Product Evaluation

SDI

Riva Star, Riva SC HV, and Aura Bulk Fill

These 3 products work together to provide a non-invasive caries prevention and restorative treatment option 

Dentists are painfully aware that what begins as a small problem can quickly progress into something far more serious, sometimes resulting in accelerated decay, severe pain, the need for invasive and expensive intervention, or even tooth loss. When caries are present, it’s challenging to find a product that arrests caries development at an early stage and enables immediate placement of a definitive restoration to protect the affected area. SDI has met that challenge with a combination of 3 innovative products that arrest, restore, and protect.

Touted as the latest generation of silver diamine fluoride (SDF), Riva Star helps arrest decay at an early stage while providing immediate and long-term hypersensitivity relief and reducing the risk of staining. Riva SC HV, a bioactive, self-curing, high-viscosity glass ionomer, adheres to the tooth, mimics dentin without causing sensitivity, prevents caries formation, and—with SDI’s proprietary ionglass technology— releases fluoride to aid in remineralizing dentin. Aura Bulk Fill nanohybrid composite fills posterior teeth in a single layer, and its high density provides a strong interface to withstand high compressive forces.

After using these 3 products “in very challenging clinical situations where I felt the pulp was close to being compromised,” Dr. David Fang reported promising results. “In each case, so far I have not had any problem post treatment.” It appears to be an “effective treatment (so far) for situations with guarded prognoses where endo/extraction/implant would be the only other options.”

Patient Experience

Riva Star provides immediate and long-term hypersensitivity relief, and both Riva Star and Riva SC enhance patient comfort for minimally invasive procedures. Pediatric dentist Erica Anand said, “Parents preferred these products because it was a painless, quick procedure that didn’t traumatize their children.” Steven Edelson, DDS, found Riva Star helpful in “dental phobic patients,” where he could “stress avoidance of painful and costly dental treatment.” Another pedodontist, Dr. Gregory McGann, called Aura Bulk Fill “an easy-to-place bulk fill that speeds up the restorative process,” which was especially welcome with “an anxious teenage patient for whom speed is key.” Describing a patient who had several previous failed attempts at desensitization, Richard Leiman, DDS, reported, “The immediate decrease in sensitivity was impressive. Riva Star gave him hope.”

Lack of Staining

Riva Star features a patented 2-step procedure which minimizes the risk of staining when a potassium iodide solution is applied over the silver fluoride. “Riva Star helped inhibit and block the dark staining [seen with] SDFs,” noted Joel Preminger, DMD, and Dr. Leiman said, “I love the fact that it’s non-staining.” Dr. McGann stated, “The ability to apply a silver diamine  product while controlling staining was very welcome.” Dr. Anand used Riva Star as an antibacterial material on young patients with no staining or discoloration, even on anterior teeth, and said, “Parents were happy with the results.” Praising Riva Star’s ease of application and immediate hypersensitivity relief, Dr. Marc Vance said, “The elimination of staining is a huge advantage.”

Overall Effectiveness of All Products

Riva Star increases the bond strength of glass ionomer to dentin, making its use immediately (same day) before Riva SC especially effective, reports SDI. Riva SC’s high compressive strength and low acid erosion maximize the longevity of a restoration, and the material reduces microleakage when used as a restorative or base under permanent restorations. In the posterior, Aura Bulk Fill is simple to place and features a 5-mm depth of cure and single universal shade. Calling all 3 products “a great solution that’s predictable and hopefully durable,” Dr. Robert Kirchmann said they are excellent replacements for his existing products and systems. “The procedure was similar to existing protocols, making it easy to adapt to new products.” These products are “a promising modality to conservatively treat deep caries and possibly avoid root canals, pain, and increased dental costs,” described Dr. Edelson. Pleased to “atraumatically arrest caries and place a definitive restoration” to protect areas that are difficult to restore with composite, Dr. Maricelle Abayon noted, “It gave me a treatment option I can confidently offer to my patients.” Dr. Maloney liked “having a conservative, economical, non-invasive restorative alternative,” and Dr. Vance said Riva SC “worked well for core buildups and protective restorations on fractured teeth to prevent food impaction until definitive treatment.”

"I like having a conservative, economical non-invasive resorative alternative.”

R. Kevin Maloney, DDS

Hamilton, OH

Overall Satisfaction

“The ease of technique and the success of the materials warrant their continued use as part of my daily armamentarium,” reported Dr. Leiman, who said he will recommend and purchase these SDI products in the future. Dr. Maloney called the materials “another (and better) arrow in the quiver of treatment of difficult caries situations,” and Dr. Fang said he’s confident that he found “a new option for situations that are quite compromised.” Dr. Edelson concluded, “[These products are] an excellent addition to our dental therapeutics to minimize dental caries and subsequent dental pain and costs.”

Takeaways

• Riva Star helps arrest caries, provides hypersensitivity relief, and reduces staining with a proprietary 2-step process 
• Riva SC HV mimics dentin with no sensitivity, prevents caries, remineralizes dentin, and produces strong restorations
• Aura Bulk Fill fills posterior teeth in a single layer and speeds composite placement with a 5 mm depth of cure
• All 3 products together offer a conservative, economical, noninvasive restorative alternative