Introducing NeoLINER™ LC by NuSmile®

NeoLINER LC is moisture tolerant, radiopaque, has low water solubility, and is compatible with all etching, bonding, and resin restorative materials. Read all about it!

Dr. Bill Waggoner discusses the benefits of using liners along with a case presentation from Dr. Paul Bahn

Cavity liners and indirect pulp capping (IDPC) materials have been used in dentistry for decades. The recent introduction of NuSmile’s NeoLINER™ LC now provides one of the most therapeutic, easy-to-use liners on the market! It is a light-cured MTA-modified bioactive material that is recommended for use as either a cavity liner or as an indirect pulp-capping material.  For decades, calcium hydroxide was the most popular lining or indirect pulp-capping material, primarily because of its ability to stimulate reparative dentin. However, its solubility after placement was found to be a problem. Zinc oxide and eugenol, glass ionomers, and resin-modified glass ionomers have also been used as liners, bases, and IDPC materials, but each has shortcomings.

Figure 1 (left): Preoperative periapical radiograph of tooth No. 30 with a large radiolucent lesion approximating the distal pulpal horn and a smaller radiolucent lesion closer to the mesial marginal ridge; Figure 2 (right): Large active carious lesion involving the entire distal buccal cusp and surrounding aspect of tooth No. 30. Smaller Class VI lesion located on the mesial lingual cusp on No. 30

Liners are materials that are placed in thin layers over exposed dentin in the deepest portion of cavity preparations. They function to seal dentin tubules, prevent microleakage, provide some thermal insulation, and depending on the material used, stimulate the formation of reparative or tertiary dentin. Historically, indirect pulp-capping materials have been used when a thin layer of carious dentin remains after deep excavation with no exposure of the pulp and no clinical signs of irreversible pulpitis. In recent years, indirect pulp capping in pediatric dentistry has been utilized when larger amounts of carious tissue remain, but the caries can be sufficiently sealed from the oral environment with a full coverage restoration like a stainless steel or zirconia crown. The main goal of both liners and IDPC materials is to minimize inflammation, promote healing, and maintain vitality of the dental pulp. Indirect pulp capping materials may also demonstrate some bactericidal properties to kill any remaining bacteria that may remain.

Figure 3 (left): Conservative removal of all carious dentin on all axial walls and pulpal floor. No clinical pulpal exposure noted, but likely very close to distal buccal pulp horn; Figure 4 (right): Placement and curing of two separate thin layers of NeoLINER over the dentin. Image depicts the NeoLINER following the indirect pulp cap of tooth No. 30

The MTA in NuSmile’s NeoLINER LC provides a continuous high calcium release. This, in combination with a high pH, promotes hydroxyapatite formation and protects against hypersensitivity. The high pH also has bactericidal effects to reduce remaining bacteria. NeoLINER LC is packaged in a syringe with 27-gauge disposable tips that allow for precise and easy placement. Its viscosity ensures it will stay in the area where it is placed until it is cured with a curing light. NeoLINER LC is moisture tolerant, has low water solubility, and is compatible with all etching, bonding, and resin restorative materials. It’s also radiopaque for easy postoperative assessment.

While it is an excellent liner and IDPC material, NeoLINER LC is not recommended for direct pulp capping because of its resin component which can act as an irritant. Any materials containing a resin can damage or kill pulpal tissue if placed in direct contact. If a pulpal exposure is realized, a resin-free MTA material such as NuSmile’s NeoMTA® 2 or NeoPUTTY® is recommended as a direct pulp-capping agent due to its exceptional biocompatibility. These MTA materials, which have a delayed set, may be covered with NeoLINER LC for placement of an immediate final restoration.

The versatility and handling properties of NuSmile’s NeoLINER LC make it a wonderful addition to the clinician’s restorative and pulpal therapy armamentarium.

This information was provided by NuSmile.

William F. Waggoner, DDS, MS, is the founder and owner of Galaxy Smiles of Las Vegas, Pediatric Dental Care Associates, and Kids Dental Safari. He has been a pediatric dentist for nearly 40 years. He also serves as the Chief Dental Officer for NuSmile.

Paul Bahn, DMD, is a Diplomate of the American Board of Pediatric Dentistry and the American Board of Laser Surgery. He is a member of the American Academy of Pediatric Dentistry, the American Dental Association, the Parenteral Drug Association, the Philadelphia County Dental Society, and the Academy of Sports Dentistry.

The MTA in NeoLINER promotes hydroxyapatite formation and protects against hypersensitivity. Read more about the uses of MTA in this article in our sister publication, Endodontic Practice US.