Biodentine setting

The liquid consists of water containing calcium chloride and an unspecified water soluble polymer. Calcium chloride acts as an accelerator in the hydration processes of the tricalcium silicate substance [78], It forms an acidic solution in water, and its reaction with calcium carbonate, which is basic, also helps to speed up the setting reaction. The overall effect of these components is that Biodentine sets in 9-12min, which is much faster than MTA materials based on unmodified calcium silicates [79], The set material has been shown to release calcium ions into aqueous solution [63,80] and this stimulates the deposition of hydroxyapatite in contact with simulated body fluid [81,82],... 

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],... 

Setting of Biodentine is partly caused by condensation polymerization of the silicate phase to form a chain structure based on SiO tetrahedra joined at two comers (Q2 structures). This is similar to the setting of Portland cement [61], though it occurs faster due to the accelerating effect of calcium chloride. Setting is accompanied first by a contraction in volume, as the initial solidification occurs. This is followed by expansion as secondary hydration reactions take place to form the various calcium silicate hydrates [83]. 

Set Biodentine material consists substantially of hydrated calcium silicate [79], some of which forms more rapidly in Biodentine than in MTA because of the presence of calcium chloride and calcium carbonate. This latter component, which accounts for 15% of the powder by mass, acts as nucleation sites for the deposition of calcium silicate hydrate. Consequently, the precipitation of calcium silicate hydrate occurs more rapidly within this material, which leads to a shorter setting time [79]. 

Physical and chemical properties of Biodentine are shown in Table 9.8. The material can be seen to set rapidly, and to have a reasonable compressive strength and Vicker s Hardness Number at 24h [85,86]. It shows a snbstantial wash out (solubility) in Hank s balanced salt solution (HBSS), which is presumably at least matched in deionized water. However, the pH of deionized water following storage of set Biodentine is only around 9 at 24h, rather than the 11-12.5 of traditional calcium hydroxide chelate cements or supersaturated solution. This may suggest that Biodentine is less bioactive than such materials, and hence less effective at promoting the growth of reparative dentine. 

L. Grech, B. Mallia, J. Camilleri, Characterization of set intermediate restorative material, Biodentine, Bioaggregate and a prototype calcium silicate cement for use as root-end filling materials, Int. Endod. J. 46 (2013) 632-641. 

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. 

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