- MTA (Mineral Trioxide Aggregate) Clear - 1g (approx 7 applications)
"Since its introduction a decade ago MTA has shown great promise as an alternative endodontic restorative material." It is less cytoxic and appears to have superior biocompatibility and sealing characteristics.
Biocompatibility
In a recent vitro study for 5 root ended filings MTA was compared with amalgam, GIC, Super EBA and IRM and was found to be the most biologically compatible material. "Numerous studies have shown MTA to be extremely well tolerated." It was also shown to be less cytoxic than IRM and Super EBA and also non-mutagenic
Apical Sealability
"A critical property of any prospective endodontic material used as a root end sealer, or for perforation repair, is its ability to provide a hermetic seal, as microleakage has always been the primary cause of failure of root-end fillings and perforation repairs."
A fluid transport model was used to test the comparative microleakage of MTA, amalgam, glass ionomer cement and Super EBA. "The results show that MTA had the least microleakage and that this did not diminish over the period of the study."
NOTE: The minimal thickness of MTA to prevent microleakage has been found to be 4mm although 2mm and 3mm did show similar results they were less satisfactory. MTA presents several advantages when compared to amalgam and zinc oxide-eugenol cements:
- Excellent marginal sealing
- Biological enclosing of root canal and furcation perforations through induction of periradicular cementum formation
- Prevents bacterial migration and penetration of tissue fluids in the root canal
- Promotes the formation of a dentin bridge when used in pulp capping
- Unlike other cements, which demand a completely dry field, MTA can be used even when moisture control is inadequate (e.g. surgery for root perforation, reverse root filling), without loss of its properties
Indications for use:
- Perforation of the root canal
- Pulp capping and pulpotomy in teeth with incomplete root development
- Internal Resorption
- Apexification
Properties:
- Setting time: Initial-10 minutes, final-15 minutes.
- It is not necessary to wait for the final set to continue treatment procedures
- Radiopacity is superior to those of dentine and bone; nearly matches that of gutta-percha
- Highly alkaline (pH 12); prevents bacterial growth and maintains a long lasting bactericidal potential
- Compressive Strength is 44.2 MPa after 28 days; very acceptable, considering that sites of application do not receive direct occlusal load
- MTA sealing capacity was tested in vitro (dye penetration through a dentine MTA cement interface). The low levels of dye penetration indicate that MTA presents an effective sealing potential. Considering the larger dimensions of bacteria in comparison to those of dye molecules, bacterial infiltration is highly reduced, guaranteeing excellent marginal sealing
- MTA works just as well in humid places
Repair a perforated canal and save the tooth
Step 1:
Irrigate the perforation area using Sodium Hypochlorite. Instrumentation, irrigation and obturation of the apex portion of the canal up to the perforation area.
Step 2:
MTA applied inside the perforation and condensed.
Step 3:
Obturation of the remnant of the radicular canal. Immediate Radiographic film and at 3 to 6 months for at least 2 years.
