Application of Biodentine for Apexification of Immature Teeth of Children: A Scoping Review.

Aims and background: Apexification induces calcified barrier formation to retain an immature necrotic permanent tooth. Treating these teeth is often challenging due to thin, fragile walls that are difficult to prepare effectively. Bioactive cement mineral trioxide aggregate (MTA) and recently introduced Biodentine have been applied in the apexification of necrotic immature teeth. This article aims to review the application of Biodentine for the apexification of immature teeth of children. Materials and methods: About 18 studies, both in vitro (n = 15) and randomized controlled clinical trials (RCT) (n = 3), were obtained after a thorough search in online databases such as MEDLINE (PubMed), Scopus, Embase, and Web of Science. Results: The in vitro studies evaluated and compared the fracture resistance and the seal of the apical plug of Biodentine, MTA, and calcium hydroxide (Ca(OH)2). The RCTs evaluated the effect of these cements in forming apical plugs and periradicular healing in children's immature, necrotic, and permanent teeth. The studies showed contrary results for fracture resistance and apical seal, with some reporting better outcomes for MTA than Biodentine, while others showed similar outcomes. In vivo studies revealed that both types of cement produced satisfactory periradicular healing with the formation of an apical barrier and periradicular bone. Their effects were more promising than Ca(OH)2. Conclusion: Although MTA was superior to Biodentine in the apexification procedure, the latter has advantages such as lower setting time, which makes it ideal for single-visit treatment, which is advantageous in children. Further, long-term clinical trials are required to confirm Biodentine and MTA efficacy in the apexification of immature necrotic teeth. Clinical significance: Biodentine is a promising material for the apexification of immature teeth in children. Its shorter setting time reduces the need for multiple appointments and increases patient compliance. How to cite this article: Gerard LM, Gaur S. Application of Biodentine for Apexification of Immature Teeth of Children: A Scoping Review. Int J Clin Pediatr Dent 2025;18(5):573-579.