Response of periodontium to mineral trioxide aggregate and Biodentine: a pilot histological study on humans

Aust Dent J. 2018 Jun;63(2):231-241. doi: 10.1111/adj.12605. Epub 2018 Apr 19.


Background: The aim of this study was to investigate for the first time the histological response of human periodontium to mineral trioxide aggregate (MTA) and Biodentine.

Methods: Six patients scheduled for implant full-arch rehabilitation were randomly assigned to one of the two test groups: MTA or Biodentine treatment. For each patient, two teeth scheduled for strategic extraction were randomly assigned either to the test or to the control treatment. A lateral perforation was drilled on the root and either repaired with MTA/Biodentine or filled with gutta-percha(control). Three months later, the teeth were extracted along with the coronal third of the alveolar bone and a portion of gingival tissue, while performing implant placement, and processed for histological analysis.

Results: Biodentine resulted in less extrusion into the periodontal environment. All the materials showed good biocompatibility. A new mineralized cementum-like tissue incorporating periodontal fibres was visible in all cases treated with MTA. A small amount of new mineralized tissue was found in two Biodentine cases but not in control cases. Biodentine resulted in less damage to the periodontal ligament.

Conclusions: Bioactivity and biocompatibility of MTA were confirmed in human models. Biodentine proved to be biocompatible, but it seems not to induce cementum regeneration.

Keywords: Biodentine; histology; human model; mineral trioxide aggregate; root perforation.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Aged
  • Aluminum Compounds / pharmacology*
  • Biocompatible Materials
  • Calcium Compounds / pharmacology*
  • Case-Control Studies
  • Dentin / chemistry*
  • Drug Combinations
  • Female
  • Gingiva / drug effects
  • Gutta-Percha
  • Humans
  • Male
  • Middle Aged
  • Oxides / pharmacology*
  • Pain, Postoperative
  • Periodontal Ligament / drug effects*
  • Periodontium / drug effects*
  • Pilot Projects
  • Silicates / pharmacology*
  • Single-Blind Method
  • Tooth / drug effects


  • Aluminum Compounds
  • Biocompatible Materials
  • Calcium Compounds
  • Drug Combinations
  • Oxides
  • Silicates
  • mineral trioxide aggregate
  • tricalcium silicate
  • Gutta-Percha