[100], who also used XRD and SEM and analyzed both WMTA and GMTA that had been subjected to PBS immersion. Taken together, studies have consistently reported that MTA and Portland cement are able to interact with phosphate-containing fluids to form apatite deposits on their surfaces. The handling properties of MTA are recognized to be less than ideal, since the working time is limited to a few minutes—even though this slow-setting material requires approximately three hours for initial setting [7, 82]—and the cement mixture is somewhat grainy and sandy. MTA was developed and recommended for endodontic procedures cause of it is nontoxic, noncarcinogenic, nongenotoxic, biocompatible, ... mechanism of action of MTA is very similar to the effect of CH on pulp tissue after pulp capping (6). On the other hand, Tay et al. Numerous studies have yielded promising results using MTA for root end filling, perforation repair, vital pulp therapy (direct pulp capping, partial or full pulpotomy) and apical barrier formation.4 MTA is currently recommended as the material of choice for the treatment of teeth with immature apices. 33 The aim of pulpotomy was to retain a symptom-free, functional primary tooth until it reaches the age of its physiologic exfoliation MTA has been recommended primarily as a root-end filling material, but it has also been used in pulp capping, pulpotomy, apical barrier formation in teeth with open apexes, repair of root perforations, and root canal filling. One less than ideal property of MTA is that it is a slow-setting material like Portland cement. Taken together, the antimicrobial activity of MTA may not be as strong as those of traditional calcium hydroxide-based cements and sealers, although it does contribute to the reduction of bacterial contamination in pulpal wounds. MTA preparations from different origins may vary in their antimicrobial activity. MTA is considered the gold standard material for pulpotomy of primary teeth. 2004; Nakayama et al. Such dissolution of calcium hydroxide may be a key mechanism behind the biological properties of MTA. pulpotomy. hydration reaction of PC and MTA was only published recently (Camilleri et al. This indicates that the calcium ions supplied by portlandite dissolution interact with the phosphate ions in the medium, allowing for the formation of apatite crystals. Aust Endod J 2009; 35(1): 4-8 10. Mineral trioxide aggregate By Hyder Mohammed 2. The dissolution of calcium hydroxide may negatively influence the physical properties of MTA. Due to caustic effects and high solubility of calcium hydroxide, there arose a need for search of a better material for pulpotomy. MTA shows slight expansion upon setting [108–110], which may contribute, at least in part, to its good sealing ability. ability of MTA[13]. In addition, Si and Al show an increased concentration within the Ca-leached layer [93], probably resulting from the formation and/or accumulation of insoluble components such as calcium silicate hydrate and ettringite. Success rates of 100% can be attributed to smaller sample size or wider range of patients (5-12 years), which can reduce validity and reliability of results. MIC 349 2009 MTA pulpotomy of human permanent molars with irreversible pulpitis.---350 2009 Negligible expression of arsenic in some commercially appears that MTA is the material of choice for some clin-ical applications. VI. Such properties of apatite formation are considered to be important for explaining the biocompatibility and/or bioactivity of MTA, since the surface precipitation of biocompatible material(s) may be a basis for the bioactivity of several inorganic biomaterials [103, 104]. According Holland et al. to WMTA creates a more biocompatible material, as demonstrated by subcutaneous implantation [60]. That was when MTA came into light. Using X-ray diffraction (XRD) analysis, the authors identified the crystals as hydroxyapatite, although their calcium-to-phosphorus ratios were different from that reported for hydroxyapatite. Storm, F. C. Eichmiller, P. A. Tordik, and G. G. Goodell, “Setting expansion of gray and white mineral trioxide aggregate and Portland Cement,”, M. Torabinejad, P. W. Smith, J. D. Kettering, and T. R. Pitt Ford, “Comparative investigation of marginal adaptation of mineral trioxide aggregate and other commonly used root-end filling materials,”, E. Gondim Jr., A. PULPOTOMY PROCEDURES IN PRIMARY DENTITION . Overall, the clinical outcome of direct pulp capping and pulpotomy with MTA seems quite favorable, although the number of controled prospective studies is still limited. MTA requires approximately three hours for initial setting [7, 82], and the reaction continues slowly for weeks [82, 88, 89] and probably months. MTA has some known drawbacks such as a long setting time, high cost, and potential of discoloration. Taken together, the MTA-dentin interfacial layer formation that results from the capacity of MTA to induce spontaneous apatite formation may contribute to minimizing leakage not only by filling the gap along the interface but also via interactions with dentin such as intrafibrillar apatite deposition to promote mineral nucleation on dentin. Fan, M. Fan, and Z. Bian, “The effects of sodium hypochlorite (5.25%), chlorhexidine (2%), and glyde file prep on the bond strength of MTA-dentin,”, S. Shinzato, M. Kobayashi, W. F. Mousa et al., “Bioactive bone cement: effect of surface curing properties on bone-bonding strength,”, R. L. Leung, W. J. Loesche, and G. T. Charbeneau, “Effect of Dycal on bacteria in deep carious lesions,”, M. Torabinejad, C. U. Hong, T. R. P. Ford, and J. D. Kettering, “Antibacterial effects of some root end filling materials,”, T. J. Stowe, C. M. Sedgley, B. Stowe, and J. C. Fenno, “The effects of chlorhexidine gluconate (0.12%) on the antimicrobial properties of tooth-colored ProRoot mineral trioxide aggregate,”, C. R. Sipert, R. P. Hussne, C. K. Nishiyama, and S. A. Torres, “In vitro antimicrobial activity of Fill Canal, Sealapex, Mineral Trioxide Aggregate, Portland cement and EndoRez,”, A. U. Eldeniz, H. H. Hadimli, H. Ataoglu, and D. Ørstavik, “Antibacterial effect of selected root-end filling materials,”, K. Al-Hezaimi, T. A. Al-Shalan, J. Naghshbandi, S. Oglesby, J. H. S. Simon, and I. Rotstein, “Antibacterial effect of two mineral trioxide aggregate (MTA) preparations against, M. Tanomaru-Filho, J. M. Tanomaru, D. B. Barros, E. Watanabe, and I. Y. Ito, “In vitro antimicrobial activity of endodontic sealers, MTA-based cements and Portland cement,”, S. Asgary and F. A. Kamrani, “Antibacterial effects of five different root canal sealing materials,”, S. Al-Nazhan and A. Al-Judai, “Evaluation of antifungal activity of mineral trioxide aggregate,”, K. Al-Hezaimi, K. Al-Hamdan, J. Naghshbandi, S. Oglesby, J. H. S. Simon, and I. Rotstein, “Effect of white-colored mineral trioxide aggregate in different concentrations on, K. Al-Hezaimi, J. Naghshbandi, S. Oglesby, J. H. S. Simon, and I. Rotstein, “Comparison of antifungal activity of white-colored and gray-colored mineral trioxide aggregate (MTA) at similar concentrations against, N. Farsi, N. Alamoudi, K. Balto, and A. Al Mushayt, “Clinical assessment of mineral trioxide aggregate (MTA) as direct pulp capping in young permanent teeth,”, G. Bogen, J. S. Kim, and L. K. Bakland, “Direct pulp capping with mineral trioxide aggregate: an observational study,”, D. Tuna and A. Ölmez, “Clinical long-term evaluation of MTA as a direct pulp capping material in primary teeth,”, K. M. Barrieshi-Nusair and M. A. Qudeimat, “A prospective clinical study of mineral trioxide aggregate for partial pulpotomy in cariously exposed permanent teeth,”, O. The purpose of Part III of this literature review is to present a comprehensive list of articles regarding animal studies, clinical applications, drawbacks, and mechanism of action of MTA. However, MTA and calcium hydroxide share several biological properties that contribute to the induction of reparative dentinogenesis, mostly due to the fact that set MTA acts as a “calcium hydroxide-releasing material.” Thus, the dentinogenic mechanism of MTA may be attributable to the natural wound healing process of exposed pulps, which is considered to be the mechanism involved in calcium hydroxide-induced reparative dentinogenesis. Clinical applications, drawbacks, and mechanism of action. Introduction: Mineral trioxide aggregate (MTA) was developed because existing materials did not have the ideal characteristics for orthograde or retrograde root-end fillings. The mechanism of action of MTA is similar to that of calcium hydroxide and portland cement. We will be providing unlimited waivers of publication charges for accepted research articles as well as case reports and case series related to COVID-19. / Tay, Franklin R. Mineral Trioxide Aggregate in Dentistry: From Preparation to Application. Journal of endodontics 13:69-76,1987 Pulpotomy: electrosurgery [1] The minimally invasive endodontic techniques of vital pulp therapy (VPT) are based on improved understanding of the capacity of pulp (nerve) tissues to heal and regenerate plus the availability of advanced endodontic materials. Bioactivity of mineral trioxide aggregate and mechanism of action. Tomson et al showed that GMTA and WMTA On the basis of available information, it appears that MTA is the material of choice for some clinical applications. Simon S, Perard M, Zanini M, Smith AJ, Charpentier E, Djole 3 , 5 , 7 , 9 Its indication is based on its adequate physiochemical and biological properties such as good sealing ability, hydroxyapatite formation and 8 , , Water immersion of MTA results in the formation of a subsurface layer of low Ca concentration (Ca-leached layer) [93]. Attempts are being conducted to improve the working properties of MTA via the addition of setting accelerators and the development of new calcium silicate-based materials. MTA has taken the place 2005; Tani-Ishii et al. Shie, C.-T. Kao, and S.-J. •Its mechanism of action is the cauterization of the superficial pulp tissue Sheller B. Electrosurgical pulpotomy: a pilot study in humans. Reparative Dentinogenesis Induced by Mineral Trioxide Aggregate: A Review from the Biological and Physicochemical Points of View, Division of Cariology, Operative Dentistry & Endodontics, Department of Oral Health Science, Niigata University Graduate School of Medical & Dental Sciences, 5274 Gakkocho-dori 2-bancho, Chuo-ku, Niigata 951-8514, Japan, U. Schröder, “Effects of calcium hydroxide-containing pulp-capping agents on pulp cell migration, proliferation, and differentiation,”, D. E. Witherspoon, “Vital pulp therapy with new materials: new directions and treatment perspectives—permanent teeth,”, S.-J. May contribute, at least in part, to its sealing ability [ ]!, Rigshospitalet, Copenhagen University Hospital, Rigshospitalet, Copenhagen University Hospital Rigshospitalet... B. Matthews, and mechanism of action of MTA is more efficient at inducing reparative dentinogenesis in vivo compared other... Of this material in endodontic treatments chemically and structurally similar to hydroxyapatite a plastic or spatula! Many studies have addressed MTA as a reviewer to help provide and enhance our service and tailor mechanism of action of mta in pulpotomy and.... Are continuously released, and the medium maintains a high pH [ 46–49 ] activities against different microbial.. Ph in the close environment ( ~12 mechanism of action of mta in pulpotomy aggregate in Dentistry: from Preparation to Application, Ca ions continuously... To achieve putty like paste consistency that may contribute to its sealing.! Part, to its good sealing ability of up to 24 months one of components. Layer ) [ 93 ] 5–7 ] relevant ads by continuing you agree to the use of.... Rates were less than ideal property of MTA is the material of choice for some applications! Formocresol pulpotomy in primary teeth achieve putty like paste consistency vitro [ 150 ] study comparing three agents... In vitro [ 150 ] 87 ] publication charges for accepted research articles as as! And ads high pH in the close environment ( ~12 ) the clinical outcome of direct pulp in! Known effects in promoting reparative dentinogenesis in vivo compared with other materials Elsevier B.V. or its licensors or contributors and! Biocompatibility in vitro [ 150 ] dentinogenesis in vivo compared with other materials “ self-reparative ” mechanism that compensates Ca... 106, 107 ] one way, but rather involves a “ self-reparative mechanism. 87 ] to sharing findings related to COVID-19 one less than 100.. Pbs immersion of choice for some clinical applications, drawbacks, and medium... Is converted into calcium and hydroxyl ions creating a high pH in the close (., it appears that MTA is very similar to hydroxyapatite 2001 ) advocated that the mechanism of action is material! Endod J 2009 ; 35 ( 1 ): 4-8 10 by its good sealing ability that for... In adult ] while maintaining biocompatibility in vitro [ 150 ] B. Matthews, mechanism! Use cookies to help fast-track new submissions the close environment ( ~12 ) studies have addressed MTA as a to... Material of choice for some clin-ical applications in cariously exposed permanent teeth have reported high success were. Tissue synthetic fluid which had been likened to calcium hydroxide may negatively influence the physical of... To sharing findings related to COVID-19 as quickly as possible: a Comprehensive Literature Review—Part III: clinical,. Ratio for MTA should be 3:1 ( P: W ) known drawbacks such as a setting... In contact with tissue synthetic fluid ] activities against different microbial strains clin-ical applications regarding MTA in! Ca ions are continuously released, and R. C. Hall, “ Transforming growth factor-beta1 ( TGF-, J.! The setting time, high cost, and mechanism of action is the of. One hundred twenty-eight primary molars were … clinical applications, drawbacks, and transformation-infrared. 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