Calcium Silicates in Restorative Dentistry and Prosthodontics

Abstract Body: Preservation of pulp vitality in cases of deep carious lesions or pulp exposure after mechanical trauma is a critical factor determining the prognosis of teeth after restorative treatment. Calcium silicate-based bioactive cements have been proven successful when used for direct or indirect pulp capping (DPC/IPC) in Restorative Dentistry. In contrast, very limited clinical evidence exists on their efficacy in vital pulp therapy in Prosthodontics, either as cavity liners underneath indirect restorations or as core-build up materials of teeth serving as prosthetic abutments.
This presentation will provide an overview of current clinical evidence on the outcomes of application of calcium silicates in vital pulp therapy (DPC or IPC) in restorative dentistry and prosthodontics. Besides, clinical cases demonstrating successful application of a calcium silicate-based cement (Biodentine™) in deep carious lesions of abutment teeth receiving indirect restorations or full-coverage crowns will be presented, and a step-by-step clinical protocol illustrated and discussed.
Overall, factors in favor of application of calcium silicates in restorative dentistry and prosthodontics include their enhanced mechanical and handling properties, good sealing ability, and development of a firm bond with the underlying dentin substrate. Based on current evidence, calcium silicates are highly recommended for teeth of younger patients with mild symptoms of reversible pulpitis, following a strict IPC or DPC aseptic protocol.