Product Evaluation

VISTA ApEX:  Clean & Boost 

An aqueous cleanser brushed on prior to bonding to remove contaminants from the tooth surface, etch, and disinfect

Was I getting a good bond with a single-step etch?” During his 40 years of practice, Dr. James Falk continued to ask himself this critical question when he conducted restorative procedures. Like most clinicians, he wanted to ensure that his bonding material achieved optimal adhesion to dentin and, in turn, that his restorations held up long-term. Yet, creating a sufficient bond means having a clean cavity devoid of contamination, and this feat requires assistance from a uniquely compatible cleansing material.

Designed to prepare the enamel surface for bonding,  Vista Apex’s Clean & Boost is an aqueous cleanser that aims to remove any contaminants from the tooth surface, such as temporary cement, bacteria, blood, saliva, handpiece oil, and imaging powder used to create digital impressions for CEREC. In addition to cleansing and disinfecting to ensure a pristine surface for bonding, Clean & Boost etches to increase bond strengths of self-etch materials.

After trialing the liquid and gel formulations of the material for this DPS evaluation, Dr. Falk was pleased to have his question answered; “I have become more confident that I am getting excellent adhesion.” Christine Henry, DDS, also said using Clean & Boost made her feel more secure that she was giving her patients “high-quality dentistry.”

Ideal Handling & Viscosity

 Vista Apex created 2 separate formulas for Clean & Boost: gel and liquid. Each evaluator tried both forms of the material and then chose their preferred viscosity. While the majority voted for the gel formulation, the clinicians described benefits of using each.

“I preferred the gel formulation because I felt it was easier to manipulate on the axial walls of a prep,” shared Dr. Brian Lee, adding that it was “very easy to apply.” James Merrett, DDS, said he preferred the liquid because the gel was harder to push out of the delivery system, while Dr. William Fink appreciated that the gel was “easier to control.” Dr. RJ Sondkar noted, “The gel has less flow and is better managed when applied to the area.”

Handling capabilities played a role in the evaluators’ satisfaction, with many clinicians reporting that the syringe’s ease of use was their favorite feature. Paul Olenyn, DDS, liked that Clean & Boost “did not require many additional steps,” and suggested that the manufacturer add “a light tint to  liquid to assure that it has been thoroughly applied.”

Disinfects & Strengthens

While some self-etch cements and adhesives may lack the ability to thoroughly prepare the enamel—resulting in margin staining, microleakage, and marginal wear—Clean & Boost roughens the enamel and dentin surfaces to promote bonding and produce more robust margins. At the same time, the material disinfects surfaces to help eliminate bacteria and reduce the opportunity for secondary caries. In addition to its cleansing and disinfecting properties, Clean & Boost has been shown to improve bond strength up to 33%, according to the manufacturer.

“I like that this product acts as a cleaner and etchant,” shared Dr. Carol Aiken, and Dr. Falk said, “It definitely improves debris removal prior to final cementation.” Dr. Henry discovered that his “cavity preparations seem to be cleaner and maintain the integrity of the restorations.” Calling Clean & Boost a “great addition to make our composite restorations better,” Dr. Olenyn said he was pleased to “see the etched surface inside the prep.”

Simple Cleanup & No Sensitivity

Water alone cannot sufficiently clean off imaging powder prior to the final delivery of a restoration—and the residual layer can block dentin tubules and lead to numerous issues, including sensitivity and debonds. Clean & Boost uses a unique blend of ingredients to lift and suspend the imaging powder in solution. Then, it can be easily and completely rinsed from the tooth surface, making the cleanser compatible with all other dental materials.

Mirweiss Nawaz, DDS, used Clean & Boost for Class V lesions, and “after application and bonding the restoration, the patient had no sensitivity.” Dr. Poyak praised its “ability to remove temp cement without discomfort,” and Dr. Aebli also “had no complaints of postop sensitivity.” Emery Cole, DMD, noticed that the “product easily removed CEREC imaging powder” without extensive scrubbing. He summarized his positive evaluation of Clean & Boost by simply saying, “It does what it says it does.”

"I used Clean & Boost in multiple composite restorations and consistently got good usage results."
RJ Sondkar, DDS
San Leandro, CA

Overall Satisfaction

For its ability to clean the tooth surface, maintain viscosity and integrity of the margins, and etch to strengthen bonds, Clean & Boost earned a DPS Best Product rating. Nearly all of the evaluators said they would recommend this product to colleagues, including Dr. Henry, who called it “a very good addition to debridement of decay.” Noting that the “preliminary results look great!” Dr. Merrett said he would like to see long term results before he can widely recommend the product. “I used Clean & Boost in multiple composite restorations and consistently got good usage results,” expressed Dr. Sondkar. “Definitely a plus to the restorative materials armamentarium.”

Takeaways:

• •Aqueous dentin and enamel cleanser used prior to bonding 
• •Designed to remove contaminants such as debris, bacteria, temporary cement, etc.
• •Etches tooth surfaces to increase bond strengths of self-etch materials
• •Properly prepares the enamel surface, resulting in improved long-term results