Use MTA in Your Endodontic cases

Many Dentists have written a lot about MTA and there are tons of theory in the books and the internet for you. Ill not provide with notes of MTA. 
So why read this post ? 

Read this post because ill tell you about clinical application of this material - How to use MTA? Where to use MTA ? How to Manipulate MTA. Advantages and Disadvantages of MTA.

MTA stands for Mineral Trioxide Aggregate.
It was 1993 when Torabinejad first introduced MTA in the dental field. Technically its nothing but a super fine and modified "Portland cement" what we find in hardware stores. 
Endodontics need precision and care, Miscalculation of 1mm can increase the chances of failure.

Composition: 
                      Tricalcium  Silicate
                      Tricalcium aluminate
                      Tricalcium Oxide
                      Silicate Oxide
                      Bismuth Oxide- radio-opaque
                      A small amount of other mineral oxides
On hydration of this powder, it forms a colloidal gel, on solidification this mass forms an impermeable barrier. After solidification, it reaches to pH of 12.5 which is similar to CaoH.            

Clinical application:
Cases of Root perforation-Its healing results are remarkable.
Root End feeling material in open apex. ( Apexogenesis )
Vital pulp therapy- Direct pulp therapy
Teeth with open apices and necrotic pulps (Apexification)
Pulp Capping
Pulpotomy
Furcation Perforation
Extra-Radicular perforation repair
Surgical root repair
Internal resorption repair


How big the exposure should be The size of the exposure can be 0.5 mm (the tip size of a perio probe) to 4 mm with the same success


Before application thoroughly disinfect the area with Sodium hypochlorite
Arrest any hemorrhage by applying pressure with a cotton plug or by using suproxol 


How to mix[Note- Every company provide their proper manipulation guide with the packet follow it for best result and for idea read following]

It comes in pouches so  open one 
Mix with the water ampule (sterile water) provided or you can buy it from the medical store and get to a creamy consistency
powder liquid ratio is 3:1
you can use perio-probe, excavators or cement carrier - whatever suits you to place it and condense it with a condenser. Remove excess moisture.
MTA has approximately 5 - 15 minutes' working time and 4 - 6 hours' setting time.



Pros:
Excellent sealing ability
Low solubility
Radioopaque
Biocompatible
Hydrophilic
High pH- 12.5
Bacteriostatic

Allows normal healing response
Allows formation of new cementum
Allows formation of new dentin
Least leakage

Cons:
Cost vise high in compare to CaoH
irreversible application
            
If you are interested in further study. Here is a nice collection of  Scientific articles on MTA from  Vesna Miletic.

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