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Pediatric dentistry plays a critical role in ensuring the oral health and well-being of children and adolescents. The quest for effective dental materials that are safe, biocompatible, and capable of promoting natural remineralization has led to the emergence of biosilicate cements as a promising advancement in this field. Biosilicate cements are bioactive materials composed of amorphous silica, calcium oxide, phosphorus pentoxide, and other trace elements. The bioactivity of biosilicate cements allows them to interact with living tissues, promoting remineralization and stimulating the formation of hydroxyapatite, a vital component of teeth and bones. Their ability to release essential ions, such as calcium, phosphate, and fluoride, supports the natural healing processes, aiding in the preservation of pulp vitality and reducing the risk of secondary caries. Biosilicate cements offer versatility in pediatric dentistry, finding application indirect pulp capping, indirect pulp capping, and small-sized restorations. Their rapid setting time proves advantageous when treating young patients with limited cooperation. Furthermore, the continuous release of fluoride contributes to caries prevention and enhances the long-term oral health of children. While the advantages of biosilicate cements in pediatric dentistry are promising, this manuscript also discusses the limitations and challenges associated with their use. Some biosilicate cements may have different handling characteristics compared to traditional materials, necessitating adaptations in clinical techniques. In addition, long-term clinical data on the performance of these materials in pediatric patients are still limited, requiring further research to establish their efficacy and longevity. This manuscript explores the potential of biosilicate cements in pediatric dentistry.

BackgroundBioactivity refers to the ability of a material to interact with living organisms or biological systems in a way that elicits a specific response. In the context of materials science and medicine, bioactivity is particularly important because it can determine the suitability of material for various applications. ObjectiveTo evaluate and compare different commercially available calcium silicate-based materials regarding: 1. Morphological and elemental analysis at the dentin/material interface. 2. Calcium and silicon release and uptake by adjacent root canal dentine by evaluating the calcium and silicon incorporation depth in adjacent root canal dentin. Materials and MethodsThis study examined four calcium silicate-based cements: Biodentine, MTA Angelus, BioAggregate, and MTA Plus. One hundred extracted human teeth with intact apices and no cavities were selected. Root sections measuring 3 mm in length were created at the mid-root level using low-speed diamond discs. Bioactivity was evaluated at 1, 7, 30, and 90 days, respectively. ResultsThe principal composition of the interfacial dentine layer and incorporation of calcium and silicon into dentine was measured at 1, 7, 30, and 90 days. Statistical analysis was performed by multiple comparisons using post hoc Tukey HSD. ConclusionAll the materials have shown bioactivity, i.e. release of calcium, silicon, and their uptake in the adjacent dentin in the presence of phosphate-buffered saline.

Aim: The aim of this study was to assess the outcome of biodentine apexification for the management of traumatized immature teeth with necrotic pulp over a period of 12 months. Methods: Eighty-five human maxillary incisors with traumatized immature necrotic pulp in patients aged 10–50 years were selected for this study. Root canal treatment was initiated and the biodentine apexification procedure was performed in a single appointment for all teeth. Intraoral preoperative and postoperative periapical radiographs were used to assess periapical (PA) changes, changes in root length (RL), and radiographic root area (RRA). Preoperative and postoperative cone-beam computed tomography (CBCT) images were used to assess the three-dimensional (3D) volumetric changes. Patients were recalled at 12 months posttreatment for the evaluation of clinical symptom, percussion, and palpation examination. Descriptive statistics was computed for preoperative demographic, patient-centric data, and treatment success. Paired t-test was used to compare the preoperative and 12-month postoperative changes in RRA, RL, and 3D volumetric changes of the parameters. Results: Forty-eight out of the 49 teeth that completed the study were asymptomatic and functional. Comparing the preoperative and the 12-month review radiographs using the periapical index scores based on the size of the lesion, completely healed lesions were 79.16% while lesions in the process of healing were 20.83%. There was a significant (P < 0.05) increase in RL (14.17%), RRA (40.87%), and dentin volume (26.63%). Conclusion: 3D volumetric analysis suggests that biodentine apexification has the ability to deposit hard tissue 3-dimensionally, and it is an effective alternative to the conventional apexification materials.

Introduction: An in vitro comparative analysis was performed to calculate the push-out bond strength of commercially existing root repairing cements like glass ionomer cement (GIC), biodentine, mineral trioxide aggregate (MTA), and endosequence root repair material (RRM) employed in furcation perforation, with or without blood contamination present. Materials and Methods: Eighty molars were selected and subjected to furcal perforations. They were categorized based on the cement used for repair (GIC, MTA, biodentine, and endosequence RRM); furthermore, they were sub-divided into two sub-groups, that is, blood contaminated and non-contaminated. For 24 hours, all the samples were kept in an incubator till the materials were fully set. Then these samples were examined for push-out bond strength measurement. Results: The 24-hour push-out bond strength of was the highest in biodentine and the lowest in glass ionomer cement. The push-out bond strength of endosequence RRM, MTA, and GIC was influenced by blood contamination. Conclusion: The push-out bond strength of biodentine was the highest as compared to endosequence RRM, MTA angelus, and GIC. The push-out bond strength of endosequence RRM and MTA angelus after 24 hours with or without blood contamination showed insignificant differences. Group 1A (GIC contaminated with blood) displayed the least push-out bond strength among other groups.

Aim: The aim of the study was to comparatively evaluate the effect of white tea extract-incorporated mineral trioxide aggregate (MTA) and Biodentine (BD) on collagen degradation and flexural strength of coronal dentin. Methods: Two hundred and fifty dentin beams (10 mm × 2 mm × 2 mm) were obtained from the mid-coronal portion of caries-free human 3rd molars. They were randomly assigned to five experimental groups (n = 50). Group 1-control group (No experimental materials placed); Group 2-MTA; Group 3-MTA with 10% white tea extract (WMTA); Group 4-BD; and Group 5-BD with 10% white tea extract (WBD). All experimental materials were mixed and then spread onto the prepared dentin beams. Each group was further divided into five subgroups with each 10 samples according to aging periods of 24 h, 1, 3, 6 months, and 1 year as A, B, C, D, and E, respectively. The dentin beams were placed in contact with a set calcium silicate cement block in silicone molds, with only one side of each beam exposed to the cement at 37°C in a 100% relative humidity chamber. At each designated time period, the beams were copiously rinsed with deionized water and tested for flexural strength and collagen degradation using a universal testing machine and Fourier Transform-Raman spectrometer, respectively. Flexural strength results were statistically analyzed using one-way ANOVA, followed by post hoc adjustment with Tukey's test for pair-wise comparisons with P < 0.05. Results: Collagen degradation was more in Group 2, followed by 4, 3, and 5. All the groups showed a gradual reduction in flexural strength over 1 year. Group 2 showed the highest reduction in flexural strength over 1 year. Group 5 showed the least reduction in flexural strength. Conclusion: BD and white tea-incorporated BD showed less collagen degradation and better flexural strength than MTA and white tea-incorporated MTA, respectively.

Aim: This randomized clinical trial aimed to compare the effectiveness of mineral trioxide aggregate (MTA), Biodentine, platelet-rich fibrin (PRF) with MTA, and PRF with Biodentine as pulpotomy medicament in the permanent molars with symptomatic irreversible pulpitis clinically and radiographically. Materials and Methods: Sixty permanent first molars with a carious exposed tooth showing signs and symptoms of irreversible pulpitis with caries extending >2/3rd of dentin, but no signs of pulpal necrosis, were randomly allocated in four groups, and full pulpotomy was performed using MTA, Biodentine, PRF with MTA, and PRF with Biodentine as pulpotomy agents. The clinical and radiographic assessment was done after 24 h, 3 months, 6 months, and 9 months postoperatively. Nonparametric tests, including Kruskal–Wallis, Friedman test, and Chi-square test, were used for repeated measures among the biomaterials. For pair-wise comparison of subgroups, the Wilcoxon sum-rank test was used. Results: The clinical success rate was 90.5% at a 9-month interval. There was a nonsignificant result among all the groups (P < 0.05), and all agents were equally effective in providing pain relief at all the intervals tested. No significant difference was observed between the radiographic success rates observed among the groups (P = 0.089 at 6 months and P = 0.095 at 9 months). Conclusion: Pulpotomy dressing agents used proved to be a success in mature permanent teeth with carious exposure with clinical signs and symptoms of irreversible pulpitis.

Objectives: To evaluate the clinical and radiographic outcomes of apexogenesis with mineral trioxide aggregate (MTA) against other pulpotomy agents in carious/traumatized immature permanent teeth. Data Source: A web-based search for possibly relevant scientific papers in the English language between January 2013 and August 2022 was undertaken in the databases such as PubMed, Scopus, Cochrane Library, and EMBASE. Only randomized clinical trials that compared MTA against other pulpotomy medicaments conducted in vital immature permanent dentition with open apex, having a sample size of not less than 20 with at least 6 months follow-up, reporting clinical or radiographic outcomes were included in the current review. Case studies, case series, animal studies, in vitro studies, non-clinical/clinical trials on mature/necrotic permanent or primary dentition, systematic reviews, and letters to the editor were excluded. Study Selection: A total of 236 articles were retrieved from the databases during the search procedure. Two independent investigators conducted a full-text review of 83 studies following a screening of titles and abstracts. Eventually, seven studies were considered for the review. The Cochrane bias assessment tool was used to evaluate the quality of included studies. Five of the selected studies were assigned a low evidence level, whereas two were rated a high evidence level. Conclusion: The present review indicated that the diverse pulpotomy agents had comparable clinical outcomes with MTA for apexogenesis in traumatized or carious immature permanent teeth. However, there is a lack of substantial information to draw firm conclusions about the benefits of one material over another.

Aim: Caries or traumatic injuries affecting young permanent teeth during root development usually result in an open apex which is highly challenging to treat. The aim of this study was to evaluate the push-out bond strength of apical plugs of Mineral Trioxide Aggregate (MTA) Plus, Biodentine, and calcium-enriched mixture (CEM) after premedication with chlorhexidine, triple antibiotic paste (TAP), and calcium hydroxide. Methods: Fifty-four extracted intact anterior teeth were decoronated and 3 mm was sectioned from the apex. The canals were rendered parallel using #80 K-files and #3, #4 Peeso reamers to mimic an open apex situation. The samples were divided into 3 groups containing 18 samples each for the three intracanal medicaments. After premedication, the samples were stored for 2 weeks at 37°C, following which the canals were cleaned using #80 K-file along with ethylenediaminetetraacetic acid and sodium hypochlorite irrigation. The samples were further divided into three subgroups, each containing six samples for the three calcium silicate cement used in this study. They were later subjected to push-out bond strength testing. Results: Regardless of the type of intracanal medicament used, Biodentine had significantly higher bond strength than MTA Plus and CEM. The highest push-out bond strength results were obtained in samples premedicated with chlorhexidine. Compared to TAP and calcium hydroxide (Ca(OH) 2), this value was statistically significant (P < 0.001). Conclusion: Within the limitations of this study, Biodentine showed the highest push-out bond strength as compared to MTA Plus and CEM. Chlorhexidine may be superior to calcium hydroxide and TAP medicaments when used for apexification procedures with calcium silicate cement.

Aim: This in vitro study aimed to compare the fracture resistance of simulated immature permanent teeth restored with apical plugs of mineral trioxide aggregate (MTA), Biodentine, and bone cement. Methods: Forty-eight single-rooted human maxillary central incisors were selected and decoronated 6 mm above and 9 mm below the cementoenamel junction to simulate the immature teeth. Based on weight and homogeneity, the samples were distributed into three experimental groups (n = 12) and one control group (n = 12). In all the experimental group samples, a peeso reamer size 5 was stepped out 1 mm beyond the apex to enlarge the apices to a diameter of 1.5 mm. Apical plugs of MTA Plus (Prevest DenPro Limited, India), Biodentine (Septodont, France), and Bone cement (Surgical Simplex P, Stryker, Australia) were placed to 4 mm, and obturation was done using gutta-percha and AH Plus® sealer (Dentsply DeTrey, Konstanz, Germany). The force was applied at 45° angulation until fracture, using the universal testing machine. The results were analyzed using a one-way analysis of variance followed by Tukey's post hoc test at a 95% confidence level. Results: The Biodentine group showed a statistically higher fracture resistance value than the MTA Plus and bone cement group (P = 0.014 and P = 0.016, respectively). No statistically significant difference was reported between MTA Plus and the bone cement group. Conclusion: Within the limitations of this study, using Biodentine as an apical plug increases the fracture resistance of immature teeth. Bone cement can be used as a viable alternative to MTA.

Aim: Pachymic acid (PA) has been shown to induce reparative dentinogenesis at the cellular level. The aim of the present study was to histologically evaluate reparative dentin (RD) formation by Biodentine (BIO) and PA when used as pulp capping agents in entire human tooth culture models under in vitro conditions. Materials and Methods: Forty human maxillary and mandibular premolar or third molar teeth with immature root apices were included in the study. The specimens were randomly allocated to two groups (n = 20) based on the pulp capping material used. In a tooth culture model set up, pulp (approximately 1 mm2) was intentionally exposed and capped respectively with BIO (Group I) or PA (Group II). The capping material was overlaid with a 2 mm thick layer of light cure glass ionomer cement, followed by resin composite restoration. The samples were cultured in a 5% CO2 incubator at 37°C for 45 days, with the culture media being replenished every day. At the end of the incubation period, the samples from both the groups were removed from the model and taken up for histological analysis. Results: PA formed significantly less uniform and less thicker dentin bridge compared to BIO. A mild inflammatory response was seen in PA treated samples. A more uniform odontoblast layer was seen in samples treated with BIO. Conclusion: Though PA has the potential to initiate RD formation, BIO proved to be a superior pulp capping material.

Aim: the present study aimed to evaluate and compare the bacterial sealing ability of ProrootMTA, Biodentine and EndoSequenceRRM putty as retrograde filling material using E-faecalis leakage model over a period of 6weeks. Materials and Method: Forty single rooted human premolar teeth were collected, disinfected and decoronated to a standardized of 16mm. Cleaning and shaping was done up to 40#K-file apical preparation and step back method. The roots were sectioned 3 mm from the apex. Root end cavities were prepared using ultrasonic tips (Woodpecker EMS EndoScaler TipE3D) and restored using the three different materials. Specimens were divided in to four groups with a sample size of n =10. Group 1–ProRootMTA, Group2– Biodentine, Group3– EndoSequenceRRM putty, Group 4-Control without any filling. Specimens were then mounted on the E-faecalis (ATCCstrain29212) bacterial leakage models. The bacterial leakage was assessed by measuring the optical density of the broth at every 7th day for a 6 weeks period. Results: In the baseline reading there was significant difference between all the groups. In the 2nd week, Group1 has got significantly higher values than Group 3 and not with Group 2. In the 3rd, 4th, 5th and 6th weeks, Group1 show significantly higher turbidity values than Group 2 and 3. No significant difference between Group2 and 3. Conclusion: Within limitations of this study it was concluded that, both ESRRMputty and Biodentine have got comparable sealing properties. ProrootMTA has got higher microleakage than others in the 3rd, 4th, 5th and 6th week. The microleakage for ProrootMTA, Biodentine and ESRRM putty was increasing up to the third week following which it is static.

Objectives: The aim of this study is a comparative evaluation of the sealing ability of mineral trioxide aggregate (MTA) Angelus, pozzolan-based Endoseal MTA, and Biodentine when used as sealing materials for furcation perforation. This was done with a bacterial leakage model. Materials and Method: Sixty-four permanent mandibular molars were selected and horizontally sectioned at middle third of the root. Cavities of 2 mm depth were prepared at the root ends. Access cavities were prepared, and the canal orifices and the root end cavities were restored with light cured resin. Perforations of diameter 1.6 mm were created in the center of the pulpal floor using a round bur in a low-speed handpiece. The teeth were randomly assigned to three experimental groups (n = 20). The perforation sites in Groups 1, 2, and 3 were repaired with MTA Angelus, EndoSeal MTA, and Biodentine, respectively. The teeth were inserted individually in an Eppendorf vial which was then placed in a McCartney's bottle containing nutrient broth. The reservoirs were filled with 0.5 ml of Enterococcus faecalis. The system was incubated at 37°C and checked for appearance of turbidity in the nutrient broth for 30 days, and these findings were noted. Level of significance was fixed at P = 0.05, and statistical analysis was done with Chi-square analysis using IBM SPSS statistics 20.0 (IBM Corporation, Armonk, NY, USA). Results: In the time interval of 30 days, all the materials showed contamination to varying degrees (MTA Angelus 8/20 samples, Endoseal MTA 10/20 samples, and Biodentine 7/20 samples). There was no significant difference between the three groups (P > 0.05). Conclusions: MTA Angelus, Endoseal MTA, and Biodentine showed contamination in a 30-day incubation period when used as furcation perforation seal materials.

Aim: To compare the sealing ability of polymethylmethacrylate (PMMA) bone cement, mineral trioxide aggregate (MTA), and Biodentine as root-end filling materials by assessing the degree of microleakage through confocal laser scanning microscopy. Materials and Methods: Thirty extracted maxillary incisors were root canal treated using the rotary ProTaper system. Apical root resections followed by retrograde cavity preparation were done. The teeth were divided into three groups and filled with the 3 tested materials (PMMA bone cement, MTA, and Biodentine). Samples were coated with nail varnish, immersed in 0.5% aqueous solution of rhodamine B dye for 24 h, and rinsed with water to remove excess dye. Samples were horizontally sectioned at 1 mm intervals into three using a diamond disk and were labeled A, B, and C and considered first, second, and third, respectively, based on their distance from the apex. Each slice was divided into four equal parts and evaluated using a confocal laser scanning microscope. Dye penetration was scored based on the amount of microleakage. The data were analyzed using one-way analysis of variance. Results: Intergroup comparison of the mean scores of dye penetration among the three materials showed that there is a statistical difference between PMMA bone cement, MTA, and Biodentine, in sections B and C (P ≤ 0.05). The three groups showed no statistical difference in dye penetration scores in section A. Conclusion: The microleakage is least with PMMA bone cement followed by Biodentine and MTA. Microleakage was least in section C followed by sections B and A.

Aim: The aim of this study was to evaluate the shear bond strength of glass ionomer cement (GIC) with e-mineral trioxide aggregate (MTA) and Biodentine when placed immediately and after initial set. Materials and Methodology: Forty acrylic blocks with 2-mm height and 5-mm diameter central holes were prepared and randomly divided into two equal groups (n = 20). Group A (n = 20) and Group B (n = 20) were filled with E-MTA and Biodentine, respectively. These groups (n = 20) were further divided into two subgroups each; subgroup A1 (n = 10) and A2 (n = 10) were the placement of GIC immediately over freshly mixed e-MTA and after initial set e-MTA, respectively, subgroup B1 (n = 10) and B2 (n = 10) were the placement of GIC immediately over freshly mixed Biodentine and after initial set Biodentine, respectively. All the samples were later subjected to UTM for shear bond strength test. Results: The highest shear bond strength was recorded with subgroup B1 were the placement of GIC immediately over freshly mixed Biodentine, i. e., (18.72 MPa) and lowest with subgroup A2 placement of GIC after initial set MTA (5.96MPa). The shear bond strength of GIC condensed over freshly mixed e-MTA (subgroup A1) shows higher mean value then after initial set MTA (subgroup A2); however, SBS was highest in the placement of GIC immediately over freshly mixed Biodentine (subgroup B1). Conclusion: Within the limitation of this in vitro study, it can be concluded that freshly mixed Biodentine can be restored immediately with GIC.

Introduction: Pulp exposure in permanent teeth conventionally has been treated with calcium hydroxide pulp capping. The purpose of this study was to evaluate the histological finding of healthy human pulp tissue after pulp capping using new materials, Biodentine (BD) and Propolis (Pr). Materials and Methods: Forty intact human premolars scheduled for extraction for orthodontic reasons were mechanically exposed. Teeth were divided into four groups of ten teeth each and capped with Pr and BD. The final restoration was done with glass ionomer restorative material. The teeth were then extracted on the 15th or the 45th day and subjected to processing for histological evaluation by an image analysis software. Results: Differences in inflammatory response and dentine bridge formation of the exposed pulp to the different materials. The BD group, at all evaluation periods, exhibited a thick newly formed reparative bridge of dentin that totally obliterating the site of exposure. At the exposure site, cell inclusions and mineralization, variable numbers of odontoblast-like cells, preserved pulp tissue, marked numerous collagen fibers, and blood vessels, were observed. On the other hand, the Pr group did not show any presence of dentin bridge or calcified material and intermediate to acute inflammation after the 15th day. On the 45th day, Pr showed an entire newly formed bridge of reparative dentin tissue, complete pulp degeneration with multiple edematous spaces, hyperemic blood vessels, vacuolated odontoblasts, extravasated red blood cells, multiple mineralized structures dispersed just underneath the dentin bridge and through the pulp tissue, and newly ill-defined odontoblasts. Conclusion: For pulp capping, BD has a better dentin bridge formation and pulp preservation than pr in the human teeth.

Palatogingival groove is a developmental anomaly that is most often seen on maxillary incisors, with a predilection for lateral incisors. It begins in the central groove and can extend to varying lengths and depths into the root. This groove can communicate with the pulp internally and periodontium externally, thereby establishing a milieu for the development of complex endodontic-periodontic lesion. In this article, we report multidisciplinary management of a maxillary central incisor, which was mistaken to be a vertical root fracture instead of a palatogingival groove. We also discuss the significance of early recognition of this lesion, differential diagnosis, and it's interdisciplinary management with the aid of cone-beam computed tomography.

Introduction: Direct pulp capping treatment (DPC) maintains pulp vitality by promoting healing or repair in dentistry, which can be attributed to the advent of bioceramic materials. Aim: This examination looked to evaluate the clinical and histological effectuality of Biodentine with Dycal for DPC. Materials and Methodology: In this study, 30 intact human orthodontic teeth undergoing therapeutic extraction were chosen to perform DPC. They were arbitrarily divided into two groups (n = 15) and DPC with Biodentine and Dycal was performed. Composite resin was used as permanent restoration. After a period of 1 and 6 weeks, clinical as well as electric pulp tests were carried out. Asymptomatic patients were re-called after 6 weeks; follow-up radiograph was taken. Electric pulp testing and thermal testing was done to check the pulpal status of the teeth. This was followed by atraumatic extraction, and the teeth were sent for histological examination. SPSS Version 21.0. Armonk, NY: IBM Corp.was used for data analysis. Results: There was no pain and sensitivity in using Biodentine. Whereas, sensitivity and pain was noted when Dycal was used. The dentinal bridge was better with Biodentine when compared with Dycal. Conclusion: In accordance with the obtained results, it was concluded that on clinical and histological evaluation, Biodentine performed better as DPC agent. Subsequently, Biodentine is more dependable for the long-haul protection of dental pulp than Dycal.

A male patient aged 28 years presented with a chief complaint of discolored left central incisor and missing tooth, due to road traffic accident 15 years ago with no associated symptoms. Clinical and radiographic examination revealed no pulp to response to vitality test, large periapical radiolucency, and root resorption of the middle third of the root. A definite diagnosis of pulpal necrosis with asymptomatic apical periodontitis and external resorption was made. Root canal treatment was done, and the extent of the lesion was analyzed and planned for surgical management. The periapical lesion was curetted, and the external resorption site was sealed with a matrix of Biodentine and platelet-rich fibrin. The case has shown successful healing after 3-year follow-up.

Aim: The aim of the study is to evaluate and compare the apical seal obtained with Biodentine after conditioning of root end with three different solutions (HEBP, chitosan, and ethylenediaminetetraacetic acid [EDTA]). Materials and Method: Forty-eight maxillary incisors were selected and decoronated. Instrumentation was done with protaper rotary files up to F4 file and obturated with AH plus sealer (Dentsply, Germany) and Protaper gutta-percha cone using lateral condensation technique. The apical part of each root was resected at 90° to the long axis of the root for 3 mm, and retrograde cavity preparation was done in standardized dimensions. The teeth were randomly divided into four groups with 12 samples in each group and later subjected to a standard regimen of 3 ml of respective solutions for 5 min: Group I – 18% HEBP, Group II – 0.2% chitosan, Group III – 17% EDTA, Group IV – saline (control). All teeth were then restored with Biodentine (Septodont, USA). Samples were coated with two coats of nail varnish except in the apical 3 mm which will be immersed in 5 ml of 2% methylene blue dye and stored in incubator for 72 h. The nail varnish will be removed later, and the teeth will be immersed in 35% nitric acid for 72 h. The solutions were then filtered using a fine-grit filter paper and centrifuged at 2000 rpm for 1 min. The solutions thus collected will be used to determine absorbency in ultraviolet-visible spectrophotometer. Results: The mean values of absorbance were greatest for Group IV (saline) followed by Group III (17% EDTA), Group II (0.2% chitosan), and Group I (18% HEBP). Group IV (saline) and Group III (17% EDTA) have got statistically significant difference with all the other groups. Group II has got statistically significant difference with all the other groups except Group I. Conclusion: Within the limitations of the study, it was concluded that irrigation with newer agents significantly influenced the sealing ability of biodentine. Root-end irrigation with 18% HEBP and 0.2% chitosan showed the least microleakage when compared to 17% EDTA.

Aim: The objective of the study was to compare the effect of different irrigation regimes on push out bond strength of calcium silicate cements – Biodentine and mineral trioxide aggregate (MTA). Materials and Methods: Forty-eight human teeth with single root canals were divided into three groups according to irrigation regimes. Each canal was irrigated with 5 ml of each irrigant during and after biomechanical preparation as follows: 3% sodium hypochlorite (NaOCl) and 17% ethylenediaminetetraacetic acid; 3% NaOCl during and Q mix 2 in 1 after instrumentation and distil water as the control group. Canals were filled with biodentine and MTA accordingly. A horizontal middle root section of 1.5-mm thickness was taken, and analysis was done under the universal testing machine. Statistical Analysis Used: The statistical analysis was done by the one-way analysis of variance and post hoc Tukey test. The comparative analysis was done by using the independent t-test. Results: The push-out bond strength of 3% NaOCl + Q mix 2 in 1 was highest. The least was of the control group. Conclusion: The irrigation regimes have a differential effect on root canal sealers.

Background: Perforations can occur during any endodontic procedure which may affect prognosis if not repaired immediately. During perforation repair, various irrigating solutions were used which may affect the bond strength of repair materials. Methods: In this study, sixty dentin slices of 2 mm thickness were prepared with lumen 1.3 mm. Samples were divided into two groups. Biodentine and EndoSequence Root Repair Material (RRM) were placed in the respective samples and incubated for 24 h. Subdivision of groups into three was done: control, 17% ethylenediaminetetraacetic acid (EDTA), and QMix. Immersion was done for 30 min, followed by incubation for 48 h. The samples were then tested for compressive strength through a push-out test. The mean, standard deviation, median, and range of bond strength of EndoSequence Bioceramic RRM and Biodentine were obtained. One-way analysis of variance was used to determine the statistical significance of difference in the mean push-out strengths of each material across decalcifying agents. Paired analysis of push-out strength between decalcifying agents for each material was performed using Tukey's post hoc test. All the analyses were performed using R-3.0.0 programming language, and the statistical confidence was tested at 95%. Results: Results showed that EndoSequence RRM had superior bond strength than Biodentine. 17% EDTA and QMix showed negative influence on the bond strength. However, QMix samples had more bond strength than 17% EDTA. Conclusion: QMix showed less negative influence than EDTA on Biodentine and EndoSequence RRM.

Treatment of open apex cases with biodentine is promising over calcium hydroxide and alternative materials. The present case illustrates the successful management of teeth 11 and 21 with failed root canal treatment which was done so many years back with wide open apex. The apex of the tooth was sealed with biodentine to act as an apical barrier and to provide a platform for obturation, following canal cleaning with sodium hypochlorite and minimal biomechanical preparation. Intracanal medicament, calcium hydroxide was placed in both the tooth. Hand pluggers were used to compact biodentine to form an apical plug of adequate thickness. Thermoplasticized gutta percha was back filled or obturated in the remaining part of the radicular canal. One year follow-up revealed that the tooth was asymptomatic clinically as well as radiographically with the signs of healing and healing of periapical radiolucency supported the successful outcome results in the present case.

Aim and Objectives: This study sought to evaluate and compare the fractured resistance of simulated immature teeth and the effect of single visit apexification versus complete obturation using MTA and biodentine. Material and Methodology: Forty-five freshly extracted sound maxillary central incisors with single canal were selected. The apical 5 mm of each sample was then sectioned to simulate Cvek's stage 3 root development access cavity preparation, followed by preparation using peeso reamers. Irrigation was carried out followed by randomization of samples. Obturation was performed using different materials. Fracture resistance was checked under universal testing machine, by recording the ultimate load to fracture in Newtons. Statistical Analysis: Statistical analysis was performed using SPSS 20.0 Software. One-way analysis of variance followed by pair wise comparison of the groups was performed using Tukey's post-hoc test. The significance level was set at P < 0.05. Results: All the experimental groups showed statistically higher value of fracture resistance than the control groups. Group I (entire canal obturated with MTA) reported highest value of fracture resistance followed by group III (entire canal obturated with biodentine), group II, and group IV. Conclusion: In apexification cases, reinforcing the immature teeth with bioceramic materials such as MTA and biodentine is advantageous. Clinical Significance: Clinically in patients, high success rate of apexification can be achieved with complete MTA obturation as compared to MTA and biodentine apical plug and gutta percha obturation.

Background: The aim of this study was to evaluate the microleakage of apical plugs made of four different materials in simulated immature teeth. Materials and Methods: Ninety extracted single-rooted teeth were selected and randomly divided into six groups according to the materials used: NeoMTA, EndoSequence Bioceramic Root Repair Material Fast Set Putty (BC RRM-FS), Biodentine, Endo Repair, negative control, and positive control group. Microleakage was evaluated by using a stereomicroscope to assess the penetration of methylene blue solution. Data were analyzed using descriptive statistics and Pearson's Chi-square test (P

Purpose: The purpose of this study was to evaluate the sealing ability and microleakage of Biodentine and mineral trioxide aggregate (MTA) Repair HP as furcal perforation repair materials. Materials and Methods: Twenty permanent mandibular molars were divided for ten samples each in Group I – Biodentine and Group II – MTA Repair HP. After access cavity preparation, artificial perforation was created and sealed with the repair material. Specimens were suspended in 2% methylene blue dye for 24 h and then split into longitudinal sections. After examining the depth of dye penetration under stereomicroscope, microleakage was calculated. Results: A higher mean microleakage was recorded in MTA Repair HP as compared to Biodentine. Conclusion: The study showed that Biodentine shows maximum sealing ability and least microleakage when compared with MTA Repair HP.

Aim: The purpose of this in-vitro study was to compare and evaluate the best sealing ability of five different root end filling materials i.e. Silver Amalgam, RMGIC, Cermet Cement, MTA Angelus and Biodentine using ConFocal Laser Scanning Microscope. Methods and Material: 90 extracted caries free, maxillary incisor teeth were collected and were root canal treated using standardized technique. Apical root resections followed by retrograde cavity preparation were done with ultrasonic retrotip. The teeth were divided into six groups depending upon different root end filling materials (Amalgam, RMGIC, Cermet cement, MTA, Biodentine) and one control group and apical leakage was observed under confocal laser scanning microscope. Statistical Analysis Used: The data was analyzed by ANOVA and Post Hoc test. Results: The mean dye penetration of different groups were Group I (Control Group) 0.00±(0.00) mm, Group II (Silver amalgam) 3.00±(0.00) mm, Group III (RMGIC) 1.84±(0.26) mm, Group IV (Cermet cement) 1.83 (0.25) mm, Group V (MTA) 1.25±(0.12) mm, Group VI (Biodentine) 0.26±(0.21) mm. Conclusion: It was concluded that Biodentine exhibits best sealing ability followed by mineral trioxide aggregate, followed by Cermet Cement and RMGIC, whereas silver amalgam exhibited least sealing ability.

Background: Apical plug formation by mineral trioxide aggregate (MTA), Biodentine, and EndoSequence root repair material (RRM) is an excellent alternative technique to the conventional apexification procedure. Several antimicrobial agents have been incorporated in MTA and Biodentine to boost their antimicrobial efficacy. Considering the polymicrobial nature of root canal infection, a combination of potent antimicrobials like triple antibiotic powder (TAP) would be needed to address the diverse flora encountered. Calcium release is the consequential factor in the clinical excellence of these cements. Aim: The aim of the study was to evaluate and compare the calcium released from the apical plugs formed by MTA, Biodentine, and EndoSequence RRM with and without incorporation of 2% TAP. Methods: Ninety single-rooted teeth were divided into (n = 15) Group A: MTA + 2% TAP, Group B: MTA, Group C: Biodentine + 2% TAP, Group D: Biodentine, Group E: EndoSequence RRM + 2% TAP, and Group F: EndoSequence RRM to form the 4 mm apical plugs. Each sample tooth was then immersed in 10 ml of deionized water. Evaluation of calcium release was done on days 7, 15, and 30 using an atomic absorption spectrophotometer. Data were analyzed using one-way analysis of variance, post hoc test, and unpaired t-test. Results: Calcium released was maximum for Group E compared to Group F (P < 0.05), maximum for Group C compared to Group D, and was maximum for Group A compared to Group B (P < 0.05) at days 7, 15 and 30. Conclusion: Incorporation of 2% TAP resulted in increased calcium ions released from MTA, Biodentine, and EndoSequence RRM.

Introduction: Coronal microleakage holds importance among various causes of failure after endodontic treatment leading to infection in the periradicular, periodontal ligament, or supporting osseous structures. Loss of coronal seal may occur due to leakage of temporary filling material or fracture of the permanent restoration. Therefore, the use of an intraorifice barrier material would be advantageous in reducing leakage and increasing possibilities for success. Materials and Methods: Fifty single-rooted mandibular premolars were decoronated, cleaned, shaped, and obturated. Gutta-percha was removed to the depth of 3 mm from the orifice. Ten specimens each were sealed with Cention N (Ivoclar Vivadent), Biodentine (Septodont), and glass-ionomer cement (GIC, GC9 high-strength posterior restoration) along with positive and negative control groups, respectively. The teeth were then submerged in dye. Specimens were longitudinally sectioned, and leakage was measured using ×10 stereomicroscope and graded for the depth of microleakage. Results: The samples were subjected to statistical analysis using one-way ANOVA and post hoc Tukey's test and showed that mean microleakage values in all the groups were significantly different from each other (P < 0.001) with the lowest microleakage in Biodentine followed by GIC and Cention N and highest in positive control group. No microleakage was seen in negative control group. Conclusion: The present study concluded that intraorifice barrier placement provides better coronal seal, prevents microleakage, and enhances the longevity of postobturation restorations. Biodentine proved to be the best followed by GIC, Cention N, and control groups.

Invasive cervical resorption (ICR) is an aggressive form of tooth resorption that is not well understood. Accurate diagnosis and early management are prerequisites for long-term retention of the tooth. Treatment procedure includes eliminating the resorptive tissue followed by restoring the defect with a suitable biocompatible material. This case report is on successful management of an ICR lesion; inaccessible to the conventional procedure; by root canal treatment and intentional replantation (IR) of the tooth for complete debridement and sealing of resorptive site with biodentine. At 18-month recall, the tooth was clinically sound with no radiographic evidence of inflammatory or replacement root resorption. Thus, IR should be considered as a viable treatment option.

Open apices are a constant challenge to an endodontist. The one-step apexification technique in which an apical barrier is placed to achieve an adequate apical stop has become a popular procedure nowadays. This case series describes eight clinical cases with immature necrosed pulp which were subjected to one-step apexification procedure using different materials and techniques. The materials used varied from mineral trioxide aggregate (MTA) with hydroxyapatite (matrix), biodentine with hydroxyapatite (matrix), MTA alone, tailor-made gutta-percha with platelet-rich fibrin (matrix), and gutta-percha alone. All the cases were successful regarding the resolution of symptoms and periapical healing concluding that one-step apexification has successfully replaced the traditional methods of apexification. No matter what barrier is used or matrix is placed or not, healing takes place if the procedure is followed carefully using recommended protocols.

Background: The advancement in the dentin regeneration aiming at the preservation of pulpal vitality has challenged the traditional concept of substituting diseased tooth with inert materials. Clinical studies, demonstrating preservation of pulpal vitality with the use of biomimetic materials in deep carious lesions, are lacking in the literature. Objective: This clinical study aims to assess the treatment outcome of vital pulp therapy using Biodentine in cases of deep carious lesion in a single visit treatment protocol. Methodology: Twelve posterior teeth with deep carious lesion with no signs of irreversible pulpitis were selected for the study. After rubber dam application, excavation of caries was performed until all infected dentin was removed leaving behind affected dentine. Biodentine was applied followed by immediate restoration with bonded composite resin. The patient was recalled at time intervals of 1 day, 1 month, 3 months, 6 months and up to 1 year for clinical and radiographic evaluation. Outcome was described in terms of success and failure. Success was defined as clinical absence of signs and symptoms, response to sensibility test on every recall visits, no tooth discoloration seen, and radiographical absence of periapical pathosis. Results: All the 12 patients were recalled at the end of 1 year for follow-up. The overall success rate was 83.4%. Two of the twelve cases required root canal treatment to relieve painful pulpitis. On clinical and radiographic examination, no signs of periapical pathosis were noted in the 10 successful cases. Conclusion: In deep carious lesions, vital pulp therapy with Biodentine has proven to maintain the pulpal vitality in permanent teeth with single visit treatment protocol.

Background: This study clinically and histologically compared the human pulp response to direct pulp capping (DPC) with mineral trioxide aggregate (MTA), Biodentine, and propolis in 2 months. Materials and Methods: In this clinical trial evaluated 41 premolars candidate for extraction due to orthodontic purposes of patients between 15 and 25 years of age. A group of 5 was separated randomly as the negative control. The remaining teeth were randomly divided into three experimental groups of 12 after mechanical exposure of the pulp by bur in high-speed handpiece under air and water spray. The exposed areas were capped with MTA, Biodentine, or propolis. Glass ionomer was applied as base over the cap. The teeth were restored with composite resin. Patients were recalled in 2 months for clinical and radiographic examinations and also pulp vitality test. Teeth were then extracted. Slides were prepared and tissue sections were evaluated for the presence and severity of inflammation, dentinal bridge, and continuity. Data were analyzed using the Chi-square and Fisher's exact tests. Results: The clinical success rate was 100% in the MTA and 91.7% in both the propolis and Biodentine groups. The presence and severity of pulpal inflammation and dentinal bridge formation were similar in all the experimental groups (P > 0.05). Dentinal bridge formation was similar in the MTA and Biodentine groups and was higher than in the propolis group. Continuation of dentinal bridge in the MTA group was significantly higher than that in the Biodentine and propolis groups (P < 0.05). Conclusion: MTA, Biodentine, and propolis are equally effective for DPC.

Background: To compare and evaluate the strength rendering capacity of three restorative materials in tooth model simulated as immature teeth. Materials and Methods: In this in vitro study, 80 human maxillary permanent central incisors scheduled for periodontal extraction were collected, and an immature tooth model was prepared using a 3 mm twist drill. To simulate single-visit apical barrier, all the teeth were prepared with peso number 1–6. The teeth were segregated into three experimental and a control group. The experimental groups (n = 20) comprised of fiber-reinforced composite (FRC), Biodentine, and glass ionomer cement. The fracture resistance of all the teeth was tested using universal testing machine. The final reading of the applied load to cause fracture was noted and later was subjected to statistical analysis, P ≤ 0.05 was considered statistically significant, and the level of significance was fixed at 5%. Student's t-test was applied to compare values among experimental groups Results: There was a significant difference in the values of peak load resulting in fracture among experimental groups which was observed statistically (P ≤ 0.001). FRC exhibited superior reinforcing capacity (mean: 1199.7 N) among the experimental materials followed by Biodentine and Bioglass R. The lowest value to fracture was observed in control group (mean: 236.7 N). Conclusion: The results indicate that FRC could substantially contribute positively in reinforcing the simulated thin-walled immature roots.

Introduction: The purpose of the present study was to evaluate the short-term clinical outcomes of pulp capping using mineral trioxide aggregate (MTA) Angelus (Angelus Londrina, PR, Brazil) or Biodentine (Septodont, Saint Maur des Fosses, France) as capping materials in a prospective randomized controlled study. Subjects and Methods: A total of 50 teeth were confirmed to eligible for pulp capping randomly assigned into either the MTA Angelus or the Biodentine Group (25 teeth per group). Direct\indirect pulp capping was performed using these two materials, and clinical and radiographical evaluations were performed at 0, 3, and 6 months after the treatments. Teeth with no response to pulp vitality test and those exhibiting clinical or radiographic signs and/or symptoms of irreversible pulpitis or pulp necrosis were considered to be failures. Results: Forty-five patients (47 teeth) were examined at the 6-month follow-up (patient recall rate = 92%); 23 of these teeth were in the MTA Angelus group, and 24 were in the Biodentine group. The overall success rate was 93%, and the success rates in the MTA Angelus and Biodentine groups were 95.5% (21/23 teeth) and 96% (23/24 teeth), respectively. Statistical analyses of these success rates did not reveal any significant difference between the groups. Conclusions: In this randomized controlled study, no significant difference in the short-term clinical outcomes of direct\indirect pulp capping using MTA Angelus or Biodentine as the capping material was found.

Aim: The aim is to evaluate the obturating potential of thermoplasticized gutta-percha, mineral trioxide aggregate (MTA), and Biodentine in simulated internal resorption cavities. Materials and Methods: Thirty human extracted teeth with single canal and mature apex were collected for the study. Access cavity was prepared in each. For all the teeth, standardized instrumentation was done to apical size of ISO #50 K stainless steel hand file. Following instrumentation, at the length of 6 mm short of working length, internal resorption cavity was simulated using Gates–Glidden drill, as the canal of the selected teeth was wide enough and thus widening of the canal occurred only at the desired working length. The teeth were radiographed to check internal resorption cavity. The teeth were randomly divided into three groups; ten teeth in each group. Samples were obturated as follows: Group 1 – thermoplasticized gutta-percha, Group 2 – MTA, and Group 3 – Biodentine. Samples were stored at room temperature for 48 h. After 48 h, samples were evaluated radiographically and microscopically using Dental Operating Microscope. Statistical analysis of the results was performed using Kruskal–Wallis test. Results: Results obtained were statistically significant. Conclusion: MTA and Biodentine showed better sealing than thermoplasticized gutta-percha.

Background: A furcation perforation is mid-curvature opening into periodontal ligament space which is a worst possible outcome in root canal treatment. Perforations should immediately be repaired with a biocompatible material to seal the communication between perforation site and gingival sulcus. Aim: The aim of this study was to evaluate the push-out bond strength of glass ionomer cement, hydroxyapatite, mineral trioxide aggregate, and biodentine (BD) when used in repairing furcal perforations with and without blood contamination in permanent molars. Materials and Methods: A total of 120 human extracted molars were collected and divided on the basis of perforation repair materials and blood contamination status (n = 15). All the materials were subjected to universal testing machine to a load cell from 0 N to 100 KN at a crosshead speed of 1 mm/min. Statistical Analysis: The data obtained were subjected to statistical analysis using SPSS version 20.0. Results and Conclusion: The push-out bond strength was maximum in BD contaminated with blood and least for the hydroxyapatite contaminated with blood. A significant difference was found between all the perforation repair materials.

Introduction: Treatment of mechanical exposure of the pulp during caries excavation presents a clinical challenge. In this case series of 15 patients, with a follow-up period of over a year, the outcome of direct pulp capping with Biodentine (septodont) after mechanical pulp exposure was assessed. Aim of Study: The aim of this study is to evaluate the outcome of direct pulp capping with Biodentine in deeply carious teeth when pulp was mechanically exposed during caries excavation and cavity preparation. Vital pulps exposed during caries excavation in molar teeth were treated with 3% sodium hypochlorite for 2 min. If adequate hemostasis was achieved, the pulp tissue was capped with Biodentine, which covered the entire pulpal floor. This was followed by the placement of a layer of resin-modified glass ionomer cement and a final layer of composite resin (Filtek Z350-3M) to complete the restoration. The patients were recalled periodically and evaluated for any evidence of pulpal/periapical pathology. Results: In the follow-up period that ranged from 12 to 24 months, all teeth were asymptomatic. Conclusion: Biodentine appears to be a suitable material for direct pulp capping under clinical conditions. However, long-term follow-up studies and controlled trials involving a large sample size are warranted.

Aim: To evaluate the effect of 17% ethylenediaminetetraacetic acid (EDTA) and 7% maleic acid (MA) irrigation on microleakage of mineral trioxide aggregate (MTA) and Biodentine® (BD) when used as a root-end filling material. Materials and Methods: Sixty human anterior teeth were decoronated and subjected to root canal instrumentation. 3 mm of apical root portion was resected, and root-end cavities were prepared using ultrasonic tips. Teeth were then randomly divided into two groups (n = 30). Group 1 - root end cavity to be filled with MTA; Group 2 - root end cavity to be filled with BD. Each group was further divided into three subgroups A, B, and C based on irrigation regimen. Group A - 17% EDTA; Group B - 7% MA; Group C - 0.9% saline. About 5 mL of all irrigating solutions were used for 1 min. After final irrigation, root-end cavities were filled with respective root end filling material. Specimens were then subjected to microleakage analysis at 24 h, 7 days and 14 days using glucose filtration technique. For smear layer evaluation, six central incisors were subjected to root canal instrumentation and irrigation with 7% MA and 17% EDTA. Then, these samples were analyzed under the standard error of the mean data was analyzed using one-way ANOVA, Bonferroni test, Mann–Whitney U-test and Kruskal–Wallis test. Results: Saline group demonstrated significant higher leakage than that of 17% EDTA and 7% MA in both MTA and BD groups. However, there was no significant difference between 17% EDTA and 7% MA group when MTA was used as root-end filling material. In BD group, 17% EDTA showed more leakage than 7% MA. 7% MA was able to remove the smear layer better than 17% EDTA. Conclusion: MTA had a better sealing ability as compared to that of BD when root-end cavities were irrigated with 7% MA.

Aim: This study aims to evaluate and compare the antibacterial potential of biodentine and mineral trioxide aggregate (MTA) cement against Streptococcus mutans and Enterococcus faecalis. Materials and Methods: Biodentine and MTA were used to assess the antibacterial efficacy against S. mutans and E. faecalis., using the agar well diffusion test. Agar plates were incubated at 37°C for 24 h in an incubator. The diameter of bacterial inhibition zones around each well was measured to the nearest size in mm with a digital caliper. Results: Inhibition zones formed by Biodentine against S. mutans and E. faecalis were significantly larger than the zones formed by MTA (P < 0.05). Conclusion: From the present study, it can be concluded that Biodentine and MTA have antimicrobial activity against S. mutans and E. faecalis, but higher mean zone of inhibition was recorded in biodentine.

Apexification is the process of induction of calcific barrier across the open apex or the continued apical development in an immature tooth with infected necrotic pulp. The presented case was of a 19-year-old male patient with discolored and fractured upper front left tooth and open apex. Immature permanent teeth pose difficulties during endodontic treatment because of the wide-open root apex and thin dentin walls. This article describes single-visit apexification using Biodentine, a new calcium silicate-based material as an apical barrier along with platelet-rich fibrin as internal matrix.

To describe the management of endodontic-periodontal lesion attributable to palatogingival groove extending from crown to root surface, contributing to severe periodontal breakdown in relation to maxillary central incisor. Palatogingival groove may act as a nidus of plaque accumulation and contribute to the pathogenesis of endodontic-periodontal lesions. The management of such lesions requires an integrated interdisciplinary approach with careful application of endodontic and periodontal surgical procedures. In the present case, the patient presented with advanced bone loss and negative pulpal response in relation to left maxillary central incisor. The etiology of such isolated periodontal lesion could be attributed to palatogingival groove as there was no history of endodontic pathology or trauma. The treatment plan included endodontic treatment followed by surgical exploration, elimination, and sealing of palatogingival groove using biodentine.

Background: This study assessed the antimicrobial activity of Biodentine, mineral trioxide aggregate (MTA), and calcium-enriched mixture (CEM) cement against Enterococcus faecalis, Streptococcus mutans , and Candida albicans. Materials and Methods: In this in vitro study, microbial suspensions were inoculated onto agar plates. The antimicrobial effects of MTA, Biodentine and CEM cement were assessed against E. faecalis, S. mutans, and C. albicans by the agar diffusion test. In each experimental group, 7 plates containing 3 wells were prepared and immediately filled with freshly mixed cements. Positive and negative control plates were prepared with/without the bacterial suspension, respectively. After 2 h of preincubation at room temperature, the plates were incubated at 37°C for 24 h. The diameter of growth inhibition zones was measured after 24 h. Data were analyzed using ANOVA and Tukey's test (α = 0.05). Results: Biodentine showed strong antimicrobial activity against all three microorganisms with an average inhibition zone of 9.10 mm. The inhibitory effect of Biodentine on E. faecalis and C. albicans was significantly superior to that of the other two cements (P < 0.05). MTA and CEM cement showed significantly higher antimicrobial activity against S. mutans (P < 0.05). The antimicrobial effects of Biodentine on S. mutans and E. faecalis were significantly greater than on C. albicans (P < 0.05). Conclusion: All cements revealed antimicrobial properties against the tested microbial strains. Biodentine had stronger antimicrobial effects against E. faecalis and C. albicans compared with MTA and CEM cement. Furthermore, the largest inhibition zones around all three cements belonged to S. mutans.

Aim: To evaluate the fracture resistance in simulated immature teeth that had been backfilled using composite resin and Biodentine after using Biodentine as an apical plug material immediately and after 3 months of aging. Materials and Methods: Sixty extracted human maxillary central incisors were simulated in an immature open apex. The roots of all the specimens were then standardized to a length of 10 mm and canals were instrumented to obtain the radicular dentin thickness around 1.5 mm. All the specimens were then randomly divided into three groups of twenty teeth each. Group I (control) - 4 mm apical plug of Biodentine backfilled with thermoplasticized gutta-percha. Group II - 4 mm apical plug of Biodentine and then backfilled with ParaCore. Group III - completely filled with Biodentine. Ten samples from each group were randomly divided into two subgroups. In subgroup A: Specimens were stored for 1 week. In subgroup B: Specimens were stored in phosphate-buffered saline solution for 3 months and were subjected to universal testing machine. Statistical analysis was done using one-way analysis. Results: No significant difference in fracture resistance between the groups was observed when tested immediately. After 3 months of aging, only Biodentine group showed a significant reduction in fracture resistance without significant reduction with other two groups. Conclusion: Biodentine group has shown a drastic reduction in fracture resistance after 3 months of aging, and hence cannot be recommended as a reinforcement material in immature teeth with thin dentin walls.

Background: One of the unfavorable outcomes of endodontic treatment in primary molars is furcal perforation. During treatment, bacterial infection at the site of perforation should be prevented for better prognosis. Aim: This study aims to compare sealing ability of mineral trioxide aggregate (MTA) Plus™ and Biodentine™ for the repair of furcal perforation in primary molars using spectrophotometry. Materials and Methods: Access opening was done for all ninety extracted teeth. Perforation was made in furcation area in all the teeth. The sample size consisted of ninety extracted teeth. They were divided into four groups, Group 1 (n = 30) in which perforations were repaired with MTA Plus™, Group 2 (n = 30) in which perforations were repaired with Biodentine™. The other two groups were considered as control groups, Group 3 (n = 15) in which perforations were left unsealed (positive control) and Group 4 (n = 15) without perforations (negative control). Dye extraction method was used to compare the sealing ability of MTA Plus™ and Biodentine™. Statistical analysis was done using ANOVA test to compare the mean between the different groups. Intergroup comparison was performed using post hoc Scheffe test. Results: The highest dye absorbance was seen in the positive control group with a mean value of 0.080 ± 0.033. The mean value of MTA Plus™ was 0.031 ± 0.026 and Biodentine™ was 0.024 ± 0.031. Conclusion: The mean value of dye absorption of MTA Plus™ was greater than Biodentine™ but it was statistically insignificant.

Background: Search for a root-end filling material fulfilling all the ideal characteristics is an ongoing process. The present study aimed to evaluate the marginal seal of the following materials when used as root-end filling materials, MTA Angelus, White ProRoot MTA, Biodentine and Glass ionomer cement (GIC). Materials and Methods: Sixty single-rooted maxillary central incisors were included in the study. The crowns were resected followed by cleaning and shaping with hand files and protaper rotary files followed by obturation of the roots. The root ends were resected at 3 mm level. Then, root-end cavity preparation of 3 mm depth was done using ultrasonic tips. The samples were randomly divided into four groups of 15 each and cavities restored with, such as (1) Group 1: MTA Angelus, (2) Group 2: ProRoot MTA, (3) Group 3: Biodentine, and (4) Group 4: GIC. The root samples were coated with two coats of nail varnish and immersed in methylene blue dye 2% for 48 h. Longitudinal root resection was done. The depth of dye penetration was evaluated under the stereomicroscope to examine the extent of microleakage. The amount of dye penetration was measured in millimeters. The results were then statistically analyzed using one-way analysis of variance and post-hoc Tukey′s test. Conclusion: Microleakage was present in all the samples. Least amount of apical dye microleakage was seen in biodentine with mean value of 0.16 mm followed by ProRoot MTA 0.68 mm, MTA Angelus 0.74 mm, and GIC 1.53 mm. The best sealing ability was seen in biodentine, and this difference was statistically significant.

The presence of foreign objects in the pulp chamber of fractured permanent teeth is a rare phenomenon and often diagnosed accidently .These foreign bodies are most commonly self inflicted by young patients and remain impacted within the pulp canal thereby acting as potential source of infection and painful conditions1. In the present case report, we present successful endodontic management of stapler pin lodged in fractured maxillary central incisor with challenge of open apex in young patient using biodentine as a novel apical matrix.

Resorption of tooth structures can occur as a result of physiological, pathological, and idiopathic factors. Early diagnosis and appropriate treatment can prevent its serious complications. This case report presents surgical endodontic management of a trauma-induced perforating external root resorption, which was diagnosed with the help of cone beam computed tomography. Following root canal treatment, intentional replantation of the tooth was performed so as to expose the opening of the resorption defect to allow for complete debridement and closure. Eighteen months follow-up showed arrest of root resorption, and progressive healing of the defect.

Biodentine TM , a calcium silicate based material has been popular now and can be used as an alternative to mineral trioxide aggregate (MTA) due to superior physical and biologic properties. It has been known by several terms as Biodentine, dentin substitute, and RD 94. It has varied clinical applications such as apexification, apexogenesis, pulpotomy, internal resorption, root perforation repair, retrograde filling, pulp capping procedure, and dentin replacement. This article describes the clinical case reports using Biodentine in apexification, apexogenesis, pulpotomy, and root perforation repair.

Background: Class ll sandwich restorations are routinely performed where conventional Glass ionomer cement (GIC) or Resin-modified GIC (RMGIC) is used as a base or dentin substitute and a light curing composite resin restorative material is used as an enamel substitute. Various authors have evaluated the microleakage of composite resin restorations where glass ionomer cement has been used as a base in class II sandwich restorations, but a literature survey reveals limited studies on the microleakage analysis of similar restorations with biodentine as a dentin substitute, as an alternative to glass ionomer cement. The aim of this study is: To evaluate the marginal sealing efficacy of a new calcium-silicate-based material (Biodentine) as a dentin substitute, at the cervical margins, in posterior class II sandwich restorations.To compare and evaluate the microleakage at the biodentine/composite interface with the microleakage at the resin-modified GIC/composite interface, in posterior class II open sandwich restorations. To compare the efficacy between a water-based etch and rinse adhesive (Scotch bond multipurpose) and an acetone-based etch and rinse adhesive (Prime and bond NT), when bonding biodentine to the composite. To evaluate the enamel, dentin, and interfacial microleakage at the composite and biodentine/RMGIC interfaces. Materials and Methods: Fifty class II cavities were prepared on the mesial and distal surfaces of 25 extracted human maxillary third molars, which were randomly divided into five groups of ten cavities each: (G1) Biodentine group, (G2) Fuji II LC GIC group, (G3) Biodentine as a base + prime and bond NT + Tetric N-Ceram composite, (G4) Biodentine + scotchbond multi-purpose + Tetric N-Ceram composite, (G5) Fuji II LC as a base + prime and bond NT+ Tetric-N Ceram composite. The samples were then subjected to thermocycling, 2500× (5°C to 55°C), followed by the dye penetration test. Scores are given from 0 to 3 based on the depth of penetration of the dye at the cervical, dentin, and interfacial surfaces. The data was analyzed with the nonparametric Kruskal-Wallis and Mann Whitney U test. Results: No statistically significant differences were found between the five groups in the enamel, dentin, and interfacial regions. Conclusion: Within the limits of this in vitro study, biodentine is a new calcium-silicate-based material, which can be used as a dentin substitute in class II open-sandwich restorations, where its scores better than resin-modified GIC.

Aim: Endodontic management of open apex using Biodentine as an apical matrix. Summary : An immature tooth with pulpal necrosis and periapical pathology imposes a great difficulty to the endodontist. Endodontic treatment options for such teeth consist of conventional apexification procedure with and without apical barriers. Biodentine™ is new calcium silicate based cement that exhibits physical and chemical properties similar to those described for certain Portland cement derivatives. This article demonstrates the use of the newer material, Biodentine as an apical matrix barrier in root end apexification procedure. This case reports present apexification and successful healing with the use of Biodentine as an apical barrier matrix. Conclusion : Apexification in one step using an apical plug of Biodentine can be considered a predictable treatment and may be an alternative to mineral trioxide aggregate apexification.