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eved through the penetration of the material into the dentinal tubules forming tag-like structures. Unlike resin-based dentine replacement materials, Biodentine can be used in bulk thus preventing layering and interface that could cause microleakage or restoration failure. Restorative Clinical applications include using Biodentine as an immediate enamel restoration, it is placed in the cavity preparation so that the volume of missing dentin is replaced. If a matrix is used, it should not be removed before the setting time. The permanent enamel restoration should be placed at the end of the setting time. Or as a non-immediate enamel restoration, in which the occlusal portion of the restoration would be removed within 1 week to 6 months and a permanent restoration (amalgam, composite, etc.) is placed. The compressive strength of Biodentine increases with time and will be strong enough to withstand chewing after a few hours. Biodentine is a good candidate for a dentine substitute in open sandwich restorations because it does not require photoactivation and thus can be placed in bulk in the cavity. And finally, the use of acid etchant for Biodentine, in 2014, Table 2 Comparison between BioDentine and MTA. OdabaƟ et al evaluated the bond strength of Biodentine with different etching systems. There was no difference found when tested at the same time intervals (12 minutes and 24 hours). On the other hand, different time intervals showed that the etch and rinse adhesive had the lowest bond strength at 12 minutes while the 2-step self-etch had the highest with the 24-hour duration. Another study done in 2013 by Josette Camilleri proved that total etch, and rinse was more effective than self- etch. 4.BioDentine in Direct & Indirect Pulp Capping procedures: 4.1 Direct Pulp Capping Direct pulp capping is a treating procedure of an exposed pulp using dental materials that promotes the formation of tertiary (reparative) dentine and maintenance of pulp. It can also be considered as an alternative way to avoid vital pulp excision. However, vital pulp excision success rate is much higher than the direct pulp capping. Before treatment, the pulp should be asymptomatic as in clear from bacteria or toxins, and bleeding should be controlled by sodium hypochlorite for example. Any remnants might cause treatment failure. A study was done on the maxillary and mandibular sound 3rd molars of twenty-eight patients for 6 weeks, and pulp vitality was examined prior extraction. After teeth cleaning, disinfection, local anesthesia and rubber dam are applied, class 1 cavities were prepared and an exposure around 1.2 mm in diameter was done. The teeth were divided into Biodentine and MTA experimental groups and one control group for comparison. Within a week, patients returned for the application of the final composite restoration. After 6 weeks, teeth were extracted. After extraction teeth were fixed and demineralized, then samples were evaluated under normal and ultraviolet light. The results showed that the pulp-dentin response was the same in both groups, where dentin bridge was formed directly under the capping material in site of exposure. Odontoblast cells near dentinal bridge were discovered with dentinal tubules. In conclusion Biodentine is considered an alternative material to MTA in treating vital pulps. However, further studies are needed to assess the mode of action of Biodentine on the pulp. 4.2 Indirect Pulp Capping
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