Abstract
The aim of this systematic review is to investigate the teeth discoloration potential of Biodentine. An electronic search in six databases (PubMed, Cochrane Library, LILACS, SCIELO, Web of Science, and Scopus) was conducted by three independent reviewers to identify eligible articles. The following search terms were used: ((discolo*, staining potential, color, colour, or spectrophotomet*), (teeth or tooth), and (Biodentine)). Methodology following the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analysis) guidelines was adopted for this investigation. At the end of the selection process, 30 articles were identified as eligible, of which 14 in vitro studies were included in this systematic review. Nine of the included studies evaluated the discoloration potential of Biodentine in the presence of blood. Within the limitations of this review, teeth discoloration using Biodentine is highly expected when material is placed in direct contact with blood during dental procedures. In the absence of blood, Biodentine causes less teeth color changes than MTA-based materials, but it is still unclear what clinically relevant results could be expected regarding the discoloration frequency and intensity induced by Biodentine.
Highlights
Nowadays, success in endodontic treatment is presented by functioning teeth without clinical symptoms and radiographic evidence of periapical inflammation [1]
The first commercial calcium silicate-based cements (CSC) introduced to the market, grey mineral trioxide aggregate (MTA), was composed of calcium, silica, and bismuth oxide [6]
Many studies reported that grey MTA leads to tooth discoloration [2,9,10,11,12,13,14,15]
Summary
Success in endodontic treatment is presented by functioning teeth without clinical symptoms and radiographic evidence of periapical inflammation [1]. Discoloration of tooth structure, secondary to the use of endodontic cements, is currently the most common concern regarding endodontic treatment [2,3,4,5]. Materials, such as mineral trioxide aggregate (MTA) and calcium silicate-based cements (CSC), are widely used for various restorative and endodontic treatment procedures, such as indirect and direct pulp capping, pulpotomy, apexification, regenerative endodontics, sealing of perforations, and retrograde root fillings [4,6,7,8]. It has been shown that bismuth oxide can cause tooth discoloration and possible mechanisms of it are related to the oxidation of the iron content [2], oxidation of bismuth oxide [16,17], and interference of bismuth oxide with dentin collagen [9]
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