Biodentine: from biochemical and bioactive properties to clinical applications

Biodentine is a tricalcium silicate-based material designed as a permanent dentin substitute. It is biocompatible and bioactive material. Its interactions with both hard and soft tissues lead to a marginal sealing preventing marginal leakage and provide protection to the underlying pulp by inducing tertiary dentin synthesis. Unlike other dentin substitutes, Biodentine application does not require any conditioning of the dentin surface and the restoration sealing is provided by micromechanical retention as Biodentine penetrates into the dentin tubules forming tag-like structures. After setting, Biodentine can be cut and reshaped like natural dentin. It can also be bonded with different types of adhesives before finishing the final restoration with composite resin. Published clinical trials, histology of human teeth and clinical cases show that Biodentine has a wide spectrum of clinical applications as a permanent bulk dentin substitute in endodontics, in restorative dentistry, and pediatric dentistry as a possible replacement material of formecresol. This review brings a comprehensive understanding of Biodentine composition, preparation properties and the mechanism of interactions with hard and soft tissues. It explains the scientific mechanisms of the induction of these specific functions and illustrates the scientific basis beyond their clinical successful use. The article provides an overview of Biodentine clinical applications summarizing published clinical trials and reporting published clinical cases with this material in restorative and pediatric dentistry as well as in endodontics.