3. INTRODUCTION
Biodentine - calcium silicate based cement.
Physical and chemical properties - Portland cement derivatives.
Biocompatibility
Bioactive dentin substitute
Root perforations
Apexification
Retrograde root filling
A modified powder composition, the addition of setting accelerators and softeners, and a new predosed capsule formulation for use
in a mixing device, largely improved the physical properties of this material making it much more user-friendly with a shorter setting
time.
Therefore, present case report highlights the nonsurgical management of teeth with immature apices and large periapical
radiolucencies using biodentine matrix to promote periapical healing.
5. Endodontic access
The working length. Biomechanical preparation
was done using No: 80 K-file
Root canal debridement
The root canal was then dried with sterile paper
points.
Calcium hydroxide - recalled after 1 week.
6. → Biodentine : five drops of liquid - triturator for 30 s.
→The material was then delicately pushed towards the apex with a root-canal plugger.
→ Several increments were required to form a plug of adequate thickness
→ After verifying that the material was hard-set
→ Gutta-percha obturation was performed using obtura II and the access cavity was
sealed using composite resin.
7. → The clinical follow-up at 18 months showed the patient functioning
well with no reportable clinical symptoms and the absence of any sinus
tract formation.
→ The radiographic follow-up showed complete healing of the periapical
radiolucency and regeneration of the periradicular tissues.
PRE-OPERATIVE POST-OPERATIVE
8. DISCUSSION
The goal of this treatment is to obtain an apical barrier to prevent the passage of
toxins and bacteria into periapical tissues from the root canal.
Technically, this barrier is necessary to allow compaction of root filling material.
Despite higher success rate of apical barrier formation using calcium hydroxide, long
term follow-up is essential.
Using a suitable biocompatible material reduces leakage in the sealing material and
allows favorable response of the periodontal tissues for periapical healing and
apexification.
APEXIFICATION
'a method to induce a calcified barrier in a root with an open apex or the continued apical development of an
incomplete root in teeth with necrotic pulp‘ (American Association of Endodontists).
BIODENTINE
11. • Laurent et al. investigated the capacity of Biodentine to affect transforming growth factor-β1 (TGF-β1)
secretion from pulp cells
• CONCLUSION: Biodentin caused a significant increase of TGF-β1 secretion from pulp cells, thus inducing
an early form of dental pulp mineralization shortly after its application.
12. • HAN AND OKIJI compared calcium and silicon uptake by adjacent root canal dentine in the presence of
phosphate buffered saline using Biodentine and ProRoot MTA.
• RESULTS: Both materials formed a tag-like structure composed of the material itself or calcium-or phosphate rich
crystalline deposits. The thickness of the Ca-and Si-rich layers increased over time, and the thickness was
significantly larger in Biodentine compared to MTA after 30 and 90 days
• CONCLUSION: Dentine element uptake was greater for Biodentine than for MTA.
13. KOKATE AND PAWAR compared the microleakage of glass ionomer cement, MTA and Biodentine when
used as a retrograde filling material
CONCLUSION: Biodentine exhibited the least microleakage when compared to other materials used.
Research suggests that a high pH and released calcium ions are required for a material to stimulate
mineralization in the process of hard tissue healing.
14. SULTHAN evaluate the pH and calcium ion release of MTA and Biodentine when used as
root end fillings.
CONCLUSION: Biodentine presented alkaline pH and ability to release calcium ions similar to
that of MTA.
The 24-h push-out strength of MTA was less than that of Biodentine.
Blood contamination affected the push-out bond strength of MTA irrespective of the setting
time.
15. CONCLUSION
This case report emphasizes the novel approach of using Biodentine to
achieve single visit apexification of the cases with an open apex and large
periapical lesion.
The use of Biodentine has been demonstrated to induce faster periapical
healing for single visit apexification of the cases with large periapical lesions.
Although the efficacy of BioDentine as a dentin substitute is yet to be
clinically proven for its therapeutic indications, it may be a promising
material for apexification.
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