The Best of Bisco

With DPS Best Products designed for simplicity and compatibility, BISCO continues to stick to the science of restorative success—adding a growing number of clinicians to its fan base“

While most companies set out to accomplish one major goal every year, some go above and beyond that benchmark, promising to do multiple good things consistently, year after year. For BISCO, that means developing best-in-class dental products, educating and sharing its knowledge and research with the dental community, and being a go-to restorative dental expert for its customers.

Doing these 3 things year after year has paid off for the manufacturer, as shown by its robust product portfolio of both new and tried-and-true restorative materials. Over the years, many of these products have made their way into the hands of DPS evaluators, who have not hesitated to deem them DPS Best Products.

From the gold-standard adhesion of All-Bond Universal to the calcium-releasing TheraFamily to the exceptional handling of Core-Flo DC and the designed-for-zirconia priming power of Z-Prime Plus, BISCO products continue to delight clinicians everywhere.

Here’s a look at how BISCO's DPS Best Products are elevating restorative dentistry for your peers.

Generation Universal

Whether you’re a baby boomer, a Gen Z member, or somewhere in between, every new generation breeds fresh ideas and perspectives that, if given the opportunity, can help improve the quality of our lives. Similarly, dental adhesives over the years have undergone an incredible evolution, as marked by 4th, 5th, 6th, and 7th generations—each with a unique set of steps and materials that work together to ensure a successful bond

.A member of the 8th (and last) generation of bonding agents, All-Bond Universal has been alive and well for over a decade. But while it may be the first truly universal bonding agent available in dentistry, it’s far from the only one. Today, most dentists reach for a universal bonding agent to complete their direct and indirect restorations, which begs an important question: Aren’t all universal adhesives the same?“The definition of a universal bonding agent is that it works in all etch modes, but that doesn’t mean every product achieves that the same way,” warns Dr. Rolando Nuñez, Clinical Marketing Manager at BISCO. “Every formula is different," he said, adding that not all manufacturers use the same adhesive monomers, solvents, or water content in their products.“If you break it down, you’ll see that every adhesive performs and degrades differently. In some cases, the differences are nuanced, but in others, they are huge,” he added.

Peer Perspectives

“I originally began using All-Bond Universal after taking a CE course led by Dr. Ed Suh,” said Craig Smith, DDS, a general dentist who practices 20 miles north of Milwaukee. "At the time, I remember being impressed by its strength, thin film thickness, compatibility with self-, dual and light-cure materials, and its ability to lower patient postop sensitivity.”

Today, Dr. Smith uses All-Bond Universal for virtually all his restorative procedures. “All-Bond Universal allows me to use the adhesive in multiple ways depending on the clinical application,” he said. “Whether I use it in total-etch or self-etch mode, I feel confident that it’s going to work as designed.”

While many restorative materials claim to minimize or eliminate postop sensitivity, for All-Bond Universal, the proof is in the product reviews.

“BISCO is right on target when it says this product has virtually no postop sensitivity,” said Scott Miller, DDS. "In fact, I’ve never had a patient complain about sensitivity in all the years I’ve been using All-Bond Universal. I’ve previously had that issue, and when it happens, it is problematic both for the patient and for my office."

Dr. Miller also appreciates that he can use All-Bond Universal on any toothstructure, whether it’s wet, dry, or moist, with total confidence that the bonding resin will penetrate dentinal tubules and etched enamel to form a reliable bond.

“Over my years of practicing dentistry, I’ve successfully used many different BISCO products. My positive experience with those products, along with the knowledge that the company spent over 3 decades performing research to develop a universal adhesive, made trying All-Bond Universal adhesive an easy decision—and I’m so glad I did,” said Dr. Miller. “It’s been the most consistent product for all my bonding needs, which is why I continue to trust its performance year after year. I consider it essential to my practice.”

Meeting Zirconia’s Needs

Just when it seemed that clinicians everywhere had bonding down to a science, zirconia splashed onto the scene in the early 2000s. With a strength 5 times greater than that of other ceramics, it quickly became a popular restorative material to consider, especially for posterior crowns.

Soon after, BISCO began fielding questions from clinicians about why their zirconia crowns were debonding. So, BISCO embarked on numerous research studies dedicated to zirconia bonding, ultimately discovering that while zirconia is a ceramic, it is not silica-containing, which means the standard adhesive protocol of applying an acid etch followed by a silane primer simply won’t work.

Adding to the confusion is the fact that zirconia readily bonds with the phosphates present in saliva, making intraoral try-in a surefire way to weaken bond strength.

“Many dentists don’t realize saliva inter- acts chemically with zirconia, depleting the bond,” said Dr. Nuñez. But there is some good news. Once this factor is ad- dressed, he said, bonding to zirconia not only becomes possible, but predictable.

It takes 2 BISCO products to meet the needs of zirconia, but fortunately for clinicians, both are easy to apply and add into the adhesive routine. ZirClean is a syringeable extraoral cleaning gel used after intraoral try-in to remove phosphate contamination from zirconia, ceramic, and metal restorations, while Z-Prime Plus is a single-priming agent that enhances the adhesion between resin cements zirconia. “The experience using ZirClean and Z-Prime Plus is straightforward, predictable, and offers a very simple application process,” said Steven Edelson, DDS, who uses zirconia for 95% of his crowns, especially for chronic tooth grinders or those with a history of fracturing PFM crowns.

With a unique formula that combines 2 active monomers—MDP, a phosphate monomer, and BPDM, a carboxylate monomer—Z-Prime Plus employs a homogeneous solution that eliminates the need to shake the bottle, and it’s compatible with both light and dual-cure resin cements.

“The added benefit of using Z-Prime Plus means that the crowns I cement rarely, if ever, debond,” added Dr. Edelson. “I really do not use other primers because of my success with Z-Prime Plus.”

Meet the TheraFamily

Of the many myths that can be found circulating in restorative dentistry is the idea that all materials A hallmark of BISCO’s growing TheraFamily of restorative materials, calcium release is built into 2 DPS Best Products—TheraCem and TheraBase.

THERACEM

A dual-cured, calcium and fluoride-releasing, self-adhesive resin cement indicated for luting crowns, bridges, inlays, onlays, and prefabricated metal, nonmetal, and fiber posts, TheraCem has a unique chemical property that enables it to transition from acidic during initial bonding to alkaline within minutes.* It contains the MDP monomer, which allows it to bond to restorative materials without the need for an additional primer or etchant.

“In my office, we never look at a cement in terms of how it will affect the bottom line. Instead, we look for a cement that works well and will benefit our patients without causing postoperative sensitivity,” noted Sheri B. Doniger, DDS, a clinician, author, and educator who practices in Lincolnwood, IL. “One of the reasons we use TheraCem is because it’s simple to use. It is self-etching, allows for dual tack cure, and delivers an incredibly strong bond to nearly all substrates—from zirconia to metal to resin—in addition to all types of endodontic posts.

“It also has continuous calcium and fluoride release,* encourages a higher physical strength than other cements, and transitions from an acidic to an alkaline pH in minutes."* It offers a better environment for increased compressive strength,” she added.

Dr. Doniger also appreciates that cleaning up TheraCem is a “cinch,” it’s easy to see the material on radiographs, and that patients rave about their lack of pain and sensitivity post-treatment.

“TheraCem continues to be a simple and durable option for luting crowns, bridges, inlays, onlays, and endodontic posts. It just so happens that what’s good for us is also good for our patients,” she said.

THERABASE

A dual-cure, calcium and fluoride-releasing, self-adhesive base/liner, TheraBase chemically bonds to tooth structure and releases and recharges calcium and fluoride ions.* Stronger and more durable than other base materials, glass ionomers, and resin-modified glass ionomers,* its dual-cure ability fully cures—even in deep restorations where light cannot reach.

“I use liners or bases under 80% of my restorations,” shared Columbus, OH, clinician Daniel H. Ward, DDS. “I like TheraBase because it can be used in varying thicknesses, releases calcium and fluoride, is dual-cured, and adheres well to dentin without using phosphoric acid. Its self-etching base eliminates a separate etching and rinsing step, so you’re never leaving the dentinal tubules open, reducing sensitivity,” he said. “It also eliminates a separate bonding agent—a timesaver in my busy workflow.

”The ability to save on time and extra materials is not lost on Dr. Alex Vasserman, who uses TheraBase in a variety of cases in his busy practice located on New York City’s Upper East Side. That includes restorations when the preparation is near the pulp, and in situations with evidence of affected dentin on the pulpal floor.

“I love that it’s self-adhesive,” he said. “You don’t need to prime and bond the pulpal floor prior to its application. I typically just particle abrade the pulpal floor and apply TheraBase right onto the surface and light cure. It’s very convenient and easy to use.”

Core Buildups with Confidence

Sometimes, choosing a new restorative material can feel like riding a seesaw. A material that’s too viscous can be difficult to shape and sculpt to match tooth contours, while low-viscosity materials have the potential to slump or run all over the preparation—not only causing mess and waste, but also leading to gaps and voids that can affect the stability of the restoration or lead to postop sensitivity for the patient. It can be a challenge to find the ideal balance of properties.

“Some core buildup materials I’ve used have either been too thick and don’t provide a nice flow, or they are too runny and end up everywhere, so you wind up wasting a lot of material,” said Devin McClintock, DDS. “BISCO's Core-Flo DC and Core-Flo DC Lite offer superior handling—striking that delicate balance of being flowable but not too runny.”

Core-Flo DC is a dual-cure flow-able core buildup material that, in addition to core buildups, can be used for post-cementation and dentin replacement. Dr. McClintock prefers the lower viscosity of Core-Flo DC Lite, which she often uses when building against a matrix band in deep-margin elevation cases.

“When I’m placing the material, I have the freedom to stack and let it stick in place, knowing it won’t move or slump,” she said. “I can mold and shape it for the first few seconds, hit it with the curing light, leave for 5 minutes, and it won’t do anything I don’t want it to do. I have complete control.”

Also appreciated by Dr. McClintock is Core-Flo DC’s syringe delivery system, which saves time and makes the material easy to dispense. “Because the material is less viscous, I know it will level against the matrix and reduce air bubbles,” she added. “When I finalize the crown prep and lift up the margin, that transition from buildup material to the tooth has a nice, contoured anatomy."

Intraoral Repair Kit

Any time you can garner a joyful response from a patient following treatment—not to mention an 86-year-old patient—is a time worth celebrating. That’s exactly what happened to Dr. Alan Pressman after using BISCO’s Intraoral Repair Kit to splint 2 crowns for a patient. “I was able to complete the procedure quickly, and the patient was overjoyed not to have to redo the crowns,” he said. “This kit is versatile, easy to use, and the results are incredible.”

A cost-effective kit that includes everything needed for a successful intraoral restorative repair, BISCO’s Intraoral Repair Kit helps clinicians quickly and easily repair the framework of broken or damaged restorations. BISCO’s newest DPS Best Product, the repair kit earned high marks from clinicians during its review period for its esthetics, versatility to repair a variety of materials—including porcelain, lithium disilicate, PFM, zirconia, and composite—and time savings from housing every material needed in one place.

“The kit is comprehensive and has all the necessary components for most clinical repair scenarios,” said R.J. Sondkar, DDS, a DPS evaluator practicing in San Leandro, CA. He frequently uses the Intraoral Repair Kit to repair minor fractured porcelain and chips in the anterior cosmetic zones, including a recent case where a patient’s crown on tooth No. 7 chipped less than a year after placement. “It makes minor repairs more feasible vs replacing the entire crown restoration and incurring lab costs,” he added.

Dedicated to Dentists

The heart of BISCO beats at its 91,000-square-foot headquarters in Schaumburg, IL, where its R&D, marketing, and sales and customer service teams go above and beyond to ensure that BISCO products aren’t just sold, but understood. This commitment to supporting clinicians is one reason why Dr. Vasserman has stayed loyal to the brand for the past several years. “Whenever I'm discussing my workflow with other dentists and they ask me why I started using the BISCO line of restoratives, I tell them that it’s really about ease of use, which allows for an efficient workflow, as well as simple cleanup, outstanding support from the company, and, of course, the cost factor," he said. “For some reason, I feel more confident knowing that the products come from the same company, and that they all originate from the same chemical floor.”

FOR MORE INFORMATION:

800.247.3368 | www.bisco.com

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