PULPDENT CORPORATION,

Bioactivityand

PreventionConnie Kugel, RDH, BS

Professional Relations & Marketing Manager

PULPDENT CORPORATION

Pulpdent Corporation is a family owned dental

manufacturing company founded in 1947.

Introduction

Warehouse and

manufacturing

Administrative offices and

shipping department

Manufacturing and R&D

Who is PULPDENT?

• PULPDENT CORPORATION is a

manufacturer of professional dental

materials and operates:

• an R&D laboratory . . .

• a chemical production facility

• a fully automated machine shop

Located in Watertown, MA

Pulpdent products have a worldwide reputation for

excellence and are sold in more than 100

countries.

Introduction

PULPDENT

Founding Father

Pulpdent’s founder, Dr.

Harold Berk, began his

career in a public health

setting first as an intern

and later as the Chief of

the Pediatric Clinic at

Forsyth from 1940-1946.

Dr. Berk

At Forsyth

Founding Father

In the early 1950s, together with Dr. Manny Album and

other concerned clinicians, Dr. Berk was a founding

member of the American Academy of Dentistry for

Handicapped Children, now part of the Special Care

Dentistry Association and the Academy of Dentistry for

Persons with Disabilities.

Founding Father

Dr. Berk continued to

provide dental care for

diverse patient populations

in the Pediatric Clinic at

Tufts Dental School, where

he was a faculty member

from 1946-2005.

Under the management of Dr. Berk’s sons since

1975, Pulpdent has continued this family legacy

and commitment to public health.

His Legacy Continues

PULPDENT

Pulpdent supports the public health community in

its effort to expand access, increase productivity‚

provide education, champion prevention, and

raise the standard of care while reducing costs.

PULPDENT & Public Health

• They are biomimetic, i.e., they mimic nature.

• Bioactive dental materials behave much like teeth and release and uptake significant amounts of calcium, phosphate and fluoride ions.

• They react to changes in the oral environment.

• They play a dynamic role in the mouth.

Bioactive Materials Imitate Nature

• They have the capacity to interact with living tissue or systems1

• They are “smart” materials that can react to changes in the oral environment to bring about advantageous changes in the properties of the material itself or the material-tooth complex.2

Bioactive Materials are Dynamic

1. Comisi JC. Using bioactive materials to achieve proactive dental care. Oral Health, December 2011:34-46.2. McCabe JF, et al. Smart materials in dentistry. Aust Dent J 2011;56 Suppl 1:3-10.

Why is Bioactivity Important?

• Having an effect on or eliciting a response from living tissue

• Biologically Active

• Biomineralization: the exchange of calcium & phosphate ions forming apatite

Prevention Products are Active and Include

• Fluoride

• Calcium

• Phosphate

• Xylitol

• Antimicrobials

• Other minerals

BIOACTIVITY

• Did you know?

1. Resin technology has advanced and can be like

tooth structure

2. Minerals are available to promote remineralization

3. Fl2 Varnish products can also contain therapeutic

amounts of Xylitol, Calcium and Phosphate

Bioactive Materials for Proactive Dentistry

Bioactive materials are considered to have “smart” behavior if:

1. They can react to changes in the environment to bring about advantageous changes in properties, either within the material itself or in the material-tooth complex.**

2. They have the capacity to interact with living tissue or systems.*

*Comisi JC. Using bioactive materials to achieve proactive dental care. Oral Health, December 2011:34-46.** McCabe JF, et al. Smart materials in dentistry. School of Dental Sciences, Newcastle University, UK.

The development of bioactive materials is inspired by nature.

• When the pH is low, the demineralization

process releases calcium and phosphate

ions from the tooth surfaces. As the pH rises,

these ions interact with fluoride ions in our

saliva and precipitate onto the teeth in the

form of acid-resistant fluorapatite.

• Bioactive materials participate in this ionic

exchange.

pH Cycles: Demin and Remin

Bioactive PreventionToday we will discuss two preventive dental

materials that CAN BE BIOACTIVE:

• Pit and Fissure Sealant

• Fluoride Varnish

3 Types of Sealant Materials

Traditional Resin Sealants

Glass Ionomer Sealants

Wet-bonding Resin Sealants

Currently Available Moisture-Tolerant

Sealants

All Glass Ionomer Sealants

Embrace WetBond Pit & Fissure

Sealant

UltraSeal XT hydro Pit & Fissure

Sealant

MOISTURE TOLERANTFOR THE MOIST ORAL ENVIRONMENT

PULPDENT CORPORATION

The First Wet-bonding Resin Dental Sealants in 2002

Bonds to moist teeth

Tooth integrating - Margin-free

Fluoride releasing

Exceptional marginal seal

Eliminates microleakage

Contains no Bisphenol A or BPA derivatives

36.6% filled

A low fill formula is now available to practitioners

and public health programs requiring a sealant

that is less then 10% filled.

Embrace Low Fill Self-adjusting

7.9% filled

Off-white shade

Visible on the natural tooth.

The Challenge

The challenge for dental researchers has been to develop

materials that behave favorably in the moist oral environment.

Traditional Resins are Hydrophobic

Traditional dental resins are based on Bis-GMA

and urethane di-methacrylate (UDMA) monomers

that are hydrophobic, repel water and require a dry

environment.

This is not convenient in the mouth.

EMBRACE is Moisture Tolerant

EMBRACE™ WetBond™ Pit and Fissure Sealant

is hydrophilic, moisture tolerant and forms a

positive association with water. It is activated by

the moisture that is always present in the mouth.

EMBRACE is Hydrophilic

It is water friendly and even mixes with water. In fact, moisture

activates Embrace resin chemistry, enabling it to integrate with

the tooth and provide a better seal. Apply Embrace WetBond

Pit & Fissure Sealant to slightly moist tooth surfaces.

A drop of Embrace

Pit & Fissure Sealant

is placed on a glass

slide.

A drop of water is

placed next to

Embrace.

Embrace mixes with the water.

EMBRACE: An Acidic Monomer

When activated by moisture, Embrace is

acidic. In the cured state, the material is no

longer affected by water, has a neutral pH

and extremely low water solubility of 0.06%.

UNCURED Embrace

+ WET litmus paper

= Reaction indicating pH < 1

CURED Embrace

+ WET litmus paper= No reaction

Slightly Moist Tooth Surfaces Defined

Slightly moist tooth surfaces exhibit neither dryness

nor pooling of water. Lightly dry and remove excess

water with compressed air or a cotton pellet. Tooth

surfaces should be shiny or glossy.

Slightly moist tooth appears shiny and glossy after etching, rinsing and lightly drying.

Dry tooth surface appears chalky white after etching, rinsing and complete drying.

Embrace exhibits remarkable adaptation to pits

and fissures. It integrates with the tooth ֽ

creating a margin-free interface between resin

and tooth structure that eliminates microleakage.

EMBRACE: Tooth Integrating, Margin-free

“Embrace showed consistently more intimate

marginal adaptation than [the leading competitor] in

fissures of the same approximate width and depth.

The superior adaptation and penetration of Embrace

may produce longer lasting sealants.”*

* Kane B, Karren J, Garcia-Godoy C, Garcia-Godoy F. Sealant adaptation

and penetration into occlusal fissures. Am J Dent 2009;22(2):89-91.

EMBRACE: Adaptation Into Pits and Fissures*

EMBRACE CLINPRO

SEM shows EMBRACE Pit &

Fissure Sealant without

bonding agent. Note intimate

adaptation of sealant to the

tooth and smooth margin .

SEM shows traditional

hydrophobic sealant. Note

large gap between sealant

and tooth.

* Kane B, Karren J, Garcia-Godoy C, Garcia-Godoy F. Sealant adaptation and

penetration into occlusal fissures. Am J Dent 2009;22(2):89-91.

Perfect

marginal

integrity

EMBRACE

Sealant

Perfect

adaptation

to tooth

Enamel

Poor

marginal

integrity

Traditional

hydrophobic

sealant

Gap

Enamel

EMBRACE: Antibacterial Properties

0450 Comparison Of Antibacterial Properties Of Sealants and Amalgam. Sharma S, Kugel G, et al. Tufts University School Of Dental Medicine, Boston, MA,USA

Strep Mutans

Zone of inhibition: 4 mm(dark ring)

Embrace WetBond Pit & Fissure Sealant(white dot in center)

“It’s amazing. I can’t find the margin.”

After curing Embrace, clinicians report they cannot find

the margin with an explorer. Embrace is tooth integrating ֽ

margin-free and perfectly adapted to the anatomy of the

tooth, providing an exceptional seal against microleakage.

“Margins are incredibly smooth . . . virtually undetectable.”Dental Advisor 2004;21(8)

Microleakage and the inability to create a

permanent seal at the margins results in decay

and failure of restorations.

Embrace performed exceptionally in marginal

leakage testing, without using adhesives or

bonding agents.1,2,3

EMBRACE Seals Against Microleakage

1. Pameijer CH

2. Degrange M;

3. Khanbodaghi A, Kugel G, Sharma S, Ferreira S

Here’s what your colleagues have

to say about EMBRACE WetBond

Pit & Fissure Sealant:

“It’s an absolutely sensational product.”John D. Doykos III, DMD, MSD

“Moist field placement increases success and reduces frustration.”Peggy Yamagata, RDH, MED

“Margins are incredibly smooth . . . virtually undetectable.”Dental Advisor 2004;21(8)

“[Sealants] looked the same as they did the day we placed them.”RDH 2006;26(7):58-60

“Bonds under adverse conditions.”REALITY 2006

“100% caries free.”RDH 2006;26(7):58-60

BEST SEALANT EVER

Nothing is Faster or Easier

Than EMBRACE

Clean, isolate, etch

tooth for 15 seconds.

Rinse well. Remove

excess water. LEAVE

TOOTH SURFACE

SLIGHTLY MOIST.

Apply Embrace

sealant on the

slightly moist

occlusal surface.

Light cure

With EMBRACE Pit & Fissure Sealant, the

moisture in the mouth is beneficial, and

bonding agents are not required.

Etch, rinse and lightly

dry. LEAVE TOOTH

SLIGHTLY MOIST. Apply

Etch-Rite for 15 seconds.

Apply Embrace WetBond

Pit & Fissure Sealant to

the slightly moist tooth.

After curing, the margin

is undetectable with an

explorer.

PULPDENT CORPORATION

CXP™ = Xylitol-coated Calcium and Phosphate for unsurpassed fluoride release

PULPDENT

Embrace Varnish is a permeable resin-based varnish containing 17.6% Xylitol, sodium fluoride ֽ calcium, phosphate, and less than 20% ethanol.

It releases fluoride, calcium and phosphate ions.

4 Years in the Making

• A complete Varnish not just Fluoride

• Highest Fl2 release in 4 hours (98%)

• No separation, predictable dosage and

outcome

• 18% Xylitol is micro-coating the Calcium

and Phosphate. Reactivity takes place in

the mouth not in the package!

• Maximum Release, Maximum Benefit

By incorporating xylitol-coated calcium and phosphate in a permeable resin matrix that does not separate, Pulpdent has developed a sustained time-release varnish with uniform dosage that delivers 10 times more fluoride than the leading brand.

CXP

• Saliva breaks down Xylitol

• Xylitol prevents premature binding of phosphate and fluoride

• Phosphates enhance the release of Fluoride

• Desensitizes

Xylitol-coated calcium & phosphate

for unmatched fluoride release

Protective Fluorapatite

Saliva exposure dissolves the Xylitol and releases the calcium and phosphate ions. These ions react continuously in saliva with the fluoride ions to form protective fluorapatite on the teeth.

Fluorapatite

Enamel

Better and different than other

varnishes:

Permeable, bioactive resin matrix with xylitol-coated calcium and phosphate

Releases 10 times more fluoride than the leading brand

Does not separate – No mixing required Delivers a predictable, uniform dose Provides sustained time-release of fluoride

It is best if patients refrain from eating hard foods or drinking hot liquids or alcohol for 3-4 hours after treatment. Eating soft foods for the rest of the day is advantageous. Instruct patients not to brush their teeth for at least 4 hours.

Cumulative Fluoride Release of Leading Fluoride Varnishes(measured in micrograms [mcg] per 50 mg of solid weight)

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PULPDENTEMBRACE

PremierEnamel Pro

PreventechVella

Colgate Prevident 3MVanish

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mcg

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4-Hour Cumulative Fluoride Release In micrograms relative to 50.0 +/- 1.0 mg solid weight

Yapp R, Powers JM. Fluoride Ion Release from Several

Fluoride Varnishes. Dent Advis Res Rpt 45:1, March 2012

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1 hr 2 hr 3 hr 4 hr

PULPDENT EMBRACE VARNISH

Competitor varnish

Competitor varnish

#1 Competitor varnish

Competitor varnish

Competitor varnish

Cumulative Fluoride Release of Leading Fluoride Varnishes(measured in micrograms [mcg] per 55 mg of solid weight)

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Time in hours

The Dental Advisor: Report (2-15-12)“Fluoride Ion Release From Several Varnishes”R. Yapp, J.M. Powers

Available in a Tube!

12 mL tubeContains 30-40 applications

Individual Package

Boxes of 50

Boxes of 200

PULPDENT and Oral Health America

PULPDENT has had a partnership with Oral Health

America since 2007

• PULPDENT provides Oral Health America Kits (OHAK)

for qualified programs.

• Retail value of the kit is $335.74 each

Oral Health America KitsThese kits include:

• 50 Disposable mirrors

• 15 x 1.2mL syringes Embrace Pit & Fissure Sealant

(off-white shade)

• 50 Patient sealant brochures

• 1 x 6mL syringes Etch-Rite phosphoric acid etch

• 50 x unit dose (.4mL) Embrace Varnish

• 1 x 12mL tube Embrace Varnish

• Various tips, Instructions

• $335.74/retail

• PULPDENT CORPORATION

Contact:

Connie Kugel, RDH, BS

Professional Relations and Marketing Manager

connie@pulpdent.com

(617) 926-6666, extension 652