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Protecting the dentin and pulp complex is of essence in restorative dentistry. This can be accomplished by performing an adequate bonding technique, sealing the margins of the restoration, and by using a liner.
 

Liners are materials that should be used in direct contact with the dentin in a thickness of less than 1mm. They will provide protection against changes in pressure and temperature, acting as an insulating barrier in deep areas of the preparation. 
 

Another interesting property of liners is the ion exchange. Calcium and fluoride have been added to the formulation of liners in order for the materials to release ions to the area in contact with the tooth structure. These ions can generate an alkaline pH, which can promote healing as well as hydroxyapatite crystal precipitation.
 

BISCO’s Theracal LC is a light-cured, resin-modified calcium silicate. Its unique apatite stimulating ability^1,2 makes it ideal for direct and indirect pulp capping and as a protective liner. Upon placement, alkaline pH promotes healing³ when applied in deep cavity preparation.

 

The following case shows the proper sequence for the application of Theracal LC in the deepest part of the preparation, followed by a selective-etch bonding technique.

 

Step 1: Caries on occlusal and distal of #14

 

Step 2: Isolation and caries removal

 

Step 3: Application of Theracal LC in the deepest area of the preparation. Selective-etch of enamel using Select HV® Etch with BAC

 

Step 4:Rinsing off the etch. Application of 2 consecutive coats of All-Bond Universal on both enamel and dentin

 

Step 5: Final composite restoration

 

1 ADA definitions for direct and indirect pulp capping at: www.ada.org/en/publications/cdt/glossary-of-dental-clinical-and-administrative-ter Apatite-forming 

2 Ability of TheraCal Pulp-Capping Material, M.G. GANDOLFI, F. SIBONI, P. TADDEI, E. MODENA, and C. PRATI J Dent Res 90 (Spec Iss A):abstract number 2520, 2011 (www.dentalresearch.org)

3 Okabe T, Sakamoto M, Takeuchi H, Matsushima K (2006) Effects of pH on mineralization abil-ity of human dental pulp cells. Journal of Endodontics 32, 198-201.