I often think about what dentistry will be like in the future. What will our restorative workflows be? Will most restorations be made in the office? Will 3-D printing become the way that we produce all of our restorations? What will direct restorations be like? There is obviously a lot to be determined with these, but I think we can all agree that further advancement in biomimetic dental materials is a sure thing. The idea of placing restorations that continue to exert effects on the tooth structure around them is extremely appealing. In this respect, the future has come now with Activa Presto from Pulpdent.
Pulpdent makes a couple of products I use almost daily, Activa Restorative and Tuff Temp. Activa Presto joins those ranks. Activa Presto is the first biomimicing light-cure composite resin. Wait, what? You might be thinking of the original Activa. How can Activa Presto be the first? Well, the original Activa is a compomer, while Activa Presto is a true resin composite. That means that you can use it in all of the situations that you would normally use resin composite and get that biomimicing benefit.
The biomimicing benefit comes in the form of facilitating ionic exchange between the saliva and the tooth. We obviously first think of fluoride in this scenario. Equally important are calcium and phosphate. To take you back to freshman year chemistry, fluoride is a negative ion, and calcium and phosphorus are positive ions. We need the calcium and phosphorus to be able to shepherd the fluoride into the tooth. The three ions are a team.
Just like Pulpdent’s Tuff Temp, Activa Presto has rubberized resin incorporated into it. For my provisionals with Tuff Temp, this means temps that don’t fracture. For Activa Presto, this means less fracture and chipping than traditional composites. After having made over 100 temps with Tuff Temp with literally one fracture, this rubberized resin molecule has made a believer of me.
Activa Presto comes in a typical flowable composite delivery system and handles like a nice flowable. It is stackable and can be placed to full contour. For very large restorations, you could use it as a base or liner and use a universal composite on top. For smaller restorations and minimally invasive preps, I use Activa Presto to full contour. While original Activa is a dual-cure material, Activa Presto is not bulk fill and must be cured in 2 mm increments. Activa Presto comes in eight different shades (A1, A2, A3, A3.5, A4, A6, B1, and Bleach White), so there is a wide variety of esthetic options.
I really like the idea of using a restoration that does something besides fill space. That is the allure of biomimetic materials. I think we are on the bleeding edge of this family of restorative materials and I am stoked to see where we end up. Solo home run to right field for Activa Presto!
