Mineral Trioxide Aggregate Repair Research Articles

Shear bond strength of calcium silicate-based cements to composite resin using a universal adhesive in different application modes: an in vitro study.

To assess the shear bond strength (SBS) of four calcium silicate-based cements (CSCs) to composite resin using a universal adhesive in self-etch (SE) and etch-and-rinse (ER) modes and to evaluate surface microstructure and chemical composition of CSCs after acid-etching. In total, 30 specimens of each cement, Biodentine (BD), mineral trioxide aggregate (MTA) Angelus (MTA-A), ProRoot MTA (MTA-P) and MTA Repair HP (MTA-HP), were prepared and assigned into 2 groups (n = 15) according to universal adhesive (Clearfil Universal Bond Quick) applied in SE and ER mode. After composite resin (Clearfil Majesty Esthetic) was applied, the SBS was measured. Scanning electron microscope-energy dispersive spectroscopy (SEM-EDS) analysis was used to evaluate the changes in surface structure and elemental composition. MTA-P demonstrated significantly higher SBS than all CSCs, except for MTA-HP in the SE mode. The ER mode exhibited significantly higher SBS compared to the SE mode for MTA-P and MTA-A. Acid-etching caused morphological differences and affected elemental distribution. MTA-P may be a more suitable pulp capping material due to its superior SBS compared to BD and MTA-A. The application of a universal adhesive in ER mode may be suggested to increase the SBS of MTA-P and MTA-A to composite resin.

Comparison of the sealing ability amongst orthograde apical plugs of mineral trioxide aggregate plus, mineral trioxide aggregate repair HP, and Biodentine after root resection: a bacterial leakage study.

This study aimed to analyse the effect of root-end resection on the sealing ability of orthograde apical plugs of three root-end filling materials (MTA Repair HP, Biodentine, MTA Plus) using the bacterial leakage method and compare it with the retrograde root-end filling technique. Eighty-four extracted mandibular premolar teeth with single root and single straight canals were selected and randomly divided into two main experimental groups (n = 36) depending on the apical plug placement technique and a control: Group I: orthograde technique, followed by root-end resection; Group II: retrograde root-end filling technique; one control Group III (n = 12): obturation with gutta-percha, followed by root-end resection. Experimental groups were further subdivided into three subgroups A, B, and C (n = 12) depending on the three different root-end filling materials used. An apical plug of 3mm thickness was obtained in both the experimental groups. The apical sealing ability was evaluated with the dual-chamber bacterial leakage method. Statistical analysis was performed using the Kaplan-Meier survival analysis test. By the end of 30days, the occurrence of turbidity indicating bacterial leakage was 75% in MTA Repair HP, 83.3% in Biodentine, and 91.7% in MTA Plus samples. This trend of turbidity was similar in both orthograde and retrograde technique. The control group showed turbidity in all the samples (100%). More MTA Repair HP samples (25%) survived the 30days observation period with no bacterial leakage compared to Biodentine (16.7%) and MTA Plus (8.3%). The sealing ability of already set root-end filling materials placed through the orthograde technique did not deteriorate after root-end resection. Also among three root-end filling materials, MTA Repair HP presented the lowest bacterial microleakage followed by Biodentine and MTA Plus, respectively.

Response of stem cells derived from human exfoliated deciduous teeth to Bio-C Repair and Mineral Trioxide Aggregate Repair HP: Cytotoxicity and gene expression assessment

Background: The aim of this study was to investigate and compare the cytotoxicity and gene expression of Bio-C Repair, Mineral Trioxide Aggregate (MTA) HP Repair, and Biodentine on stem cells derived from exfoliated deciduous teeth.Materials and Methods: In this in vitro study MTT assay was used to assess the cellular viability at three different dilutions. The gene expression of Runt-related transcription factor 2 (Runx2), alkaline phosphatase (ALP), osteocalcin [OCN], and dentin matrix protein-1 (DMP-1) was measured with real-time polymerase chain reaction after 7 days, 14 days, and 21 days of incubation. One-way analysis of variance and Bonferroni posttest were used for statistical analysis (p=o.o5).Results: After 72 h of incubation at dilution 1:4, stem cells derived from human exfoliated deciduous teeth (SHEDs) cultivated in Biodentine, followed by Bio-C Repair and MTA Repair HP reported with highest cellular viability. The highest mRNA expression of Runx2, ALP, OCN, and DMP-1 was reported in SHEDs cultured in Biodentine (after 21 days of incubation). Conclusion: Bio-C Repair and MTA HP Repair are biocompatible and capable of odontogenic differentiation similar to Biodentine when cultured in stem cells derived from exfoliated primary teeth.

Portland Cement: An Overview as a Root Repair Material: Applications and Various Modifications

Background: Portland cement has promisingly been utilized for the reconstruction of root perforation and bone defects, although its key drawbacks, including low mechanical properties and radiopacity as well as long setting time, necessitate pragmatic modifications. Objective: The main objective of this review was an overview of portland cement as a root repair material, its applications and various modifications. Methods: The electronic search of the literature was done on the Pubmed and Google Scholar databases with the keywords of Portland cement, carbon nanotube, graphene oxide, MTA, pulp capping, and root repair material. Results: The first part of this paper presents the data published in the literature on applications of Portland cement in endodontic situations, including vital pulp therapy, root perforation repair, root canal filling and root-end filling following apical endodontic surgery. This bioactive endodontic cement has shown promising success rates compared to mineral trioxide aggregate (MTA), however, considerable modifications are required in order to improve its clinical performance and expand its application scope as a root repair material. Hence, nano-reinforcements (graphene oxide, carbon nanotube, silica and hydroxyapatite) and extensive chemical modifications incorporated into Portland cement composition to produce innovative bio-dental materials with superior rheological properties have been discussed. Moreover, the current knowledge of the microstructure, mechanical properties and durability of nanomaterial-incorporated cement has been summarized. Ultimately, this article outlines the main points of animal and clinical studies on resin-modified Portland cement (TheraCal) as a pulp capping material and suggests further investigations prior to marketing authorization. Conclusion: It can be concluded that Portland cement has the potential to be used as an acceptable pulp capping material with the least complaints in the long term.

Biological and chemical properties of five mineral oxides and of mineral trioxide aggregate repair high plasticity: an in vitro study

Calcium silicate-based cements have diverse applications in endodontics. This study aimed to evaluate the antibiofilm action, biocompatibility, morphological structure, chemical composition and radiopacity of Five Mineral Oxides (5MO), Mineral Trioxide Aggregate Repair High Plasticity (MTA Repair HP), and Mineral Trioxide Aggregate (MTA) cements. MTT analysis was used to test the antibiofilm action of these cements against five anaerobic microorganisms, and test their biocompatibility with mouse macrophage (RAW 264.7) and osteoblasts (MG-63) cultures. Their morphological structure and chemical composition were evaluated by scanning electron microscopy (SEM) coupled to energy dispersion X-ray spectroscopy (EDX), and the phase analysis was performed by X-ray diffraction (XRD). Conventional radiography was used to assess the radiopacity of the cements. 5MO, MTA Repair HP and MTA were effective against Porphyromonas gingivalis, Parvimonas micra, Fusobacterium nucleatum and Prevotella intermedia, they were biocompatible with macrophages and osteoblasts after 5 min of contact, and they had adequate radiopacity to be used clinically. Bismuth oxide (Bi2O3) is used as a radiopacifier in MTA and 5MO, and calcium tungstate, in MTA Repair HP. Titanium dioxide (TiO2) (ANATASE) is responsible for the antimicrobial action and biocompatibility of 5MO.

Materials for retrograde filling in root canal therapy.

Root canal therapy is a sequence of treatments involving root canal cleaning, shaping, decontamination, and obturation. It is conventionally performed through a hole drilled into the crown of the affected tooth, namely orthograde root canal therapy. When it fails, retrograde filling, which seals the root canal from the root apex, is a good alternative. Many materials are used for retrograde filling. Since none meets all the criteria an ideal material should possess, selecting the most efficacious material is of utmost importance. This is an update of a Cochrane Review first published in 2016. To determine the effects of different materials used for retrograde filling in children and adults for whom retrograde filling is necessary in order to save the tooth. An Information Specialist searched five bibliographic databases up to 21 April 2021 and used additional search methods to identify published, unpublished, and ongoing studies. We also searched four databases in the Chinese language. We selected randomised controlled trials (RCTs) that compared different retrograde filling materials, with the reported success rate that was assessed by clinical or radiological methods for which the follow-up period was at least 12 months. Records were screened in duplicate by independent screeners. Two review authors extracted data independently and in duplicate. Original trial authors were contacted for any missing information. Two review authors independently assessed the risk of bias of the included studies. We followed Cochrane's statistical guidelines and assessed the certainty of the evidence using GRADE. We included eight studies, all at high risk of bias, involving 1399 participants with 1471 teeth, published between 1995 and 2019, and six comparisons of retrograde filling materials. - Mineral trioxide aggregate (MTA) versus intermediate restorative material (IRM): there may be little to no effect of MTA compared to IRM on success rate at one year, but the evidence is very uncertain (risk ratio (RR) 1.09, 95% confidence interval (CI) 0.97 to 1.22; I2 = 0%; 2 studies; 222 teeth; very low-certainty evidence). - MTA versus super ethoxybenzoic acid (Super-EBA): there may be little to no effect of MTA compared to Super-EBA on success rate at one year, but the evidence is very uncertain (RR 1.03, 95% CI 0.96 to 1.10; 1 study; 192 teeth; very low-certainty evidence). - Super-EBA versus IRM: the evidence is very uncertain about the effect of Super-EBA compared with IRM on success rate at 1 year, with results indicating Super-EBA may reduce or have no effect on success rate (RR 0.90, 95% CI 0.80 to 1.01; 1 study; 194 teeth; very low-certainty evidence). - Dentine-bonded resin composite versus glass ionomer cement: compared to glass ionomer cement, dentine-bonded resin composite may increase the success rate of the treatment at 1 year, but the evidence is very uncertain (RR 2.39, 95% CI 1.60 to 3.59; 1 study; 122 teeth; very low-certainty evidence). Same result was obtained when considering the root as unit of analysis at one year (RR 1.59, 95% CI 1.20 to 2.09; 1 study; 127 roots; very low-certainty evidence). - Glass ionomer cement versus amalgam: the evidence is very uncertain about the effect of glass ionomer cement compared with amalgam on success rate at one year, with results indicating glass ionomer cement may reduce or have no effect on success rate (RR 0.98, 95% CI 0.86 to 1.12; 1 study; 105 teeth; very low-certainty evidence). - MTA versus root repair material (RRM): there may be little to no effect of MTA compared to RRM on success rate at one year, but the evidence is very uncertain (RR 1.00, 95% CI 0.94 to 1.07; I2 = 0%; 2 studies; 278 teeth; very low-certainty evidence). Adverse events were not assessed by any of the included studies. Based on the present limited evidence, there is insufficient evidence to draw any conclusion as to the benefits of any one material over another for retrograde filling in root canal therapy. We conclude that more high-quality RCTs are required.

Push-out bond strength and marginal adaptation of apical plugs with bioactive endodontic cements in simulated immature teeth.

ObjectivesThis study evaluates the bond strength and marginal adaptation of mineral trioxide aggregate (MTA) Repair HP and Biodentine used as apical plugs; MTA was used as reference material for comparison.Materials and MethodsA total of 30 single-rooted teeth with standardized, artificially created open apices were randomly divided into 3 groups (n = 10 per group), according to the material used to form 6-mm-thick apical plugs: group 1 (MTA Repair HP); group 2 (Biodentine); and group 3 (white MTA). Subsequently, the specimens were transversely sectioned to obtain 2 (cervical and apical) 2.5-mm-thick slices per root. Epoxy resin replicas were observed under a scanning electron microscope to measure the gap size at the material/dentin interface (the largest and smaller gaps were recorded for each replica). The bond strength of the investigated materials to dentin was determined using the push-out test. The variable bond strengths and gap sizes were evaluated independently at the apical and cervical root dentin slices. Data were analyzed using descriptive and analytic statistics.ResultsThe comparison between the groups regarding the variables' bond strengths and gap sizes showed no statistical difference (p > 0.05) except for a single difference in the smallest gap at the cervical root dentin slice, which was higher in group 3 than in group 1 (p < 0.05).ConclusionsThe bond strength and marginal adaptation to root canal walls of MTA HP and Biodentine cement were comparable to white MTA.

A Microstructure Insight of MTA Repair HP of Rapid Setting Capacity and Bioactive Response.

Mineral trioxide aggregate (MTA) is considered a bioactive endodontic material, which promotes natural mineralization at the material-tooth tissue interface. MTA Repair HP stands out because of the short setting time and the quick and effective bioactive response in vitro. The bioactivity, depens on material composition and microstructure. This work is devoted to analyze MTA Repair HP microstructural features, of both the powder precursor and set material, to get insights into the material physicochemical parameters—functionality performance relationships. Transmission electron microscopy (TEM), and field emission gun scanning electron microscopy (FEG-SEM) coupled with energy-dispersive X-ray (EDX) analyses were performed. X-ray diffraction (XRD) measurements were carried out at different times to investigate setting process. Bioactivity evaluation in vitro was carried out by soaking the processed cement disk in simulated body fluid (SBF). The presented results point out those MTA Repair HP precursor material characteristics of tricalcium silicate particles of nanometric size and high aspect ratio, which provide an elevated surface area and maximized components dispersion of calcium silicate and very reactive calcium aluminate. The MTA Repair HP precursor powder nanostructure and formulation, allows a hydration process comprising silicate hydrate structures, which are very effective to achieve both fast setting and efficient bioactive response.

Solubility, pH change, and calcium ion release of low solubility endodontic mineral trioxide aggregate

BackgroundInsolubility is the main requirement for ideal root end filling material to provide perfect sealing ability. Moreover, alkalinity and bioactivity provide great chance for tissues healing and remineralization. So, the aim of this work was to evaluate the chemical composition, solubility, pH change, and calcium ion release of recently introduced commercial mineral trioxide aggregate (MTA) endodontic repair cement (Harvard, Universal HandMix MTA) compared with ProRoot MTA repair material.MethodsSolubility was evaluated after 7- and 14-day immersion time of specimens in phosphate buffer saline solution (PBS); the mean weight loss was evaluated and solubility was calculated as a percentage of the weight loss. For assessment of pH change and calcium ion release polyethylene tubes filled with the materials were soaked in distilled water for 7 and 14 days. Measurement of pH change was done by analytical pH meter. Concentrations of calcium ion release were measured using inductively coupled plasma optical emission spectroscopy. Data were statistically analyzed by independent sample t test and paired sample t test at 5% significance level.ResultsHarvard MTA endodontic cement showed significant lower solubility and higher pH values compared with that of ProRoot MTA. ProRoot MTA exhibited significant higher calcium ion release value after 14 days (P value ≤ 0.05).ConclusionHarvard, Universal HandMix MTA repair cement with its different chemical composition; exhibits a low solubility with enhanced alkaline pH value compared to ProRoot MTA repair material.

Comparative evaluation of sealing ability of two different biocompatible materials in repair of furcal perforation: An In vitro study

Purpose: The purpose of this study was to evaluate the sealing ability and microleakage of Biodentine and mineral trioxide aggregate (MTA) Repair HP as furcal perforation repair materials. Materials and Methods: Twenty permanent mandibular molars were divided for ten samples each in Group I – Biodentine and Group II – MTA Repair HP. After access cavity preparation, artificial perforation was created and sealed with the repair material. Specimens were suspended in 2% methylene blue dye for 24 h and then split into longitudinal sections. After examining the depth of dye penetration under stereomicroscope, microleakage was calculated. Results: A higher mean microleakage was recorded in MTA Repair HP as compared to Biodentine. Conclusion: The study showed that Biodentine shows maximum sealing ability and least microleakage when compared with MTA Repair HP.

Cytotoxicity, Biocompatibility and Biomineralization of a New Ready-for-Use Bioceramic Repair Material.

New mineral trioxide aggregate (MTA) formulations are constantly introduced in the market, usually in a powder-and-liquid form. Bioceramic (Bio-C) Repair is a ready-for-use material suggested as substitute for MTA, but its properties need to be studied. This study evaluated the cytotoxicity, biocompatibility and biomineralization of Bio-C Repair compared to MTA Repair High-Plasticity (MTA-HP) and white MTA-Angelus (MTA-Ang). L929 fibroblasts were exposed to material-extracted (undiluted, ½ and ¼ dilutions; 6, 24 and 48h). Polyethylene tubes with material or empty (control) were implanted in the subcutaneous tissue of rats. After 7 and 30 days (n=8), the specimens were removed for analysis (hematoxylin-eosin, von Kossa and polarized light). Cytotoxicity data were statistically analyzed by two-way ANOVA, and biocompatibility data by Kruskal-Wallis and Dunn tests (p<0.05). The cells exposed to the materials had greater viability at most of the periods compared with control (p<0.05). The undiluted and ½ dilutions of MTA-HP extract showed higher cytocompatibility than Bio-C Repair at 6 h and with the ¼ dilution at 24 h (p<0.05); the white MTA-Ang showed higher cytocompatibility than Bio-C Repair at most of periods (p<0.05). The undiluted white MTA-Ang extract had higher cytocompatibility at 6 and 24h than MTA-HP, and with ½ dilution at 24h (p<0.05). The materials' cytocompatibility was similar at 48h for most dilutions (p>0.05). At 7 and 30 days, the groups had moderate and mild inflammation, respectively (p>0.05). All materials showed positive structures for von Kossa and polarized light. In conclusion, Bio-C Repair had similar cytocompatibility to MTA-based materials is biocompatible and induces biomineralization.

Comparative Analysis of Clinical Effects of Mineral Trioxide Aggregate in the Treatment of Endodontic Diseases

We aimed to evaluate the efficacy of mineral trioxide aggregate (MTA) in the treatment of endodontic disease. Oversell, 384 patients with endodontic disease treated in Xuzhou Stomatological Hospital, Xuzhou, China, from June 2015 to June 2017 were selected, and randomly divided into four groups with 96 cases per group. The repair effects of MTA, zinc phosphate cement (ZPC), silver amalgam and light-curing calcium hydroxide (LCH) on the teeth and dental pulp of patients in the four groups were compared. Meanwhile, the ill symptoms of the patients were observed to confirm whether they could be alleviated. Besides, whether the repair effects were related to ages of patients, perforation diameters of diseased teeth and repair materials was discussed. The success rates of MTA group, ZPC group, LCH group and silver amalgam group were 90.6%, 68.7%, 70.8% and 52.1%, respectively. The success rate of MTA group was significantly higher than that of ZPC group, silver amalgam group and LCH group. When the success rates of four groups were compared, the differences were statistically significant (P=0.0072). The patient's age, repair material and perforation diameter were positively correlated with MTA repair effect (P=0.003, P=0.002, P=0.01). The patients' teeth in each group were repaired with different materials, and the reexamination was conducted 4 weeks later. Three patients in the silver amalgam group were found to have gingival swelling. The therapeutic effect of MTA was significant in the treatment of endodontic disease, and it is worthy of clinical application.

Micro‐XRD and nanoindentation investigation of bioceramics for dental pulp therapy

AbstractTherapeutic bioceramics for dental pulp treatment are an area of active research. This study investigated the phases in two commonly used bioceramics and depth of dentin remineralization after application of these bioceramics. Cavities in non‐carious third molars were filled with ProRoot White mineral trioxide aggregate (MTA) (Dentsply Tulsa Dental), EndoSequence Root Repair Material (Brasseler USA) and with calcium hydroxide (Dycal, Dentsply Caulk) serving as a control. Specimens were immersed in simulated body fluid (SBF) for 3 months, and Micro‐X‐ray diffraction (Micro‐XRD) analyses were performed on the bioceramics two minutes after placement and at seven subsequent intervals. After three months in SBF, specimens were subjected to nanoindentation testing. Micro‐XRD revealed the presence of dicalcium silicate, tricalcium silicate, tricalcium aluminate and calcium sulphate in both bioceramics. Opacifying agents bismuth oxide and zirconia were also detected in ProRoot White MTA and EndoSequence Root Repair Material, respectively. There was no evidence for the silicate gel matrix that forms during setting of these bioceramics. Nanoindentation testing revealed that at &lt;17 µm from the interface, the nanohardness of dentin in specimens filled with Dycal was lower than for EndoSequence and ProRoot White MTA, whereas at 21–97 µm from the interface, there was no significant difference in nanohardness of dentin filled with any material.

Physical and Biological Properties of a High-Plasticity Tricalcium Silicate Cement.

Introduction Mineral Trioxide Aggregate (MTA) is a tricalcium-based silicate, dicalcium silicate matrix. Despite its good biologic properties, some clinicians still claim to have difficulties in handling MTA after its preparation due to its sandy consistency. The aim of the present study was to evaluate the physicochemical properties and cytotoxicity of MTA Repair HP (Angelus, Londrina, PR, Brazil) compared with MTA Angelus (Angelus, Londrina, PR, Brazil). Materials and Method The properties assessed were particle size, setting time, flow, film thickness, radiopacity, water solubility, compressive strength, and cytotoxicity. Statistical analysis was performed considering p < 0.05 as statistically significant. Results For radiopacity, water absorption and solubility MTA Repair HP were statistically similar to MTA Angelus. The MTA Angelus had statistically different film thickness values, higher than MTA Repair HP (p < 0.05). Besides, MTA Angelus showed a lower and statistically different compressive strength after 28 days than MTA Repair HP (p<0.05). Additionally, MTA Repair HP set more slowly (p < 0.05). Relative to cell viability, MTA Repair HP was statistically similar to MTA Angelus after 24 and 48 h in cell viability. Conclusions The MTA Repair HP presented similar cell viability, lower film thickness, higher flow, setting time, and compressive strength values after 28 days than MTA Angelus. In general, the MTA Repair HP presented physicochemical and biological properties similar to the MTA Angelus.

Immediate and Delayed Repair of 2 Sizes of Furcal Perforations in Dogs' Teeth Using Mineral Trioxide Aggregate Cement

IntroductionThis histologic study aimed to measure the morphometric and morphologic changes in periodontal tissue after immediate and delayed mineral trioxide aggregate (MTA) repair of 2 sizes of furcal perforations. MethodsThere were 72 premolars from 12 beagle dogs that were divided equally into 4 experimental and 2 control groups (n = 12). Experimental groups included immediate small (0.6 mm in diameter), immediate large (1.8 mm in diameter), delayed (30 days) small, and delayed large furcal perforation MTA repair. The control groups included negative (no furcal perforation) and positive (nonrepaired small and large furcal perforations) controls. After 3 months, tissue blocks were harvested and processed for histologic assessment. Morphometric analysis measured the thickness of periodontal ligaments (average, maximum, and minimum) in millimeters, the area of interest in square millimeters, and the area of healing tissue at the perforation site in square millimeters. Morphologic assessment consisted of 7 parameters for tissue inflammation, resorption, and repair. Histologic assessment was completed by 2 calibrated examiners who were blinded to the study group. ResultsMorphometric and morphologic measurements showed no significant difference between immediate and delayed MTA repair of small perforations and the negative control. The average thickness of the periodontal ligaments in delayed large perforations was 0.467 mm, which was significantly different from 0.294 mm in the delayed small perforations repair. The area of healing tissue in the positive control was 0.473 mm2, which was significantly different from 0.311 mm2 in delayed large perforation repair. ConclusionsWithin the study limitations, periodontal tissue responded more favorably to MTA repair of furcal perforation when it was placed in smaller perforations. The time of treatment became more critical as the perforation size increased.

Endodontic management of type II dens invaginatus with open apex and large periradicular lesion using the XP-endo Finisher: A case report

Dens invaginatus (DI) represents an endodontic challenge because of its complex root canal morphology. This case report presents the clinical management of a 22-year-old woman with type II DI in right maxillary lateral incisor with a painful swelling. Pulp testing revealed no response with the tooth. Type II DI with open apex and large periradicular lesion was seen on radiograph. The treatment was planned by using cone-beam computed tomography (CBCT) imaging. Canal treatment was completed in two appointments with the aid of a dental operating microscope. In the first appointment, the internal anatomy was modified using an ultrasonic tip, and chemo-mechanical preparation was performed using the XP-endo Finisher instrument and NaOCl; calcium hydroxide intracanal dressing was used for one month. In the second appointment, an apical plug of mineral trioxide aggregate (MTA) Repair HP was performed and the remaining pulp space was then filled with gutta-percha and AH Plus sealer using the continuous wave of condensation technique. At the fourteen-month reevaluation, the patient was asymptomatic, the tooth had remained functional, and radiographic and CBCT assessment showed significant osseous healing of the lesion. Successful non-surgical management of the present type II DI was achieved in the present case. The association of CBCT, dental operating microscope, XP-endo Finisher, NaOCl and MTA Repair HP were important for ensuring a predictable outcome. Key words:Cone beam computed tomography, dens invaginatus, MTA apexification, XP-endo Finisher.

Green discoloration of the crown after internal root resorption treatment with grey mineral trioxide aggregate (MTA)

Root resorption (RR) is the loss of dental hard tissues as a result of clastic activities. Internal inflammatory root resorption (IRR) is a type of RR characterized by progressive loss of tooth substance starting from the root canal wall. IRR is usually asymptomatic, slowly progressing, and detectable upon routine radiographic examination or by the clinical sign of a ‘pink spot’ when the IRR involves the crown or the coronal third of the root canal. Mineral trioxide aggregate (MTA) is a biocompatible cement that has been used successfully in pulp capping, pulpotomy, treatment of traumatized teeth with immature apices, and for treatment of root resorption. The treatment and follow-up of a maxillary central incisor with perforating IRR managed by root canal treatment and grey MTA repair is reported. IRR affected tooth 11 (FDI World Dental Federation) in a 29-year-old female patient, with a history of previous trauma. Follow-up radiographs over 24 months demonstrated the maintenance of a functional tooth. However, the tooth showed a green discoloration of the crown after MTA treatment.

MTA Repair of a Supracrestal Perforation: A Case Report

Root perforations are undesired complications of endodontic treatment. In the recent literature, MTA has been regarded as an ideal material for perforation repair. This article describes a case report where an iatrogenic supracrestal perforation was repaired successfully with mineral trioxide aggregate (MTA).