Bioceramic materials represent a significant paradigm shift in endodontics over the past three decades. This revolution, initiated by the development of mineral trioxide aggregate (MTA) in 1993, is attributed to the superior properties of these materials, such as excellent biocompatibility, bioactivity, sealing ability, and high alkalinity (pH ~12.5). This review summarizes the historical development, classification, physical, chemical, and biological properties, and current clinical applications of bioceramics. In clinical applications, calcium silicate-based materials such as MTA and Biodentine demonstrate success rates exceeding 90% in vital pulp therapy (pulp capping and pulpotomy) by promoting the formation of a dentin bridge. As root canal sealers, they have popularized the single-cone technique, achieving 90-99% clinical success rates by chemically bonding to dentin and providing a long-term seal. Furthermore, they have become the gold standard for apexification, perforation repair, management of resorption defects, and as a retrograde filling material in apical surgery. In regenerative endodontic procedures, they enhance long-term tooth survival by supporting continued root development. Nevertheless, certain limitations remain, including prolonged setting times, handling difficulties, the potential for tooth discoloration, and challenges associated with retreatment procedures. Despite these limitations, bioceramics have become an indispensable component of modern endodontics when applied with proper indications and techniques, significantly improving treatment outcomes and offering patients more biologically-oriented and conservative treatment options.

DOI: https://doi.org/10.62838/ASMJ.2025.2.02