Bioceramics and Endodontics: Present and Expectations in Clinical Use

Currently bioceramics are preferentially used in various endodontic treatments such as pulp capping, pulp amputation, apexification, root-end fillings, perforation repair, and pulp regeneration. Additionally, bioceramics started to replace traditional materials still used in root canal fillings. The promising clinical results achieved during last 20 years by mineral trioxide aggregate (MTA) promoted in root canal treatments other MTA-like innovative endodontic materials, some of them produced by nanotechnology. Though the newcomers claim to have at least the same efficacy as MTA only rigorous long-term clinical studies might confirm the expectations. Probably the most spectacular effect of using bioceramics in endodontics is mirrored in regenerative treatments. However, are still required proper treatment protocols able to optimize the signaling environment of bioactive molecules for achieving the most efficient pulp regeneration. Pivotal is also the balance between clinical and histological outcomes. As compared to conventional materials used in endodontic treatments bioceramic cements are not only biocompatible but also bioactive as they proved to be involved in controlling the tissue healing and pulp regeneration. MTA or MTA-like cements are already the material of choice in regenerative endodontics, conservative vital pulp therapy and periradicular surgery due to their clinical success rate that spectacularly upraised in recent years. Based on in progress technology of fabrication it is expected that the newcomers belonging to bioceramic cements will overcome some potential clinical and histological downsides. MTA-based endodontic sealers are also promising promoters of improved interfacial bond between the filling material and the dentinal walls of root canal as a guarantee against microinfiltration.