I have been using the materials that make up BISCO’s family of Thera products for about 10 years and I am a believer in their restorative capabilities. I occasionally reach for TheraCal LC, typically as a block-out material in a semi deep prep to ensure a selective-etch technique.
I also use TheraBase because it’s a great self-adhesive base that I use in larger, deeper excavations. Since it is dual cure and has great compressive strength, I employ it when it will comprise about half of the restoration.
But in the deepest excavations of adult teeth where I need to place an indirect pulp cap, I choose TheraCal PT. These are situations that do not clinically or visually open the pulp chamber but that I cannot radiographically tell whether or not I caused an exposure.
I also use it for minor exposures where the bleeding is quickly halted in primary teeth or permanent teeth of patients age 16 and under. Regardless of whether a direct exposure occurred, TheraCal PT is designed to adhere to the tooth.
Case 1
In this first case, my patient was a 37-year-old woman with no revealed or evident health problems or history beyond a lifetime of poor diet choices. Gross decay was present at her initial visit on 19 of 28 teeth, but all appeared restorable (Figures 1 and 2).
We began a full-mouth excavation plan to temporize or place protective restorations with the intention of returning as necessary to reinforce. I applied TheraBase and then closed with layers of resin for multiple restorations. As of this writing, we have completed 4 of the 6 sextants.
Tooth No. 2 was excavated (Figure 3), and then a large layer of TheraBase was applied to the interior wall to support the new restoration (Figure 4). The exterior restoration was built with a flowable composite (Figure 5).
Case 2
In this next case, a 34-year-old woman presented with very few decayed teeth and no health issues. On the day of treatment, she had a fractured lingual cusp on tooth No. 13 where a distoocclusal restoration had been previously treatment planned. Although I didn’t capture a good preoperative photo, you can see from the x-ray this was a deep problem (Figure 1).
After removing the cusp and a surprisingly small amount of decay, we had not penetrated the pulp chamber (Figure 2). I used a diode laser for gingival removal and hemostasis and rebuilt with TheraCal PT and a flowable composite (Figures 3 and 4).
I kept the restoration smooth and out of occlusion to prevent any fracturing. The plan is to wait 1 year prior to fabricating an indirect ceramic restoration in case endodontic treatment is needed. At her 1-month follow-up, the tooth was still responding vital but with no lingering sensitivity (Figure 5).
