Using a Baseliner: When and Why?

Ionosit Baseliner is a light-curing material that acts as a stress breaker for composite restorations, it can minimize postoperative sensitivity, micro-fractures, and secondary caries.
Furthermore, its active chemistry prevents marginal gap formation and guarantees reliable and durable restorations. Ionosit Baseliner combines the favorable properties of glass ionomers and composites in one material. Its controlled expansion prevents structural stress or micro-fractures in the composite, serving as a stress-breaker within the cavity. The material reacts with dentin to prevent bacterial penetration and seal the dentinal tubules to protect the pulp from bacterial ingress. This is a reliable and predictable means of preventing pulp damage and postoperative sensitivity. The application of Ionosit Baseliner in a 1 mm layer between dentin and composite produces a release of fluoride and zinc ions, forming a protective barrier for the tooth at the junction between the tooth surface and the restoration. Its innovative chemistry forms a connection to dentin, sealing possible gaps created by polymerization shrinkage of the composite material, and avoiding stress on the dentinal interface. The Saferinge enables easy single dose application of the baseliner.
Overall, Ionosit Baseliner’s unique combination of properties make it an ideal one-component base material for composite restorations and a stress-free solution for gap-free restorations.

style italiano styleitaliano pre-operative picture

Fig.1
Case workflow summary:
A patient presents with pain in the upper left hand side complaining of food packing and discomfort when biting down. Figure 1 and 2 showed the photographic and radiographic findings. Caries in the upper left quadrant (from first premolar to the second molar).

style italiano styleitaliano Section of pre-operative x-ray

Fig.2
After discussing the treatment modalities and risks of treatment with the patient, the cleaning of carious lesions, in addition to the restoration of the form and the function of the teeth was set as the main goal.

style italiano styleitaliano Rubber dam placed

Fig.3
After local anesthesia, a rubber dam was placed and the teeth were cleaned.

style italiano styleitaliano Caries removal & air abrasion

Fig.4
After the removal of caries, air abrasion (Aquacare) with 29μm aluminium oxide was used to clean the cavity walls and all the margins.

style italiano styleitaliano Cleaning the cavities and bonding procedure

Fig.5
Cavities cleaned. The cavities are now ready for etching and bonding.

style italiano styleitaliano Selective enamel-etch

Fig.6
The enamel was etched with 37% phosphoric acid gel (Etching Gel) for 30 seconds (Fig 6) and was washed for 30-60 seconds with water (Fig 7) before bonding.

style italiano styleitaliano Rinse with water

Fig.7
Rinse with water.

style italiano styleitaliano Cavities ready to bond

Fig.8
The enamel should be frosty white after drying with air before applying the adhesive.

style italiano styleitaliano Sectional matrix & ring placed

Fig.9
Sectional matrix & ring placed.

style italiano styleitaliano Adhesive application

Fig.10
Ecosite Bond was applied to the cavities for 30 seconds and left to dry for 5 seconds before being light-cured for 20 seconds.

style italiano styleitaliano Liner application Ionosit Baseliner

Fig.11
Ionosit baseliner was applied to the deepest part of the cavity in the tooth 27 using the special single dose applicator “Saferinge”.

style italiano styleitaliano Polymerization of the liner

Fig.12
The Ionosit baseliner was light-cured for 20 seconds.

style italiano styleitaliano Cavities ready for restoration

Fig.13
Cavities ready for restoration.

style italiano styleitaliano Direct posterior composite restoration

Fig.14
The cavities were restored with composite and the fissures were sealed with brown colored composite.

style italiano styleitaliano Occlusion checked

Fig.15
Once the restorations are completed, they are polished and the rubber dam was removed (the teeth will be dehydrated and appear white). Further, the occlusion was checked with articulating paper.

style italiano styleitaliano Immediate post-operative picture

Fig.16
The high contacts are polished off and the case was completed.

style italiano styleitaliano One month recall

Fig.17
One month recall.

style italiano styleitaliano Section of post-operative x-ray

Fig.18
Section of post-operative x-ray.

Conclusions

Ionosit Baseliner is a dental material that can be used as a base material for composite restorations. It is designed to compensate the shrinkage that is typical for composite fillings, which can cause marginal gaps and postoperative sensitivities. One of the most significant benefits of Ionosit Baseliner is the ability to counteract the polymerization shrinkage of composite fillings. Another benefit is the ability to prevent marginal gap formations. When there are gaps between the filling and the tooth, it can allow bacteria to penetrate, leading to secondary caries. Ionosit Baseliner reacts with the dentin and seals the dentinal tubules, thus, preventing the formation of gaps and protecting the pulp from exogenic influences. Ionosit Baseliner is also radiopaque, which makes it easy to see on X-rays, and provides fluoride release, which helps to protect the tooth from decay. Additionally, its zinc content gives it antibacterial properties, which further helps to prevent secondary caries. Overall, Ionosit Baseliner is a reliable and durable material that can help to create stress-free and long-lasting composite restorations.

Bibliography

  1. Nie, E. M., Jiang, R., Zhang, C. Y., Zeng, J. D., & Tan, J. Z. (2015). Long-term effects of five kinds of pulp capping agents: a comparative study. Chinese Journal of Tissue Engineering Research19(16), 2557.
  2. G. Chiodera, Essential Lines, 2018 styleitaliano.org
  3. Hardan L, Sidawi L, Akhundov M, Bourgi R, Ghaleb M, Dabbagh S, Sokolowski K, Cuevas-Suárez CE, Lukomska-Szymanska M. One-Year Clinical Performance of the Fast-Modelling Bulk Technique and Composite-Up Layering Technique in Class I Cavities. Polymers (Basel). 2021 Jun 4;13(11):1873.
style italiano styleitaliano Essential Dentistry kit online on demand course
style italiano styleitaliano Essential Dentistry kit online on demand course

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