Introducing Natures Magic in a Dental Composite Natures

Introducing Nature’s Magic in a Dental Composite

Nature’s Way Pulpdent is the leader in the development of esthetic restorative materials that mimic nature and provide an environment favorable for the natural remineralization process that helps protect teeth, Nature’s Way.

Biomimicry: Imitating Nature Biomimicry is the design and production of materials that imitate nature and nature’s processes.

Biomineralization The continuous growth of crystalline structures constitutes biomineralization. Water is required for this process.

Introducing The first light cure composite designed to mimic the properties of natural teeth

Product Description • ACTIVA Presto is a universal, stackable and shapeable, low flow, light cure composite that holds its shape and does not slump. • Presto is a versatile, esthetic composite that is easy to place, highly radiopaque, and indicated for all classes of cavities.

Product Description • ACTIVA Presto is a dynamic, moisture-friendly, dentin and enamel replacement material that releases and recharges calcium, phosphate, and fluoride. • Presto is formulated with a patented rubberized resin that is strong, durable, and wear and fracture resistant, even in thin areas on bevel margins.

Product Description • The resin is urethane-based and contains no Bis-GMA, no Bisphenol A, and no BPA derivatives. • Presto is available in in A 1, A 2, A 3. 5, A 4, A 6, B 1, BW (Bleach White). A 4 and A 6 are cervical shades that are especially useful when treating older patients.

Modified Calcium Phosphate • ACTIVA Presto contains a patented, modified calcium phosphate component that is soluble in monomers and is attracted to the calcium in tooth structure. • The material penetrates and integrates with the tooth providing margin-free adaptation and an excellent seal. • The hydrophilic resin facilitates the diffusion of essential ions, and the modified calcium phosphate creates nucleation sites for apatite formation.

Mimics Nature Two Fundamental Elements in Presto that Mimic Nature 1. Moisture friendly, mineral-enriched, ionic resin first introduced in Pulpdent’s Embrace products 2. Rubberized-resin first introduced in Pulpdent’s Tuff -Temp Provisional Crown & Bridge Material

Patent: Ionic Resin Presto’s moisture friendly ionic resin interacts with saliva and tooth structure and releases and recharges calcium, phosphate, and fluoride ions that help regulate the natural chemistry of teeth and promote oral health.

Patent: Rubberized-resin • Presto’s rubberized resin absorbs stress and is tougher and more resistant to fracture and chipping than traditional composite resins • In nature, dentin and the periodontal ligament are natural shock absorbers

The Magic is in the Resin • Moisture friendly, mineral-enriched ionic resin facilitates the diffusion of calcium, phosphate, and fluoride, and integrates with tooth structure • Patented rubberized-resin is tough, absorbs shock, and resists fracture, wear, and chipping • Patented modified calcium phosphate component is soluble in monomers and binds to the calcium in teeth • Urethane-based resin contains no Bis-GMA, no Bisphenol A, and no BPA derivatives

Properties of Presto • • • Mimics the physical and chemical properties of teeth Moisture friendly, mineral-enriched composite resin Releases/recharges calcium, phosphate and fluoride Highly esthetic rubberized resin Tough, durable, resists wear, fracture and chipping Favorable for the slow, natural remineralization process Stackable, shapeable, low flow, no pull back, does not slump Universal ─ for all restorative procedures. Indicated for load bearing applications

Presto vs. Bio. Glass Presto is not Bio. Glass Properties of Bio. Glass, MTA and calcium silicate Strengths Weaknesses • Very high calcium release • Not esthetic • Fast mineralization • Brittle, not durable • Can repair large defects • Not indicated for load • Very good dentin bearing applications replacement materials. • Moisture friendly

ACTIVA Presto vs. Bio. Glass • Presto is an esthetic, mineral-enriched, ionic composite with high phosphate release that provides an environment favorable for the natural remineralization process. It is both a dentin and enamel replacement material. • Bio. Glass, MTA, and calcium silicate materials have high calcium release and fast mineralization, but they are not esthetic, not durable, and not load bearing. They are indicated for endodontic uses and dentin replacement, but they are not esthetic enamel replacement materials.

Unique Selling Propositions • • Highly esthetic, moisture friendly, light cure composite Stackable, shapeable, injectable, medium viscosity Rubberized resin absorbs shock and stress Resists fracture and chipping Strong, tough, durable, wear resistant Versatile – Indicated for all classes of cavities Indicated for load bearing applications Releases/recharges calcium, phosphate and fluoride

Unique Selling Propositions • • • Easy placement Easy to use syringe dispensing with 1. 2 m. L syringes 8 shades: A 1, A 2, A 3. 5, A 4, A 6, B 1, BW (Bleach) A 4 and A 6 are cervical shades ideal for older patients Urethane-based resin contains no Bis-GMA, no Bisphenol A, and no BPA derivatives

The Tooth is the Standard Material Esthetic Moisturefriendly High Strength Tooth Structure ACTIVA PRESTO Composite Yes Yes Yes No Releases/ Shock Recharges Absorbing Calcium & Phosphate Yes Yes Yes No No

Wear Testing Volume Wear 2 1, 5 1 0, 5 0 ACTIVA Presto Filtek Supreme Ultra Fuji II LC Conclusions: Activa Presto experiences slightly more wear than Filtek Supreme Ultra but there was no statistical difference. Both Activa Presto and Filtek Supreme Ultra experience significantly less wear than Fuji II LC. Source: University of Alabama School of Dentistry

Gloss Testing 60 50 40 30 20 10 0 ACTIVA Presto Filtek Supreme Ultra Enhance Fuji II LC Enhance + Po. Go Conclusions: Activa Presto achieved slightly lower gloss than Filtek Supreme Ultra but there was no statistical difference. Both Activa Presto and Filtek Supreme Ultra experience significantly higher gloss than Fuji II LC. Source: University of Alabama School of Dentistry

Flexural Strength Flexural Stress (MPa) 120 100 80 60 40 20 0 Activa Presto TPH Spectra® ST Filtek™ One Bulk Fill G-ænial Universal Flo There is no statistical difference between the flexural strength of ACTIVA Presto and leading composites. Source: The University of Tennessee Health Science Center

Deflection at Break 0, 4 0, 3 0, 2 0, 1 0 ACTIVA Presto TPH Specra ST Filtek One Bulk Fill G-aenial Universal Flo Deflection at Break of Presto, which indicates toughness and fracture resistance, is superior to leading composites. Source: The University of Tennessee Health Science Center

Fluoride Release/Recharge Release and Recharge of Fluoride Ions from Dental Restorative Materials PRESTO 14 Activa Restorative Beautifil Filtek Supreme mg F- ionsc/cm 2 12 10 1 st recharge 8 2 nd recharge 3 rd recharge 6 4 th recharge 4 2 0 0 5 10 15 20 25 30 Days Source: Pulpdent 35 40 45 50 55

Phosphate Release/Recharge Release and Recharge of phosphate ions from Dental Restorative Materials in distilled water mg of phosphate ions release/cm 2 20 18 16 PRESTO Activa Restorative Beautifil Flow Plus Filtek 14 12 10 recharge 8 recharge 6 4 2 0 0 Source: Pulpdent 5 10 15 Days 20 25 30 35

Calcium Release and Recharge of Calcium Ions in Distilled water mg of calcium ioons released/ cm 2 6 Presto 5 recharge 4 3 2 1 0 0 5 10 15 20 Days Source: Pulpdent 25 30 35

Radiopacity of Presto is equivalent to 2. 5 mm Al (250%) Compares 1 mm thick disk of ACTIVA PRESTO to an aluminum step scale 0. 5 mm 1. 0 mm 1. 5 mm 2. 0 mm 2. 5 mm 3. 0 mm 50% 100% 150% 200% 250% 300% ACTIVA PRESTO 250% Step scale Aluminum step scale cross section Each step = 0. 5 mm Aluminum

Physical Properties • • • Light cure setting time: 20 ± 2 seconds Depth of light cure: 2. 5 mm Percentage filler by weight: 70% Compressive strength: 327 MPa ± 15 MPa Diametral tensile strength: 53 MPa ± 2 MPa Deflection at break 0. 8 mm Solubility: 0. 26% Polymerization shrinkage: 2. 1% Radiopacity: 2. 5 Al (250%)

Standard Clinical Procedure

Clinical Cervical repair was made with Activa Presto A 6 shade. Can you find it? Courtesy of Dr. Robert A. Lowe

Clinical Class II fractured filling replaced with Activa Presto A 3 shade Courtesy of Dr. Robert Ho

Clinical Severe caries restored with ACTIVA Presto A 1 and A 2 shade Courtesy of Dr. Stefano Daniele

Clinical Mesial restoration with ACTIVA Presto Courtesy of Dr. Raymond Kimsey

Clinical Mesial restoration of upper left lateral incisor (#10) with ACTIVA Presto A 4 shade Courtesy of Dr. Robert Ho

Clinical Restoration of tooth #3 using ACTIVA Bio. ACTIVE-RESTORATIVE for dentin replacement and ACTIVA Presto for enamel layer Pre-op tooth #3 shows failed restoration Removal of failed restoration ACTIVA Bio. ACTIVERESTORATIVE used for dentin replacement ACTIVA Presto placed as enamel layer Courtesy of Dr. Robert A. Lowe

Dynamic Mineral-Enriched Composites that Create a Favorable Environment for the Natural Remineralization Process Hydrophilic Dual Cure Contains Glass Ionomer Injectable/Flowable Ideal for Bulk Fill 5 Shades: A 1, A 2, A 3. 5, Kids (white opaque) Rubberized Resins Calcium /Phosphate Enriched Ionic Resins Natural Esthetics Dynamic Composites Release/Recharge Calcium, Phosphate, Fluoride No Bis-GMA No Bisphenol A No BPA Derivatives Light Cure Contains Modified Calcium Phosphate Stackable, Sculptable, No Slump, Low Flow 2 mm Increments 8 Shades: A 1, A 2, A 3. 5, B 1, Bleach White, plus A 4 and A 6 cervical shades

Clinical Vertical crown fracture on upper left central incisor (#9) repaired with ACTIVA Presto Courtesy of Dr. Les Rykiss

Clinical Recurrent decay on mesial and buccal of #6 restored with ACTIVA Presto A 3. 5 and A 6 Pre-op Prepped with tissue retracted Selective etch Restored with Presto A 3. 5 on mesial and A 6 on buccal Courtesy of Dr. Lou Graham

Nature’s Magic in a Dental Composite