What I've Seen as a Dentist using Bioactive Giomer Restoratives

You're listening to the Dr. Phil Klein Dental Podcast from Viva Learning.com. Welcome to the show. I'm Dr. Phil Klein. Bioactivity, as we all know, has become a recent buzzword in dentistry. Today, we'll be discussing the importance of using bioactive restoratives on young patients, and we'll discuss some of the key clinical advantages of a specific bioactive restorative that incorporates giomer technology. Our guest is Dr. Shukan Kanuga, who practiced dentistry in India. came to the States to get her pediatric training, and now practices pediatric dentistry here in the U.S. She is a diplomat of the American Board of Pediatric Dentistry. Dr. Kanuga, it's a pleasure to have you on Dental Talk. Dr. Phil, the pleasure is all mine. Thank you for having me. Most dental restorative materials have a neutral effect on the tooth. There's really nothing going on bioactively at the tooth restorative interface. But all this has apparently changed with the introduction of bioactive materials. especially evident in Shofu's bioactive giomer technology restoratives. So from what I understand, Dr. Kanuga, the giomer technology uses a proprietary filler particle that has been clinically proven to inhibit plaque. It apparently neutralizes acid and most importantly reduces and in many cases virtually eliminates the risk of secondary decay, which is a big thing for our pediatric patients. And I know you've been using this product in your office for some time. If you can tell us how long you've been using it. on your young patients and what kind of success are you seeing? Great question. To be very honest with you, I was guilty of blindly trusting the restorative materials that each office had when I used to work there as an associate. When I started my career several years ago, I would say like 10 to 12 years ago, without doing much background research on the properties. After all, composite resins are just that, as evidence-based as it gets. The other factor was the credibility of the company and if there has to be a lot of solid research behind the qualities of that material. So I have been using the Shofu line of restorative materials for over five to six years. Only in the last couple of years, it has all started making sense as I'm taking the time to learn about this Guyomer technology. The science behind this gets backed up by hundreds of successful restorations and then lack of recurrent carries, as you just mentioned, which we see day in and day out in our practice. It is a proprietary technology that's incorporated, as I mentioned, in this bioactive restorative material. giomer technology, as I mentioned on previous podcasts, has been around a while. It's not a brand new technology, but it's being utilized more now. So why is it important, Dr. Kanuga, for dentists and, of course, pediatric dentists to use bioactive materials on their young patients? While parents demand aesthetic tooth-colored materials for smaller to moderate caries lesions, as a clinician, we have to weigh in on the longevity of the restoration, especially in this particular population. Less is more when it comes to pediatric dentistry. So if a material allows me to practice minimally invasive restorative dentistry and not have to treat the tooth again in its life cycle of few years, it's a win-win for me, my team, and the patient. And Bio2 materials have checked all these boxes quite well so far. What are you currently using on your pediatric patients? The Shofu line of products that we are currently using is the Beautifil products, the Beautifil composite packable as well as flowable. They have great shade compatibility with primary teeth, with permanent teeth, all the shades, A1, B1, A2. It works great for both interior as well as posterior restorations. Great consistency to work with, adequate working time. And their newest flowable in this line of products is the Fit Essay. That's the newest one, which I have had the pleasure of trying. And so far, it's been great. So I always thought that a lot of pediatric practices used glass ionomer as a restorative. It helps for a number of reasons. It's not that sensitive to saliva, right? And that's isolating the tooth in a young patient is always challenging. There's something about this material, Butifil, that with the giomer technology that pediatric dentists are starting to realize are really helpful to the patients. What are you seeing as the main advantage with this material? And you're right. You know, I mean, as a pediatric dentist, you know, you cannot really have a cookie cutter approach. You have to have, you have to be flexible in your material choices. depending on the patient and the situation at hand, you know, I mean, one day you can have little Johnny, like, you know, he's like, hey, yeah, let's do this, you know, all for it, turn on the nitrous and, you know, he'll open wide, you know, you put your rubber dam or your isolite and you can get like great restorations done, no issues, but. You know, there are times when, you know, he's not having the best day and then, you know, you have to kind of modify your technique, your material choice, and, you know, just get a little more creative. So, by glass ionomer materials definitely have a place in our practice or in any pediatric practice. You know, the main advantage of the Giomer restorative materials is the aesthetics, the polishability, and of course, you know, the lack of secondary caries. They are bioactive. So I consciously choose to use these in my group practices because of the various clinical advantages that I've seen in my patients. So to name a few, ease of use, aesthetics and polishability, like I said, minimal failure of the restorations, minimal marginal breakdown or leakage, of course, excellent compressive strength, you know, which comes with composite resin, and then very rare occurrence of recurrent caries. And while all these combined sound too good to be true, You'll be surprised to know that it also checks the budget box pretty well with the favorable pricing of these materials. So you don't cut any corners and continue to provide the highest standard of care to your patients. As a practice owner, you also want to be mindful of the overhead. And so it does help when the material is priced fairly. So when it comes to bioactive materials, Dr. Kanuga, you have various choices. Was it the giomer technology that led you to use? the Shofu products as far as choosing the bioactive material for your practice? I was already using them and seeing some great clinical results. And so, you know, once I opened my own practice about like four years ago and, you know, partnered in another practice, it just made so much sense to continue using the Shofu's restorative materials. And, you know, it's all attributable to the Giomer technology, you know, the wonderful qualities and the clinical results that we see on recall after recall. The proprietary filler particles that are in there, is there anything you can tell us about how it is antimicrobial and how it does prevent recurrent decay? Yes. So basically, you know, I mean, again, I don't want to get into the depth of science. You know, I mean, I like to stick to more like more of the clinical big picture. But the great advantage is it neutralizes the acid. While it's in an ideal world, we can have the kids kind of stop snacking on carbohydrates and, you know, junk snacks and stop drinking juices altogether and, you know, neutralize their saliva. But we know in reality, that's very, very habits are very different. to change human behavior, especially when you have like families with grandparents involved and multiple caregivers, those habits don't change overnight. So, I mean, while you do your best to focus on that preventive aspect, when you have a material that can inhibit plaque, the filler material that can neutralize acid. you know, you're ultimately helping eliminate secondary decay. And that just makes so much more sense than something that is just neutral and does not have this proprietary filler particle in it. So regarding your recare visits, you're seeing patients, a young child who may have had some restorative work, and then six months later, they come back. What are you seeing on the recare visits? So recares or recalls are both a learning opportunity and an opportunity to, you know, give yourself a pat on the back, especially when you see a bunch of little happy campers return with intact restorations and lack of newer or recurrent caries lesions at their... three and six month recall visits based on the clinical exam and radiograph. So in a high volume pediatric practice like ours, recalls make up the bulk of the daily schedule. So if we can help them stay disease-free with excellent preventive care, education on home care and diet, and last but not the least, clinically sound restorations after their initial encounter with dental caries. It frees up so much clinical time to care for the new patients who have disease and who need the restorative care. So, you know, it's a cycle, you know, and it helps you believe in your work because you have more than just anecdotal evidence that it does work. You work in a pediatric practice and you say it's a high volume pediatric practice. Do you recommend this product to GPs and other specialists that are treating patients in the older population? Absolutely. And that's, you know, the beautiful line of products, the Shilful Restoratives, the composites are our go-to for, you know, teenagers, for the adolescent population that we see in our pediatric practice. So we do have a number of teen patients as well. And Beautiful is the exclusive material of choice, you know, for myself and my colleagues, you know, my other pediatric dentists, my associates as well. You know, it works great. You know, again, it's a tried and tested material, great compressive strength, excellent aesthetics, polishability. You get great results, no marginal breakdown, no staining on the margins, you know, and longevity, you know, which are very, very important in the adult population as well. We learned a lot about this product. If our audience wants to learn more, you can visit Shofu, S-H-O-F-U. We are focusing on this one particular product line because Jayamer technology is unique. You can't just go out there and buy a composite restorative with giomer technology. And that's why we're focusing on this for this particular podcast. Normally, we don't have a product-centric podcast because we do not want to make this show a series of infomercials on products. But giomer technology, as I mentioned earlier, has been around a long time. And many dentists who have not used it for many, many years are now experiencing it, similar to the story that Dr. Kanuga just told us, where she was working in associate offices. ended up using this product. And now she's working in her busy pediatric practice, using it regularly and seeing excellent results. So we decided to do this podcast. We appreciate Shofu introducing us to Dr. Kanuga, who has a lot of experience with the Shofu product line, the Shofu restorative product line. And she's having, as I said, excellent success. So again, feel free to look it up. G-I-O-M-E-R is the name of the technology. It's incorporated into the Shofu direct restorative product line. Just something that I would add before I say goodbye is like just today I'm returning from a very busy IV sedation day. You know, a lot of pediatric dentists do comprehensive dental treatment under IV sedation with a dental anesthesiologist. So we had at least four kids today, age ranging from like age three to... And, you know, all of them got multiple restorations with this Giomer technology. I'm sure that, you know, these restorations will be there, you know, when I see them back in three months, six months, looking just as great as they were today. It's very exciting to work with products that you believe in, that you have confidence in, because you're doing the work anyway. And to know that these... The products are designed to keep secondary decay away from those margins. And you want to make sure that the acidity is reduced as much as possible, as you say, especially in a pediatric practice. It's got to make you feel more confident using products like this. And I'm glad we had this discussion. Have a great evening. And thank you very much that you took the time on your busy day to share with us. Thank you for your time. And thank you for having me.