Clinical application of calcium silicate-based bioceramics in endodontics

Abstract

Pulp treatment is extremely common in endodontics, with the main purpose of eliminating clinical symptoms and preserving tooth physiological function. However, the effect of dental pulp treatment is closely related to the methods and materials used in the process of treatment. Plenty of studies about calcium silicate-based bioceramics which are widely applied in various endodontic operations have been reported because of their significant biocompatibility and bioactivity. Although most of these materials have superior physical and chemical properties, the differences between them can also have an impact on the success rate of different clinical practices. Therefore, this review is focused on the applications of several common calcium silicate-based bioceramics, including Mineral trioxide aggregate (MTA), Biodentine, Bioaggregate, iRoot BP Plus in usual endodontic treatment, such as dental pulp capping, root perforation repair, regenerative endodontic procedures (REPs), apexification, root-end filling and root canal treatment (RCT). Besides, the efficacy of these bioceramics mentioned above in human trials is also compared, which aims to provide clinical guidance for their clinical application in endodontics.

Platelet rich fibrin and MTA in the treatment of teeth with open apices

“…By introducing platelet-rich fibrin (PRF) [ 7 ], this strong fibrin membrane enriched with platelets and growth factors has become popular in dentistry, especially in endodontic therapy [ 8 – 10 ]. The PRF membrane has been successfully used as an apical barrier for safe MTA or Biodentine placement in previous studies [ 11 , 12 ].…”

Platelet-rich fibrin as an apical barrier for MTA placement in the treatment of teeth with open apices: a pilot study

“…The MTA used for the apical plug is chosen for discoloration of the dental structure, especially for the anterior tooth [ 1 ]. Although calcium silicate-based cement is placed only in the apical third, discoloration of the coronal portion of the tooth should be considered an adverse effect during this procedure [ 27 ]. Modern MTA erases the discoloration of teeth and is a reasonable reason for its use in the clinical setting.…”

“…Modern MTA erases the discoloration of teeth and is a reasonable reason for its use in the clinical setting. The moisture environment required for the setting of the conventional MTA is eliminated in the manipulation of this modern MTA; therefore, the following appointment for treatment completion is unnecessary [ 27 ]. Water is rapidly separated from the PRF membrane; therefore, this substance should be manipulated as soon as possible to establish a parched region, facilitating subsequent MTA placement [ 17 ].…”

“…The discoloration of the aesthetic tooth structure is not considered with respect to the new MTA materials, as is currently the case for Angelus MTA. With improvements in the composition of the material, the new MTA could be used for teeth in both the posterior and anterior Sect [ 27 ].…”

“…After several years of endodontic treatment for periapical lesions with hydroxide calcium, the healing process is normally elongated and unpredictable. Manipulation of the combination of MTA with PRF is a promising means to reduce the treatment process and healing period [ 27 ].…”