Biodentine™ with Active Biosilicate Technology™ was announced by dental materials manufacturer Septodont in September of 2010, and made available in January of 2011. According to the research and development department of said manufacturer, “a new class of dental material which could conciliate high mechanical properties with excellent biocompatibility, as well as bioactive behaviour” (Septodont Biodentine™ scientific file, 2010) had been produced. According to the manufacturer, the material can be used as a “dentine replacement material whenever original dentine is damaged

1. PRESENTED BY : DR ANUJ KUMAR PATHAK
2 ND YEAR PGT
DEPT OF PEDODONTICS
R.A.D.C.H

2. Introduction
 Introduced by septodont.
 New class of dental material with high mechenical
properties and excellent biocompatibility.
 Short setting time and high mechenical strength
which makes it clinically easy to handle and
compatible.
 Forms reactionary dentine when used in both direct
and inderect pulp capping.
 Besides endodontic application it has been evaluated
for it’s use as restorative material.

3. Physical properties

4. Composition
 Powder
 Ca3SiO5 (tricalcium silicate C3S) Main core material
 Ca2SiO5 (dicalcium silicate C2S) Second core material
 CaCO3 (calcium carbonate) Filler
 CaO (calcium oxide) Filler
 Fe2O3 (iron dioxide) Shade
 ZrO2 (zirconium dioxide) Radiopacifier
 Liquid
 CaCl2 . 2 H2O Accelerator
 Hydrosoluble polymer Water reducing agent
 Water

5.  The calcium silicate has the ability to interact with water
leading to the setting and hardening of the cement.
 Hydration of the tricalcium silicate (3CaO.SiO2 = C3S)
produces a hydrated calcium silicate gel (CSH gel) and
calcium hydroxide (Ca (OH)2).
 2(3CaO.SiO2) + 6H2O 3CaO.2SiO2.3H2O + 3Ca(OH)2
Setting reaction
C3S CSH

6. This dissolution process occurs at the surface of each grain of calcium
silicate. The hydrated calcium silicate gel and the excess of calcium
hydroxide tend to precipitate at the surface of the particles and in the
pores of the powder, due to saturation of the medium. This precipitation
process is reinforced in systems with low water content.

7. The unreacted tricalcium silicate grains are surrounded by layers of calcium
silicate hydrated gel, which are relatively impermeable to water, thereby
slowing down the effects of further reactions.
The C-S-H gel formation is due to the permanent hydration of the
tricalcium silicate, which gradually fills in the spaces between the
tricalcium silicate grains. The hardening process results from of the
formation of crystals that are deposited in a supersaturated solution.

8. Setting time
 The working time of Biodentine™ is up to 6 minutes
with a final set at around 10-12 minutes.
 The classical glass ionomer sets faster that
Biodentine™ in less than 4 minutes.
 This represents a great improvement compared to the
other calcium silicate dental materials (ProRoot®
MTA), which set in more than 2 hours.
 The setting times of Biodentine™ are in the same
range as the amalgams

10.  Compressive strength is a classical mechanical
evaluation of the dental biomaterials
 The setting of Biodentine™ is illustrated by a sharp increase in the
compressive strength reaching more than 100 MPa in the first hour.
 The mechanical strength continues to improve to reach more than 200
MPa at 24h which is more than most glass ionomers values.
 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, (O’Brien 2008)).
 This maturation process can be related to the decrease of porosity with
time, which was illustrated previously.
 Biodentine™ is an evolutive biomaterial which improves its
mechanical properties with time

11. Physical Properties :

12. Time (h)
Compressivestrength(Mpa)

13. Micro hardness
 The reported micro hardness values for natural
dentine are in the range of 60-90 HVN (O’Brien 2008).
 Biodentine™ has surface hardness in the same range as
natural dentine.
 In a study comparing the physical properties of
Biodentine with a conventional glass ionomer (Fuji IX)
and a resin modified glass ionomer (Vitrebond),
showed that Biodentine exhibited higher surface
microhardness compared to the other materials when
unetched.

14. Bond strength
 Considering that Biodentine is recommended for use
as a dentine substitute under permanent restorations,
studies were performed that assess the bond strength
of the material with different bonding systems.
 No significant differences were found.

15. Porosity
 Tricalcium silicate based materials are especially
indicated in cases such as perforation repair, vital pulp
treatments, and retrograde fillings where a hermetic
sealing is mandatory.
 Therefore, the degree of porosity plays a very
important role in the overall success of treatments
performed using these materials, because it is critical
factor that determines the amount of leakage.
 Biodentine exhibits lower porosity than ProRoot®
MTA.
 The density and the porosity of Biodentine™ and Fuji
IX are equivalent.

16. Radiopacity
 Radiopacity is an important property expected from a
retrograde or perforation repair material as these
materials are generally applied in low thicknesses and
they need to be easily discerned from surrounding
tissues
 3.5 mm of aluminum.
 This value is over the minimum requirement of the
ISO standard (3 mm aluminum).
 This makes Biodentine™ particularly suitable in the
endodontic indications of canal repair.

17. Effect on flexural properties of
dentine
 Prolonged contact of root dentine with calcium
hydroxide as well as MTA has detrimental and
weakening effects on the resistance of root dentine.
 it is critical to consider the effects of released calcium
hydroxide on dentine collagen, specifically in
procedures where there is a permanent contact of
dentine with calcium silicate based materials.
 careful consideration is necessary when obturating the
entire root canal system with these materials or when
using them for the purpose of dentine replacement

18. Resistance to acid
Biodentine
Ketac Fill
Fuji II.
Time (h)
Depth(μm)

19. Microleakage Biodentine has the ability to form hydroxyapatite
crystals at the surface. These crystals might have the
potential to increase the sealing ability, especially
when formed at the interface of the material with
dentinal walls.
 The interaction between the phosphate ions of saliva
and the calcium silicate based cements might lead to
the formation of apatite deposits, thereby increasing
the sealing potential of the material.
 Leakage was evaluated separately, in contact with
enamel or in contact with Dentine
 Biodentine exhibits better leakage resistance both to
enamel and to dentine compared to Fuji II LC.

21. Discoloration
 One study evaluated Biodentine from this perspective
where Biodentine, along with 4 different materials, was
exposed to different oxygen and light conditions and
spectrophotometric analysis was performed at different
periods until 5 days .
 Favorable results were obtained for Portland Cement (PC)
and Biodentine and these 2 materials demonstrated color
stability over a period of 5 days.
 Based on their results, the authors suggested that
Biodentine could serve as an alternative for use under light-
cured restorative materials in areas that are esthetically
sensitive .

22. Wash out resistance
 Washout of a material is defined as the tendency of
freshly prepared cement paste to disintegrate upon
early contact with fluids such as blood or other fluids.
 Biodentine demonstrated a high washout.

23. Comparison with glass ionomers
and pro root® MTA
 It can be concluded that Biodentine™ has a
mechanical behavior similar to glass ionomers and is
also similar to natural dentine.
 The mechanical resistance of Biodentine™ is also
much higher than that of ProRoot® MTA.

24. Mta vs biodentine
MTA BIODENTINE
P:L RATIO 3:1 1 capsule powder : 5
drops of liquid
MANIPULATION Manually on glass slab
with mixing spatula
In amalgamator for
30 sec.
SETTING TIME
(Minutes)
Initial – 70
Final - 175
Initial – 6
Final - 10-12
DENSITY (g/cm3) 1.88 2.26
POROSITY (%) 22.6 6.8
COMPRESSIVE
STRENGTH (MPa)
- (1 hr.)
7.5 (24 hr.)
131.5 (1 hr.)
241.1 (24 hr.)
MECHANICAL
RESISTANCE
Lower Higher

25. Mechanism of action
 Forms CH that releases calcium ions for cell
attachment and proliferation
 Creates an antibacterial environment by its alkaline
pH
 Modulates cytokines production
 Encourage differentiation and migration of hard tissue
producing cells
 Forms HA (or carbonated apatite) on the surface and
provides a biological seal

26. Preclinical safety conclusion
 Compared to well known dental materials such as
Dycal® (calcium hydroxide), Biodentine™ exhibits less
cytotoxicity.
 Moreover, when compared to ProRoot MTA,
Biodentine™ demonstrates at least equivalent
biocompatibility.

27. Clinical efficacy
 Biodentine™ can be used as dentine substite
under the composite
 Biodentine™ is used as a direct pulp capping
material
 Biodentine™ is used as an endodontic repair
material - Perforation
- Apexification
- Resorption

28. BIODENTINE
A NEW BIOACTIVE CEMENT FOR DIRECT PULP CAPPING
 Currently, Calcium Hydroxide products serve as gold
standard for direct pulp capping.
 Reported success rate in excess of 80% of dpc.
 Nevertheless, calcium hydroxide has some drawbacks.
-poor bonding to dentine
-material resorption
-mechanical instability
-porosities
-liquefication necrosis at surface of pulp tissue

29.  Biodentine is biocompatible and is capable of
stimulating hard tissue formation.
 Hard tissue formation is shown in both direct and
indirect pulp capping.
 Used for pulp capping it offers some benefits vesus
calcium hydroxide.
 It is stronger mechanically, less soluble, produces
tighter seal.
 Compared to MTA it handles easily and need much
less time for setting.
 Unlike other portland cement based products it is
sufficiently stable and can be used both for pulp
protection and temporary fillings.

30. Bioactivity – In Vitro Pulp Capping
To conclude, Biodentine™ is able to stimulate
initiation and development of mineralization.
Dentine bridge

31. Biodentine
A novel dentinal substitute for single visit apexification.
 Use of an apical plug in management of cases with
open apices has gained popularity.
 In contrast with MTA, the mechanical properties of
Biodentine are similar to those of natural dentine.
 The compressive strength, elasticity modulus and
microhardness are comparable with that of natural
dentine.
 The material is stable, less soluble, non-resorbable,
hydrophilic, easy to prepare and place, needs much
less time for setting, produces a tighter seal and has
greater radiopacity.
 Biodentine has a distinct advantage over its closest
alternatives in treatment of teeth with open apex.

32. Bioactivity- angiogenesis
 The concentration level of TGF-β1 was enhanced by
both ProRoot® MTA and Biodentine™. Moreover,
VEGF and FGF-2 were enhanced in presence of
Biodentine™.
 Biodentine™ is able to stimulate
angiogenesis, in order to heal pulp
fibroblasts.

33. Bioactivity- indirect pulp capping
 Biodentine™ was able to stimulate a reactionary
dentine which is a naturalbarrier against bacterial
invasions. The reactionary dentine formation stabilises
at 3 months, indicating that the stimulation process is
stopped when a sufficient dentine.

34. Overall-bioactivity
 Biodentin was well tolerated. Moreover, Biodentine™
was able to promote mineralisation, generating a
reactionary dentine as well as a dense dentine bridge.
These phenomena illustrate the great potential for
Biodentine™ to be in contact to the pulp, by
demonstrating its bioactivity in several indications.
 As a conclusion, Biodentine™ is bioactive.

35. Clinical tips
 Use metal or plastic instruments - spatulas, amalgam
gun or MTA gun.
 If material is too runny – wait.
 If material is too hard – check if all liquid has been
poured into the capsule, if yes – re.mix 10 s.
 Material is too slumpy – it is not sculptable – wait, do
not overwork it – crystal structure can be destroyed
and it prevents setting.
 12 min is too long? Min working time, 6 min setting
time in oral cavity.

36. Clinical tips
 Trimming is not necessary, at the end of the setting it
is possible to shape the material do not overwork the
material.
 Matrix removal – at the end of the setting time, it can
be treated with vaseline or orange solvent.
 Patints should be advise to be careful forst hours (they
should avoid liquids which are too hot, too cold, too
acid. The staining is on the surface.
 Second visit – the surface layer should be removed
using red coded (fine) diamond bur.

37. CHARACTERISTICS MTA BIODENTINE
SETTING TIME
(minutes)
INITIAL –70
FINAL-175
INITIAL –06
FINAL- 10
DENSITY 1.882 g/cm3 2.260 g/cm3
POROSITY 22.6% 6.8%
COMPRESSIVE
STRENGTH ( Mpa)
1) 24 HRS
2) 7 DAYS
1) 7.5
2) 164.5
1) 241.1
2) 253.2
Ph initial 10.2 , rises to 12.5
after 3 hours
12
CYTOTOXICITY:
Cell Death
0+9 0+8
HANDLING difficult to handle Easier to manipulate
RADIOPACITY 7.17 mm of equivalent
thickness of aluminum,
3.5 mm of equivalent
thicknes of aluminum
COMPARISON OF MTA and BIODENTINE