Information about Biodentine - a Bioactive dentine substitute

1. Prepared By:
Azhi Karim
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3.  Biodentine: is the first all-in-one,
biocompatible and bioactive material to use
wherever dentine is damaged.
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4. Loss of dentine structure restricts
the integrity of the
tooth structure to a
significant extent.
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5. Dentile Loss must be
substituted with an artificial
material that restores the
physiological integrity of the
tooth structure.
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6. Also the preservation and
protection of the dental pulp
with emphasis on regeneration is
the new treatment strategy in
fields of dentistry.
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8.  For many decades
since 1928, Calcium Hydroxide (Dycal)
Has been the standard material for
maintaining the vitality of pulp since
it is capable of stimulating tertiary
dentine formation.
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9. After that, hydraulic calcium
silicate cements were available
which showed bioactive dynamic
interaction with dentine and
pulp tissue interface.
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10. Recently, various calcium
silicate based products have
been launced to the market, one
of these is Biodentine, which
became commercially availabe
in 2009.
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11. Biodentine is a new tricalcium
silicate (Ca3SiO5) based
inorganic restorative
commercial cement and
advertised as “bioactive dentine
substitute”.
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12. This material possesses better
physical and biological
properties compared to other
tricalcium silicate cements such
as mineral trioxide aggregate
(MTA) and Bioaggregate.
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13. 1.Powder (Packaged in Capsule)
-Tri-calcium silicate- This is the main core
material.
-Di-calcium silicate- this is the second core
material
-Calcium carbonate & oxide- it acts as a filler.
-Iron oxide-it acts as a colouring agent.
-Zirconium oxide- it acts as a radioopacifier.
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14. 2.Liquid (Packaged in Pipette)
-Calcium chloride- it acts as an
accelerator.
-Hydrosoluble polymer- it is a water
reducing agent.
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15. 
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17.  The powder is mixed with liquid in capsule in
triturator for 30 seconds.
 The setting time of Biodentine is between (9-
12 minutes).
 This represents a great improvement
compared to the other calcium silicate
dental materials (MTA), which set in more
than 2 hours.
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18. Adhesion of Biodentine is higher
than (Dycal) and (MTA).
There are two hypothesis or two
processes may well combine,
eventually in contributing to the
adhesion of the biodentine cement
to dental surface:
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19.  A. Physical process of crystal
growth within dentine tubules
leading to a micromechanical
anchor (tag) which ensuring long
lasting seal.
 B. Ion exchanges between
The cement and dental tissues
Biodentine-Adhesive systems
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20.  The use of hydrosolube polymer in
Biodentine composition which reduces the
amount of water which has positive influence
on density of Biodentine.
 The lower porosity of Biodentine leads to
higher mechanical strenght.
 Biodentine exhibits lower porosity than Dycal
and MTA.
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21.  Biodentine contains
zirconium oxide allowing
identification on radiographs.
 Biodentine displays
radiopacity.
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22. There is a sharp increase in the
compressive strength reaching more
than 100MPa in the first hour.
Then compressive strength continues
to improve to reach more than
200MPa at 24h which is more than
most glass ionomer values.
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23.  A specific feature of biodentine is its
capacity to continue improving with time
over several days until reaching 300MPa
after one month.
 This value becomes quite stable and is in
the range of the compressive strength of
natural dentine (297MPa).
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24. There is an increase in the
microhardness of Biodentine
with time.
After one month, hardness of
Biodentine reaches the same
range as natural dentine.
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25. 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 increased resistance to
acid erosion and microleakage.
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26. Biodentine appears
resistant to erosion
and microleakage
more than MTA,
Dycal and GIC.
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27. Biodentine is associated with its
ability to release hydroxil and
calcium ions.
The release of free Ca ion in
Biodentine is higher than MTA
and Dycal.
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28.  The high Ca release of Biodentine can be
correlated with the presence of a calcium
silicate component and calcium chloride
and calcium carbonate.
 In addition, the fast hydration reaction of
tricalcium silicate can be correlated with
high calcium release at early endpoints.
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30.  Biodentine exhibits significant amount of
antibacterial activity.
 Calcium Hydroxide ions released from
cement during setting phase of Biodentine
increases pH to 12 (alkalinization of
medium) which inhibits the growth of
microorganisms and can disinfect the
dentine.
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31.  Biodentine is not as stable as a composite
material, so that biodentine is not
suitable as a permanent enamel
replacement.
 However, in comparison to other portland
cement-based products, Biodentine is
stable enough to find use as a temporary
filling in the chewing load bearing region.
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32. Biodentine induces
mineralization after its
application, mineralization
occurs in the form of
osteodentine that form
reparative dentine.
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33. The ability to release Calcium 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)
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34. Ca and Hydroxide ions enhance the
activity of:
((Osteopontin, Alkaline Phosphatase,
Pyrophosphatase, Bone Morphogenetic Protein-
2(BMP-2) which belongs to the TGF-β))
Which helps to maintain dentine
mineralization and the formation of
dentine bridge.
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35. TGF-β1 is Responsible for
early mineralization of
reparative dentine that
secrete from the pulp cells.
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36.  For crown and root indications.
 Helps in remineralization of dentine.
 Preserves pulp vitality and promotes pulp
healing.
 Replaces natural dentine with the same
mechanical properties.
 Better handling and manipulation.
 Reduced setting time.
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38. Due to its dentine-like mechanical
properties, Biodentine can be used
as a permanent dentine substitute
(base) under a composite or
amalgam especially in deep carious
teeth.
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39.  MTA can’t be used as a base under
restoration because it contains on aluminates
which increase the brittleness of it, while
Biodentine doesn’t contain on aluminates
that results smart ideal base under
restoration.
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40.  It includes direct and indirect pulp capping.
 Biodentine can be used as pulp capping agent
since it causes early mineralization by
release of TGF-β1 from pulpal cells to
encourage pulp healing and by
odontoblast stimulation for dentine
bridge formation to protect the pulp.
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41. 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
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Reactionary & Reparative Dentine
Formation Pattern
Dycal MTA Biodentine

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Indirect pulp
capping with
Biodentine
Direct pulp capping
With Biodentine

44.  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.
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45.  This methodology is specifically useful and
preferred when the coronal pulp tissue is
inflamed and a direct pulp capping is not a
suitable option.
 The rate of success of vital pulpotomy with
Biodentine is higher than MTA and pulpotec.
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47. 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.
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48.  Also Biodentine can be used in repair of root
resorption, in apexification.
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49.  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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50.  72% rated Biodentine equal to or better than
glass ionomers.
 88% rated it equal to or better than calcium
hydroxide.
 90% rated it equal to or better than MTA.
 78% indicated they are ready to purchase and
use Biodentine.
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