Geristore^®
Dual-Cure Composite
Research Reference Guide

1. Mark A. Camp, Billie G. Jeansonne, Thomas Lallier "Adhesion of Human Fibroblasts to Root-End-Filling Materials" Journal of Endodontics Vol. 29, No.9, September 2003.

This study evaluated the attachment of cultured explants of human periodontal ligament fibroblasts and gingival fibroblasts to different root-end-filling materials. Although periodontal ligament and gingival fibroblasts initially attached avidly to Geristore^®, these same cells displayed no significant attachment to ProRoot^™, Tytin^® amalgam, or SuperEBA^™. With further incubation on Geristore^®, the attachment of both periodontal ligament and gingival fibroblasts improved and these cells proliferated. In contrast, no improvement in attachment or proliferation was observed for cells incubated for greater times with ProRoot^™, Tytin^® amalgam, or SuperEBA^™.
Because the attachment characteristics of these two groups of fibroblasts were identical, we examined the potential role of the extracellular matrix family of receptors (integrins) on the attachment of gingival fibroblasts. Gingival fibroblast attachment to collagen type I was determined to be dependent on α1β1 and α2β1 integrins, whereas their attachment to the RGD-binding sequence of fibronectin and vitronectin was partially inhibited by antibodies to the β1 and αV integrin subunits. However, attachment of gingival fibroblasts to Geristore^® was not reduced by the addition of any of the attachment-perturbing anti-integrin antibodies examined. Thus, gingival fibroblasts attach to Geristore^®, but this attachment was mediated by mechanisms other than integrins.

2. Yu, Xinyi, "Saving a Cracked Tooth Using Geristore," Dental Town, September 2003.

This is a case study using Geristore^® to save a cracked tooth (root)"the traditional reatment option was extraction. Using Geristore, with Core Paste and Tenure^®, the author sealed, bonded, and built up the remaining root structure and was then able to complete the restoration with a Cerinate^® porcelain crown. Geristore was used because of its superior biocompatibilty and its ability to be a successful, subgingival restorative material.

3. Ouellet, David, "Use of Geristore in the Treatment of a Split, Vital Tooth," Dental Town, December 2002.

This case report demonstrated the use of Geristore and Tenure^® Uni-Bond^® on a split, vital, first bicuspid. The tooth was first prepared with Tenure Uni-Bond and then Geristore was syringed into the cracked area. After the split was sealed and bonded, the tooth was restored with a three-quarter gold crown. The patient is symptom free, percussion free, and has no sensitivity.

4. Al-Sabek, Fuwad, Ciancio, Sebastian, Kirkwood, Keith. School of Dental Medicine, University at Buffalo, Buffalo, NY, "InVitro Assessment of Gingival Fibroblasts with Resin Modified Glass Ionomer," 2002 Annual Meeting, American Academy of Periodontalogy, New Orleans, Louisiana.

The purpose of this in-vitro study was to evaluate cellular growth and morphology of human gingival fibroblasts on a newer resin modified glass ionomer and compare relative biocompatability to another resin modified glass ionomer, and intermediate restorative material by scanning electron microscopy.

Results indicated that fibroblasts in this study attached and spread well over the newer resin modified glass ionomer (Geristore) with a morphology close to that of the control glass coverslips after 72 hours. Fibroblasts did not attach and spread as well on the other resin modified glass ionomer or the intermediate restorative material after 72 hours incubation, where these cells appeared rounded and less fibroblastic in appearance compared to the newer resin modified glass ionomer and the glass controls. These results suggest that human gingival fibroblasts may have a favorable response to this newer ionomer material compared to existing glass 
ionomers and intermediate restorative materials.

5. Ibsen, R., Ouellet, D., Yu, Xinyi, "Geristore"A Lifeline in Everyday Practice," Dental Town, March 2001.

This article discussed two case reports where Geristore was used to treat subgingival caries. One case had a large carious lesion under a PFM bridge. Instead of extraction, Geristore was used to save the tooth. A one-month, follow-up revealed healthy gingival tissue with good tissue adherence. The second case had a deep carious lesion on the lingual surface of tooth #30 to the alveolar crest. Because the patient could not tolerate any anesthetics for involved procedures, the choice was to apply Geristore to the lesion and save the tooth. Geristore was applied to the lesion and after a three-month recall; the patient had normal vitality with no discomfort. Both cases showed that Geristore was able to replace tooth structure subgingivally with direct contact with the alveolar bone, pulp, and gingival tissue.

6. Kurthy, Rodger, "Use of a Resin-Ionomer for Subgingival Restorations (External Root Resorption): Case Report," Dentistry Today, Vol. 20, No. 2, February 2001.

This case report is about the use of Geristore on a large resorptive lesion located in the lingual root surface. After two years, the patient still has excellent results and the tooth is stable. It was determined that biocompatible Geristore offers restorative options for traditionally difficult-to-treat, clinical problems.

7. Harris, Randall J., "Treatment of a Cracked Tooth with a Resin-Ionomer Restoration and a Connective Tissue Graft: A Case Report," The International Journal of Periodontics & Restorative Dentistry, Vol. 20, No. 2, November 2000.

This case study was about using a resin-ionomer, Geristore, to repair a cracked tooth. The treatment involved a resin-ionomer restoration and a connective tissue with partial-thickness, double-pedicle graft. After fifteen months, the final evaluation revealed a clinical success. There was no evidence that a crack was present.

8. Aboushala, Ayman, "Resin-Ionomer Restoration of Molar Furcation in Humans," The Journal of Cosmetic Dentistry, Vol. 16, No. 3, Fall 2000.

The purpose of this study was to evaluate the feasibility of Geristore to treat multi-rooted teeth. Geristore was selected for the study because it provided an additional seal not provided by sutures, the membrane could be placed more subgingivally with reduced incidence of membrane exposure, and the resin-ionomer served as a delivery system for local, antimicrobial therapy during healing. The results determined that Geristore restorations of Class 1 furcation lesions showed biocompatibility to the surrounding periodontal tissue, with stable results after one year.

9. Behnia, Ali, Strassler, H., Campbell, R., "Case Report: Repairing Iatrogenic Root Perforations," JADA, Vol. 131, 2000:196"201.

Subosseous root perforations can be difficult to treat. In many cases, the prognosis of these, even with surgical and restorative treatment, is guarded. In this article, a novel surgical and orthograde approach to the treatment of a mechanical root perforation was presented. The choice of material used to restore and seal root perforations should be based on sound clinical judgment. Geristore was used based on favorable clinical reports of its biocompatibility.

10. 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.

11. Resilez-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 chairtime 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.

12. Murray, M., Vertucci, F., Nixon, E., "The Sealing Ability of Retrograde Filling Materials: Spectrophotometric Study," Journal of Dental Research, Abstract No. 1104, 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 a 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.

13. 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, 1997.

This study consists of twenty-five patients with 50 subgingival restorations. Clinical applications included external root resorption, root fracture, root perforation, and facial root resorption. The the study concluded there is clinical and histological evidence of epithelia and connection tissue adherence to a resin ionomer: Geristore. Recalls were after 1 year, 18 months, and 3 years in some cases.

14. Abitbol, T., Palat, M., Santi, E., Scherer, W., "The Use of a Resin-Ionomer in the Regenerative Treatment of an Interproximal Lesion," Compendium, Vol. 18, No. 2, 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.

15. Perry, R., "Geristore Furcation Study," Tufts University Dental School 1997. Unpublished data available on 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.

16. 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, 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.

17. Dennison, D.K., Keefe, T.F., "Cellular Response to Various Restorative Materials," Journal of Dental Research, Vol. 75, Abs. No. 709, 1996.

Responses of gingival fibroblasts to various restorative materials were studied. Cells were monitored after 24 and 48 hours. Cells cultured with Geristore, and three other restorative materials, were viable, firmly adherent to the plate and approximated the restorative material at each time point.

In contrast, at 24 hours, cells incubated with Ionosphere and Vitremer showed a 1 mm acellular bond around the disks, cell death adjacent to the bond, and only a few viable cells at the extreme periphery of the culture plate. The conclusion indicated that there was variable biocompatibility among the restorative materials tested.

18. Li, Y., Ferguson, J.L., "Evaluation of Cytotoxicity of Geristore AB Using the Agar Diffusion Method," Indiana University School of Dentistry 1996.

The purpose of this study was to examine the cytotoxicity of Geristore using the agar diffusion method. The test was conducted following the procedures specified in ISO 10993-5 and the proposed ISO CD TR 7405. Using the agar diffusion method, Geristore is not cytotoxic.

19. Scherer, W., Dragoo, M., "New Subgingival Restorative Procedures with Geristore Resin-Ionomer," Practical Periodontics and Aesthetic Dentistry, 1995.

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

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

21. The Dental Advisor Plus, Vol. No. 5 Jul."Aug. 1995.

The evaluators from The Dental Advisor reported Geristore Multi-Shade with a 31/2-STAR rating. The report stated that Geristore mixed easily and had good flow capabilities. Restorations were said to be easy to finish and polish, and had good translucency.

22. Wieczkowski, G., et al., "Amalgam/Base Bond Strength in a V-Shaped Cavity Preparation," Journal of Dental Research, Abs. No. 1184, Nov. 1993.

In evaluating the bond strength of amalgam used with various base materials in a three-dimensional cavity preparation, this study showed greater variability in bond strength with Geristore than with other groups. Failures were cohesive in amalgam. Results indicate that the use of adhesive base materials can significantly increase the bond strength of amalgam restorations.