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Dong X, Xu X. Bioceramics in Endodontics: Updates and Future Perspectives. Bioengineering (Basel) 2023; 10:bioengineering10030354. [PMID: 36978746 PMCID: PMC10045528 DOI: 10.3390/bioengineering10030354] [Citation(s) in RCA: 21] [Impact Index Per Article: 21.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2023] [Revised: 03/06/2023] [Accepted: 03/09/2023] [Indexed: 03/14/2023] Open
Abstract
Bioceramics, with excellent bioactivity and biocompatibility, have been widely used in dentistry, particularly in endodontics. Mineral trioxide aggregate (MTA) is the most widely used bioceramic in endodontics. Recently, many new bioceramics have been developed, showing good potential for the treatment of endodontic diseases. This paper reviews the characteristics of bioceramics and their applications in various clinical endodontic situations, including root-end filling, root canal therapy, vital pulp therapy, apexification/regenerative endodontic treatment, perforation repair, and root defect repair. Relevant literature published from 1993 to 2023 was searched by keywords in PubMed and Web of Science. Current evidence supports the predictable outcome of MTA in the treatment of endodontic diseases. Although novel bioceramics such as Biodentine, EndoSequence, and calcium-enriched mixtures have shown promising clinical outcomes, more well-controlled clinical trials are still needed to provide high-level evidence for their application in endodontics. In addition, to better tackle the clinical challenges in endodontics, efforts are needed to improve the bioactivity of bioceramics, particularly to enhance their antimicrobial activity and mechanical properties and reduce their setting time and solubility.
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Affiliation(s)
- Xu Dong
- State Key Laboratory of Oral Diseases and National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China;
- Department of Cariology and Endodontics, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
| | - Xin Xu
- State Key Laboratory of Oral Diseases and National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China;
- Department of Cariology and Endodontics, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
- Correspondence: ; Tel.: +86-028-85503494
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Makeeva MK, Daurova FY, Byakova SF, Turkina AY. Treatment of an Endo-Perio Lesion with Ozone Gas in a Patient with Aggressive Periodontitis: A Clinical Case Report and Literature Review. Clin Cosmet Investig Dent 2020; 12:447-464. [PMID: 33149696 PMCID: PMC7604462 DOI: 10.2147/ccide.s267933] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2020] [Accepted: 09/16/2020] [Indexed: 01/29/2023] Open
Abstract
The pulp and periodontium have obvious relationships that have been described in many studies. Pulp infections may affect periodontal tissues and vice versa. Teeth with endo-perio lesions have a worse prognosis than isolated endodontic or periodontal lesions. Elimination of endodontic and periodontal infections is essential for successful treatment, so co-operation between endodontists and periodontists is necessary. In this clinical case, a 44-year-old male presented with primary periodontal disease with secondary endodontic involvement in his lower right canine because of aggressive periodontitis. There was 10 mm of clinical attachment loss and 8 mm periodontal pocket mesial from the tooth and bone radiolucency periapical and lateral from the root. Periodontal therapy was followed by endodontic treatment. Periodontal therapy included root scaling and planing, treatment of the periodontal pocket with ozone gas, systemic antibiotics, oral hygiene instructions, and chlorhexidine rinsing. Endodontic therapy included root canal instrumentation with rotary endodontic files, irrigation, root canal treatment with ozone gas, and obturation with lateral compaction. Radiographs at a 6-month follow-up appointment showed complete healing of the periapical lesion and alveolar bone lateral to the root. Using an interdisciplinary approach to treat endo-perio lesions provides favorable clinical outcomes. Ozone therapy is beneficial for the successful treatment of endo-perio lesions with narrow periodontal pockets in patients with aggressive periodontitis and poor prognosis.
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Affiliation(s)
- Maria K Makeeva
- Conservative Dentistry Department, People's Friendship University of Russia (RUDN University), Moscow, Russia.,Therapeutic Dentistry Department, I.M. Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia
| | - Fatima Yu Daurova
- Conservative Dentistry Department, People's Friendship University of Russia (RUDN University), Moscow, Russia
| | - Svetlana F Byakova
- Therapeutic Dentistry Department, I.M. Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia
| | - Anna Yu Turkina
- Therapeutic Dentistry Department, I.M. Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia
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3
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Adl A, Javanmardi S, Abbaszadegan A. Assessment of tooth discoloration induced by biodentine and white mineral trioxide aggregate in the presence of blood. J Conserv Dent 2019; 22:164-168. [PMID: 31142987 PMCID: PMC6519179 DOI: 10.4103/jcd.jcd_466_18] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
Introduction: In clinical dental application, using silicate-based cements is extremely popular. These materials come into direct contact with blood during or after placement and may cause tooth discoloration. Objectives: The purpose of this study was to compare the coronal tooth discoloration induced by white mineral trioxide aggregate (MTA) and biodentine in the presence of blood. Materials and Methods: Seventy specimens were chemomechanically prepared and divided into four experimental and two control groups. In the experimental groups, the pulp chambers were filled with white MTA angelus or biodentine. Blood or saline saturated cotton pellets were placed within the canals. Saline or blood alone was used in the control groups. Color was assessed with a spectrophotometer at baseline, 1 week, and 1 and 3 months, and color change values were calculated. Tukey's honestly significant difference and Sidak tests were used for statistical analysis. Results: The color change was significantly less with biodentine/saline than MTA/saline and MTA/blood (P < 0.05). Regardless of the material type and blood presence, discoloration increased after 3 months (P < 0.05). Conclusion: Discoloration induced by biodentine/saline may not be clinically noticeable and it was less than MTA-containing groups. Irrespective of blood presence or absence, MTA caused perceptible color change.
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Affiliation(s)
- Alireza Adl
- Biomaterials Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.,Department of Endodontics, School of Dentistry, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Samane Javanmardi
- Department of Endodontics, School of Dentistry, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Abbas Abbaszadegan
- Department of Endodontics, School of Dentistry, Shiraz University of Medical Sciences, Shiraz, Iran
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Rajasekharan S, Martens LC, Cauwels RGEC, Anthonappa RP. Biodentine™ material characteristics and clinical applications: a 3 year literature review and update. Eur Arch Paediatr Dent 2018; 19:1-22. [PMID: 29372451 DOI: 10.1007/s40368-018-0328-x] [Citation(s) in RCA: 52] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2017] [Accepted: 01/11/2018] [Indexed: 12/12/2022]
Abstract
INTRODUCTION Biodentine™ has frequently been acknowledged in the literature as a promising material and serves as an important representative of tricalcium silicate based cements used in dentistry. AIM To provide an update on the physical and biological properties of Biodentine™ and to compare these properties with those of other tricalcium silicate cements namely, different variants of mineral trioxide aggregate (MTA) such as ProRoot MTA, MTA Angelus, Micro Mega MTA (MM-MTA), Retro MTA, Ortho MTA, MTA Plus, GCMTA, MTA HP and calcium enriched mixture (CEM), Endosequence and Bioaggregate™. STUDY DESIGN A comprehensive literature search for publications from November 20, 2013 to November 20, 2016 was performed by two independent reviewers on Medline (PubMed), Embase, Web of Science, CENTRAL (Cochrane), SIGLE, SciELO, Scopus, Lilacs and clinicaltrials.gov. Electronic and hand search was carried out to identify randomised control trials (RCTs), case control studies, case series, case reports, as well as in vitro and animal studies published in the English language. CONCLUSIONS The enhanced physical and biologic properties of Biodentine™ could be attributed to the presence of finer particle size, use of zirconium oxide as radiopacifier, purity of tricalcium silicate, absence of dicalcium silicate, and the addition of calcium chloride and hydrosoluble polymer. Furthermore, as Biodentine™ overcomes the major drawbacks of MTA it has great potential to revolutionise the different treatment modalities in paediatric dentistry and endodontics especially after traumatic injuries. Nevertheless, high quality long-term clinical studies are required to facilitate definitive conclusions.
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Affiliation(s)
- S Rajasekharan
- Department of Paediatric Dentistry and special care, PAECOMEDIS Research Cluster, Ghent University, 9000, Ghent, Belgium.
| | - L C Martens
- Department of Paediatric Dentistry and special care, PAECOMEDIS Research Cluster, Ghent University, 9000, Ghent, Belgium
| | - R G E C Cauwels
- Department of Paediatric Dentistry and special care, PAECOMEDIS Research Cluster, Ghent University, 9000, Ghent, Belgium
| | - R P Anthonappa
- Paediatric Oral Health Research Group, School of Dentistry, The University of Western Australia, Perth, Australia
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Torabinejad M, Parirokh M, Dummer PMH. Mineral trioxide aggregate and other bioactive endodontic cements: an updated overview - part II: other clinical applications and complications. Int Endod J 2017; 51:284-317. [PMID: 28846134 DOI: 10.1111/iej.12843] [Citation(s) in RCA: 201] [Impact Index Per Article: 28.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2017] [Accepted: 08/22/2017] [Indexed: 12/16/2022]
Abstract
Mineral trioxide aggregate (MTA) is a dental material used extensively for vital pulp therapies (VPT), protecting scaffolds during regenerative endodontic procedures, apical barriers in teeth with necrotic pulps and open apices, perforation repairs as well as root canal filling and root-end filling during surgical endodontics. A number of bioactive endodontic cements (BECs) have recently been introduced to the market. Most of these materials have calcium and silicate in their compositions; however, bioactivity is a common property of these cements. These materials include the following: BioAggregate, Biodentine, BioRoot RCS, calcium-enriched mixture cement, Endo-CPM, Endocem, EndoSequence, EndoBinder, EndoSeal MTA, iRoot, MicroMega MTA, MTA Bio, MTA Fillapex, MTA Plus, Neo MTA Plus, Ortho MTA, Quick-Set, Retro MTA, Tech Biosealer, and TheraCal LC. It has been claimed that these materials have properties similar to those of MTA but without the drawbacks. In Part I of this review, the available information on the chemical composition of the materials listed above was reviewed and their applications for VPT was discussed. In this article, the clinical applications of MTA and other BECs will be reviewed for apexification, regenerative endodontics, perforation repair, root canal filling, root-end filling, restorative procedures, periodontal defects and treatment of vertical and horizontal root fractures. In addition, the literature regarding the possible drawbacks of these materials following their clinical applications is reviewed. These drawbacks include their discolouration potential, systemic effects and retreatability following use as a root filling material. Based on selected keywords, all publications were searched regarding the use of MTA as well as BECs for the relevant clinical applications. Numerous publications were found regarding the use of BECs for various endodontic applications. The majority of these investigations compared BECs with MTA. Despite promising results for some materials, the number of publications using BECs for various clinical applications was limited. Furthermore, most studies had several methodological shortcomings and low levels of evidence.
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Affiliation(s)
- M Torabinejad
- Department of Endodontics, School of Dentistry, Loma Linda University, Loma Linda, CA, USA
| | - M Parirokh
- Endodontology Research Center, School of Dentistry, Kerman University of Medical Sciences, Kerman, Iran
| | - P M H Dummer
- School of Dentistry, College of Biomedical and Life Sciences, Cardiff University, Cardiff, UK
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Naik MM, de Ataide IDN, Fernandes M, Lambor R. A novel technique of sculpting Biodentine in the restoration of iatrogenic dentin loss. J Conserv Dent 2017; 20:365-369. [PMID: 29386788 PMCID: PMC5767835 DOI: 10.4103/jcd.jcd_311_16] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Excessive tooth structure loss is a common iatrogenic error encountered during endodontic practice. Conservative treatment planning is essential to maintain the structural integrity in such teeth. This case report elucidates a novel approach in sculpting Biodentine as a dentin substitute followed by internal bleaching and restoration with fiber-reinforced composite.
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Affiliation(s)
- Mayuri Mohan Naik
- Department of Conservative Dentistry, Goa Dental College and Hospital, Bambolim, Goa, India
| | | | - Marina Fernandes
- Department of Conservative Dentistry, Goa Dental College and Hospital, Bambolim, Goa, India
| | - Rajan Lambor
- Department of Conservative Dentistry, Goa Dental College and Hospital, Bambolim, Goa, India
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Nadig PP, Agrawal ISK, Agrawal VSK, Srinivasan SC. Palato-Radicular Groove: A Rare Entity in Maxillary Central Incisor Leading To Endo-Perio Lesion. J Clin Diagn Res 2016; 10:ZJ14-5. [PMID: 27656596 DOI: 10.7860/jcdr/2016/19630.8315] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2016] [Accepted: 04/25/2016] [Indexed: 11/24/2022]
Affiliation(s)
- Priyadarshini Prasad Nadig
- Reader, Department of Periodontics and Implantology, Manubhai Patel Dental College and Hospital , Vadodara, Gujarat, India
| | - Isha Suresh Kumar Agrawal
- Postgraduate Student, Department of Periodontics and Implantology, Manubhai Patel Dental College and Hospital , Vadodara, Gujarat, India
| | - Vineet Suresh Kumar Agrawal
- Reader, Department of Conservative and Endodontics, Manubhai Patel Dental College and Hospital , Vadodara, Gujarat, India
| | - Sarath Chandran Srinivasan
- Head of Department, Department of Periodontics and Implantology, Manubhai Patel Dental College and Hospital , Vadodara, Gujarat, India
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Meharwade VV, Shah DY, Mali PP, Meharwade VV. Management of apicomarginal defect in esthetic region associated with a tooth with anomalies. Restor Dent Endod 2015; 40:314-21. [PMID: 26587418 PMCID: PMC4650528 DOI: 10.5395/rde.2015.40.4.314] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2015] [Accepted: 05/26/2015] [Indexed: 11/20/2022] Open
Abstract
Tooth related factors such as palatoradicular groove can be one of the causes for localized periodontal destruction. Such pathological process may result in apicomarginal defect along with inflammation of pulp. This creates challenging situation which clinician must be capable of performing advanced periodontal regenerative procedures for the successful management. This case report discusses clinical management of apicomarginal defect associated with extensive periradicular destruction in a maxillary lateral incisor, along with histopathologic aspect of the lesion.
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Affiliation(s)
| | - Dipali Yogesh Shah
- Department of Conservative Dentistry, Sinhgad Dental College and Hospital, Pune, Maharashtra State, India
| | - Pradyna Prabhakar Mali
- Department of Periodontology, Sinhgad Dental College and Hospital, Pune, Maharashtra State, India
| | - Vidya Vinayak Meharwade
- Department of Conservative Dentistry, Sinhgad Dental College and Hospital, Pune, Maharashtra State, India
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9
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Vallés M, Roig M, Duran-Sindreu F, Martínez S, Mercadé M. Color Stability of Teeth Restored with Biodentine: A 6-month In Vitro Study. J Endod 2015; 41:1157-60. [DOI: 10.1016/j.joen.2015.03.014] [Citation(s) in RCA: 45] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2014] [Revised: 03/13/2015] [Accepted: 03/19/2015] [Indexed: 10/23/2022]
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