Activate your restorations with Activa™!

– Dr Nupur Shrirao, Editorial for April 2022 issue (Volume 5, Issue 4)

For years, it has been a goal to develop composite restorative materials that facilitate a more simplified, less technique-laden approach during clinical placement. The additional benefit of bioactivity of the material can be advantageous to the patient as well as the clinician in providing long lasting esthetic restorations. This, combined with its high polishability and shade-matching ability, makes Activa™ a high-quality restorative option for a variety of clinical applications.

Why Activa™ Pronto?

The manufacturer Pulpdent®, USA claims that Activa™ is hydrophilic (contains water but not bisphenol A or its derivatives), creating an ionic resin matrix that is receptive to a moisture-friendly environment which exists in the oral cavity (although Activa™ is not soluble). The material reportedly extracts fluoride, calcium, and phosphate ions from saliva and then releases these ions.

According to the manufacturer, other benefits of the restorative are an “intimate adaptation to tooth structure” and “exceptional marginal integrity.” This so-called smart material purportedly interacts with the constantly changing pH levels of the oral cavity to enhance and revitalize the physical properties of the tooth structure as well as the material itself (fracture resistance, durability, and toughness).

Activa™ can be characterized as a hybrid material because its physical qualities are comparable to those of traditional composite resins and its biologic properties are similar to those of glass ionomer systems. Due to its bioactive ionic matrix, Activa™ reportedly accomplishes polymerization from both light and chemical- curing processes.

Where can Activa™ Pronto be used?

Bioactive and highly esthetic Activa™ Pronto is slowly proving to be the obvious material of choice in a number of clinical situations because it is:

• universal
• stackable and shapeable
• strong and durable
• wear and fracture resistant
• releases and recharges calcium, phosphate and fluoride.

The key components of Activa™ products 1 are:

• Bioactive ionic resin is moisture tolerant with high release and recharge of calcium, phosphate, and fluoride ions.
• Rubberized resin is extremely tough and durable and mimics the physical properties of the tooth.
• Bioactive ionomer glass bonds to the tooth and has a high fluoride release. Hence, it has a wide array of indication right from simple caries management to the complex carious lesions involving multiple surfaces.

It is also indicated in cases where the isolation is compromised and in patients with high caries index due to its fluoride-releasing properties.

DentalReach readers personally experienced clinical situations where Activa™ Pronto can be used. Here are a few —

—Class V cavities—

The delivery of quality resin restorations is a bit challenging in cervical lesions. The combination of comfortable tooth preparation, auxiliary retention forms, then placement of composite such as Activa™ Pronto that will help protect the gingival marginal seal, is an excellent approach to handling Class V composites in restorative practice.

Using a hydrophillic resin like Activa™ Pronto in subgingival restorations facillitates ionic interaction that binds resin to the minerals in the tooth, forming a strong resin-hydroxyappatite complex and a positive seal against microleakage.

Layering/incremental built up with bioactive filling materials such as Activa™ Pronto (rubberised resin) in Class V cavities very close to the pulp allows for fewer stresses to develop within the restoration, lesser shrinkage and long term marginal seal.

(Info credits: DR readers & practitioners Dr Sonal Yerpude 2, Dr Alpa Savla 3)

—Class III cavities—

Activa™ Pronto can be placed in a Class III cavity as:

1. It is a caries prone area best replaced with mineral enriched bio-mimicking composite
2. Ease of application + Moisture tolerance
3. Ability to flex and does not chip inter-proximally
4. Ability to avoid biofilm formation unlike regular composite

(Info credits: DR reader & practitioner Dr Urvashi Tanwar 4)

—Class IV cavities—

With Activa ™(Pulpdent ®, USA), we have the ability to treat the tooth from within and strengthen tooth structure by replacing the missing calcium and phosphate that is lost in the decay process. Activa ™ is the first esthetic restorative to not only give us fluoride release and recharge, but also calcium and phosphate, which are the building blocks of tooth structure. This brings strength to the restoration and allows to truly restore a tooth, which is what is required in Class IV cavities, and not just repair it temporarily.

(Info credits: DR reader & practitioner Dr Neha Momin 5)

—Pediatric trauma cases—

Activa™ Pronto is a unique stackable versatile universal composite for all classes of cavities. It has patented rubberised technology which absorbs stress and resist wear. It is free from Bis-GMA, Bisphenol A and BPA derivatives. It also facilitates diffusion of bioavailable calcium, phosphate and fluoride ions which penetrates and integrates with the tooth.

Being a fluoride releasing composite, along with being flowable and stackable hence easy to use, Activa™ Pronto material is one of the best commercially available materials for the mixed dentition phase and difficult patients like children.

(Info credits: DR reader & practitioner Dr Priti Lamba 6)

—Deep Margin Elevation (DME) cases—

In cases where subgingival margins are present, deep margin elevation (DME) can be a useful technique to help restore teeth to the proper form and function. This procedure involves placing a material to raise the restorative margin to an equigingival or supragingival location.

Due to its hydrophilic nature Activa™ Pronto is the material of choice for DME cases. In all sense, it is a new age composite that exhibits biomimetic properties which prevents marginal leakage and subsequent secondary caries.

(Info credits: DR reader & practitioner Dr Sanjali Manerkar 7)

—Fractured fragment reattachment—

Fractured tooth fragments can be re attached using flowable / stackable mineral enriched composites like Activa™ Pronto. Fracture cases especially with youth, need not be replaced with regular composite passive restorations that could crack and chip and fracture again. It needs a new material like Activa™ Pronto which has rubberised urethane to repel biofilm and also be incapable of cracking and chipping, besides patented resin that allows for recharging of the tooth with minerals as required keeping the tooth alive and responsive to oral PH changes .

(Info credits: DR reader & practitioner Dr Nikhil Bahuguna 8)

—Interdental spacings—

The natural remineralization process knits the material and the tooth together, penetrates and fills micro-gaps, guards against secondary caries, and seals margins against microleakage and failure.

Hence, the use of conservative direct composite resins for proximal build-ups and recontouring of tooth shape results in a symmetrical, esthetic, and harmonious appearance.

(Info credits: DR reader & practitioner Dr. Ridyumna Garain 9)

—Caries along the midline—

Activa™ combines the esthetics, strength, and resilience of composites with bioactive properties that are superior to glass ionomers and RMGIs, much required in maxiallry upper incisors where esthetics and strength for anterioir guidance is a must. Activa™ Pronto is moisture friendly and reacts to changes in pH levels in the oral environment to help fortify and recharge the ionic properties of saliva, teeth, and the material itself, especially helpful in lower anterior teeth.

(Info credits: DR reader & practitioner Dr. Jibin Karim 10)

The bioactive difference supports a prevention model and helps maintain the health of the dentition.

Special issues dedicated to the DR Pronto Esthetic Challenge 2021-2022!

When we conducted the DR Pronto Esthetic Challenge 1-3, we noticed a beautiful healthy competition amongst our participants, and decided to honour this brotherhood (and sisterhood) by dedicating two issues to their hard work. The second issue comprises of the following articles:

1. Dr Priti Lamba – Challenge 3 mentor
2. Dr Bharathi Mahadevaiah – Challenge 2 winner
3. Dr Neha Momin- Challenge 2 winner
4. Dr Urvashi Tanwar- Challenge 2 winner
5. Dr Sanjali Manerkar- Challenge 2 winner
6. Dr Jibin Karim- Challenge 2 winner

Did you read our March 2022 issue? The theme was: DR Pronto Esthetic Special 1!

You can read our March 2022 special issue by clicking here.

>>> Up next: Stay tuned for the upcoming May issue! It will be an eBook on Dental Dream Team, which you can download for free!>>>

If you wish to contribute articles for our upcoming issues, get in touch with me on editor@dentalreach.co.

References

1. Bharathi M. Management of deep Class III caries for a healthy and happy smile DentalReach, 2022 Apr; 5(4).
2. Yerpude S. A curious case of a carious Class V restoration. DentalReach, 2022 Mar; 5(3).
3. Savla A. Success with Class V restorations in day to day dentistry! DentalReach, 2022 Mar; 5(3).
4. Tanwar U. Saving teeth ‘Activa-ly’!DentalReach, 2022 Apr; 5(4).
5. Momin N. Case Report: Lifelike Restoration with Mineral Enriched Activa™ Pronto. DentalReach, 2022 Apr; 5(4).
6. Lamba P. Treating the Class IV – a case of pediatric trauma!DentalReach, 2022 Apr; 5(4).
7. Manerkar S. Anterior Esthetic Restoration with DME using Activa™ Pronto – A Case Report. DentalReach, 2022 Apr; 5(4).
8. Bahuguna N. Fragment Re-Attachment – Preserve and Conserve. DentalReach, 2022 Mar; 5(3).
9. Garain R. Biomimetic Rehabilitation of Multiple Teeth with Interdental Spacing. DentalReach, 2022 Mar; 5(3).
10. Karim J.Restoring Class 3 caries along the midline in rotated teeth. DentalReach, 2022 Apr; 5(4).