Solving Dental Practice Restorative Dilemmas with Geristore By: Xinyi Yu, DDS Den-Mat Corporation

This award-winning, multi-use, resin ionomer has been resolving tough challenges for more than a decade. For example, dentists, such as Lloyd Marcum DDS, of San Luis Obispo, California, Dr. Ronald J. paler, of Westland, Michigan, and Dr. Harry Bobotis, of Panama City, Florida, to name just a few, have had impressive results by using Geristore for subgingival surface defects, such as root resorption lesions and root fractures.

Lloyd Marcum, DDS, has been using Geristore for many years. “I had heard some positive reports from periodontists about good results…and it made good sense to me to use it for subgingival resorption defects,” explains Marcum, a specialist in Endodontics. “I strongly suggest using Geristore for subgingival repairs because of its exceptional biocompatibility.” Dr. Marcum also cited good adhesion, the dual cure feature, and radiopacity as reasons for his consistent usage of Geristore. “It is very liquid when placed, and has a nice flow to it…this helps because it goes where I put it, stays there, and fills in all of the voids.”

This easy-application attribute is especially important for geriatric and pediatric patients. Dr. Ronald J. Paler concurs that Geristore has been a “big success with my geriatric patients.”

Dr. Peter Gambino uses Geristore for cases with subgingival restorations and fractured roots. “I have used it to cement Maryland bridges with a 0% failure rate,” he said, adding, “This product saves me precious time by avoiding redos.”

Dr. Harry Bobotis strongly believes in Geristore’s restorative qualities. He continually applauds Geristore’s biocompatibility. “This has aided in stabilizing completely avulsed, intact teeth, preventing unnecessary extractions.”

In addition to the experiences of individual practitoners, the excellent results from formal clinical studies also substantiate the outstanding and unique performance of Geristore.

A1 Before Treatment A1 After Treatment

B1 Furcation lesion, Before B2 Geristore applied B3 Recall showing exellent gingival health with Geristore

Here are some of the published studies regarding Geristore….

1. Behnia, Ali; Strassler, H.; Campbell, R., “Case Report: —Repairing Iatrogenic Root Perforations,” JADA, Vol. 131 (2000): 196-201.

Geristore was used for root perforations based on favorable clinical reports of biocompatibility.

2. Breault, Lawrence, et al, “Subgingival Restorations With Resin Ionomer: A Periodontal Alternative,” Compendium, Vol. 21, No. 9 (2000): 733-737.

The successful use and placement of subgingival resin-ionomer restorations (Geristore) in both anterior root and molar furcation defects are demonstrated in this article. Sustained tissue health and minimal probing depths at the surgical site demonstrate clinical success. These case reports illustrate the continued success of alternative treatment procedures for restoring subgingival mechanical root or periodontal lesions.

3. Reilez-Urioste, F., Sanandajt, K., “Use of a Resin-Ionomer in the Treatment of Mechanical Root Perforation: Report of a Case,” Quintessence International, Vol. 29, No. 2 (1998): 115-118.

This clinical study used Geristore to repair a mechanical root perforation. It was concluded that when Geristore is used to repair a root perforation, the procedure involves less chair time and fewer appointments; the procedure is less invasive; the treatment maintains crown-to-root ratios; the therapy involves less expense for the patient; and postoperative recovery is usually faster.

4. Murray, M., Vertucci, F., Nixon, E., “The Sealing Ability of Retrograde Filling Materials: Spectrophotometric Study, ” Journal of Dental Research, Abstract No. 1104 (Special Issue A – Volume 77 – March 1998).

The purpose of this in vitro study was to evaluate apical dye penetration when SuperEBA or Geristore (Den-Mat Corp.) was used as a retrofilling material. It was concluded that placing bonding agent over the SuperEBA and across the beveled root surface significantly decreased apical dye penetration. Geristore placed solely in a retropreparation or completely across a concave root surface allowed no apical dye penetration.

5. Dragoo, M., “Resin-Ionomer and Hybrid-Ionomer Cements: Part II. Human Clinical and Histologic Wound Healing Responses in Specific Periodontal Lesions,” The International Journal of Periodontics & Restorative Dentistry, Vol. 17, No. 1 – Pages 75-87 (1997).

This study consists of twenty-five patients with 50 subgingival restorations. Clinical applications included external root resorption, root fracture, and root perforation. The conclusion that can be made from these cases is that there is clinical and histological evidence of epithelia and connective tissue adherence to a resin Ionomer: Geristore. Recalls were after 1 year, 18 months, and 3 years in some cases.

6. Abitbol, T.; Palat, M., Santi, E., Scherer, W., “The Use of Resin Ionomer in the Regenerative Treatment of an Interproximal Lesion,” Compendium, Vol. 18, No. 2 – Pages 132-137 (1997).

The purpose of this study was to introduce a new technique for guided tissue regeneration with the use of Geristore. The conclusions of this study are as follows: 1) Geristore may be used as a barrier in the regenerative treatment of an intrabony defect; 2) Geristore demonstrated a self-adhesiveness and biocompatibility with surrounding tissue. When used subgingivally, it did not interfere with postsurgical wound healing, 3) Geristore’s fluoride releasing ability within the resin Ionomer reduces the gingival inflammatory state and postsurgical complications.

7. Perry, R., Kugel, G., McGarry, P., Hurley, E., “An In Vivo Subcutaneous Investigation of a Resin Ionomer,” Journal of Dental Research, Vol. 76, abs. No. 2499 (1997): 326.

Histology studies were performed on tissues surrounding Geristore after it had been subcutaneously implanted into guinea pigs that were sacrificed at 12 weeks post implantation. The focal nature of the skeletal muscle compression seen microscopically suggested little movement of the tested material in situ, a feature consistent with attachment of the test material to adjacent tissue. The results suggested that Geristore had features of biocompatibility and was void of severe tissue reactivity when used under the conditions of the study.

8. Perry, R., “Geristore Furcation Study”, Tufts University Dental School (1997). Unpublished Data Available Upon Request.

This six-month clinical study involved 10 patients with Class I furcation lesions restored with Geristore. The results showed 100% retention of the restoration without discoloration of the margins of the restoration or postoperative sensitivity. The present study clearly establishes the biocompatibility of Geristore restorative material in Class I furcation lesions to the tooth structure and surrounding periodontal tissues. The results indicated that Geristore could be used in early prevention of furcation lesions.

9. Dragoo, M., “Resin-Ionomer and Hybrid-Ionomer Cements: Part I. Comparison of Three Materials for the Treatment of Subgingival Root Lesions,” The International Journal of Periodontics & Restorative Dentistry, Vol. 16, No. 6 – Pages 595-601(1996).

This study compared the characteristics of three different resin ionomer materials, specifically Dyract (Dentsply) Geristore (Den-Mat) and Photac-Fil (ESPE Premier). Of the three materials tested, Geristore displayed the most favorable results.

10. Abitol, T., Santi, E., Scherer, W., Palat, M., “Using a Resin-Ionomer in Guided Tissue Regenerative Procedures: Technique and Application – Case Reports,” Periodontal Clinical Investigations, Vol. 18 (1996): 17-21.

The purpose of these case reports is to introduce a potential use for a resin-ionomer, namely Geristore, in guided tissue regeneration. This technique paper discusses how to use Geristore for such regenerative procedures.

11. Scherer, W., Dragoo, M., “New Subgingival Restorative Procedures with Geristore Resin Ionomer,” Practical Periodontics and Aesthetic Dentistry (Reprint – January/February 1995 Supplement)

This article presented the clinical application of Geristore with emphasis on its use in subgingival and periodontal applications.

12. Abitbol, T., Santi, E., Scherer, W., “Use of a Resin-Ionomer in Guided Tissue Regeneration: Case Reports,” American Journal of Dentistry, Vol. 8, No. 5, (1995).

The cases presented demonstrated the clinical potential for the subgingival use of Geristore as a barrier in surgical regenerative procedures. The preliminary evidence with respect to surgical reentries looks promising.

Attached are some subgingival clinical applications

In conclusion, it can be seen that Geristore has earned its outstanding reputation many times over with exceptional performance in a wide variety of difficult clinical applications.

*D. Ouellet, Use of Geristore in the Treatment of a Split Vital Root, DentalTown, 3(12): 36-38,Dec. 2002

**Den-Mat thanks Drs. Dragoo and Perry for the use of their clinical images for this article.

Dr. Yu is a native of China and holds dental degrees in both the US and his homeland. He has published more than 60 clinical and research-related papers in the area of adhesive dentistry. Currently, he is Vice President of Clinical Affairs for the Den-Mat Corpooration.

If you have questions about Geristore or other Den-Mat products, please call them at (800) 445-0345.