Regenerative Treatment of Mature Teeth with Pulp Necrosis and Apical Periodontitis Using Biodentine Compared with MTA: Randomized Controlled Clinical Trial

Eur Endod J. 2024 Dec 20;9(4):365-373. doi: 10.14744/eej.2024.30075. Epub 2024 Oct 30.

Abstract

Objective: The purpose of this randomized, controlled study was to evaluate the effectiveness of Biodentine compared with MTA used as a pulp space barrier in healing periapical lesions and regaining pulp sensitivity after regenerative treatment in mature single-canal permanent teeth with pulp necrosis and apical periodontitis.

Methods: The study involved 36 patients with mature teeth with necrotic pulp and apical periodontitis. The patient underwent a regenerative treatment that utilized the blood clot technique. Teeth were randomly allocated to either the intervention, Biodentine, group (n=18) or the control, MTA, group (n=18). The healing of periapical lesions and tooth sensibility were evaluated throughout follow-up visits for up to 18 months.

Results: The study analyzed 31 patients; two patients within the biodentine group and three in the MTA group were lost to follow-up. After 18 months, both groups showed effective healing of periradicular lesions; 21 out of 31 patients (67.7%) were healed, ten patients (32.3%) were healing, and no failure cases occurred. There were no significant differences between the groups (p=1.00). More than 70% (22 out of 31 patients) regained their sensibility in their teeth, and the groups had no statistically significant difference (p=0.703).

Conclusion: Regenerative treatment using blood clots with either MTA or Biodentine effectively resolved periapical lesions and regained the sensibility of mature teeth.

Publication types

  • Randomized Controlled Trial
  • Comparative Study

MeSH terms

  • Adult
  • Aluminum Compounds* / therapeutic use
  • Calcium Compounds* / therapeutic use
  • Dental Pulp Necrosis* / therapy
  • Drug Combinations*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Oxides* / therapeutic use
  • Periapical Periodontitis* / drug therapy
  • Periapical Periodontitis* / therapy
  • Regenerative Endodontics / methods
  • Silicates* / therapeutic use
  • Young Adult

Substances

  • Silicates
  • Calcium Compounds
  • mineral trioxide aggregate
  • tricalcium silicate
  • Aluminum Compounds
  • Oxides
  • Drug Combinations