MTA by Basel Awad

Mineral Trioxide Aggregate (MTA)
By: Basel Awad

Student NO: 21610740
Introduction
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MTA is a newly discovered dental material that has earned it's reputation. MTA first
discovery was in 1993 and has gained it's FDA approval in 1998. MTA stands for
mineral trioxide aggregate, and it has been used in many dental procedurs especially for
endodontics treatments like; perforation repairs, apexifications, regenerative procedures,
apexogenesis, pulpotomies & pulp capping.The trioxide aggregate in MTA consists of
calcium, aluminum and selenium. MTA has several desirable properties in terms of its
biocompatiblity, bioactivity, hydrophilicity, radiopacity, sealing ability and low
solubility. The most important of these properties in dentistry are its biocompatibility
and sealing ability.The high biocompatibility encourages high healing responses with
very minimal inflammatory response.The excellent seal achieved is due to its expansion
and contraction properties being very similar to dentin which results in high resistance to
marginal leakage and to bacterial migration into the root canal system, so there is a
stable barrier to bacterial and fluid leakage which is the most two exceptional
advantages we gained from MTA.
MTA sets in a moist envieroment which is in unlike other dental materials like calcium
hydroxide. MTA when in contact with moisture, it's main component, calcium oxide is
converted to calcium hydroxide .This cenversion leads to a high PH enviroment which
has antibacterial effects. Another advantage of MTA, is it's very low solubility and
maintenance of it's physical integrity after placment,which is unlike calcuim hydroxide.
This is another huge advantage of MTA.
MTA materials are derived from a Portland cement parent compound. Although these
compounds are similar in some respects, Portland cement and MTA are not identical.
MTA products undergo additional processing and purification. MTA products when
compared to Portland cements have a smaller mean particle size and contain fewer toxic
heavy metals.
First MTA that was discovered had a setting time of 2-3 hours which was undesirable by
clinicians as they could not cemplete their restorative procedures without worrying of
MTA being washed away, and they can't be sure if it sets at time of placment.Newer
MTA has been driven to market with setting time of 15 minutes and more enhanced
easier manipulation during application. This MTA is due to reduced concentration of
calcium sulfate.
Clinical Applications
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pulp capping
MTA has shown improved results in pulp capping procedures. MTA properties of being
less soluble than calcium hydroxide and better sealing quality due to it's setting
expansion, makes it the material of choice for pulp capping. Studies have shown that in
asymptomatic cases or in cases with reversible pulpits (where the infection has not
spread into the pulp chamber proper), MTA pulp capping can serve as a viable treatment
option.
Pulpotomy and Apexogenesis
MTA has shown it's effectivness in these procedures, as we get the good sealing and low
solubility qualities.
Apexification
The treatment of a necrotic pulp in an immature root has always presented a challenge to
clinicians due to the lack of an apical stop. This has classically been addressed with long
term calcium hydroxide treatment which may require several years of treatment time,
involve multiple visits and theoretically at least, increase the fracture potential of the
root involved. MTA has become an excellent predictable alternative to address these
issues by creating a biocompatible apical plug in a single visit.The apical third should be
plugged with 3-5 mm of MTA, the remaining coronal canal is filled using warm gutta-
percha technique.
Perforations Repair
Due to the excellent sealing ability and biocompatibility of MTA, it has been used to
repair root perforations with predictable results.The dentinal portion of the tooth that has
been perforated is restored with MTA. A 16 case study has proven that MTA has an
excellent outcomes.All 16 cases demonstrated normal tissue architecture adjacent to the
repair site at the recall visit. Teeth with existing lesions showed resolution of the lesion,
and teeth without preoperative lesions continued to demonstrate absence of lesion
formation at the follow-up visit. Based on the results of this study, MTA provides an
effective seal of root perforations and shows promise in improving the prognosis of
perforated teeth that would otherwise be compromised.
Root-End Filling
MTA exhibits unusual physical sealing property, which makes it NO.1 candidate for
retrofillings.furthermore, there is an additional biological seal obtained by the
proliferation of cells directly on the cementum during the healing process.
References;
-https://www.ncbi.nlm.nih.gov/pubmed/25821936
-https://www.ncbi.nlm.nih.gov/pubmed/14977301/
-https://www.sciencedirect.com/science/article/pii/S0929664616000516?via%3Dihub

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Mineral Trioxide Aggregate (MTA)

By: Basel Awad

Pulpotomy and Apexogenesis

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