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Pulpotomy in primary teeth using Biodentine™: 18-month follow-up
Case courtesy of Dr. Gloria Saavedra Marbán
Madrid, Spain
In this clinical case study, the clinical and radiographic findings reveal that Biodentine™ exhibits good clinical and radiographic behavior in pulpotomies in primary teeth. However, more long-term randomized controlled clinical trials which support these observations would be desirable.
CASE 1: A 5-year-7-month-old patient
Once the caries lesion was removed
the pulp chamber was dried with a cotton ball, the crown was then cut and adjusted, and the dental pulp was removed.
Root Canal
Appearance of the opening to the root canals once it has clotted.
Biodentine Applied
Image after Biodentine™ has been applied.
X-ray
Right bitewing X-ray after 18 months.
CASE 2: 3-year-9-month-old patient
Appearance of the opening to the root canals after clotting.
Biodentine™ applied to the pulp chamber.
Clinical view of the molar with the cemented crown, after the isolation system was removed.
X-ray taken at the 18-month. Dentin bridge formation can be seen in the mesial root.
”An old and large perforation, with the associated destruction of bone and purulent infection -variables that produce a poor prognosis- can be solved by using a material that performs well in the presence of blood contamination, has good compressive strength and resistance to leakage, is osteo-inductive and offers good adhesion to the dentin in a single cement: Biodentine.
Dr Clara Eugenia Adrada CruzBogotá, Colombia
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“Biodentine offers better bone regeneration properties than MTA, as it releases more calcium ions. This material creates a bond with root dentin that is significantly stronger than that achieved with MTA.”
Dr Clara Eugenia Adrada CruzBogotá, Colombia
Biodentine in the management of complex root perforations
Case courtesy of Dr Clara Eugenia Adrada Cruz
Bogotá, Colombia
The initial setting time is 6 minutes and the final time between 10 and 12 minutes, followed by 2% hypochlorite as an irrigant and sealing the canals by lateral condensation (Fig. 1).
The patient is then referred to the rehabilita-tion specialist for the placement of the core and provisional crown, and a period of 3 months is established to evaluate the evolution and be able to recommend the placement of a porcelain crown.
In the follow-up radiograph at 3 months, 80% bone formation is found at the site of the lesion at the furcation, and in the apical zone of the two roots (Fig. 2).
The patient is absent for a period of 5 years. When he returns for his dental control, radiogra-phically he presents a complete healing of the bone defects caused by the perforation and the apical lesions (Fig. 3).
CASE : Partial pulpotomy on a lower permanent incisor with complicated fracture of the crown and open apex using Biodentine™
Case courtesy of Guzman de Hoyos A.I.
Mexico
Isolation achieved.
Partial pulpotomy
Biodentine™ capsule and liquid.
Biodentine™ setting after 12 minutes.
Tooth was beveled.
GC Premio bond after enamel selective etch.
Picture after light curing: frontal view.
13 Months clinical control.
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Technical Insights
Place Biodentine on the pulp
Proven biocompatibility and bioactivity for vital pulp therapy
- High biocompatibility assessed and evidenced through 15 scientific publications
- Highest amount of calcium and hydroxide ions released upon setting (1)
- Induces thick dentin bridge formation (2) thanks to largest calcium surface concentration compared to similar dental materials (3)
- Shows both osteogenic and angiogenic properties to promote pulp & tissues healing (4)
1. Kurun Aksoy M, Tulga Oz F, Orhan K. Tomographic Evaluation of Reparative Dentin Formation after Direct Pulp Capping with Ca(OH)2, MTA, Biodentine™, and Evaluation of calcium (Ca2+) and hydroxide (OH-) ion diffusion rates of indirect pulp capping materials International Journal of Artificial Organs. 2017
2. Lipski M, Kołecki J, Buczkowska-Radlińska J. Tomographic Evaluation of Reparative Dentin Formation after Direct Pulp Capping with Ca(OH)2, MTA, Biodentine™, and Dentin Bonding System in Human Teeth. Journal of Endodontics. 2015
3. Gong V, França R. Nanoscale chemical surface characterization of four different types of dental pulp-capping materials. Journal of Dentistry. 2017
4. Costa F, Sousa Gomes P, Fernandes MH. Osteogenic and Angiogenic Response to Calcium Silicate-based Endodontic Sealers. Journal of Endodontics. 2016
