A Versatile, Durable Material for the Most Challenging Cases

GC America Inc’s EQUIA Forte® HT solves problems for pediatric patients

Lance Kisby, DMD

Lance Kisby, DMD, loves a challenge. Kisby chose to specialize in pediatric dentistry while in dental school because the specialty requires knowledge of other dental specialties as they apply to pediatric patients. In addition, pediatric dental patients pose the challenge of their constantly changing dentition, which develops alongside other physical, mental, and emotional changes as the patients age. In search of new challenges, after 17 years in private practice, Kisby moved on to hospital dentistry for more than a decade. Now, Kisby works as the pediatric dentist for the Chippewa Tribe in Lac Du Flambeau, Wisconsin. "In this area, it is rare to find a town with fluoridated town water, and I would guess about 95% of the people use well water," Kisby says. "There is also a lot of misunderstanding about the decay process and how to prevent it. As a result, there is a high level of severe rampant caries across all ages of children. My job is very challenging due to the amount of patient/parent education that my team and I do. The extensive dental caries and multiple dental abscesses we see weekly often require that I perform the dental work in the hospital under general anesthesia, which can take as long as 3 to 4 hours per case because of the number and extent of caries. Everything I have learned in my career is put to good use here. There are a lot of issues one does not usually encounter in a residency or private practice, such as different and unusual pathology, social issues, behavioral health issues, and the need for many different patient behavioral guidance techniques."

Despite the challenges, Kisby loves the amount of thinking and treatment planning that goes into treating pediatric patients. "Every patient brings unique challenges and needs, and as a result, each one needs to be treated differently. One method or technique does not fit all children, and when doing restorations, we must get it right the first time because if the restoration fails, the child will probably not let us do it again," he says.

Unsurprisingly, Kisby is a strong advocate for prevention. "When I was in dental school, it was shocking to learn how easy it is to prevent caries," he says. "The science is clear." In his first year of private practice, Kisby restored 2,700 teeth, but within a decade, he averaged restoring eight teeth per year. "It was just about motivating and educating the parents and children," he says. "It can be done."

Still, Kisby's list of children in need of restorative care at the clinic never ends, and he needs reliable materials to treat them. One of his favorite products is GC America Inc's EQUIA Forte^® HT—a strong, biocompatible, long-term bulk-fill restorative system with enhanced mechanical properties, superior fluoride release, excellent handling, and improved translucency. EQUIA Forte HT's unique glass hybrid technology, which features intelligent particle size distribution and a synergistic coat, makes it a versatile and durable restorative solution for patients of all ages.

Kisby has found EQUIA Forte HT to be particularly useful for pediatric patients. Composites, he notes, lose their bond in under 6 years. "Imagine putting a material in the mouth of a 7-year-old and needing to replace it every 6 years," he says. "Glass-ionomer cements are the solution. They release and recharge fluoride, they are hard, and they chemically bond to enamel and dentin so there is no leakage because of the perfect seal. I have not had any recurring caries when I have used EQUIA Forte HT glass-ionomer cement."

Kisby refers to EQUIA Forte HT in his lectures as the duct tape of pediatric dentistry. "It can be used as a filling material after a pulpotomy, as a final restorative material on primary teeth, or for permanent teeth," he says. "It is an excellent, versatile material."

Recently, molar incisor hypomineralization (MIH) has been a hot topic in pediatric dentistry; drilling these teeth is a challenge because they cannot be adequately anesthetized. "For MIH patients, EQUIA Forte HT provides thorough protection and insulation from thermal changes, releases fluoride, and offers instantaneous relief," Kisby says. Another use for EQUIA Forte HT has been for patients who cannot be operated on immediately because of the long waiting list for treatment in the operating room. "With some caries, I can do an indirect pulp cap or caries control," Kisby says. "I can take some caries out without numbing the patient and apply EQUIA Forte HT, which then slows the caries process until I can get the patient into the operating room."

Regardless of the application, the strength and durability of EQUIA Forte HT are advantageous. The material features intelligent particle distribution and interaction in the filling matrix, and its high-molecular-weight polyacrylic acid makes it stronger and more chemically stable. "It holds up, even in stress-bearing areas," Kisby says. "I never get recurrent decay around it. It never breaks. It never chips."

The material is packable, non-sticky, and moisture-tolerant, ensuring a fast and easy bulk placement. It has a prolonged working time and short setting time. Kisby recommends applying it the way soft-serve ice cream is put into a cone and then condensing it with a slightly wet Q-tip^®. "You can then add some anatomy to the restoration, smooth it off, and have the patient bite down to make sure it is not too high," he says. "Once it sets, there is a perfect seal, and it is chemically bonded to the enamel and dentin. It is solid; there are no gaps or voids."

Kisby attributes the material's reliability to GC's research and development team. "GC America Inc does a lot of research and development on their products," he says. "They back up their work with research from independent sources, and they are always making their products better."

With such a strong, versatile material, Kisby is well-equipped to deal with some of the most challenging cases of his caree—which is exactly what he wants to do. "I wanted something super challenging, and I have gotten that. As I treat these patients, I am grateful to have a material that I can use in so many different ways, in different places, and for different reasons. It is very close to being an ideal material."

Key Points

• Packable, non-sticky, and moisture-tolerant (no rubber dam needed).

• Intelligent particle distribution and interaction in the filling matrix.

• Stronger and more chemically stable cement matrix as a result of the high-molecular-weight polyacrylic acid.

• Suitable for many indications, from amalgam replacement to treatment of molar incisor hypomineralization (MIH).

CONTACT INFORMATION
GC America
gc.dental/america
800-323-7063