List of Contributors xv Foreword by Professor Nutayla Said Al Harthy xix Foreword by Stephen Cohen xxi Preface xxiii Acknowledgments xxv About the Companion Website xxvii 1 Bioceramics in Dentistry 1 Vineeta Nikhil, Sachin Gupta, Shikha Jaiswal, and Padmanabh Jha 1.1 Introduction 2 1.2 History and Evolution of Bioceramics 3 1.3 Classification of Bioceramics 4 1.3.1 Based on Generations 4 1.3.2 Based on Tissue Interaction 5 1.

3.3 Based on Structure 5 1.3.4 Based on Composition 6 1.3.5 Based on Resorbability 6 1.3.6 Based on Their Location-Specific Use in Endodontology 7 1.

4 Forms of Bioceramics 7 1.4.1 Alumina 7 1.4.2 Zirconia 7 1.4.3 Hydroxyapatite (HA) 8 1.4.

4 Calcium Phosphate 8 1.4.5 Mineral Trioxide Aggregate 8 1.4.6 Biodentine 9 1.5 Physicochemical Properties of Bioceramics 9 1.5.1 Portland Cement 9 1.

5.2 ProRoot MTA 10 1.5.3 MTA Angelus 12 1.5.4 Biodentine 12 1.5.5 BioAggregate 14 1.

5.6 Ceramicrete 14 1.5.7 Calcium-Enriched Mixture Cement 15 1.5.7.1 Physical Properties 15 1.5.

7.2 Antibacterial Activity 16 1.5.7.3 Sealing Ability 16 1.5.8 EndoSequence Root Repair Material 16 1.5.

8.1 Setting and Working Time 16 1.5.8.2 pH Value 16 1.5.8.3 Microhardness 17 1.

5.8.4 Bioactivity 17 1.5.8.5 Sealing Ability 17 1.5.8.

6 Antibacterial Activity 17 1.5.9 iROOT 17 1.5.9.1 Physical Properties 18 1.5.10 Endo-CPM 18 1.

5.10.1 Physical Properties 18 1.6 Physicochemical Properties of Some Bioinert Bioceramics 20 1.6.1 Alumina (High Purity Dense Alumina/Al2O3) 20 1.6.2 Zirconia 20 1.

7 Biological Properties of Bioceramics 21 1.7.1 Cytological Investigation of Biocompatibility 21 1.7.2 Subcutaneous and Intraosseous Implantation 23 1.7.3 Periradicular Tissue Reactions 23 1.7.

4 Pulpal Reactions 24 1.7.5 Antibacterial Properties 26 1.8 Application of Bioceramics in Dentistry 26 1.9 Advantages of Bioceramics 28 1.9.1 Regenerative Endodontic Therapy 29 1.9.

2 Advantages of BCs When Used as a Sealer/Obturating Material 29 1.10 Limitations 30 1.11 Future Trends 30 1.12 Conclusion 32 References 32 2 Calcium Silicate-Based Dental Bioceramics: History, Status, and Future 43 Abubaker Qutieshat, Shahab Javanmardi, and Gurdeep Singh 2.1 Introduction 44 2.2 Bioceramics: The What and the Why 45 2.3 Endodontic Repair Materials with Ideal Properties 45 2.4 Calcium Silicate-based Materials: A Look Back in History 45 2.

5 Chemical Properties 48 2.5.1 Heavy Metal Contamination 52 2.5.2 Setting Reaction 53 2.6 Synthetic Calcium Silicates 55 2.6.1 Biodentine 55 2.

6.2 BioAggregate 55 2.6.3 EndoSequence 56 2.6.4 iRoot BP Plus 56 2.6.5 NeoMTA Plus 57 2.

6.6 BioRoot RCS 57 2.7 Technical Report 57 2.7.1 Methods 57 2.7.1.1 Flame Emission Spectroscopy 58 2.

7.1.2 X-ray Diffraction 59 2.7.2 Results 60 2.8 Recommendations for Implementation 61 2.9 Conclusion 64 References 64 3 Bioceramics in Clinical Endodontics 71 Ayfer Atav, Burçin Arican, and Keziban Olcay 3.1 Introduction 72 3.

2 Classification of Hydraulic Cements in Endodontics 73 3.2.1 Type 1 Hydraulic Cements 73 3.2.1.1 ProRoot MTA 73 3.2.2 Type 2 Hydraulic Cements 75 3.

2.2.1 MTA Angelus 76 3.2.2.2 MTA Bio 77 3.2.2.

3 MM-MTA(tm) 77 3.2.3 Type 3 Hydraulic Cements 78 3.2.3.1 EndoSeal MTA 78 3.2.3.

2 MTA Fillapex 78 3.2.3.3 TheraCal LC 79 3.2.3.4 TheraCal PT 80 3.2.

4 Type 4 Hydraulic Cements 80 3.2.4.1 BioAggregate 81 3.2.4.2 Biodentine(tm) 82 3.2.

4.3 BioRoot RCS 83 3.2.4.4 MTA BIOREP 84 3.2.4.5 Bio-C Pulpo 84 3.

2.4.6 MTA Repair HP 85 3.3 Conclusion 93 References 93 4 Bioceramics: Root-End Filling Material 105 Sanjay Miglani, Swadheena Patro, Ankita Mohanty, and Antarikshya Das 4.1 Introduction 106 4.2 Microsurgical Endodontics 106 4.3 History 107 4.4 Properties of Root-End Filling Material 108 4.

5 Bioceramic Materials 108 4.5.1 Mineral Trioxide Aggregate 108 4.5.2 Bioaggregate 111 4.5.3 Biodentine 112 4.5.

4 iRoot BP Plus Bioceramic Putty 112 4.5.5 Capasio 112 4.5.6 Calcium-Enriched Material 113 4.5.7 EndoSequence 114 4.5.

8 EndoBinder 115 4.5.9 Generex A 116 4.5.10 Quick-Set 117 4.5.11 Ceramicrete-D 118 4.5.

12 Bioglass 119 4.6 Conclusion 121 References 121 5 Bioceramics as an Apical Plug 129 Riccardo Tonini and Marilu'' Garo 5.1 Apical Plug 129 5.2 MTA Apical Plug Outcome 131 5.3 Other Apical Plug Materials 132 5.4 Apical Plug Technique 133 5.4.1 In the First Session 133 5.

4.2 In the Second Session 133 5.4.3 Extra-Apical Resorbable Barriers 135 5.4.4 Apical Sounding Technique Procedure 137 5.5 Complex Clinical Cases 141 References 147 6 Regeneration in Endodontics with Clinical Cases 153 Abhishek Parolia, Maya Feghali, and Catherine Ricci 6.1 Introduction 153 6.

2 Factors Affecting the Clinical Outcome of REP 155 6.2.1 Etiology 155 6.2.2 Type of the Tooth 155 6.2.3 Induction of Bleeding and Blood Clot 156 6.2.

4 Disinfection of the Root Canal System 156 6.2.5 Coronal Barrier 157 6.3 Materials used for REP 157 6.4 Key Points to Remember While Performing REPs 159 References 164 7 Management of Deep Caries with Bioceramics 169 Antonis Chaniotis and Viresh Chopra 7.1 Introduction 169 7.2 Patient Information 170 7.2.

1 Tooth 170 7.3 Treatment Plan 170 7.4 Learning Objectives 172 References 172 8 Regenerative Management of an Infected Pulp of a Permanent Tooth Using Bioceramics 173 Antonis Chaniotis and Viresh Chopra 8.1 Introduction 173 8.2 Patient Information 174 8.2.1 Tooth 174 8.3.

1 First Visit 175 8.3.2 Second Visit 176 8.3.3 Recall 177 8.4 Learning Objectives 177 References 177 9 Endodontic Management of a Necrosed Pulp with Wide Open Apex 179 Antonis Chaniotis and Viresh Chopra 9.1 Introduction 179 9.2 Patient Information 180 9.

2.1 Tooth 180 9.3 Treatment Plan 180 9.4 Technical Aspects 181 9.4.1 First Visit 181 9.4.2 Second Visit 182 9.

5 Learning Objectives 183 References 184 10 Clinical Application of Bioceramics as Direct Pulp Capping Material 185 Antonis Chaniotis and Viresh Chopra 10.1 Introduction 185 10.2 Patient Information 186 10.2.1 Tooth 186 10.3 Treatment Plan 187 10.4 Technical Aspects 188 10.5 Learning Objectives 188 References 188 11 Sealer-Based Obturations Using Bioceramics in Nonsurgical Root Canal Treatments 189 Garima Poddar, Ajay Bajaj, and Viresh Chopra 11.

1 Introduction 190 11.2 Case 1 192 11.2.1 Patient Information 192 11.2.2 Details of the Tooth 192 11.2.3 Radiographic Evaluation of Tooth Number 35 Revealed the Following 193 11.

2.4 Diagnosis 193 11.3 Treatment Plan 193 11.4 Treatment Done 194 11.4.1 Instrumentation Protocol 194 11.4.2 Irrigation Protocol 194 11.

4.3 Obturation Protocol 195 11.4.4 Post Endodontic Restoration 196 11.4.5 Rationale on the Treatment Protocol and the Material Used 196 11.5 Learning Objectives for the Readers 196 11.6 Case 2 196 11.

6.1 Patient Information 196 11.6.2 Details of the Tooth 197 11.6.2.1 Clinical Examination Findings 197 11.6.

2.2 Preoperative Radiological Assessment 197 11.6.3 Diagnosis 198 11.7 Treatment Plan 200 11.8 Treatment Done 202 11.8.1 Instrumentation Protocol 202 11.

8.2 Irrigation Protocol 203 11.8.3 Obturation Protocol 204 11.8.4 Post Endodontic Phase 205 11.8.5 Rationale on the Treatment Protocol and the Material Used 206 11.

9 Learning Objectives for the Readers 206 11.10 Case 3 206 11.10.1 Patient Information 206 11.10.2 Details of the Tooth 206 11.10.3 Preoperative Radiological Assessment 207 11.

10.4 Diagnosis 207 11.11 Treatment plan 207 11.12 Treatment Done 207 11.12.1 Instrumentation Protocol 207 11.12.2 Irrigation Protocol 208 11.

12.3 Obturation Protocol 209 11.12.4 Post Endo Restorative Phase 211 11.12.5 Rationale on the Treatment Protocol and the Material Used 211 11.13 Learning Objectives for the Readers 211 11.14 Discussion 211 References 212 12 BioConeless Obturation 215 Francesca Cerutti and Calogero Bugea 12.

1 Introduction 215 12.2 Why BioConeless? 217 12.2.1 BioConeless: Indications 221 12.2.2 BioConeless: How to Do It? 224 12.2.3 Concerns Regarding the Complete Filling of the Root Canal with the Coneless and BioConeless Techniques 231 12.

2.4 Concerns Regarding the Consistency of the Obturation 234 12.2.4.1 Time Required to Complete the Obturation 234 12.3 Final Remarks 234 12.4 Learning Objectives 235 References 235 13 Pr.