Bioceramic Technology in Endodontics
Since bioceramic technology was introduced to endodontics, the response has been exceptional. As more and more practitioners have thought through the process, they have been able to see not only the clear benefits of this technology in endodontics, but they are now asking how this technology can be applied to other aspects of dentistry. The application of bioceramic technology has not only changed endodontics both surgically and non surgically, it has also begun to change the way we treatment plan our patients. As a result of bioceramic technol- ogy, we now have the ability to save more teeth in a predictable fashion, while, in addition, improving their long-term prognosis. The option of “saving the natural dentition” is now back on the table.
However, before we investigate specific techniques, we must first ask ourselves, “What are bioceramics?” Bioceramics are ceramic materials specifically designed for use in medicine and dentistry. They include alumina and zirconia, bioactive glass, glass ceramics, coatings and composites, hydroxyapatite and resorbable calcium phosphates.
There are numerous bioceramics currently in use in both dentistry and medicine, although more so in medicine. Alumina and zirconia are among the bioinert ceramics used for prosthetic devices. Bioac- tive glasses and glass ceramics are available for use in dentistry under various trade names. Additionally, porous ceramics such as calcium phosphate-based materials have been used for filling bone defects. Even some basic calcium silicates such as ProRoot MTA (Dentsply) have been used in dentistry as root repair materials and for apical retrofills.
It is important to understand the specific advantages of bioceramics in dentistry and why they have become so popular. Clearly the first reason is related to physical properties. Bioceramics are exceedingly biocompatible , non–toxic, do not shrink, and are chemically stable
within the biological environment. Additionally, and this is very important in endodontics, bioceramics will not result in a significant inflammatory response if an overfill occurs during the obturation process or in a root repair.
A further advantage of the material itself is its ability (during the setting process) to form hydroxyapatite and ultimately create a bond between dentin and the filling material. A significant compo- nent of improving this adaptation to the canal wall is the hydrophilic nature of the material. In essence, it is a bonded restoration. However, to fully appreciate the properties associated with the use of bioceramic technology, we must understand the hydration reactions involved in the setting of the material.