Innovative Biological Approach of Restorative Dentistry

Abstract Body: In Restorative Dentistry, caries removal, cavity preparation or accidental coronal pulp injury may cause dental pulp exposure (DPE) which often leads the clinician to perform endodontic treatment going deep into “death spiral” of the tooth. Clinicians can use direct and indirect pulp cupping to maintain pulp vitality, ensuring the formation of mineralized tissue or dentin bridge between the lesion and the pulp chamber. The preservation of pulp vitality is important for tooth homeostasis, nutrition, innervation and immune defense and allows to postpone further invasive treatments.
Nowadays, innovative new biomaterials were developed for achieving this goal. The introduction of calcium silicate-based materials, commonly named bioceramics, has caused a paradigm shift in the treatment of DPE. In the past, calcium hydroxide was widely used for DPE since it is able to stimulate the formation of tertiary dentine. However, it reported some disadvantages, including pulp surface inflammation, tunnel defects in the dentin bridge and lack of adhesion. Recently, bioceramics have been suggested as alternative material for pulp capping as they showed bioactivity, water tightness, biocompatibility, and adequate mechanical properties. The objective of this lecture is to describe and summarize the properties of the new bioceramics and their biological principles, giving suggestions not only to make the most of their potential, but also to face the daily clinical practice.