Biodentine™

Biodentine™- �A Promising Dentine substitute

1. prepa ren usseln

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MSC: © Biodentine™

Biodentine™

Biodentine™

Biodentine™

Biodentine”
Biodentine”
Biodentine”

Biodentine™

A FP, remising Dentine substitute

2. Introduction

> Loss of dentine is perhaps one of the major losses which restrict the integrity of the
tooth structure to a significant extent. Whether be in the coronal or radicular
portion, dentine loss must be substituted with an artificial material, which can

restore the physiological integrity of the tooth structure.

> For many decades since 1928, calcium hydroxide (Dycal) has been standard
material for maintaining the vitality of pulp since it is capable of stimulating
tertiary dentine formation. However it has some drawbacks like poor bonding to

dentine, material resorption.

3. > After that, hydraulic calcium silicate cements were available which showed a

bioactive dynamic interaction with dentine and pulp tissue interface.

> Biodentine is a new tricalcium silicate (Ca3SiO5) based inorganic restorative

commercial cement and advertised as ‘bioactive dentine substitute’.

4. Composition of Biodentine

Tricalcium Silicate: it’s the main component.
Diclacium Silicate: it’s the second main component.
Calcium Carbonate: as filler.

Zirconium Oxide: responsible for radiopacity.

fp 5

Tron Oxide: responsible for shade.

1. Calcium Chloride: as accelerator.
2. Hydrosoluble polymer: (water reducing agent) maintain the balance
between low water content and consistency of mixture.

3. Water.

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6. Setting reaction

> The calcium silicate has the ability to interact with water leading to the setting

and hardening of the cement as following:

is considered as the matrix of the cement, and the crystals of

CaCO3 (rough and irregular) are filling the spaces between gel of cement.
has two distinct functions: as an active agent (implicated
in the process of hydration) and as filler (improves the mechanical

properties of the cement).

7. > The final result of hydration reaction includes:

(slowing down the effect of further reaction),

2(3Ca0.SiO,) +6H,O > 3CaO.28i0,.3H,0 + 3Ca(OH),

8. Properties of Biodentine

1. Setting time:

> The powder is mixed with liquid in capsule in triturator for 30 seconds.

> This represents a great improvement compared to the other calcium silicate

dental materials (MTA), which set in more than 2 hours.

9. 2. Adhesion:

> There are two hypothesis or two processes may well combine, eventually in

contributing to the adhesion of the Biodentine cement to dental surface:

> Adhesion of Biodentine is higher than Dycal and MTA.

10. Plugs of crystals in tubules openings

Mineral tags inside dentine tubules

11. 3. Density & Porosity:

> The use of hydrosoluble polymer in Biodentine composition which
reduce the amount of water which has positive influence on

density of Biodentine.

> The lower porosity of Biodentine leads to higher mechanical

strength. Biodentine exhibits lower porosity than Dycal and MTA.

12. 4. Radiopacity:

> Biodentine contains zirconium oxide allowing identification on

radiographs Biodentine displays radiopacity.

13. 5. Compressive strength:

> There is a sharp increase in the compressive strength reaching more than 100

MPa in the first hour.

> A specific feature of Biodentine is its capacity to continue improving with time
over several days until reaching 300 MPa after one month. This value becomes
quite stable and is in the range of the compressive strength of natural dentine

(297 MPa).

14. 6. Micro hardness:

> There is an increase in the micro hardness of Biodentine with

time.

> After 1 month, hardness of Biodentine reach in the same range as

natural dentine.

15. 7. Biodentine Interfaces:

> The deposition of apatite like calcium phosphate crystals on the surface.
This improves interface between Biodentine and adjacent phosphate-
rich hard tissue substance. This leads to increase resistance to acid

erosion and microleakage.

> Biodentine appeared resistance to

erosion and microleakage more

than MTA, Dycal and GIC.

16. 8. lon release:

> Biodentine is associated with its ability to release hydroxyl and calcium ions.

> The release of free calcium ion in Biodentine is higher than MTA and Dycal.

> In addition, the fast hydration reaction of tricalcium silicate can be

correlated with high calcium release at early endpoints.

17. Biodentine™ Particle

18. 9. Antibacterial properties:

> Biodentine exhibits significant amount of antibacterial activity.
Calcium hydroxide ions released from cement during setting phase
of Biodentine increases which
inhibits the growth of microorganisms and can disinfect the

dentine.

19. 10. Stability in the oral
environment:

> Biodentine is not as stable as a composite material, so that
Biodentine is not suitable as permanent enamel replacement.
However, in comparison to other Portland cement- based
products, Biodentine is stable enough to find use as a temporary

filling even in the chewing load bearing region.

20. Mechanism of action

> Biodentine induces mineralization after its application. Mineralization

occurs in the form of osteodentine that form reparative dentine.

> The ability to is a key factor for successful pulp
capping therapies because of the action of calcium on differentiation,
proliferation and mineralization of pulp cells (osteoblasts,

cementoblasts, and odontoblasts).

21. > Ca and hydroxide ions enhances the activity of:

which helps to maintain dentine mineralization and the formation of

dentine bridge.

> is responsible for early mineralization of reparative dentine

that secrete from the pulp cells .

22. Advantages of Biodentine

> For crown and root indications.

> Helps in reminerlization of dentine.

> Preserves pulp vitality and promotes pulp healing.

> Replaces natural dentine with the same mechanical properties.
> Better handling and manipulation.

> Reduced setting time.

23. Clinical Applications of
Biodentine

Dentine caries

Perforations

Internal Extemal
Resorptions
Apexification

Apical surgery

24. > Due to its dentine like mechanical properties, Biodentine can be used as
permanent dentine substitute (base) under a composite or amalgam especially

in deep carious teeth.

> MTA cant be used as a base under restoration because it contains on aluminates
which increase the brittleness of it, while Biodentine not contains on aluminates

that results smart ideal base under restoration.

25. 2. AS pulp Gapping agent:

> It includes direct and indirect pulp capping.

> Histologically, Biodentine were showed complete dentinal bridge formation
(well localized pattern) and absence of inflammatory pulpal response in
contrast to Dycal that associated with tissue necrosis and inflammation during

initial period of placement.

26. Biodentine

28. 8. In vital PUlpotomiys

> Pulpotomy is another vital pulp treatment method in which Biodentine is
advocated to be used. This method is widely used in pediatric dentistry and
involves the amputation of pulp chamber and the placement of a material for

the preservation of the radicular pulp tissue's vitality.

> The rate of success of vital pulpotomy with Biodentine is higher than MTA and

Pulpotec.

30. 4.

‘pail

> Due to their good adhesion to dentine surface and fast setting time,
Biodentine is the ideal material for repairing of perforation
(bifurcation, root) after endodontic treatment. Also Biodentine can

be used in repair of root resorption, in apexification.

31. 5 Killing:

> Many materials (amalgam, ZOE, GIC, MTA) were used as root

end filling, which have many problems.

> Biodentine can be used as root end filling after apicectomy because
it has better consistency, better handling, safety and faster setting

time.

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