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Biomimetic materials used in conservative dentistry & endodontics


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this presentation describes the concept of biomimetic materials and their brief descriptions

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Biomimetic materials used in conservative dentistry & endodontics

  1. 1. Nature is the mystery and chasing and unfolding that mystery is human nature.
  2. 2. Biomimetic materials used in Conservative Dentistry & Endodontics Presented by: Dept. of Conservative Dentistry & Endodontics Guru Nanak Institute of Dental Sciences & Research Kolkata Dr. Tirthankar Bhaumik, Dr. Antava Maiti, Dr. Debojyoti Majumdar, Dr. Monojit Roy
  3. 3. • Starting from prehistoric era man behaved similarly to animals in hunting and making shelter for survival. • In the legend of Icarus & his father Daedalus, inspired by birds, made wings from feathers and wax for them to escape from prison.
  4. 4. • In the real world, Leonardo da Vinci in the 15th century dreamed of fabulous flying machines based on birds, although it was not until the 20th century that the Wright brothers successfully created a prototype that led to the modern aircraft of today.
  5. 5. • So these revolution from flying birds to todays aircraft reflects the human’s nature of mimicking the Nature’s secrets. • Thus Nature acts as a motivation factor which lead to development of new era of science— Yes, it is
  8. 8. WHAT IS BIOMIMICRY ? Biomimicry is the science and art of emulating Nature's best biological ideas to solve human problems.
  9. 9. In biomimicry, we look at nature as model, measure, and mentor. Janine Benyus 1997,Biomimicry
  10. 10. After 3.8 billion years of evolution, nature has learned What works. What is appropriate. What lasts.
  11. 11. Biomimicry introduces an era based not on what we can extract from organisms and their ecosystems, but on what we can learn from them.
  12. 12. Examples….
  13. 13. Mimicking can be done by using either Natural substitutes or Synthetic substitutes
  14. 14. Why synthetic materials are preferred? • More availability • Relatively easier synthesis • Reduced risk of pathogen transmission • Biocompatibility • Biodegradability
  15. 15. Synthetic mimicking • Structural • Functional • Esthetic • Structural-functional • Biological process mimicking
  16. 16. WHAT IS BIOMIMETICS? Biomimetic refers to human-made processes, materials, devices, or systems that imitate nature.
  17. 17.  Materials  Processing & tools  Fabrication/Manufacturing  Devices & machines  Functions & Mechanisms  Principles Almost all engineering could be thought of as a form of biomimicry
  18. 18. Scope of Biomimetics • Biomedical science • Dentistry • Electronics • Materials scientists • Chemists • Geologists
  19. 19. What is Biomimetic material? A material fabricated by Biomimetic technique based on natural process found in biological systems is called a biomimetic material
  20. 20. Don’t Confuse with…
  21. 21. Bioactive material A bioactive material is one that elicits a specific biological response at the interface of the material which results in the formation of a bond between the tissues and the material Hench LL, Splinter RJ, Allen WC, Greenlee TK Jr.; Bonding mechanisms at the interface of ceramic prosthetic materials. J Biomed Mater Res., 1972; 2:117-141
  22. 22. Bioactive material Osteoproductive (45S5 Bio glass) Osteoconductive (Synthetic HA)
  23. 23. Key points of biomimetic materials
  24. 24. 1) Should be synthetic in origin 2) Should mimic biology 3) Should bond with natural structure 4) Should not elicit any biological responses Advanced Ceramics for Strategic Applications, Prof. H. S. Maiti, Department of Mechanical Engineering, Indian Institute of Technology, Kharagpur , Lecture – 47, Bio ceramics
  25. 25. HISTORY
  26. 26. • The foundation of this broad new field has ancient roots. • First or second century AD- Evidence of crude dental implants seen in roman population and the first use of dental amalgam was recorded in pre-Columbian cultures of central and south America.
  27. 27. • 659 AD- use of heart pacemaker the artificial heart valve and hip and knee joint are written in Chinese literature. • 1960 - The subject of copying, imitating, and learning from biology was coined Bionics by Jack Steele • 1969- Otto Schmitt, an American academic and inventor, coined the term biomimetics
  28. 28. • 1974- The term biomimetics only entered the Websters Dictionary. • 1982- The term biomimicry appeared. • 1997- The term biomimicry was popularized by scientist and author Janine Benyus in her book ‘Biomimicry: Innovation Inspired by Nature.’
  29. 29. Biomimetic materials used in Biomedical Science • PMMA (acrylic), Silicone- Intra ocular lens, Breast implant • Titanium & its alloys, Polyether ether ketone (PEEK)- Artificial hip joints, Dental implants • Polyurethane, Teflon & Dacron- Vascular grafts etc……
  30. 30. Biomimetic dentistry • The use of dental materials and technologies that mimic tooth structure and function. • Maintaining as much natural tooth structure as possible. • Materials should absorb and distribute stress like tooth structure and should bond with natural structure. • Enamel like materials. • Dentin like materials.
  31. 31. Biomimetic materials used in Conservative Dentistry and Endodontics
  32. 32. Why? Natural hard tooth structure once lost for any reason is not ever reproduced by the body system, hence dependence on simulating materials becomes essential for restoring it to form and function.
  33. 33. • Some of the materials simulate tooth materials but additionally exhibit some bio- active properties. • These materials are clubbed together in the group of bioactive material • e.g.- MTA, Biodentine, Synthetic hydroxyapatite etc..
  34. 34. 1) Glass ionomer cement 2) Dental composite material 3) Dental ceramics
  35. 35. Definition • Glass-ionomer is the generic name of a group of materials that use silicate glass powder and aqueous solution of polyacrylic acid” -Kenneth J Anusavice.
  36. 36. Composition Conventional Glass- ionomer cement Basic Component Calcium aluminosilicate glass containing fluoride Acid Component Polyelectrolyte which is a homopolymer or copolymer of unsaturated carboxylic acids known scientifically as alkenoic acids.
  37. 37. GLASS-IONOMER CEMENT is a Biomimetic Material
  38. 38. Because , 1. It is synthetic 2. It does not form any natural tooth structure. 3. It’s similar mechanical properties to dentin. 4. Adheres chemically to the tooth structure 5. Less shrinkage ,so less microleakage 6. Dimensional stability at high humidity
  39. 39. Elastic Modulus (Gpa) Thermal Expansion Coefficient (ppm) Ultimate Tensile Strength (Mpa) Ultimate compressive strength (Mpa) Hardness (KHN) Enamel ~82 ~10 ~384 350-430 Dentin ~40-105 ~297 ~68 Conventional GIC ~4.5 196-251 87-177 ~11 ~10-11 ~14 ~4-10 ~8
  40. 40. • Properties of GIC not adequately matching it’s biomimetic behaviour 1. Low Tensile strength 2. High opacity (Contrast ratio- 0.9 ) 3. Less Wear Resistance
  41. 41. Modifications of Glass-Ionomer • 1) Water settable GIC • 2) Metal modified GIC • 3) Resin modified GIC
  42. 42. Metal modified GIC – • Glass ionomer have been modified by addition of filler particles ,to improve fracture toughness & resistance to wear with different results. • Disadvantages- Poor aesthetics
  43. 43. Alteration of Biomimetic property • Inspite of modification the mechanical properties did not reflect much improvement. Compressive strength ,flexural strength and solubility remained same . • Wear resistance- wear resistance of silver cermet cement is somewhat improved over traditional glass ionomer cement. • Esthetics- By the incorporation of silver particle it takes away the esthetic property of glass ionomer .
  44. 44. Resin modified GIC – It may be auto-cured, Light-cured, dual-cured depending on activator initiator system.
  45. 45. • Alteration of Biomimetic properties – • Optical properties- Improved from conventional GIC, as translucency improved. • Strength- The diametral tensile strength is much higher but compressive strength and hardness is lesser. • Adhesion- Bond strength of resin modified glass ionomer with dentin is higher than that of conventional G.I.C • Microleakage- Increased due to polymerization shrinkage of resin
  46. 46. N-vinylpyrrolidone (NVP) or N-vinylcaprolactam (NVC) containing GIC – • NVP or NVC co-monomers when incorporated in GIC they act as a spacer in between itaconic acid and acrylic acid, thereby increasing the degree of freedom of side chain carboxylic group for reaction. • AA-IA-NPV (Fuzi IX) mechanical properties-- Compressive strength-277 Mpa Flexural strength- 46 Mpa Diametral Tensile strength-21.6 Mpa
  47. 47. GIC as Biomimetic Material • Glass-Ionomer cement is extensively used to replace Dentin, hence it is called as • Dentin Substitute • Man made Dentin • Artificial Dentin
  48. 48. Restorative including deep cavities Luting GIC as Biomimetic Material in Conservative Dentistry Liner & BasesMinimum Intervention
  49. 49. Restoration of Non Carious Cervical Lesion with G.I.C
  50. 50. Class V caries restored with G.I.C
  51. 51. Restoration of Class I cavity with G.I.C
  52. 52. GIC as base
  53. 53. GIC as a luting agent
  54. 54. • GIC as Biomimetic Material inEndodontics – • Intracanal Rehabilitation, reinforcement- • To ensure a better prognosis in cases like flared canal where intraradicular dentin thickness is very less, “Reinforcement Technique” should be followed. • The intraradicular reinforcement method includes placing a thick intermediate layer of adhesive material, sandwiched between the root dentine and a small-diameter metal post or dowel, to improve the fracture resistance of such roots , which acts as a dentin substitute. • GIC is one of the preferred dentin substitute here, as a biomimetic material.
  55. 55. Core Build up – • The metal reinforced glass ionomer cements are used for this purpose • Glass ionomer cements reinforce the teeth
  56. 56. Glass-ionomer based sealer • Glass ionomer based sealer has been advocated for use in obturation because of their dentin bondng property • It enables adhesion between the material and canal wall • Disadvantage-It has minimum anti bacterial property • Removal is difficult in case of retreatment
  57. 57. Root canal perforation repair— • GIC can be used to repair perforation during root canal procedure as dentin substitute.
  58. 58. • Calcium phosphate i.e hydroxyapati te substituted with carbonate ions. • Ions of Strontium,Mg ,lead,Fl. Inorganics,96% by vol. ENAMEL Organics & water,4% by vol. • Proteins like enamelins.. • Ameloblast cells
  59. 59. DENTIN Organics 20% by wt.,33% by vol.  Calcium 26.9%  Phosphorous 13.2%  Carbonate 4.6%  Sodium 0.6%  Magnesium 0.8% • Collagen 90% • Proteins • Lipids Water 10% by wt.,22% by vol.
  60. 60.  Materials formed from two constituents that are insoluble in one another, forming a material with properties that are superior or intermediate to those of the constituents but at the same time maintaining their own characteristics..
  61. 61. I Resin Matrix :BIS-GMA or Urethane Dimethacrylate (UDMA) + Dimethacrylate monomers (TEGDMA) II Inorganic Fillers :  Quartz/Glass Particles (0.1 to 100µm)  Colloidal Silica (0.02 to 0.04 µm) CONTENT 30-70% vol. 50-85% wt. III Coupling Agents : organosilanes IV Pigments : oxides of titanium ACTIVATOR:Tertiary amines PHOTO- INITIATOR:Camphorquinone CHEMICAL- INITIATOR:Benzoyl Peroxide
  62. 62. Esthetics The Influence of Dental Anatomy Dental anatomy and contour influence the color of the teeth and esthetic restorations. Dentin gives teetha more opaque (dense) appearance than enamel.
  63. 63. Variation of shade • Acc. to age: In younger patients, enamel and dentin are thicker, and more opaque and less translucent, in the incisal area. In newly erupted permanent incisors, the mamelons are present and result in a dense, slightly darker, yellowish area at the incisal edges.
  64. 64. • Whether enamel or dentin is exposed • the vitality of the tooth:
  65. 65. Physics, Light and Color • The hue is what we would typically think of as “color”. • The chroma is the degree of saturation or purity of that hue. • The value is the degree of lightness or darkness of the color or material and ranges from black (value 0) to white (value 10). Acc. to the Munsell system
  66. 66. The type of light under which color/shade is judged influences the perception of color/shade. A shade must mimic the translucency and opacity of the tooth in order to be able to blend in.
  67. 67. • Ask patient to remove lipstick. • Place a light blue/grey/white bib over the patient’s clothing. • Select shades at the start of the appointment and before prep-ping the tooth. • Select shades after removal of any significant extrinsic stain on the adjacent dentition. • Place the shade guide tab at arm’s length from your eyes. • Place the shade guide tab alongside the patient’s surrounding dentition. • Look for only a few seconds at a time to avoid eye fatigue that would influence shade selection. • Use the shade guide recommended by the composite manufacturer. • Consider the light source – natural daylight is best. • Use more than one source of light. • Ensure that the shade taker has been tested for color blindness and has no such abnormality. Other Shade Influencing Factors
  68. 68. MEGAFILL : >100 µm MACROFILL : 10 - 100 µm MIDIFILL : 1-10 µm MINIFILL : 0.1 - 1 µm MICROFILL : 0.01 - 0.1 µm NANOFILL : 0.005 – 0.01 µm Shade of composite dependson Size of filler particle Filler content influences esthetics; micro-filled and nanofilled composites contain microscopic filler particles that scatter light, whereas hybrid resins are less esthetic. Shape of filler particle Light-scattering is also influenced by the shape of the filler particles – multifaceted particles scatter and reflect light in different directions, and nanofilled composites transmit light more than other composites.
  69. 69. When performing shade selection, first the hue, then the chroma and then the value are chosen. If using a Vitapan shade guide, this order will result first in choosing from A-D for the hue, then selecting from within that group for the chroma. Lastly, the value is selected based on degree of lightness/darkness and may result in a different shade being viewed as an alternative. When using a composite resin, the manufacturer’s recommended shade guide must be used to ensure the best match possible of the restoration with the teeth.
  70. 70. Digital Shade Vita 3D Shade Guide
  71. 71. flexural strength modulus of elasticity
  72. 72. UNFILLED TRADITIO NAL MICRO- FILLED SMALL PARTICLE HYBRID COMPRE- SSIVE STR.(MPa) 70 250-300 250-300 350-400 300-350 TENSILE STR.(MPa) 24 50-65 30-50 75-90 70-90 ELASTIC MODULUS (GPa) 2.4 8-15 3-6 15-20 7-12 CO-EFF. OF THERMAL EXP. 10-6 /0 C 928 25-35 50-60 9-26 30-40 KHN 15 55 5-30 50-60 50-60 ENAMEL DENTIN 384 297 10 52 84 18 16.96×10 10.59×10 68343
  73. 73. BONDING..
  76. 76.  Generation classification of bonding agents does not exist anymore. It was officially withdrawn by its introducer Dr. Marcus Vargas during 5th Indiana Conference held at University Centre on June 2000.  Marketing gimmicks are being played by various manufacturers giving generation classification to their systems on their own.
  77. 77. From that time the classification of bonding agents have been classified as – (a) Total etch. (b) Self etch. Kuraray was the first company to manufacture the first dentin bonding agent of the world in 1978 called Clearfil Bond System – F, which gave birth to adhesive dentistry based on the research of Prof. Fusayama and clinical trials by Dr.Raymond Berttoloti.
  78. 78. Formationof a hybridlayer involving dentincollagen& resin.
  79. 79. Dentin immediately after application of Self Etching Systems Demineralization of dentin 20 s after application of Self Etching Systems forms retentive resin
  80. 80. Lower right lateral incisor with etched Class IV preparation
  81. 81. Placement of bonding agent
  82. 82. Light-curing of bonding agent
  83. 83. Class IV restoration during light-curing
  84. 84. Class IV restoration after light-curing
  85. 85. Completed Class IV restoration
  86. 86. COMPOSITE RESIN is a Biomimetic Material
  87. 87. Good esthetics Long term color stability High hardness & compressive strength Chemical inertness Excellent biocompatibility
  89. 89. Modulus of elasticity(Al2O3)-350GPa Fracture toughness(Al2O3)- 3.5 to 4 MPa.m1/2 Flexural Strength- 1) Platinum foil Method- 139 to 145 Mpa 2) Dry pressing and Sintering(15500C)-600MPa Fracture toughness: 1.6- 2.1MPa.m1/2 Flexural strength 81 ± 6.8 Mpa Marginal adaptation : Avarage Flexural strength-upto 112MPa Fracture toughness- 0.9 to 1.3 Mpa.m1/2 Esthetics : high esthetic value CERESTORE Flexural strength-150MPa Fracture toughness- 1.79 MPa.m1/2 Flexural Strength- 350 MPa Fracture toughness- 3.3 Mpa.m1/2 It is fairly translucent but somewhat more opaque. ALUMINOUS CORE PORCELAIN DI-COR
  90. 90. CERESTORE Excellent fit & marginal integrity. Radio-density similar to that of enamel. Advantages
  91. 91. STAINS Stain is more concentrated than the color modifier They can be supplied as pure metal oxides but are sometimes made from lower fusion point glasses. Used as surface colorants or to provide enamel check lines, decalcification spots
  92. 92. The wear properties of indirect dental composites and all-ceramic materials were compared with each other by in vitro tests. Human teeth were used as antagonists and their wear loss was calculated and the overall properties of a composite are found to be influenced by the volume fraction and types of fillers. The results of this study indicate that indirect dental composite is relatively more wear-friendly than all-ceramic restoration. As for the wear loss of the enamel antagonist, indirect composites are favorable and less offensive. Therefore, the second generation of indirect composites is promising in long-life dental restorations. Int. J Oral Sci. 2013 Dec; 5(4): 183-190.
  93. 93. Knoop hardness, wear rate, mean friction coefficient and wear loss of antagonist
  94. 94. Studies Results, mean wear (s.d.) Occlusal wear of ceramic crowns Occlusal wear of opposing natural teeth Suputta-mongkol 2008 Wear volume/mm3 Premolar 0.19 (0.06) Premolar 0.21 (0.06) Molar 0.34 (0.08) Molar 0.50 (0.22) Wear height/µm Premolar 29 (12) Premolar 46 (13) Molar 36 (34) Molar 65 (29) Etman 2008 Procera Wear in µm after 6 months 143.60 (9.47) 130.96 (15.08) Wear in µm after 12 months 201.18 (0.22) 184.24 (15.02) Wear in µm after 18 months 243.70 (7.31) 216.84 (14.14) Wear in µm after 24 months 321.60 (12.79) 261.58 (12.88) Experimental ceramic Wear in µm after 6 months 108.50 (4.87) 102.02 (8.49) Wear in µm after 12 months 148.16 (6.38) 149.7 (6.59) Wear in µm after 18 months 194.18 (11.92) 193.92 (12.07) Wear in µm after 24 months 214.76 (4.9) 214.86 (6.09) MC Wear in µm after 6 months 87.06 (2.96) 75.52 (7.15) Wear in µm after 12 months 116.3 (4.70) 106.9 (10.19) Wear in µm after 18 months 142.30 (3.91) 133.82 (6.94) Wear in µm after 24 months 176 (3.93) 156.42 (14.34) Silva 2011 (at year 3 in mm3) MC 1.48 (0.20) 1.10 (0.10) IPS e.max Press without veneering 1.06 (0.12) 0.80 (0.09) Wear results of the teeth and their opposing crowns obtained in the reviewed studies
  95. 95. The Hunt is still on..!!!
  96. 96. Recent Advancement in Biomimetic Material
  97. 97. FIBER REINFORCED GIC It involves incorporation of a continuous network / scaffold of alumina and SiO2 ceramic fibers •Flexural strength increased(15.6 Mpa) •Compressive strength increased (200Mpa) •Fracture Toughness— 0.22 Mpam0.5 This technology is called the Polymeric Rigid Inorganic Matrix Material or PRIMM Alumina and SiO2 ceramic fibers
  98. 98. Nano-Hydroxyaptite/yttria stabilized ZIRCONIA (HA/YSZ) containing GIC Here HA/YSZ is added to GIC. Nano- Hydroxyaptite/yttria stabilized ZIRCONIA (HA/YSZ) containing GIC defines a new class of restorative glass ionomer that promises the strength and durability ideal for permanent posterior restoration maintaining aesthetics.
  99. 99. • (HA/YSZ) stabilized ZIRCONIA containing GIC– Elastic Modulus (Gpa) Thermal Expansion Coefficient (x106) Ultimate Tensile Strength (Mpa) Ultimate compressive strength (Mpa) Hardness (KHN) Enamel ~82 ~17 ~10 ~384 350-430 Dentin ~14 ~11 ~40-105 ~297 ~68 (HA/YSZ) stabilized ZIRCONIA containing GIC ~15 215-346 104-106 245~15 ~11-14
  100. 100. (HA/YSZ) stabilized ZIRCONIA containing GIC • Strength and durability match to enamel and amalgam • Packable and condensable like amalgam • No hazard of mercury, the risk of corrosion, expansion and thermal conductivity • High flexural modulus and compressive strength • Chemically bonds to enamel/dentin • Tooth-like co-efficient of thermal expansion • Excellent resistance to abrasion and erosion
  101. 101. Clinical applications of Nano- Hydroxyapatite/yttria stabilized ZIRCONIA (HA/YSZ) containing GIC 1. Class I & II cavities 2. Structural base in sandwich restorations 3. Core build-up under indirect restorations 4. Root surfaces where overdentures rest 5. Pediatric and Geriatric restorations 6. Long-term temporary replacement for fractured cusps 7. Fractured amalgam restoration 8. Suitable for ART techniques
  102. 102. Preparation of Class I Cavity Restored with (HA/YSZ) stabilized ZIRCONIA containing GIC “white amalgam” •.
  103. 103. PROLINE CONTAINING GLASS IONOMER CEMENT • Amino acid (glycin, ß-alanin, glutamic acid) are incorporated in GIC to increase the degree of freedom of side chain amino acids to increase salt bridge formation. • Compressive strength increased (193-236 Mpa) • Flexural strength increased (55-71 Mpa) • Surface Hardness increased (52.3-64.5 VHN) • Indication- • Class v cavity restoration
  104. 104. Nano Glass Ionomers (Nano-Ionomers) • Nanotechnologies have been applied to the resin modified glass ionomers in the form of nanoparticles (nanomers) and nanoclusters in fluoro-alumino-silicate (FAS) glass. • Increased polishability • Increased aesthetics • Decreased compressive strength (48 KHN)
  105. 105. • INDICATIONS 0F NANO-IONOMERS - • Class III, class V cavity restoration • Primary teeth restoration
  106. 106. Advanced Ceramics
  107. 107. Cercon It is Zirconia based smart ceramics. 1. Metal-free restoration, increased aesthetics 2. Fracture toughness (5-10 Mpa.m1/2) increased 3. flexural strength (800-1300 Mpa) increased 4. Resistance to crack formation and propagation increased.
  108. 108. Copping Cercon as Biomimetic Material Closed Bite Full Crown Elevated Occlusal Force High wear and tear Bruxism High Musculature Less Inter-occlusal Clearance Short Crown Hight
  109. 109. Full Crown Preparation By Cercon
  110. 110. Still today there is no perfect Biomimetic material
  111. 111. A perfect biomimetic restorative material that contains all the synthetically manufactured ingredients of enamel, dentin separately including Hydroxyapatite crystal with all their natural properties, that can be applied directly on the lost tooth structure to restore enamel, dentin respectively.
  112. 112. Future scope of Biomimetic Material • Future scopes of Biomimetic Materials in Conservative Dentistry and Endodontics still now is potentially dynamic. • The Dental profession continues to look for one perfect material, the “Holy Grail” of dentistry, to replace two very different structural components of the tooth ( enamel and Dentin), simultaneously.
  113. 113. Equia®System It is an upcoming system. Inorganic silica nanofillers (40 nm size) are dispersed in liquid and reinforce the resulting polymer matrix. 1. Better resistance to dissolution, disintegration and wear 2. Highly polishable surface 3. Maintenance of polished surface for a longer period of time 4. Enhancement of optical properties and translucency
  114. 114. Equia®System Many studies claimed that Equia®System is as good as of natural teeth, means towards the goal of a perfect biomimetic material.
  115. 115. Nano hydroxyapatite (HA) and Nanofluoroapatite (FA) incorporated GIC – • Nano-HA and Nano-FA particle size-100-150 nm 1. Increased bond Strength 2. Filling of demineralizing micro-pores in the tooth structure 3. Compressive strength(210 Mpa when 5% wt HA is added), diametral tensile strength and biaxial flexural strength increased.(when Ethanol is added)
  116. 116. • Research is going on a number of materials such as alumina, alumina/titania, zirconia and yttria stabilized zirconia incorporation in GIC • There are very high expectations from this on- going research on nanomaterials.
  117. 117. Nano-endodontic Sealer • It is worldwide hot topic for researchers. Composition- – calcium silicate – calcium phosphate – calcium hydroxide – zirconia – thickening agent (hydroxypropyl methylcellulose) – Bentonite
  118. 118. • Biomimetic properties of Nano-endodontic Sealer -- On hydration reaction in root canal during it’s setting calcium silicate and hydroxyapatite is formed, which adopt to irregular dentin surfaces and can rehabilitate the lost intra- canal dentin.
  119. 119. Conclusion • Replacement of diseased or lost tooth structure with biomimetic materials is currently the technique of today which will fulfil our dreams. Yes, ‘Future is coming, it will be amazing’ • But future advances in this field will require materials and computer scientist , physicist , bioengineers, clinicians, biologist and related industries working together towards a shared vision rather than pursuing their separate objectives..
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