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Title Biodentine is an Effective Alternative to Mineral Trioxide Aggregate (MTA) in Pulp Capping and Direct Pulp Capping Procedures
Clinical Question In patients with pulpal exposure who receive pulpotomy or direct pulp capping procedures is Biodentine as effective as Mineral Trioxide Aggregate in stimulating a mineralized tissue bridge?
Clinical Bottom Line Evidence suggests that Biodentine forms a mineralized tissue bridge in pulp capping and pulpotomy procedures at least as effectively as MTA. Advantages of using Biodentine over MTA include ease of handling, ease of mixing, lack of staining, and affordability.
Best Evidence (you may view more info by clicking on the PubMed ID link)
PubMed ID Author / Year Patient Group Study type
(level of evidence)
#1) 23683272Nowicka/201328 intact caries free human molars needing extraction for orthodontic reasonsClinical Trial
Key resultsOn histologic examination there was statistically no significant difference between the response of teeth to Biodentine compared to MTA as a pulp capping material (P>.05).
#2) 25146016De Rossi/201460 premolars of beagle dogsAnimal Study
Key resultsThe mineralized tissue bridge thickness in the Biodentine group (0.9350 ± 0.3876mm) was significantly thicker (P<0.0001) than the MTA group (0.4050 ± 0.3876mm).
#3) 22983409Tran/2012Maxillary molars of 27 ratsAnimal Study
Key resultsFormation of a homogenous dentin bridge was observed in both the Biodentine and MTA pulp capping groups.
Evidence Search biodentine pulp capping AND MTA AND (pulpotomy OR pulp capping) AND bridge
Comments on
The Evidence
Validity: Biodentine is a fairly new material and as such limited research is available. Much of the available research involves animal based studies. However, the animal studies as well as the available human research indicates that the material performs at least as effectively as mineral trioxide aggregate which is currently considered the gold standard for direct pulp capping and pulpotomy procedures. The current evidence is valid but is lacking in strength. Perspective: Further research is indicated to enhance the strength of evidence. However, the current evidence is promising. Many benefits have been shown including Biodentine’s favorable handling properties, ease of mixing, lack of staining, and affordability. These are all benefits over MTA and may help Biodentine emerge as the preferred material for vital pulp therapy.
Applicability The evidence is applicable in any situation where vital pulp therapy (direct pulp capping or pulpotomy) is indicated. Particularly in the esthetic zone where the non-staining benefit of Biodentine is paramount compared to severe discoloration often associated with MTA.
Specialty/Discipline (Endodontics) (General Dentistry) (Pediatric Dentistry) (Restorative Dentistry)
Keywords MTA, Pulp Exposure, Biodentine
ID# 2778
Date of submission: 11/18/2014spacer
E-mail pitcher@livemail.uthscsa.edu
Author Brandon Pitcher, DDS
Co-author(s) e-mail
Faculty mentor/Co-author James Ball, DDS
Faculty mentor/Co-author e-mail ballj@uthscsa.edu
Basic Science Rationale
(Mechanisms that may account for and/or explain the clinical question, i.e. is the answer to the clinical question consistent with basic biological, physical and/or behavioral science principles, laws and research?)
post a rationale
None available
Comments and Evidence-Based Updates on the CAT
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by Abby Shannon (San Antonio, TX) on 09/30/2021
I conducted a search on PubMed in Sept 2021 and found a recent meta-analysis Matsuura (2021) PMID: 32999260 comparing direct pulp materials, specifically if Biodentine was statistically superior to MTA for direct pulp capping success. The study found no significant difference in direct pulp capping success for the two materials. The meta-analysis further supports the conclusions of this CAT.

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