Cavity Liners Survey

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* 1) How often do you personally place cavity liner underneath your restorations?

0-2 times per day

3-7 times per day

More than 7 times per day

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* 2) Which cavity liner material do you use regularly? (Please select only one for this survey)

ACTIVA BioACTIVE-BASE/LINER

Lime-Lite Enhanced

Lime-Lite

Pulpdent Cavity Liner

Other (please specify)

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* 3) What do you like most about this product?

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* 4) How long have you been using this material?

0-1 year

1-3 years

More than 3 years

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* 5) Please rate the characteristics of the material you chose

	Excellent	Good	Fair	Poor	N/A
Induce tooth structure formation	Induce tooth structure formation Excellent	Induce tooth structure formation Good	Induce tooth structure formation Fair	Induce tooth structure formation Poor	Induce tooth structure formation N/A
Flowability	Flowability Excellent	Flowability Good	Flowability Fair	Flowability Poor	Flowability N/A
Handling	Handling Excellent	Handling Good	Handling Fair	Handling Poor	Handling N/A
Setting Time	Setting Time Excellent	Setting Time Good	Setting Time Fair	Setting Time Poor	Setting Time N/A
Durability	Durability Excellent	Durability Good	Durability Fair	Durability Poor	Durability N/A
Ion release	Ion release Excellent	Ion release Good	Ion release Fair	Ion release Poor	Ion release N/A

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* 6) For any answer of fair or poor, please explain:

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* 7) Have your patients experienced any negative issues such as allergic reaction, post-op sensitivity, or infection after use of this material?

Yes, (please specify)

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* If yes, please rate the severity of the issue

Temporary mild

Temporary moderate

Temporary severe

Required medical attention

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* Comments:

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* Are you a dental healthcare provider?

Yes

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* I give Pulpdent consent to follow up in 6 months

Agree

Disagree

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* We ask that you provide your contact information so we may reach you if needed to ensure the safety of our products. Information will not be used for marketing e-mails or phone calls, apart from notifying eligibility parties for gift card giveaways.

Name

Company

Email Address

Phone Number

Cavity Liners

Question Title

* 1) How often do you personally place cavity liner underneath your restorations?

Question Title

* 2) Which cavity liner material do you use regularly? (Please select only one for this survey)

Question Title

* 3) What do you like most about this product?

Question Title

* 4) How long have you been using this material?

Question Title

* 5) Please rate the characteristics of the material you chose

Question Title

* 6) For any answer of fair or poor, please explain:

Question Title

* 7) Have your patients experienced any negative issues such as allergic reaction, post-op sensitivity, or infection after use of this material?

Question Title

* If yes, please rate the severity of the issue

Question Title

* Comments:

Question Title

* Are you a dental healthcare provider?

Question Title

* I give Pulpdent consent to follow up in 6 months

Question Title

* We ask that you provide your contact information so we may reach you if needed to ensure the safety of our products. Information will not be used for marketing e-mails or phone calls, apart from notifying eligibility parties for gift card giveaways.

Question Title

* Internal use only