TheraCal LC—A Reliable Material That Protects the Pulp
Light-cured, resin-modified calcium silicate filled liner is designed for use in direct and indirect pulp capping and as a protective liner under composites, amalgams, cements, and other base materials
Patients and dentists alike have been seeking out minimally invasive dentistry and opting for saving teeth rather than a root canal.
This is a key strategy in the St. Paul, MN, practice of Dr. Mark Malterud. “Patients who are told they need a root canal, post, core, and crown from another dentist come to me,” he said. “We do an indirect pulp cap and resinbonded restoration instead. Their tooth is happy and they’re happy because we’ve preserved a significant amount of tooth structure.”
TheraCal LC is a light-cured, resin-modified calcium silicate filled liner designed for use in direct and indirect pulp capping and as a protective liner under composites, amalgams, cements, and other base materials. It can be used as an alternative to calcium hydroxide glass ionomer, RMGI, IRM/ ZOE, and other restorative materials. TheraCal LC performs as a barrier and protectant of the dental pulpal complex.
Many clinicians appreciate TheraCal LC’s significant calcium release, which stimulates1* hydroxyapatite and secondary dentin bridge formation2,3 while the alkaline pH promotes healing and apatite formation.2,4
Bonding is not required or recommended before placement of TheraCal LC on dentin. However, in a nonretentive preparation, such as a Class V noncarious cervical lesion, a bonding agent may be used prior to placement of TheraCal LC for an enhanced bond.
“I can categorically state that when I use it for indirect pulp-capping procedures, we are virtually at 100% for successfully saving pupal vitality.”
- Mark Malterud, DDS
Successful Outcomes
Dr. Malterud has been enjoying the success of practicing with TheraCal LC for more than five years. “I can categorically state that when I use it for indirect pulp-capping procedures, we are virtually at 100% for successfully saving pupal vitality,” he said. “We have, over the years, pushed the boundaries on direct pulp caps and have enjoyed many successes, even though we have used TheraCal LC on very large exposures. Utilizing TheraCal LC allows our more natural-minded patients the opportunity to try and save a nerve rather than have to move toward any more conventional endodontic therapies.”
Dr. Malterud had a patient who had severe decay on an upper premolar and the radiograph showed that the decay appeared to be into the pulp. The patient was experiencing sensitivity to cold and certain foods, but the response was of short duration. After a discussion, it was decided to try a direct pulp cap, should the radiographic evidence truly involve the nerve. Five years after the direct pulp cap, the tooth was completely vital, and radiographs showed a layer of dentinal bridging, revealing that the body can
repair given the opportunity.
Since Dr. Malterud and his team began working regularly with TheraCal LC, post-operative sensitivity has been reduced to virtually zero, he said, adding that the office deals with fewer urgent calls from patients, which would often come late in the day, in the evening, or over the weekend.
“TheraCal LC has been a great addition to my treatment protocols,” said Dr. Malterud, noting that he has also begun incorporating TheraCal PT in some of his cases. This newer member of BISCO’s Thera family is a biocompatible, dual-cured, resin-modified calcium silicate designed for pulpotomy treatment. “It has a self-cure mode along with the light-cure mode to allow us to use it in deeper restorations.”
References
1. Gandolfi MG, Siboni F, Prati C. Chemical-physical properties of TheraCal, a novel light-curable MTA-like material for pulp capping . International Endodontic Journal. 2012 Jun;45(6):571-9.
2. ADA definitions for direct and indirect pulp capping at: www.ada.org/en/publications/cdt/glossary-of-dental-clinical-and-administrative-ter
3. Apatite-forming Ability of TheraCal Pulp-Capping Material, M.G. GANDOLFI, F. SIBONI, P. TADDEI, E. MODENA, and C. PRATI J Dent Res 90 (Spec Iss A):abstract number 2520, 2011 (www. dentalresearch.org)
4. Okabe T, Sakamoto M, Takeuchi H, Matsushima K (2006) Effects of pH on mineralization ability of human dental pulp cells. Journal of Endodontics 32, 198-201.
5. Sangwan P; Sangwan A; Duhan J; Rohilla A. Tertiary dentinogenesis with calcium hydroxide: a review of proposed mechanisms. Int Endod J. 2013; 46(1):3-19
6. Selcuk SAVAS, Murat S. BOTSALI, Ebru KUCUKYILMAZ, Tugrul SARI. Evaluation of temperature changes in the pulp chamber during polymerization of light-cured pulp-capping materials by using a VALO LED light curing unit at different curing distances. Dent Mater J. 2014;33(6):764-9.
7. Cantekin K. Bond strength of different restorative materials to light-curable mineral trioxide aggregate. J Clin Pediatr Dent. 2015 Winter;39(2):143-8.
8. Mechanical Properties of New Dental Pulp-Capping Materials Over Time. M. NIELSEN, R. VANDERWEELE, J. CASEY, and K. VANDEWALLE, USAF, JBSA-Lackland, TX, , J Dent Res 93(Spec Iss A): 495, 2014 (www.dentalresearch.org)
* Bisco has the calcium release data for TheraCal LC on file.
