Biodentine Composition, Properties, And Applications

Biodentine Composition, Properties, And Applications

Biodentine

Biodentine is a calcium silicate-based product, specifically designed as a “dentine replacement” material.

1. Biodentine Composition
   • Powder: Tricalcium silicate, dicalcium silicate, calcium carbonate, oxide filer, and zirconium oxide. Tricalcium silicate and dicalcium silicate are core materials, zirconium oxide provides radiopacity, and iron oxide is responsible for shade.
   • Liquid: Liquid consists of Calcium chloride as an accelerator, hydrosoluble polymer as a water-reducing agent and water. The setting period is 9–12 minutes. On mixing, it forms calcium silicate hydrate and leaches calcium and hydroxide in the solution.
2. Biodentine Manipulation
   • Take capsule powder and liquid and manipulate it in an amalgamator for 30 seconds.
     1. On mixing, the following reaction products are formed:
     2. CSH gel is the matrix of the cement and crystals of CaCO₃ are filing spaces between the gel of the cement
     3. Calcite has two phases as an active agent and as the filer
     4. Final set cement structure consists of unreacted particles of the cement, CSH gel, and calcium hydroxide.
3. Biodentine Setting Time
   • The initial setting time is 8–9 minutes and the final setting time is up to 20 minutes. It can be accelerated by using calcium chloride.
4. Biodentine Properties
   • Compressive Strength
     1. The compressive strength of dentine is >100 MPa and reaches >200 in 24 hours. It becomes 300 MPa almost the same as dentin after 30 days.
5. Biodentine Density and Porosity
   • The use of hydrosoluble polymer in bio dentine reduces the amount of water which has a positive influence on density. Lower porosity causes better mechanical strength.
6. Biodentine Microhardness
   • The Microhardness of dentine is more than BioAggregate, IRM, and glass ionomer cement.
7. Biodentine Adhesion It’s because of two mechanisms:
   • Ion exchange between cement and dental tissues
   • Physical processes of crystal growth within the dentinal tubules lead to micromechanical tag formation.
8. Biodentine Ion Release
   • It releases calcium and hydroxyl ions. High calcium release is due to the presence of calcium silicate, calcium chloride, and calcium carbonate.
9. Biodentine Antibacterial Properties
   • It shows antibacterial property due to the release of calcium hydroxide and pH of 12 which inhibits microorganisms and disinfects dentin.
10. Biodentine Radiopacity
    • It is radiopaque but it’s not sufficient to well distinguish the limits of the material in tooth structure. In dentine, zirconium oxide is used as a radiopacity rather than bismuth oxide which is used in other materials because zirconium oxide is biocompatible and bioinert material with favorable mechanical properties and resistance to corrosion.
11. Biodentine Remineralization Biodentine causes remineralization because of
    • Ability to release calcium, this calcium helps in the differentiation, proliferation, and mineralization of pulp cells
    • Calcium and hydroxide ions increase the activity of alkaline phosphatase, pyrophosphatase, TGF-β, and osteopontin. TGF-β is responsible for the remineralization of reparative dentin.
12. Advantages of Biodentine
    • Helps in dentine remineralization
    • Preserves pulp vitality and promotes pulp healing
    • Replaces dentin with the same mechanical properties
    • Indicated for root and crown repair
    • Good handling and manipulation
    • Short setting time
    • Adhesion to dentin
    • Biocompatible
    • Antibacterial.

Bioceramic-Based Root Canal Sealers

The main functions of root canal sealers are to seal of the voids, form a bond between the core of the filing material and the root canal wall, and act as a lubricant. Sealers have been classified according to chemical composition as zinc oxide eugenol, calcium hydroxide, glass ionomer, silicone, resin, and bioceramic-based sealers.

MTA-based sealers

1. MTA as sealer
2. ProRoot Endo Sealer
3. Fillapex
4. CPM sealer
5. MTA Obtura
6. MTAS experimental sealer
7. F-doped MTA cement.

Bioceramic Properties

1. Biocompatibility
   • Bioceramic-based root canal sealers are biocompatible which is mainly due to the presence of calcium phosphate in the sealer.
2. Flow
   • The flow of a sealer allows it to fill canals, isthmus, accessory canals, and voids between the master and accessory cones. According to ISO 6786/2001, a root canal sealer should have a flow rate of not <20 mm. Bioceramic-based sealers meet the ISO requirements of the flow.
3. Retreatability
   • Bioceramic sealers are difficult to remove from the root canals during retreatment and post-space preparation.
4. Solubility
   • iRoot SP and MTA-Fillapex are highly soluble and do not meet ANSI/ADA requirements. MTA-Angelus has low solubility which is consistent with ANSI/ADA requirements.
5. Radiopacity
   • Bioceramic sealers are radiopaque due to the presence of bismuth trioxide and barium sulfate.
6. Antimicrobial Properties
   • Bioceramic sealers are antimicrobial in nature due to their alkalinity and release of calcium ions which stimulates repair by the deposition of mineralized tissue.
7. Adhesion
   • The sealing ability of bioceramic-based sealers is because of the following three mechanisms:
     1. Diffusion of the sealer particles into the dentinal tubules and form mechanical interlocking bonds
     2. Infiltration of sealer’s mineral content into intertubular dentin forming mineral infiltration zone, produced after denaturing the collagen fibers with a strong alkaline sealer
     3. The reaction of phosphate with calcium silicate hydrogel and calcium hydroxide, produced by the reaction of calcium silicates in the presence of dentin’s moisture, results in the formation of hydroxyapatite along the mineral infiltration zone.