major advantages and unique features as well as its ability to overcome the disadvantages of other materials, biodentine has great potential to revolutionize the different aspects of managing both primary and permanent in endodontics as well as operative dentistry.

2. BIODENTINE
Presented by
Mutyala jhansi(Jr 1)
Department of pediatric and
preventive dentistry
King george’s medical university

3. CONTENTS
 Introduction
 Composition
 Setting reactions
 Mechanism of action
 Properties
 Advantages
 clinical application
 Conclusion

4. INTRODUCTION
“Biodentine” calcium silicate based product which became
commercially available in 2009 by septodont, and that
was specifically designed as a “dentine replacement”
material.

5. COMPOSITION

6. A. Powder: Packaged in capsule (0.7 g)
Tricalcium Silicate Main Core Material
Dicalcium Silicate Second Core Materials
Calcium Carbonate As Oxide Filler
Iron Oxide Responsible For Shade
Zirconium Oxide Radiopacifier
Grechetal.2013, Camillerietal.2013

7. B. Liquid: packaged in pipette (0.18 ml)
Calcium Chloride Accelerator
Hydrosoluble Polymer Water Reducing Agent
Fast Setting Time
Water
Grechetal.2013, Camillerietal.2013

8. SETTING TIME
9-12 min
Calcium chloride as accelerator
 Hydrosoluble polymer (water reducing
agent)

9. SETTING REACTION
CSH gel matrix of the cement

10. The final result - Unreacted particles of cement
CSH GEL,
Ca(OH)2
Fills the spaces b/w the gel

11. MECHANISM OF ACTION
Mineralisation Osteodentine Reparative dentine
Succesful Pulp Therapies Due to release of Ca
Differentiation
Proliferation
Mineralisation of Pulp cells

12.  TGF- β1 is responsible for early mineralization of reparative
dentin.
Ca and
hydroxide
enhances
activity of
TGF-β
Osteopontine
Alkaline
phosphatase
BMP-2
Maintain dentin
mineralisation.
Formation of
dentine bridge

13. PROPERTIES

14. COMPRESSIVE STRENGTH
 This value is quite stable and is in the range of compressive
strength of natural dentine (297 MPa)
100MPa
200
MPa
300 MPa
After 1 Hr
After 24 Hrs
After 1 Month

15. Grech et al. attributed this result to the enhanced strength
due to the low water/cement ratio used in biodentine
Kayahan et al aimed to evaluate the compressive strength
following the etching procedure. They concluded that acid
etching procedures after 7 days did not reduce the
compressive strength of proroot MTA and biodentine

16. MICRO HARDNESS
With time micro hardness
After 1 month
Microhardness of
Biodentine
Microhardness of
Dentin

17. Grech et al. evaluated the microhardness of the material
using a diamond shaped indenter. Their results showed that
Biodentine displayed superior values compared to
Bioaggregate and IRM.
Camilleri , this study showed that Biodentine exhibited
higher surface microhardness compared to the other
materials when unetched.

18. BOND STRENGTH.
• Biodentine is recommended for use as a dentine substitute
under permanent restorations and perforation repair
material.
• It should have sufficient amount of push-out bond strength
with dentinal walls for the prevention of dislodgement from
the repair site.
• Push-out bond strength increases with time.

19. •
Odabas¸ et al.evaluated the shear bond strength of an etch-
and-rinse adhesive, a 2-step self-etch adhesive and a 1-
step self-etch adhesive system to Biodentine at different
intervals.
Aggarwal et al. studied the push-out bond strengths of
Biodentine, Push-out bond strength increased with time.
Blood contamination had no effect on the push-out bond
strength.
El-Maaita et al. aimed to assess the effect of smear layer on
the push-out bond strength of calcium silicate cements
,Harvard MTA as root fillings. The results showed that the
removal of the smear layer significantly reduced the push out
bond strengths of calcium silicate cements.

20. Hashem et al. reported that Biodentine is a weak
restorative material in its early setting phase.
In a study by Guneser et al. Biodentine showed considerable
performance as a repair material even after being exposed to
various endodontic irrigation solutions, such as NaOCl,
chlorhexidine, and saline, where as MTA had the lowest push-
out bond strength to root dentin

21. DENSITY AND POROSITY
• Hydrosoluble polymer Reduces the amount of water
Positive influence on density
• Lower porosity leads to higher mechanical strength.
POROSITY
• Camilleri et al evaluated the Biodentine and IRM exhibited the
lowest level or degree of porosity.
Dycal
MTA
BIODENTINE

22. ION RELEASE
• Biodentine has got the ability to release OH¯ and calcium ions.
• The release of free calcium ion in biodentine is higher than MTA
and dycal.

23. ADHESION
• Adhesive strength of Biodentine is higher than Dycal and
MTA.
2 Hypothesis
Micromechanical
anchor tags
Ion exchange
b/w cement and
dentine

24. RADIOPACITY
• Biodentine contains zirconium oxide allowing identification on
radiographs.
• It is a bioinert material with favorable mechanical properties
and resistance to corrosion

25. Grech et al camilleri et al valuating the prototype radiopacified
tricalcium silicate cement, bioaggregate, and biodentine,
concluded that all materials had radiopacity values greater than
3mm al.
Tanalp et al. where the radiopacity of biodentine was found to
be lower compared to other repair materials tested (MTA,
and MTA angelus) and slightly lower than the 3mm al
baseline value set by ISO

26. SOLUBILITY
• Grech et al. demonstrated negative solubility values for
biodentine
• It is due to the deposition of substances such as
hydroxyapatite on the material surface when in contact with
tissue fluids.

27. MICROLEAKAGE
• Good marginal integrity of biodentine is due to 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.

28. DISCOLORATION
• Biodentine has the color stability.
• It could serve as an alternative for use under light-cured
restorative materials in areas that are esthetically sensitive.

29. 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 has the least wash out resistance to avoid this
effect water soluble polymer added to the material to reduce
the water/cement ratio.

30. BIOCOMPATIBILITY
• Biodentine was found to be less toxic compared to
glassionomers
In a study by laurent et al. biodentine was found to significantly
increase TGF- β1 secretion from pulp cells.TGF is a growth
factor whose role in angiogenesis, recruitment of progenitor
cells, cell differentiation, and mineralization
P. Laurent, J. Camps, and I. About, “BiodentineTM induces TGF-𝛽1 release from human
pulp cells and early dental pulp mineralization,” International Endodontic Journal,
vol.45,no.5, pp.439–448,2012

31. ANTIBACTERIAL PROPERTIES
• Biodentine exhibits significant amount of antibacterial activity.
• Calcium hydroxide ions released from cement during setting
phase of biodentine increases pH to 12 (alkaliniztion of
medium) which inhibits the growth of microorganisms and
can disinfect the dentine.

32. ADAVANTAGES
 High Purity
 Highly Biocompatible And Bioactive
Short Setting Time
Easily Material Handling
Versatile
Superior Mechanical Properties
Excellent Sealing Properties
Excellent Antibacterial Properties
Universal

33. CLINICAL APPLICATIONS

34. DENTIN SUBSTITUTE
• Biodentine has dentin like mechanical properties.
• It can be used as permanent dentine substitute (base) under
composite or amalgam especially in deep carious teeth.

35. PULP CAPPING
Biodentine can be used safely and effectively as pulp capping
material.
.
• Stimulates release of TGF-β from pulp cells
• Encourage pulp healing
• Dentin bridge formation by odontoblast
stimulation
• Initiate early mineralisation

36. In 2012, tran et al demonstrated in vivo that biodentine induced
an effective dentinal repair (pulp healing) when applied directly
to mechanically exposed rat pulps. They observed the formation
of a homogeneous reparative dentin bridge at the injury site
with biodentine which was significantly different than the porous
reparative tissue induced by calcium hydroxide
Tran X, Gorin C, Willig C, Baroukh B, Pellat B, et al. (2012) Effect of a calcium-
silicate-based restorative cement on pulp repair. J Dent Res 91: 1166-1171.
biodentin 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.

37. Histological section showing thick homogenous reparative
dentine formation after the application of biodentine.

38. PULPOTOMY
 Pulpotomy is another widely used vital pulp therapy
method in which biodentine is advocated.
 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.

39. Rajasekharan et al. They concluded, “there was no significant
difference between the new product biodentine in comparison to
the well-known products (mineral trioxide aggregate (mta)
Recently at the 12th congress of european academy of
pediatric dentistry (EAPD) in poland, rubanenko et al.
Presented their preliminary results of comparing biodentine
versus formocresol as dressing agents in pulpotomized
primary molars. They demonstrated a success rate of 100%
for biodentine while that of formocresol was 94%.

40. REPAIR OF PERFORATIONS
• Biodentine has its own unique properties that make it
preferred for perforation repair either in root canal or pulp
chamber floor.
• Due to their good adhesion to
dentin surface and fast setting time.

41. RETROGRADE ROOT END FILLING
Amalgam
Zinc oxide eugenol
GIC
MTA
•Better consistancy
•Good handlingBIODENTINE

42. REPAIR OF RESORPTION
Biocompatibility and ability to induce calciumphosphate
precipitation at the interface to the periodontal tissue, calcium
silicate cements play a major role in bone tissue repair

43. In two case reports, nikhil et al. And ali et al. Showed
successful results of biodentine when it is used in treatment
of cervical and apical external root resorption with more than
1 year of follow up. On the other hand, there is some
difficulty in removal of biodentine in case of retreatment.
Arora V, nikhil V, sharma N, arora P (2013) bioactive dentin replacement. J dent med sci
12: 51-57

44. APEXIFICATION
•Tight bacterial seal
•Induction of formation of new cementum
•Induction of formation of new pdl
biodentine can be used successfully in necrotic immature teeth.
Cauwels et al. Found that necrotic immature teeth can still
achieve continued root development after proper
regenerative endodontic treatment with biodentine.

45. CONCLUSION
Due to its major advantages and unique features as well as
its ability to overcome the disadvantages of other materials,
biodentine has great potential to revolutionize the different
aspects of managing both primary and permanent in
endodontics as well as operative dentistry.
On the other hand, further studies are needed to extend the
future scope of this material regarding the clinical
applications.”

46. REFERENCES
• biodentine active biosilicate technology scientific file, septodont, paris, France.
• L. Grech, B. Mallia, and J. Camilleri, “characterization of set intermediate restorative
material, biodentine, bioaggregate and a prototype calcium silicate cement for use as root-
end filling materials,” inter national endodontic journal,vol.46,no. 7,pp.632–641,2013
• M.B.Kayahan,m.H.Nekoofar,a.Mccannetal.,“Effec to facid etching procedures on the
compressive strength of 4 calcium silicate-based endodontic cements,” journal of
endodontics,vol. 39,no.12,pp.1646–1648,2013.
• L. Grech, B. Mallia, and J. Camilleri, “investigation of the physical properties of
tricalciumsilicate cement-basedroot-end filling materials,” dental materials, vol. 29, no. 2, pp.
E20–e28, 2013.
• J. Camilleri, “investigation of biodentine as dentine replacement material,” journal of
dentistry, vol.41,no.7,pp.600–610, 2013.
• M.E.Odabas¸,m.Bani,andr.E.Tirali,“shear bond strengths of different adhesive systems to
biodentine,”the scientific world journal,vol.2013,article id 626103,5 pages, 2013

47. v.Aggarwal,m.Singla,s.Miglani,ands.Kohli,“comparative evaluation of push-out bond strength
of prorootmta, biodentine, and MTA plus in furcation perforation repair,” journal of
conservativedentistry,vol.16,no.5,pp.462–465,2013.
• M. El-maaita, A. J. E. Qualtrough, and D. C. Watts, “the effect of smear layer on the push-
out bond strength of root canal calcium silicate cements,” dental materials, vol. 29, no. 7, pp.
797–803,2013.
• F. Hashem, R. Foxton, A. Manoharan, T. F. Watson, and A. Banerjee, “the physical
characteristics of resin composite calcium silicate interface as part of a layered/laminate
adhesive restoration,”dental materials,vol.30,no.3,pp.343–349,2014.
• H.-M. Zhou, Y. Shen, Z.-J. Wang et al., “In vitro cytotoxicity
evaluationofanovelrootrepairmaterial,”JournalofEndodontics,vol.39,no.4,pp.478–483,2013.
• P. Laurent, J. Camps, and I. About, “BiodentineTM induces TGF-𝛽1 release from human
pulp cells and early dental pulp mineralization,”InternationalEndodonticJournal,vol.45,no.5,
pp.439–448,2012.
• Z.Luo,D.Li,M.R.Kohli,Q.Yu,S.Kim,andW.X.He,“Effect of Biodentine on the proliferation,
migration and adhesion of humandentalpulpstemcells,”JournalofDentistry,vol.42,no.
4,pp.490–497,2014.
• A. M. Pawar, S. R. Kokate, and R. A. Shah, “Management of a large periapical lesion using
Biodentine as retrograde restorationwitheighteenmonthsevidentfollow-up,”Journalof
ConservativeDentistry,vol.16,no.6,pp.573–575,2013.

48. • Arora V, nikhil V, sharma N, arora P (2013) bioactive dentin replacement. J dent med sci
12: 51-57
• Priyalakshmi S, ranjan M (2014) review on biodentine-a bioactive dentin substitute. J dent
med sci 13: 13-17
• Camilleri J, grech L, galea K. Keir D, fenech M, formosa L, damidot D, mallia B (2014).
Porosity and root dentine to material interface assessment of calcium silicate-based root-
end filling materials. Clin oral investig 18: 1437-46.

50. 1.Final setting time of biodentine according to grech et al
A. 2 hours
B. 1 hours 45 minutes
C. 9-12 minutes
D. 45 minutes

51. 2. The compressive strength of dentin is
a. 297 Mpa
b. 300 Mpa
c. 245 Mpa
d. 100 Mpa

52. 3.The filler material which is present in biodentine is
A. C-S-H gel
B. Calcium chloride
C. Calcium carbonate
D. Calcium hydroxide

53. 4.The shorter setting time of biodentine is achieved by
A . decreasing the particle size
B. Increasing the calcium chloride
C. Increasing the calcium carbonate
D. Increasing liquid/powder ratio

54. 5 . For how much time does the powder and liquid
components are triturated
• A. 30 seconds
• B. 20 seconds
• C. 40 seconds
• D. 10 seconds