I don’t know about you, but changing and/or adding a new restorative material is not something that I take lightly.
One material that has been important part of my arsenal is the cavity base/liner.
In dental school I was introduced to Calcium Hydroxide. It was a powder liquid material that I used on deep restorations as a thermal insulator under my amalgam restorations. However, Calcium Hydroxide was not ideal under composite restorations. So when I stopped doing amalgams (the day I graduated dental school) I made the switch to Vitrebond. It was a great material, but I hated having to mix.
We soon switched to Fuji Liner from GC America. It required mixing, but came in a paste pack. Fuji Liner stayed in my restorative material list until 2013.
In 2013, at the DentalTown “Townie Meeting”, I was introduced to a new class of ‘active’ restorative materials. The ‘active’ restorative materials release calcium, fluoride to promote secondary dentin formation. They also have a high pH to create an antimicrobial effect. But the most important thing was they were light cure materials that were syringed like a flowable composite.
I must say that I have been thoroughly impressed with the handling and the tooth response to these materials in the 18 months since I started using them. My incidence of post-op sensitivity on deep preparations has gone down to basically zero.
Although I started with TheraCal LC from Bisco, my current (September 2014) material of choice is Calcimol LC from Voco. I find that Calcimol LC handles better in my hands and is more tooth colored compared to the opaque white of TheraCal LC. Calcimol LC can be used with or without a dental adhesive.
Beyond the traditional use as pulp cap (direct and indirect), I am using Calcimol as a ‘base/liner’ on deep crown preps and as a blockout for undercuts in my indirect restorations.
I encourage you to take a closer look at the class of ‘active’ restorative materials. The handling and clinical properties are an improvement over the classic materials.
