International Journal of Applied Dental Sciences 2021; 7(3): 89-92

ISSN Print: 2394-7489

ISSN Online: 2394-7497
IJADS 2021; 7(3): 89-92 An insight into biodentine
© 2021 IJADS
www.oraljournal.com
Received: 13-05-2021 Dr. Rini SJ, Dr. Shinu Lal, Dr. Swathy Sukumaran, Dr. Rajesh Pillai and
Accepted: 15-06-2021
Dr. Afzal A
Dr. Rini SJ
Post Graduate Student,
DOI: https://doi.org/10.22271/oral.2021.v7.i3b.1285
Department of Conservative
Dentistry and Endodontics, Abstract
PMS College of Dental Science Calcium silicate based materials have gained popularity in recent years due to their resemblance to
and Research, Golden Hills, mineral trioxide aggregate (MTA) and their applicability in cases where MTA is indicated. “Biodentine”
Vattappara, Trivandrum, is a calcium silicate based product which became commercially available (Septodont) and that was
Kerala, India specifically designed as a “dentine replacement” material. The material is actually formulated using the
MTA-based cement technology, with the improvement of some material properties. Biodentine™ is a
Dr. Shinu Lal second generation hydraulic calcium silicate material that is composed mainly of tricalcium silicate and it
Post Graduate Student,
also contains zirconium oxide radiopacifier and some additives. It is scientifically engineered for a
Department of Conservative
specific purpose to be used as a dentine replacement material. The enhanced physical and biologic
Dentistry and Endodontics,
PMS College of Dental Science
properties of Biodentine™ could be attributed to the presence of finer particle size, use of zirconium
and Research, Golden Hills, oxide as radiopacifier, purity of tricalcium silicate, absence of dicalcium silicate, and the addition of
Vattappara, Trivandrum, calcium chloride and hydrosoluble polymer. This article is aimed to review the properties of Biodentine
Kerala, India by exploring the research work done in this field so far.

Dr. Swathy Sukumaran Keywords: Biodentine, composition, setting rection, physical and mechanical properties, clinical
Post Graduate Student, applications
Department of Conservative
Dentistry and Endodontics,
1. Introduction
PMS College of Dental Science
and Research, Golden Hills, For many decades since 1928 calcium hydroxide has been standard material for maintaining
Vattappara, Trivandrum, the vitality of pulp since it is capable of stimulating tertiary dentin formation. However it has
Kerala, India some drawbacks like poor bonding to dentin, material resorption. However it has some
drawbacks like poor bonding to dentin, material resorption. Later Mineral Trioxide Aggregate
Dr. Rajesh Pillai
introduced by Torabinejad M, in 1990 is used as a material of choice for all dentinal defects
Professor and HOD, Department
of Conservative Dentistry and due to their biocompatibility & ability to induce calcium phosphate precipitate at interface to
Endodontics, PMS College of periodontium & bone tissue repair. However there exist some drawbacks of this material such
Dental Science and Research, as slow setting kinetics and complicated handling properties [1].
Golden Hills, Vattappara, Calcium silicate based materials have gained popularity in recent years due to their
Trivandrum, Kerala, India resemblance to mineral trioxide aggregate (MTA) and their applicability in cases where MTA
Dr. Afzal A is indicated. Although various calcium silicate based products have been launched to the
Professor, Department of market recently, one of these has especially been the focus of attention and the topic of a
Conservative Dentistry and variety of investigations. This material is the “Biodentine” calcium silicate based product
Endodontics, PMS College of which became commercially available in 2009 and that was specifically designed as a “dentine
Dental Science and Research, replacement” material [2].
Golden Hills, Vattappara,
Trivandrum, Kerala, India
2. Composition
Biodentine™ is presented as powder and liquid. The powder is placed in a capsule while the
Corresponding Author: liquid is in an ampoule. The powder is composed of tricalcium silicate, zirconium oxide,
Dr. Rini SJ calcium carbonate and some minor additives of iron oxide added to give the colour. The liquid
Post Graduate Student,
Department of Conservative is made up of water with some additions of calcium chloride and a water soluble polymer.
Dentistry and Endodontics, Biodentine™ powder and its hydrated materials have been characterised well. The design of
PMS College of Dental Science Biodentine™ ensures optimal properties and thus enhances clinical performance.
and Research, Golden Hills,
Vattappara, Trivandrum, 2.1 Powder [3]
Kerala, India
Tri-calcium silicate- This is the main core material.
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Di-calcium silicate- this is the second core material Calcium Biodentine material is biocompatible. The material was not
carbonate & oxide- it acts as a filler. Iron oxide-it acts as a found to affect the specific functions of the target cells and
colouring agent. Zirconium oxide- it acts as a radioopacifier. thus could safely be used. About et al investigated biodentine
activity by studying the effects on pulp progenitor cells
2.2 Liquid activation, differentiation and dentine regeneration in the
Calcium chloride- it acts as an accelerator. Hydrosoluble human tooth cultures. The study concluded that bio dentine is
polymer- it is a water reducing agent stimulating dentine regeneration by inducing odontoblast
differentiation from pulp progenitor cells. Laurent et al. did
3. Setting reaction further study to investigate the capacity of biodentine to affect
The powder is mixed with the liquid in a capsule in the TGF-ϐ1 secretion from pulp cells and to induce reparative
triturator for 30 seconds. The initial setting time of Biodentine dentine synthesis. Biodentine was applied directly onto the
as indicated by its manufacturer is about 12 min. However, dental pulp in a human tooth culture model, resulting in a
some studies have reported the initial setting time of significant increase of TGF-ϐ1 secretion from pulp cells and
Biodentine to be 6.5 ± 1.7 min [4]. According to the thus inducing an early form of dental pulp mineralization
International Organisation for Standardisation guidelines, ISO shortly after its application. It does not affect human pulp
9917-1:2007, the setting time of Biodentine was assessed as fibroblast functions, expression of collagen1, dentine
15 ± 1 min. Both saliva and blood contamination, increased sialoprotein & Nestin [11-13].
the setting time of Biodentine by 1 ± 6.51 min and
16 ± 8.21 min respectively. While, the blood-contaminated 5. Physical and mechanical properties of Biodentine
group showed a signifcantly longer setting time compared to Biodentine has significantly higher push-out bond strength
the non-contaminated Biodentine group (p 0.05) [5]. than MTA. The push out bond strength of Dyract AP,
The reaction of the powder with the liquid leads to the setting amlgam, IRM and biodentine was not significantly different
and hardening of the cement. The hydration of the tricalcium when immersed in sodium chloride, chlorhexidine and saline
silicate leads to the formation of a hydrated calcium silicate solution whereas MTA has lost its strength when exposed to
gel (CSH gel) and calcium hydroxide [6]. The cement located chlorhexidine. Hence biodentine shows considerable
in inter-grain areas has a high level of calcite (CaCO3 ) performance as a perforation repair material even after being
content. The hydration of the tricalcium silicate is achieved by exposed to various endodontic irrigants [14].
dissolution of tricalcium silicate and precipitation of calcium Concerning the durability of water based cements in the oral
silicate hydrate. In general, it is designated by chemists as C- cavity, one of relevant characteristics of the dental materials is
S-H (C=CaO, S=SiO2, H=H2 O). The calcium hydroxide the resistance to acidic environment. It is known that glass
takes origin from the liquid phase. C-S-H gel layers formation ionomers have a tendency to erode under such conditions. The
is obtained after nucleation and growth on the tricalcium acid erosion and the effects of aging in artificial saliva on the
silicate surface. The unreacted tricalcium silicate grains are Biodentine TM structure and composition were investigated
surrounded by layers of calcium silicate hydrated gel, which by Laurent et al. They concluded that the erosion of
are relatively impermeable to water; thereby slowing down Biodentine TM in acidic solution is limited and lower than for
the effects of further reactions. The C-S-H gel formation is other water based cements (Glass Ionomers). In reconstituted
due to the permanent hydration of the tricalcium silicate, saliva (containing phosphates), no erosion has been observed.
which gradually fills in the spaces between the tricalcium Instead, a crystal deposition on the surface of Biodentine™
silicate grains [7]. occurs, with an apatite-like structure. This deposition process
due to a phosphate rich environment is very encouraging in
4. Characteristics of Biodentine terms of improvement of the interface between Biodentine™
The electrochemical properties of this cement are due to the and natural dentine. The deposition of apatitic structures
solid phase and ion mobility of free ions inside the pores might increase the marginal sealing of the material [15].
filled with the electrolyte. The electrical resistance increases The mechanical adhesion of BiodentineTM cement to dental
when the porosity of the system is reduced. The setting surfaces may result from a physical process of crystal growth
reaction of Biodentine leads to the formation of initial within dentine tubules leading to a micromechanical anchor.
porosities that are gradually filled after several days by new The possible ion exchanges between the cement and dental
crystal compounds. During this final step, the solid phase tissues constitute an alternative hypothesis, or the two
increases and finally reaches a maximum [8]. processes may well combine, eventually contributing to the
Biodentine induces early minerlization by increasing the adhesion of the cement, as it appears at the interface of
secretion of TGF-ϐ1 from pulpal cells after its application. It Biodentine TM - adhesive systems [12, 17].
also acts by odontoblasts stimulation and cell differentiation, The interfacial water tightness is an important parameter of
there by facilitating reactionary and tertiary dentin formation. the functionality and longevity of a restoration. The interface
Recent study results suggested that biodentine is bioactive with dentine and enamel was examined using dye penetration
because it increased OD21 cell proliferation and it can be methodology (silver nitrate), which is one of the most
considered as a suitable material for clinical indications of commonly used assays to assess, in vitro, the interfacial seal,
dentine-pulp complex regeneration [9]. It has antibacterial by measuring the percolation of a dye along the different
properties due to high alkaline pH Biodentine has inhibitory interfaces studied. They concluded that Biodentine ™ has a
effect on the micro organisms. In addition, the alkaline similar behavior in terms of leakage resistance as Fuji II LC at
change leads to the disinfection of surrounding hard and soft the interface with enamel, with dentine and with dentine
tissues [10]. bonding agents. Biodentine TM is then indicated in open
Biodentine preserves pulp vitality and promotes its healing sandwich class II restoration without any preliminary
process. Laurent et al tested a new Ca3SiO5- based material treatment. Biodentineexhibits low penetration at
to evaluate its genotoxicity, cytoxicity and effects on the enamel/dentin interface. Literature reveals that presence of
target cells specific function. The study concluded that the transitional elements namely iron, manganese, copper and
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chromium impart strong color to the material in it oxide through. Relatively easier manipulation, low cost and faster
forms. In the same way, bismuth, heavier element causes setting is the major advantages of this material when
discoloration owing to its yellow oxide [18-20]. compared to MTA. Studies have also proved that its
The compressive strength of BiodentineTM amounts to 10.6 ± compressive and flexural strength are superior to that of
2, 57.1 ± 12 and 72.6 ± 8 MPa after 35 min, 24 h and 28 days, MTA. High biocompatibility and excellent bioactivity further
respectively. The greater strength of BiodentineTM in go in favour of this dental replacement material. Due to lack
comparison to other tricalcium silicate cements is attributed to of long term observational studies, it is difficult to infer
the low water/cement ratio made possible by the water soluble concretely that which material out of MTA and Biodentine is
polymer in the liquid. The physical properties of superior, however, manoeuvrability and economical factors
BiodentineTM such as flexural strength (34 MPa), elastic fall in favour of Biodentine.
modulus (22,000 MPa) and Vickers hardness (60 HV) are
higher than those of MTA but similar to dentine. 8. References
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