Management of a large periapical lesion using Biodentine^TMas retrograde restoration with eighteen months evident follow up

Abstract

Injury to anterior teeth is a common event. It requires a treatment approach that assures the complete biologic healing and functional restoration of the tooth or teeth involved. A cystic lesion, which is unable to heal nonsurgically, heals well with surgical intervention and use of mineral trioxide aggregate (MTA) as retrograde filling has been reported in literature. Another material with largely improved handling properties; Biodentine™ (Septodont, St. Maurdes Fossés, France) was introduced in 2011. It is a calcium silicate based material and manufacturers claim that it can be used for crown and root dentin repair treatment, repair of perforations or resorptions, apexification, and root end fillings. This article presents a case report of surgical management of a large cystic lesion using Biodentine™ as retrograde filling material which has not been reported in literature so far. Eighteen months radiographic follow-up exhibited completely healed cystic lesion.

Physicochemical Properties and Dentin Bond Strength of a Tricalcium Silicate-Based Retrograde Material

“…This material was also used as pulp capping material and as reparative material in perforations, internal/external resorptions, apexifications and retrograde fillings (5). Thus, this material exhibited adequate resistance to be placed in regions where mechanical strength is required, like underneath final restorative procedures (6).…”

Management of Open Apex in Maxillary Canine Associated with Large Periapical Cyst: A Case Report

“…The periapical modality for managing failure of conventional orthograde endodontic treatment in case of a large non healing periapical lesion is apical surgery with success rate 86-92%. [2] Kolkate and Pawar conducted a study that compared microleakage of GIC , MTA and Biodentine when used as a retrograde filling material and concluded that Biodentine exhibited the least microleakage. [2] Biodentine powder contains tricalcium silicate, calcium carbonate and dicalcium silicate, zirconium oxide and liquid consist of calcium carbonate in aqueous solution with an admixture of polycarbonate.…”

“…[2] Kolkate and Pawar conducted a study that compared microleakage of GIC , MTA and Biodentine when used as a retrograde filling material and concluded that Biodentine exhibited the least microleakage. [2] Biodentine powder contains tricalcium silicate, calcium carbonate and dicalcium silicate, zirconium oxide and liquid consist of calcium carbonate in aqueous solution with an admixture of polycarbonate. It possess better physical and biological properties in comparison to other tricalcium silicate based cements.…”

“…[1] This colonization of bacteria inside the tooth causes leakage of their products and toxins through the apical foramen resulting in inflammation of periapical tissue thus causing apical periodontitis. [2] A number of chemical mediators of inflammation such as cytokines IL-1a,1b,TNFa,prostaglandins and lipopolysaccharides seem to be related to pathogenesis of periapical lesion. [3] Microbial attack and host response events result in apical granulation tissue that is resorption of periradicular bone and degradation of apical periodontal ligament which may turn into cyst.…”

Rehabilitation of surgically failed anterior teeth using bioactive material and monoblock effect

“…This material has shown promising results with respect to its biocompatibility, mechanical properties, handling characteristics, sealing ability and bioactivity. 10,11 Biodentine with its shorter setting time and potential for increased calcium (Ca) and silicate (Si) uptake in the adjacent root canal dentin similar to MTA would ensure the a monoblock effect with the achievement of an early fluid tight seal. 12 When restoring root canal treated tooth, especially when the remaining root dentine is thin, it is preferable to opt for that radicular post having elastic modulus similar to that of dentin.…”