of this molecule to a resin provides far greater toughness, fracture resistance, deflection at break, flexural strength, and flexural fatigue values than all other dental materials.

Dental manufacturers are processing glass and silica fillers for composite materials all the time. Pulpdent’s research team began to put these various chemistries and fillers together in different ways to develop products for various dental applications. This is how ACTIVA was born.

ACTIVA BioACTIVE materials behave favorably in the moist oral environment. They participate in a dynamic system of ionic exchange with saliva and tooth structure, continuously releasing and recharging calcium, phosphate and fluoride and responding to pH changes in the mouth. When the pH is low, the demineralization process releases calcium and phosphate ions from both the teeth and ACTIVA. When the pH increases, these ions are available to combine with the fluoride ions in our saliva and precipitate onto the teeth in the form of acid-resistant fluorapatite. The addition of a patented rubberized-resin molecule to the ACTIVA resin matrix absorbs stress and shock and delivers unprecedented toughness and fracture resistance.

ACTIVA BioACTIVE materials are strong, esthetic and durable, and offer an
alternative to traditional composites, which are strong and esthetic but are passive and without bioactive potential, and to glass ionomers, that release a significant amount of fluoride but have poor esthetics and undesirable physical properties. The term “bioactive” has become a trend in dental materials marketing, but many practicing dentists and researchers are struggling to understand what it truly means.1 By its most basic definition, bioactive refers to a material that has a biological effect on surrounding tissues. The desired effect will depend on the purpose of the material. For example, a bioactive liner may cause the release of growth factors from the dentinal collagen to induce the formation of reparative dentin in the pulp chamber. A desirable bioactive restorative material would create a bond with surrounding tooth structure, and release ions to allow remineralization at tooth margins following an acid challenge. A bioactive cement may have the additional benefit of attracting calcium phosphate precipitates to its surface to occlude an existing cement gap.

Dr. Milnar’s vision for the dental profession is to use “ Smart Materials” that communicate with the ecosystem of the mouth. Give the tooth what it needs and heal it, not merely removing diseased parts. Just as iPhones are mainstream in our lives, smart dental materials are now gaining traction as well. Pulpdent will rely on Dr.Milnar’s expertise to teach Bio-activity to other dentists through mentoring, seminars and dental publications.