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You are reading this because your dentist offers the option of treating your tooth with a new material called Biodentine.
Biodentine differs from other dental materials and can often replace or prevent other more invasive treatments, such as root canal treatment.
Biodentine is mainly made of tricalcium silicate powder, forming a material very similar to natural dentine when mixed and set. At the same time, other dental materials are “fillings” “dentine can remineralise and repair your tooth, even when the pulp has become exposed within the cavity. It has been clinically proven to infiltrate and seal the tiny tubes that link to the nerve and, therefore, can reduce pain immediately (see image). In most cases, your tooth will remain alive and in good condition, thanks to the unique properties of Biodentine.
Biodentine is made in France by Septodont, the World’s leading dental pharmaceutical company. But Biodentine contains no drugs. It is entirely bioactive and biocompatible, which means it works and reacts with your body’s cells. That’s what makes it unique.
Biodentine took many years to develop and finally offers some patients an alternative to root canal treatment. It can potentially keep your tooth alive and enable your dentist to restore it. It’s a better clinical outcome, less involved and at far less expense than would have previously been required.
Your dentist can see significant tooth loss, possibly due to caries. Biodentine will re-seal the pulp, kill off any remaining bacteria and fill the tooth, permanently replacing all your lost dentine. Finally, you will need a layer of hard-wearing composite filling or a crown over the Biodentine to replace the enamel.
Your tooth should settle ultimately, if not immediately, over the next few days. If the pulp/ nerve was inflamed before the treatment, the tooth may remain painful or uncomfortable for up to 10 days. Your dentist will advise on the specifics of your tooth. Please do ask them any questions that you may still have.
Your teeth are covered in a tough outer shell called ‘enamel’, but this can wear away over time, often due to excessive amounts of sugar which react with bacteria in the mouth. This can cause tiny holes in the enamel and is the start of a ‘cavity’ or ‘caries’.
This cavity then exposes the softer dentine underneath. Dentine is more vulnerable to wear from bacteria and acid and has tiny tubes that directly link with the pulp, which houses the nerves of the tooth, causing sensitivity.
If the cavity goes untreated, the decay continues, and the inflammation travels through the pulp, and you get pain – known as “pulpitis”.
This inflammation can even travel down to the bone, resulting in root canal treatment (where your tooth will no longer be vital/alive) or extraction.
Assess pulp vitality by the usual tests.
*1 session recommended
Assess pulp vitality by the usual tests.
Within one week to six months after placement of Biodentine™ XP, prepare the cavity according to the criteria recommended for the selected restorative material.
The remaining Biodentine™ XP material can be considered as sound artificial dentine and permanently left in deep areas of the cavity and in areas adjacent to the pulp chamber.
Biodentine™ XP is compatible with all direct or indirect crown restoration techniques (Inlay/Onlay), and particularly with all types of bonding systems.
*2 sessions recommended
Assess pulp vitality by the usual tests.
In case of non-immediate enamel restoration, a second session will be required.
Patients should be followed according to current recommendations.
*1 or 2 sessions recommended
Assess pulp vitality by the usual tests. In case of clinical signs and symptoms of irreversible pulpitis, pulpotomy is recommended when bleeding can be controlled in 5 minutes.
*2 sessions recommended
Complete root canal treatment at the next visit according to current recommendations.
*3 sessions recommended
At a subsequent visit, if all clinical signs of a successful treatment are present, the possibility of a permanent restoration can be considered.
*2 sessions recommended
1) Isolate the tooth with a rubber dam.
2) Prepare the root canal alternately using suitable endodontic instruments and a solution of sodium hypochlorite.
3) Dry the canal with paper points without totally dehydrating the root canal and use a calcium hydroxide paste for disinfection between visits. Tightly seal the access cavity with a temporary cement to protect the temporary filling.
1) At the next visit (usually after one week) and if no symptoms, place a rubber dam and remove the
temporary crown restoration. Clean the canal alternately using a solution of sodium hypochlorite
and suitable endodontic instruments. Dry the canal with paper points without totally dehydrating the
root canal.
2) After activating the Biodentine™ XP cartridge, use Biodentine™ Mixer to ensure a perfect mix (refer
to the instructions of use)
3) Extrude Biodentine™ XP with Biodentine™ Gun (refer to the instructions of use) on a dental pad. Then,
insert Biodentine™ XP in the perforation area using a suitable instrument.
4) Condense Biodentine™ XP with a plugger.
5) Take an X-ray to check that the material is correctly positioned.
6) Remove excess material and place a temporary filling.
Complete root canal treatment at the next visit according to current recommendations.
*3 sessions recommended
1) Isolate the tooth with a rubber dam.
2) Prepare the root canal alternately using suitable endodontic instruments and a solution of sodium hypochlorite.
3) Dry the canal with paper points without totally dehydrating the root canal and use a calcium hydroxide
paste for disinfection between visits. Tightly seal the access cavity with a temporary cement to protect
the temporary filling.
1) At the next visit (usually after one week) and if no symptoms, place a rubber dam and remove the temporary crown restoration. Clean the canal alternately using a solution of sodium hypochlorite and suitable endodontic instruments. Dry the canal with paper points without totally dehydrating the root canal.
2) After activating the Biodentine™ XP cartridge, use Biodentine™ Mixer to ensure a perfect mix (refer to the instructions of use)
3) Extrude Biodentine™ XP with Biodentine™ Gun (refer to the instructions of use) on a dental pad. Then, insert Biodentine™ XP in the apical area using a suitable instrument.
4) Condense Biodentine™ XP with a plugger.
5) Take an X-ray to check that the material is correctly positioned.
6) Remove excess material and place a temporary filling.
Complete root canal treatment at the next visit according to current recommendations.
*3 sessions recommended
1) Following apical resection, gain access to the operative site following the current recommendations
in endodontic surgery.
2) Using a specific ultrasonic tip, prepare a root-end cavity, 3 to 5 mm deep in the apical portion of the
root canal.
3) Isolate the area. Achieve haemostasis. Dry the cavity with paper points.
4) After activating the Biodentine™ XP cartridge, use Biodentine™ Mixer to ensure a perfect mix (refer
to the instructions of use)
5) Extrude Biodentine™ XP with Biodentine™ Gun (refer to the instructions of use) on a dental pad.
Then, insert Biodentine™ XP in the cavity in the root extremity using a suitable instrument. Condense
Biodentine™ XP with a small plugger.
6) Remove excess material and clean the surface of the root.
7) Take an X-ray to check that the material is correctly positioned then close the area.
*1 session recommended
Assess pulp vitality and apex diameter by the usual tests. Revitalization procedure is indicated for an immature tooth with necrotic pulp.
1) Isolate the tooth with a rubber dam.
2) Remove loose or necrotic pulp tissue using suitable endodontic instruments. Avoid mechanical instrumentation of the root canal walls
3) Irrigate with sodium hypochlorite solution (advised concentration: 1.3 to 3 %, 20 mL, 5 min), use a side-vented needle, and place 2 mm above vital tissue.
4) Irrigate with sterile physiological saline (5 mL) and dry with paper points. Dry with EDTA (advised concentration: 15 – 17 %, 20 mL).
5) Insert a non-discoloring calcium hydroxide product homogenously into the root canal. Instead of calcium hydroxide, a triple antibiotic paste consisting of ciprofloxacin, metronidazole and minocycline can be used.
6) Place the coronal seal directly onto the canal dressing with a minimum thickness.
1) Anesthesia with a local anaesthetic without a vasoconstrictor. Remove the temporary seal.
2) Irrigate with EDTA (advised concentration: 15 – 17 %), use a side-vented needle, place 2 mm above vital tissue. Rinse with sterile physiological saline (5 ml). Remove access liquid with paper points.
3) Induce mechanical bleeding of periapical tissue and rotational movement of an apically pre‑bent file. Allow the canal to fill blood until 2 mm below the gingival margin, and wait for blood clot formation for approximately 15 minutes.
4) After activating the Biodentine™ XP cartridge, use the Biodentine™ Mixer to ensure a perfect mix (refer to the instructions of use)
5) Cut a collagen matrix to a diameter more significant than the coronal part of the root canal and a height of 2 – 3 mm, and place it on top of the blood clot, allowing the matrix to soak with liquid and avoid forming a hollow space.
6) Dispense Biodentine™ XP directly on top of the collagen matrix using Biodentine™ Gun (refer to the instructions of use) in a thin homogenous layer of about 2 mm underneath the cement-enamel junction.
7) Then fill the cavity with Biodentine™ XP.
On the next visit, refresh the cavity walls with a diamond bur or grit blast with aluminium oxide and seal. Complete with the final restoration.
*three sessions recommended