Abstract
This paper aims to review the biological and physicochemical properties of mineral trioxide aggregate (MTA) with respect to its ability to induce reparative dentinogenesis, which involves complex cellular and molecular events leading to hard-tissue repair by newly differentiated odontoblast-like cells. Compared with that of calcium hydroxide-based materials, MTA is more efficient at inducing reparative dentinogenesis in vivo. The available literature suggests that the action of MTA is attributable to the natural wound healing process of exposed pulps, although MTA can stimulate hard-tissue-forming cells to induce matrix formation and mineralization in vitro. Physicochemical analyses have revealed that MTA not only acts as a “calcium hydroxide-releasing” material, but also interacts with phosphate-containing fluids to form apatite precipitates. MTA also shows better sealing ability and structural stability, but less potent antimicrobial activity compared with that of calcium hydroxide. The clinical outcome of direct pulp capping and pulpotomy with MTA appears quite favorable, although the number of controled prospective studies is still limited. Attempts are being conducted to improve the properties of MTA by the addition of setting accelerators and the development of new calcium silicate-based materials.
Highlights
The aim of direct pulp capping is to maintain the vitality and function of the dental pulp following its exposure to the external environment
Reyes-Carmona et al [58] examined the precipitates on various phosphate-buffered saline (PBS)-immersed mineral trioxide aggregate (MTA) preparations and Portland cements by means of SEM and X-ray diffraction (XRD) and found the presence of amorphous calcium phosphate crystals of different morphologies and Ca/P ratios, which may act as precursors during the formation of carbonated apatite
The available literature suggests that MTA is more efficient at inducing reparative dentinogenesis in vivo compared with calcium hydroxide-based materials
Summary
The aim of direct pulp capping is to maintain the vitality and function of the dental pulp following its exposure to the external environment. MTA is a bioactive material that was developed in the early 1990s, originally as a retrograde filling material, and first appeared in the dental scientific literature in 1993 [3]. MTA is used to seal off exposed pulps and various communications between the root canal system and surrounding tissues for a variety of indications such as root-end filling, perforation repair, and apexification [4]. The basic question of why such materials induce the hard-tissue repair of exposed pulps has not yet fully been answered. International Journal of Dentistry the available literature regarding the ability of MTA to induce reparative dentinogenesis from both the biological and physicochemical points of view
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