Product Evaluation

BISCO

TheraCal LC

A light-cured, resin-modified calcium silicate with a unique apatite stimulating ability that makes it ideal for direct and indirect pulp capping and as a protective liner under restorative materials

When DPS asked several clinicians to share their experiences with BISCO’s TheraCal LC pulp protectant and base/ liner, the feedback was unbelievably positive, with dentists describing TheraCal LC as “my go-to choice,” “a sweet bonus,” and “a huge step up.”

One of those dentists, Dr. Siti Lowery, said she “always has BISCO’s TheraCal LC resin-modified calcium silicate protective liner on hand” in her North Carolina practice. “I am currently using TheraCal LC for direct and indirect pulp caps and as a liner under composites or core buildups,” she told DPS while praising just about every quality of this unique material—including its precise dispensing, easy handling, time savings, radiopacity, calcium release, alkaline pH, and versatility.

Versatility

TheraCal LC is a light-cured, resin-modified calcium silicate filled liner designed for use in direct and indirect pulp capping procedures and as a protective liner under composite, amalgam, cement, and other base materials. It also can be used as an alternative to calcium hydroxide, glass ionomer, RMGI, IRM/ZOE, and other restorative materials, according to BISCO.

Calling it a very versatile material, Dr. Richard Siegel has used TheraCal LC for years as a direct and indirect pulp capping material and as a liner under fillings and crowns and says he has “had success preventing pulpitis in many patients.” Dr. David Mastrota noted, “It is very easy to use under all my materials, and I have had great success with it as a base/liner. I use it a lot on deep areas, and it seems to eliminate any pulp issues thus far.”

“I have been using TheraCal LC since it came out, and it is fabulous,” reported James DeFilippo, DDS. “It is our go-to base under any deeper restoration, and it has not disappointed. It works as an indirect or direct pulp cap as well.” Noting that he uses it under all restorations that approach the pulp, Dr. DeFilippo said, “I find that it helps reduce the sensitivity that a patient may experience after restorative treatment—significantly!” He also said he believes that using TheraCal LC reduces the chance of pulpitis and increases the chance of a restoration’s success, potentially eliminating future endodontic treatment.

Ease of Use

“TheraCal LC is my go-to choice for pulpal exposures and as a lining under deep preparations,” noted Dr. Marvin Stern, who reported “great success” when used as a base/liner over areas of deep decay. “It cures rapidly and allows me to continue to a final restoration quickly, ” he added. Dr. Lowery appreciates the “convenient and easy-to-handle syringe,” the small tip that “fits into small, tight spots,” and “the light curing [that] allows for immediate restoration placement.” She added, “I also love the opacity and ease of identifying this base/liner on x-rays.” Agreeing that TheraCal LC is “fast and easy to place, with no mixing for my assistants,” Dr. Mastrota said, “It stays where you put it and will block out stained dentin that may show through an anterior resin. It is a huge step up from any product that I previously used."

"I like the idea of taking the extra step to protect the pulp and provide comfort for the patient.”
- Siti Lowery, DDS

Cary, NC

Calcium Release & Alkaline pH

According to BISCO, TheraCal LC releases calcium, which stimulates¹* hydroxyapatite and secondary dentin bridge formation^2,3 while its alkaline pH promotes healing and apatite formation3,4. “The calcium release is nice in helping stimulate reparative dentin, and it clearly helps with reducing pulpitis and pulpal sensitivity,” noted Dr. Siegel. Dr. Stern said, “I believe that the calcium release and alkaline pH are responsible for the stimulation and formation of a secondary dentin bridge.” When asked about the calcium release and alkaline pH of TheraCal LC, Dr. Lowery declared, “These two traits are a sweet bonus! I believe that TheraCal LC helps to prevent pulpitis and reduces sensitivity at the site of placement.” She added, “I like the idea of taking the extra step to protect the pulp and provide comfort for the patient.”

Overall Satisfaction

When Dr. Artin Manoukian evaluated TheraCal LC for Dental Product Shopper in 2013, he mentioned that “a longer period of evaluation may be needed to evaluate the product’s efficacy, particularly if it helps avoiding pulpitis.” Now, more than 8 years later, Dr. Manoukian discussed the long-term benefits of TheraCal LC. “No patients have reported symptoms and no periapical changes [were noted] on recall radiographs. TheraCal LC performs well and is a successful product to use in deep carious teeth.” Dr. Stern concluded, “TheraCal LC is a very good product that I can highly recommend.”

Takeaways

• A light-cured resin-modified calcium silicate with a unique apitite stimulating ability³
• Ideal for direct and indirect pulp capping
• A protective base or liner under composite, amalgam, cement, and other base materials
• Delivered in a convenient syringe with a small tip for precise placement

References
* Bisco has, on file, the calcium release data for TheraCal LC.
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.