Restor Dent Endod.  2014 May;39(2):120-125.

Biodentine-a novel dentinal substitute for single visit apexification

• Nayak G
• Hasan MF

Abstract

Use of an apical plug in management of cases with open apices has gained popularity in recent years. Biodentine, a new calcium silicate-based material has recently been introduced as a dentine substitute, whenever original dentine is damaged. This case report describes single visit apexification in a maxillary central incisor with necrotic pulp and open apex using Biodentine as an apical barrier, and a synthetic collagen material as an internal matrix. Following canal cleaning and shaping, calcium hydroxide was placed as an intracanal medicament for 1 mon. This was followed by placement of small piece of absorbable collagen membrane beyond the root apex to serve as matrix. An apical plug of Biodentine of 5 mm thickness was placed against the matrix using pre-fitted hand pluggers. The remainder of canal was back-filled with thermoplasticized gutta-percha and access cavity was restored with composite resin followed by all-ceramic crown. One year follow-up revealed restored aesthetics and function, absence of clinical signs and symptoms, resolution of periapical rarefaction, and a thin layer of calcific tissue formed apical to the Biodentine barrier. The positive clinical outcome in this case is encouraging for the use of Biodentine as an apical plug in single visit apexification procedures.

Keyword

Apexification; Apical barrier; Biodentine; Collagen; Internal matrix

MeSH Terms

Apexification*
Calcium
Calcium Hydroxide
Collagen
Crowns
Dentin*
Esthetics
Follow-Up Studies
Gutta-Percha
Hand
Incisor
Membranes
Calcium
Calcium Hydroxide
Collagen
Gutta-Percha

Figure

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  Figure 1 (a) Preoperative photograph showing Elli's Class IV fracture and discolouration in relation to 21; (b) Postoperative photograph showing tooth restored with an all-ceramic crown.

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  Figure 2 (a) Preoperative radiograph showing tooth 21 with open apices and periapical radiolucency; (b) Working length radiograph; (c) Calcium hydroxide as intracanal medicament; (d) Radiograph confirming the placement of Biodentine apical plug compacted against the barrier material; (e) Backfill performed using thermoplasticized gutta-percha; (f) One year follow-up radiograph showing resolution of periapical rarefaction and a thin layer of calcific tissue formed apical to the Biodentine barrier.

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