Regenerative Potential of Biodentine in Complex Endodontic Conditions: A Systematic Review of Clinical and...

Background/Objectives: Complex endodontic lesions characterized by significant periapical bone loss, diverse anatomical variations in the root canal system and apical resorption represent a major therapeutic challenge. Biodentine, a calcium silicate-based bioactive dental restorative material, has gained considerable attention because of its potential to promote and sustain the regeneration of bone tissue. This review aims to evaluate current evidence on Biodentine's regenerative abilities in treatments of diverse endodontic pathology and highlight the clinical and radiographic outcomes. Material and Methods: A systematic review was conducted in accordance with PRISMA guidelines by searching for articles in three electronic databases: Medline (PubMed), Scopus, and Cochrane Library. Studies describing the application of Biodentine in cases of complex endodontic pathology with destruction of apical bone and apical resorption of roots were considered for inclusion in the study. Quality assessment was carried out using the Cochrane risk of bias assessment tool RoB 2.0. Results: The included clinical and radiographic studies demonstrated positive treatment outcomes after using Biodentine in difficult endodontic lesions, including a reduction in lesion size, improvement in symptoms and progression of periapical bone regeneration after 12 months of follow-up. No significant adverse outcomes were reported in the studies included. Conclusions: Biodentine proved to be an efficient biocompatible material in terms of managing complex endodontic lesions. Due to its bioactive properties and high efficiency as an apical plug, Biodentine is capable of inducing bone regeneration within the affected periapical area.