Biomaterials in Endodontics: a review

Main Article Content

Naveena Ponnada
Dalavai Praveen
Girija S Sajjan

P N V Manohar
B V Sindhuja
K Meghana Varma


Biomaterials have evolved over the past three decades and are relatively specialized, highly biocompatible, but low-strength dental materials. Bioactive materials can interact with living tissues or systems. The newly emerging bioactive category of dental materials has expanded clinical uses in restorative dentistry and endodontics. Examples of bioactive materials are  Calcium Silicate containing Mineral Trioxide Aggregate (Portland cement); Calcium Silicate cements lacking aluminium and containing phosphate: Bioagrregate,  iRoot SP and iRoot BP (Endosequence), Calcium Silicate cements containing predominantly Tricalcium Silicate: Bio-active Glass, Calcium Phosphate based materials: Tricalcium Phosphate, Hydroxyapatite, Calcium Phosphate cements and Calcium Aluminate based materials: GIC based luting cements; Bioactive Glass. Other biomimetic materials include Emdogain, Platelet Rich Plasma, Platelet Rich Fibrin, Bone grafts and barrier membranes. Thus, the objective of this review was to compare and review the composition, and properties of these bioactive materials in endodontics.

Article Details

How to Cite
Ponnada, N., Praveen, D., Sajjan, G. S., Manohar, P. N. V., Sindhuja, B. V., & Varma, K. M. (2023). Biomaterials in Endodontics: a review. International Journal of Dental Materials, 5(2), 43–51.
Author Biographies

Naveena Ponnada, Vishnu Dental College

Postgraduate student, Department of Conservative Dentistry and Endodontics, Vishnu Dental College, Bhimavaram, Andhra Pradesh, India.

Dalavai Praveen, Vishnu Dental College

Reader, Department of Conservative Dentistry and Endodontics, Vishnu Dental College, Bhimavaram, Andhra Pradesh, India.

Girija S Sajjan, Vishnu Dental College

Professor & Head, Department of Conservative Dentistry and Endodontics, Vishnu Dental College, Bhimavaram, Andhra Pradesh, India.

P N V Manohar, Vishnu Dental College

Postgraduate student, Department of Conservative Dentistry and Endodontics, Vishnu Dental College, Bhimavaram, Andhra Pradesh, India.

B V Sindhuja, Vishnu Dental College

Postgraduate student, Department of Conservative Dentistry and Endodontics, Vishnu Dental College, Bhimavaram, Andhra Pradesh, India.

K Meghana Varma, Vishnu Dental College

Postgraduate student, Department of Conservative Dentistry and Endodontics, Vishnu Dental College, Bhimavaram, Andhra Pradesh, India.


  1. Asthana G, Bhargava S. Bioactive materials: a comprehensive review. Sch J App Med Sci. 2014; 2(6E):3231-7.
  2. Sharma M, Peter E Murray, Sharma D, Parmar K, Gupta S, Goyal P. Modern approaches to use bioactive materials and molecules in medical and dental treatments. Int J Curr Microbiol App Sci. 2013; 2(11): 429-39.
  3. Srinivasan K, Chitra S. Emerging trends in oral health profession: the biomimetic - a review. Arch of Dent and Med Res. 2015;1(3):40- 47.
  4. Arjunan, Arun & Baroutaji, Ahmad & A. S., Praveen & Robinson, John & Wang, Chang. Classification of Biomaterial Functionality. Classification of Biomaterial Functionality Chapter 27; January 2020.
  5. Mustafa M, Saujanya KP, Jain D, Sajjanshetty S, Arun A, Uppin L, Kadri M. Role of calcium hydroxide in endodontics : A review. Global J Med & Public Health. 2012; 1(1): 66-97.
  6. Mohammadi Z, Shalavi S, Yazdizadeh M. Antimicrobial activity of calcium hydroxide in endodontics: A review. Chonnam Med J. 2012; 48(3):133-140.
  7. Ahmad MZ, Sadaf D, Merdad KA, Almohaimeed A, Onakpoya IJ. Calcium hydroxide as an intracanal medication for postoperative pain during primary root canal therapy: A systematic review and meta-analysis with trial sequential analysis of randomised controlled trials. J Evid-Based Dent Pract. 2022 Mar 1;22(1):101680.
  8. Ricucci D, Rôças IN, Alves FR, Cabello PH, Siqueira Jr JF. Outcome of direct pulp capping using calcium hydroxide: a long-term retrospective study. J Endod. 2023 Jan 1;49(1):45-54.
  9. Torabinejad, M. & White, D. J. Tooth filling material and method of use. US Patent 5,769,638 (1995).
  10. Germain, L.P Mineral trioxide aggregate: a new material for the new millennium. Dent Today. 1999. 18(1): p. 66-7, 70-1.
  11. Camilleri J. Hydration mechanisms of mineral trioxide aggregate. Int Endod J. 2007;40:462-70. ttps://
  12. Torabinejad M, Chivian N (1999) Clinical applications of mineral trioxide aggregate. J Endod. 25, 197-205.
  13. Kadali N, Alla RK, Vineeth G, Ramaraju AV, Suresh Sajjan MC, Raju RV. Mineral Trioxide Aggregate: An overview of composition, properties and clinical applications. Int J Dent Mater 2020;2(1): 11-18.
  14. Rao A, Rao A, Shenoy R. Mineral Trioxide Aggregate—A Review. J Clin Pedia Dent. 2009;34(1):1-8.
  15. Salem Milani A, Radmand F, Rahbani B, Hadilou M, Haji Abbas Oghli F, Salehnia F, Baseri M. Effect of Different Mixing Methods on Physicochemical Properties of Mineral Trioxide Aggregate: A Systematic Review. Int J Dent. 2023 Feb 16;2023.
  16. Terauchi Y, Torabinejad M, Wong K, Bogen G. The Effect of Mineral Trioxide Aggregate Obturation Levels on the Outcome of Endodontic Retreatment: An Observational Study. J Endod. 2023;49(6):664-674.
  17. Rajashekharan S, Martens LC, Cauwels RGEC, Verbeeck RMH. BiodentineTM. material characteristics and clinical applications: a review of the literature. Eur Arch Paediatr Dent. 2014;15:147-58.
  18. Kadali NS, Alla RK, Ramaraju AV, Sajjan SMC, Mantena SR, Raju RV. An overview of composition, properties, and applications of Biodentine. Int J Dent Mater 2021;3(4): 120-126.
  19. Arora V, Nikhil V, Sharma N, Arora P. Bioactive dentin replacement. J Dent Med Sci. 2013;12:51-57. 4.
  20. Soundappan S, Sundaramurthy JL, Raghu S, Natanasabapathy V. Biodentine versus Mineral Trioxide Aggregate versus Intermediate Restorative Material for Retrograde Root End Filling: An Invitro Study. J Dent (Tehran, Iran). 2014 Mar;11(2):143.
  21. Al-Nazhan S, El Mansy I, Al-Nazhan N, Al-Rowais N, Al-Awad G. Outcomes of furcal perforation management using Mineral Trioxide Aggregate and Biodentine: a systematic review. J Appl Oral Sci: Revista FOB. 2022 Dec 2;30:e20220330.
  22. Eshghi A, Hajiahmadi M, Nikbakht MH, Esmaeili M. Comparison of Clinical and Radiographic Success between MTA and Biodentine in Pulpotomy of Primary Mandibular Second Molars with Irreversible Pulpitis: A Randomized Double-Blind Clinical Trial. Int J Dent. 2022 Jul 12;2022.
  23. Shokouhinejad N et al. Bioactivity of EndoSequence root repair material and bioaggregate. Int Endod J. 2012;45(12):1127-34.
  24. Tian J, Zhang Y, Lai Z, Li M, Huang Y, Jiang H, Wei X. Ion release, microstructural, and biological properties of iRoot BP Plus and ProRoot MTA exposed to an acidic environment. J Endod. 2017 Jan 1;43(1):163-8.
  25. Dawood AE, Parashos P, Wong RH, Reynolds EC, Manton DJ. Calcium silicate?based cements: composition, properties, and clinical applications. J Investigat Clin Dent. 2017 May;8(2): e12195.
  26. Lovato KF, Sedgley CM. Antibacterial activity of endosequence root repair material and proroot MTA against clinical isolates of Enterococcus faecalis. J Endod. 2011 Nov 1;37(11):1542-6.
  27. Rana MJ, Rana MA, Islam S, Bangash AY, Bano S, Hamdani S. Comparison of Post-Operative Pain in Mandibular and Maxillary 1st and 2nd Molars after Pulp Capping with Biodentine and Endosequence Root Repair Material as Pulp Capping Agent. Pak Armed Forces Med J. 2022 Dec 29;72(6):1929-32.
  28. Asgary S, Shahabi S, Jafarzadeh T, Amini S, Kheirieh S. The properties of a new endodontic material. J Endod. 2008;34, 990–3.
  29. Rekha R, Kavitha R, Venkitachalam R, Prabath SV, Deepthy S, Krishnan V. Comparison of the sealing ability of bioceramic sealer against epoxy resin based sealer: A systematic review & meta-analysis. J Oral Biol Craniofac Res. 2022;13(1):28-35.
  30. Oliveira IR, Pandolfelli VC, Jacobovitz M. Chemical, physical and mechanical properties of a novel calcium aluminate endodontic cement. Int Endod J. 2010;43:1069–1076.
  31. Fabiano Gamero Aguilar, DDS, MSc, Lucas Fonseca Roberti Garcia, DDS , Biocompatibility of New Calcium Aluminate Cement (EndoBinder). J Endod. 2012;38(3):367–371.
  32. LeGeros RZ. Calcium phosphate materials in restorative dentistry: a review. Adv Dent Res. 1988;2(1):164-80.
  33. Al-Sanabani JS, Madfa AA, Al-Sanabani FA. Application of calcium phosphate materials in dentistry. Int J Biomater. 2013 Jun 26;2013. Volume 2013.
  34. Hurlbutt M. caries management with calcium phosphate. Dimensions of dental hygiene 2010;8(10):40-6.
  35. Hoppe A, Guldal N.S, Boccaccini AR. A review of the biological response to ionic dissolution products from bioactive glasses and glass-ceramics. Biomater. 2011;32(11):27572774.
  36. Khalid MD, Khurshid Z, Zafar MS, et al. Bioactive glasses and their applications in dentistry. J Pak Dent Assoc. 2017;26 (1), 3238.
  37. Farooq I, Imran, Farooq U, Leghari A. Ali H. Bioactive glass: a material for the future. World J Dent. 2012;3(2):199201.
  38. Behzadi S, Mohammadi Y, Rezaei-Soufi L, Farmany A. Occlusion effects of bioactive glass and hydroxyapatite on dentinal tubules: a systematic review. Clin Oral Investig. 2022 Oct;26(10):6061-78.
  39. Lyngstadaas SP et al. Enamel matrix proteins; old molecules for new applications. Orthod Craniofac Res. 2009;12(3):243-253.
  40. Al-Hezaimi K, Javed F, Al-Fouzan K, Tay F. Efficacy of the enamel matrix derivative in direct pulp capping procedures: a systematic review. Aust Endod J 2013;39(3):171-5.
  41. Tamzini M, Albeshti R, Abdesalam A. Enamel Matrix Derivative (Emdogain®) for Wound Healing and Bone Regeneration: A Short-Review. Libyan J Med Res. 2022;16(1):107-13.
  42. Darby IB, Morris KH. A Systematic Review of the Use of Growth Factors in Human Periodontal Regeneration. J Periodontol. 2013;84(4):465-476.
  43. Delgado JJ, Sanchez E, Baro M, Reyes R, Evora C, Delgado A. A platelet-derived growth factor delivery system for bone regeneration. J Mater Sci Mater Med 2012;23(8):1903- 12.
  44. Plachokova As, Nikolidakis D, Mulder J, Jansen JA, Creugers NH. Effect of platelet-rich plasma on bone regeneration in dentistry: a systemic review. Clin Oral Implants Res. 2008;19(6):539-45.
  45. Dohan DM et al. Platelet rich fibrin (PRF): A second generation platelet concentrate. Part 1: technological concepts and evolution. Oral Surg Oral Pathol Oral Radiol Endod. 2006;101(3):37-44.
  46. Sunitha Raja V, Munirathnam Naidu E. Platelet-rich fibrin: Evolution of a second-generation platelet concentrate. Indian J Dent Res 2008;19(1):42-6.
  47. Toffler M, Toscano N, Holtzclaw D, Corso Md, Ehrenfest DD, Introducing Choukroun’s platelet rich fibrin into reconstructive surgery milieu. J Implant Clinical Dent. 2009;1(6):21-32
  48. Lucarelli E et al. A recently developed bifacial platelet rich fibrin increases proliferation and differentiation of human dental pulp cells. Eur Cell Mater. 2010;20:13-23.
  49. Araújo LD, Goulart TS, Gil AC, Schuldt DP, Coelho BS, Figueiredo DD, Garcia LD, Almeida JD. Do alternative scaffolds used in regenerative endodontics promote better root development than that achieved with blood clots? Braz Dent J. 2022 Apr 29;33:22-32.

Most read articles by the same author(s)