Situations with and without Clinical Site Restoration

A - If the treatment site is required to be monitored, a restoration is not recommended until the desired clinical result is obtained;
B - If the treatment site is a source of collecting food or bacteria debris, however, is it required to be monitored for clinical changes, in this case a self-cured GIC may be temporarily placed and removed at the subsequent appointment for review of clinical changes to the original site;
C - If the treatment site doesn’t need to be monitored, and still requires a restoration, please follow one of the restoration protocols option below.

A – Treatment Site without restoring tooth

  1. Using a non-fluoride prophylaxis paste in a rubber cup, clean the tooth/teeth to be treated and abutting teeth.
  2. Assess condition of teeth. Only teeth with sound dentine and enamel should be treated.
  3. Isolate area to be treated with cotton rolls or rubber dam or protect the gingival tissue around the affected tooth with petroleum jelly.
  4. Apply 37% phosphoric acid, e.g. Super Etch (SDI Limited), to site for 5 seconds - wash then dry, do not desiccate.
  5. Riva Star Step 1: Using the silver brush provided, pierce through the foil of the silver capsule and carefully apply solution to treatment site only.
  6. Riva Star Step 2: Immediately after, use green brush provided, pierce through the foil of the green capsule and apply a generous amount of the solution to treatment site. Apply same solution to any other tooth surfaces that may have come into contact with the solution from the Riva Star Step 1 capsule (silver capsule).
    Note: Treatment surface initially appears creamy white, keep applying solution from Riva Star Step 2 capsule (green capsule) until it turns clear.
  7. Discard used capsules and brushes in accordance with local regulations.
  8. Blot dry or if clinical situation permits, wash thoroughly with water for at least 10 seconds and air dry, do not desiccate.
  9. Reschedule patient to return for permanent restoration procedure if required. For deciduous teeth wait for teeth to exfoliate.

B – Restoring with Self Cure (Auto Cure) Glass Ionomer Cement

  1. Using a non-fluoride prophylaxis paste in a rubber cup, clean the tooth/teeth to be treated and abutting teeth.
  2. Assess condition of teeth. Only teeth with sound dentine and enamel should be treated.
  3. Isolate area to be treated with cotton rolls or rubber dam or protect the gingival tissue around the affected tooth with petroleum jelly.
  4. Apply 37% phosphoric acid, e.g. Super Etch (SDI Limited), to site for 5 seconds - wash then dry, do not desiccate
  5. Riva Star Step 1: Using the silver brush provided, pierce through the foil of the silver capsule and carefully apply solution to treatment site only.
  6. Riva Star Step 2: Immediately after, use green brush provided, pierce through the foil of the green capsule and apply a generous amount of the solution to treatment site. Apply same solution to any other tooth surfaces that may have come into contact with the solution from the Riva Star Step 1 capsule (silver capsule).
    Note: Treatment surface initially appears creamy white, keep applying solution from Riva Star Step 2 capsule (green capsule) until it turns clear.
  7. Discard used capsules and brushes in accordance with local regulations.
  8. Blot dry or if clinical situation permits, wash thoroughly with water for at least 10 seconds and air dry, do not desiccate.
  9. If required, place suitable matrix system to tooth
  10. Place SC GIC e.g. Riva Self Cure (SDI Limited) into cavity preparation according to the manufacturer’s instruction for use
  11. Contour the restoration prior to occlusal adjustment.
  12. Polish to complete restoration
  13. Remove all protective/isolation materials used in the mouth.

C – Restoring tooth with a composite or Resign Modified Glass Ionomer Cement (RMGIC)

  1. Using a non-fluoride prophylaxis paste in a rubber cup, clean the tooth/teeth to be treated and abutting teeth.
  2. Assess condition of teeth. Only teeth with sound dentine and enamel should be treated.
  3. Apply 37% phosphoric acid, e.g. Super Etch (SDI Limited), to site for 5 seconds - wash then dry, do not desiccate
  4. Riva Star Step 1: Using the silver brush provided, pierce through the foil of the silver capsule and carefully apply solution to treatment site only.
  5. Riva Star Step 2: Immediately after, use green brush provided, pierce through the foil of the green capsule and apply a generous amount of the solution to treatment site. Apply same solution to any other tooth surfaces that may have come into contact with the solution from the Riva Star Step 1 capsule (silver capsule).
    Note: Treatment surface initially appears creamy white, keep applying solution from Riva Star Step 2 capsule (green capsule) until it turns clear. (in some cases, a residual yellowish matt surface may remain).
  6. Discard used capsules and brushes in accordance with local regulations.
  7. Wash thoroughly with water for at least 10 seconds and air dry, do not desiccate.
  8. If required, place suitable matrix system to tooth
  9. Place SC GIC e.g. Riva Self Cure (SDI Limited) into cavity preparation up to level of DEJ
  10. Prior to setting of GIC, prepare resin bonding agent e.g. Riva Bond LC (SDI Limited) and apply to GIC surface using a micro brush, condensing GIC at the same time.
  11. Place composite material e.g. Aura Bulk Fill (SDI Limited) or RMGIC e.g. Riva Light Cure (SDI Limited) and condense cavity to slightly overfill the preparation.
  12. Light cure the restoration for manufactures recommended time (heat produced from setting will help set the GIC liner).
  13. Contour the restoration prior to occlusal adjustment.
  14. Polish to complete restoration.
  15. Remove all protective/isolation materials used in the mouth.