Disease and Health Research: Recent Developments Vol. 2

Hydraulic calcium silicate cements have changed endodontic repair from passive defect filling towards materials that can seal in moist fields, release biologically active ions and support mineralised tissue formation. Mineral trioxide aggregate (MTA) established this class, whereas Biodentine was designed to improve handling, setting speed and colour stability. This critical narrative review evaluates whether these differences translate into clinically meaningful advantages across vital pulp therapy, perforation repair, root-end surgery, apexification and regenerative endodontic procedures. Literature published from 1993 to 31 May 2026 was selected through live searches of biomedical indexes, full-text repositories, DOI records and citation chains, followed by critical appraisal of methodological quality, clinical relevance and consistency. Both materials hydrate to calcium silicate hydrate phases and calcium hydroxide, generating alkaline, calcium-releasing interfaces that can promote apatite precipitation and reparative mineralisation. Biodentine generally offers faster setting and easier placement, while MTA has a longer and broader clinical evidence base. Direct comparative trials in pulpotomy and primary-tooth therapy usually show similar short- to medium-term success, but estimates remain constrained by modest sample sizes, heterogeneous diagnostic criteria, operator-dependent protocols and limited follow-up. MTA has stronger longitudinal evidence for perforation repair, apical plugs and root-end filling; evidence for Biodentine in these indications is biologically plausible but less mature. In regenerative endodontics, both act principally as coronal barriers rather than as complete regenerative systems, and favourable radiographic outcomes should not be equated with restoration of a normal pulp-dentine complex. Discolouration, washout, radiopacity, restoration timing and blood contamination remain formulation- and context-dependent concerns. The most defensible conclusion is not universal superiority of one cement, but indication-specific selection based on evidence maturity, operability, aesthetic risk and quality of coronal sealing. Future progress requires standardised material characterisation, core outcome sets, adequately powered pragmatic trials and mechanistic studies that link laboratory bioactivity to patient-centred outcomes.