Avaliação do uso de Biodentine como material capeador e substituto de dentina: revisão sistemática

Abstract

Conservative pulp treatments aims to keep teeth functioning and seek to avoid unnecessary extraction of permanent teeth in a population where endodontic treatment is economically unfeasible. A new calcium silicate based material called Biodentine has recently been introduced to the market to be used as a pulp capping material and also as a dentin substitute coronal restorative material. The Biodentine manufacturer recommends the use of the material as a capping and temporary restorative at the same time, however there are no studies that evaluate its properties in this condition. The advantage of its use would be the application of only one material as capping and restorative at the same time, resulting in less clinical time, an important aspect in its indication for young patients. Thus, this systematic review aimed to evaluate the physicochemical characteristics of Biodentine and its clinical performance as a pulp capping and restorative material. The data search was carried out until May 2021 in five electronic databases: MEDLINE, BIREME, Web of Science, Scielo and Scopus. The search resulted in a total of 748 articles, of which 25 articles were selected, by title and abstract, for full reading. After a complete reading of the articles, 2 articles were excluded for being systematic review studies and 14 articles were excluded because Biodentine was used for another purpose and did not meet the eligibility criteria. A total of 09 articles were included according to the inclusion criteria, being 01 (one) prospective longitudinal study and 08 in vitro articles. The prospective longitudinal study evaluated the clinical performance of Biodentine as a pulp capping material and determined how long it can remain as a restorative material subjected to chewing forces on posterior teeth, compared to a resin composite. Three in vitro studies compared the shear force between pulp capping agents and restorative material. One article analyzed the shear strength of different adhesives to Biodentine at different time intervals. Two studies evaluated the appropriate time to perform the restoration after pulp capping. One investigated surface changes such as roughness and dimensional stability of calcium silicate cements after exposure to different environments. A study compared the composite resin adhesion of three capping materials, and characterized their failure modes and also evaluated the waiting time to perform the composite resin restoration under Biodentine. Biodentine can be used as a capping material and as an alternative as a temporary restorative in posterior tooth restorations. Furthermore, when compared to MTA, it has better shear strength values. Studies do not recommend that Biodentine be used as a material for a final restoration, but that a composite resin restoration be made over it, but without agreement as to time, immediate or late. However, there are no longitudinal clinical studies that follow the behavior of Biodentine as a lining material and dentin substitute simultaneously. For this, the importance of further clinical studies is highlighted.