Pulp capping Biodentine

When hardened. Biodentine shows good biocompatibihty with the oral tissues and, in particular, exerts minimal influence on cells of the adjacent pulp. Some loss of cell viability has been reported, but this has been attributed to apoptosis and necrosis, rather than the toxicity of the material [71]. In one study of the performance of Biodentine, it was found that the material caused complete dentinal bridge formation in molars while creating no inflammatory response on the cells of the pulp [72]. Both of these features suggest that this material has promise for application in pulp capping. Its ability to promote regeneration of the hard tissue is particularly noteworthy, and will be considered in more detail in Chapter 9. 

A. Nowicka, M. Lipska, M. Parafiniuk, D. Lichota, J. Buczkowska-Radlinska, Response of human dental pulp capped with biodentine and mineral trioxide aggregate, J. Endod. 39 (2013) 743-747. 

Biodentine is a specific proprietary brand of calcium silicate cement that has been available to the profession since 2009 [20], It is manufactured by Septodont, St Maur des Faussds, France. The material is formulated to set more rapidly than MTA or similar calcium silicate cements, and is produced as a dentine replacement material. It is recommended for pulp capping, and also for various aspects of endodontic repair, including root perforations, apexification and retrograde filling [20],... 

Literature provided by the manufacturers suggests that Biodentine can be used for various applications, not only for pulp capping but also for other endodontic applications, such as repair of pulp chamber floor perforations and of lateral root perforations [95]. It can also be used for indirect pulp capping and to line deep carious lesions. However, to date systanatic smdies are lacking, and there is only limited evidence of clinical success of Biodentine in these applications. Early published results are promising, but more work is necessary before a definitive opinion on this material is possible [95]. 

MTA has a wide variety of clinical uses within endodontics. The main one is a root-end filling material [116-120], but it is also used for pulp capping, pulpotomy and to repair lateral root perforations [121-125]. It can be used for apical barrier formation in teeth with open apexes [126], Its relatively long setting time may be a disadvantage, but this has been addressed in related products such as Biodentine by the inclusion of calcium chloride as an accelerator. 

In an animal stndy with the pig as the animal model. Biodentine was shown to in-dnce the formation of thick calcified layers after 90 days following direct pnlp capping [93], As in previons studies, the underlying soft tissue of the pulp showed no sign of inflammation and the cells remained entirely normal. 

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