21 January 2024

---

Bio-active cements: the modern endodontic controversy

Massimo Gagliani

---

When in 1993 a Professor like Mahmoud Torabinejad brought to everyone's attention a cement with miraculous properties for sealing the endodontium, endodontics changed direction. Calcium-silicate cements, close relatives of that very interesting cement, have also been analyzed and developed in terms of composition by Italian universities and used in increasingly varied ways. The properties appeared, in clinical use, to be absolutely in line with the literature evidence, in vitro, however; today we discuss their use with presentations of very vast case studies, with remote control that is modest but sufficient to say that they do no harm, on the contrary. 

However, this cement should logically be used with a single cone technique.

This is an incontrovertible reality, if the cement is uniformly distributed on the walls of the canal and will be the interface between the sealed endodontium and the periodontium, all the beneficial qualities will be able to express themselves at their best. The real issue is how to convey it safely within the channel, a problem that is far from simple but for which, with a little research, a solution can be found, given that the current ones are not bad. Yet, there is a typically dentistry reluctance to do "as in the past", to follow protocols to which we are accustomed because we have difficulty accepting new solutions. I don't deny that I myself am a victim of this inability to peel away the ancient for the modern, who knows why we are so reluctant to change, because we always welcome new things with great distrust. 

Is it genetic, i.e. only the rigidly conservative ones can be dentists? I don't want to believe it but I'm starting to think about it.