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PubMed2004

The effects of chlorhexidine gluconate (0.12%) on the antimicrobial properties of tooth-colored ProRoot mineral trioxide aggregate.

The purpose of this in vitro study was to determine whether the substitution of 0.12% chlorhexidine gluconate for sterile water as a mixing agent would enhance the antimicrobial activity of tooth-colored ProRoot mineral trioxide aggregate (MTA) against Actinomyces odontolyticus (ATCC17982), Fusobacterium nucleatum (ATCC2586), Streptococcus sanguis (ATCC10556), Enterococcus faecalis (ER3/2S), Escherichia coli (SM10lambdapir), Staphylococcus aureus (ATCC6538), Pseudomonas aeruginosa (UME), and Candida albicans (ATCC10261). Two wells of 5-mm diameter were made in triplicate agar plates inoculated with standardized suspensions of each microorganism. MTA (33 mg) mixed with chlorhexidine (12 microl) or sterile water (12 microl) was placed to fill each well. Plates were incubated at 37 degrees C as required for microbial growth. A blinded, independent observer measured zones of inhibition. All MTA samples inhibited microbial growth regardless of mixing agent. MTA/chlorhexidine showed significantly larger zones of inhibition (p < 0.0002, paired t test). In conclusion, substituting 0.12% chlorhexidine gluconate for water enhanced the antimicrobial activity of tooth-colored ProRoot MTA.

Actinomyces↗

PubMed2004

Bacterial leakage with mineral trioxide aggregate or a resin-modified glass ionomer used as a coronal barrier.

The purpose of this study was to evaluate gray mineral trioxide aggregate (MTA), white MTA, and Fuji II LC cement as coronal barriers to bacterial leakage. Seventy-eight, matched, human teeth were obturated with gutta-percha. In group I, 18 pairs received a 3-mm barrier of gray or white MTA. In group II, 18 pairs received a 3-mm barrier of gray MTA or Fuji cement. Three pairs were used as positive (obturated without barrier) and negative (covered with epoxy resin) controls. A dual-chamber leakage model utilizing salivary microbes was used for the evaluation. Leakage was recorded when turbidity was observed. All controls behaved as expected. In group I, three gray MTA and three white MTA samples leaked. In group II, one gray MTA and three Fuji samples leaked. There was no statistically significant difference in leakage between gray and white MTA or gray MTA and Fuji at 30, 60, or 90 days. Gray and white MTA or Fuji II can be recommended as a coronal barrier for up to 3 months.

Aluminum Compounds↗

PubMed2004

Sealing ability of One-Up Bond and MTA with and without a secondary seal as furcation perforation repair materials.

This study investigated the ability of One-Up Bond alone and mineral trioxide aggregate (MTA), with and without a secondary seal of One-Up Bond or SuperEBA to seal saucer-shaped perforation defects in human molars. Cusps were removed, roots were amputated, and endodontic therapy completed on 40 extracted teeth. A cylindrical hole was made in each tooth from the furcation area to the chamber, into which a section of steel tubing was cemented. Intracoronal saucer-shaped defects were created over the perforation. The teeth were restored with MTA, One-Up Bond, or MTA with a secondary seal of One-Up Bond or SuperEBA. The integrity of the seal was evaluated by fluid filtration. MTA alone leaked significantly more than One-Up Bond or MTA with either secondary seal at 24 h. At 1 month, MTA, MTA plus One-Up Bond, and One-Up Bond alone were equivalent.

Aluminum Compounds↗

PubMed2005

In-vitro evaluation of microleakage of an orthograde apical plug of mineral trioxide aggregate in permanent teeth with simulated immature apices.

This in vitro study evaluated the seal created by varying depths of mineral trioxide aggregate (MTA) plugs placed in an orthograde fashion in five groups of 10 teeth. One group received a 2 mm thick orthograde apical plug of MTA, the second group a 5 mm apical MTA plug, and the third group a 2 mm apical MTA plug with a second 2 mm increment, 24 h later. The remaining portion of the canal in these groups was left unfilled. Group four received a 2 mm MTA plug that set for 24 h and the canal was then back-filled with gutta-percha and eugenol based sealer. Group five was a positive control without an MTA plug. The apical seal was tested using a bacterial leakage model of Actinomyces viscosus. Results showed a statistically significant difference in only the 5 mm apical plug, which completely prevented bacterial leakage.

Actinomyces viscosus↗

PubMed2005

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).

Adult↗

PubMed2005

A systematic review of in vitro retrograde obturation materials.

The purpose of this review was two-fold: (a) to determine which retrograde obturation material(s) best prevents dye/ink penetration in vitro; and (b) to determine whether in vitro results agree with in vivo results. A MEDLINE search was conducted to identify in vitro studies published between January 1966 and October, week 4, 2003, conducted on human teeth, and published in English, German, or French language, testing the resistance to retrograde penetration of retrograde filling materials. The MEDLINE search identified 278 published articles. Of those, 115 studies examined the resistance to penetration of various retrograde filling materials, in vitro. Thirty-four studies met all the inclusion and validity criteria. The results indicate that, beyond 10 days in vitro, the most effective retrofilling materials, when measured by dye/ink penetration are: composites>glass ionomer cement>amalgam>orthograde gutta-percha>EBA. The results of these in vitro studies are not congruent with in vivo study results, suggesting a need to re-evaluate the clinical validity and importance of in vitro studies.

Aluminum Compounds↗

PubMed2005

Human saliva penetration of root canals obturated with two types of mineral trioxide aggregate cements.

The sealing ability of orthograde mineral trioxide aggregate (MTA) root canal filling against human saliva was assessed in vitro. Leakage of gray-colored MTA, white-colored MTA and vertically condensed gutta-percha and sealer were compared. Forty-three extracted single-rooted human teeth were serially instrumented to a file size 40/0.06 at the apex and obturated with either gray-colored MTA (group A), white-colored MTA (group B), or gutta-percha and Kerr Canal Sealer EWT (group C). The teeth were then mounted in a model to test for saliva leakage. After 42 days, one root in group A (9.1%), four roots in group B (36.4%), and nine roots in group C (81.8%) showed saliva leakage. Statistically, a significant difference was found between group A and group C (p < 0.001). No statistical difference was found between group A and group B. Out of the root samples that leaked, the one sample in group A leaked after 36 days. Of the four samples in group B, one sample leaked after 32 days, one sample after 33 days, and two samples after 39 days. All nine samples in group C had leaked after 19 days. It appears that under the conditions of this study both MTA preparations may be more resistant to human saliva leakage than vertically condensed gutta-percha and sealer.

Aluminum Compounds↗

PubMed2005

Root-end filling materials: apical microleakage and marginal adaptation.

The purpose of this study was to evaluate the root-end sealing ability through dye leakage evaluation and the marginal adaptation through scanning electron microscopy (SEM) of some root-end filling materials. Thirty human uniradicular teeth were used. Teeth were divided into three groups: (1) retrofilled with MTA-Angelus, (2) with SuperEBA, and (3) with Vitremer. The root surfaces were isolated with nail polish and teeth were immersed in silver nitrate. Roots were sectioned transversally at each millimeter, in three sections and evaluated at a stereomicroscope to observe dye penetration. Using SEM the distance between the tested root-end filling materials and the surrounding dentin was measured at four points. The statistical analysis showed significant differences among the three materials in relation to the sealing ability (p < 0.05). Concerning marginal adaptation, MTA-Angelus presented the best results (p < 0.01). Absence of correlation between the two methodologies was clearly observed.

Aluminum Compounds↗

PubMed2001

Redetermination of CaMn2O4.

The title compound, calcium dimanganese tetraoxide, CaMn(2)O(4), was synthesized hydrothermally and is made up of edge-sharing Mn(3+) distorted octahedral layers and eight-coordinate Ca(2+) centered polyhedral layers.

Journal Article↗

PubMed2026

Outcomes and Associated Prognostic Factors for Orthograde Canal Obturation Using Ortho MTA III: A Randomised Prospective Clinical Trial.

AIM: To prospectively compare treatment outcomes for orthograde canal obturation using Ortho MTA III (OMTA) with the continuous wave of compaction (CWC) using gutta-percha (GP) and AH Plus sealer, and to identify associated predictive factors. METHODOLOGY: Informed consent was obtained (110 patients), and single- or two-rooted permanent teeth (n = 120) diagnosed with pulp necrosis (or previously treated) and asymptomatic apical periodontitis or chronic apical abscess (periapical index, PAI ≥ 3) were randomly assigned to two groups (n = 60/group). The canals were prepared to a minimal apical size #40 (ISO) based on their initial file size, disinfected and obturated by either CWC or OMTA using an enhanced disinfection protocol (GP disinfected, new gloves after each intraoperative radiograph and before starting obturation). Clinical and periapical radiographic examinations were conducted by two calibrated, independent endodontists during follow-up periods of at least 12 months. Success rates and associated predictive factors (tooth-, operator- and patient-related) were analysed statistically using binary and multiple logistic regression (p < 0.05). RESULTS: The median recall period was 30 months (14-48 months), and 104 teeth were finally analysed (recall rate: 86.67%). No significant differences in success rate were observed between the groups (p > 0.05) under both loose (OMTA: 88.24%, CWC: 83.02%) and strict criteria (OMTA: 64.71%, CWC: 58.49%). Multivariate analysis revealed that age (OR = 5.735, 95% CI: 1.286-25.577, p = 0.022), periapical lesion size (OR = 6.596, 95% CI: 1.397-31.138, p = 0.017) and PAI score (OR = 2.081, 95% CI: 1.047-4.136, p = 0.036) were significant predictors of treatment failure. CONCLUSIONS: Orthograde obturation of infected canals with Ortho MTA III demonstrated comparable success and treatment outcomes to those filled with GP and sealer by CWC, supporting its potential as a clinically viable alternative for the obturation of infected root canals. TRIAL REGISTRATION: cris.nih.go.kr registration number: KCT00099939.

Humans↗

PubMed2004

Marginal adaptation of mineral trioxide aggregate (MTA) compared with amalgam as a root-end filling material: a low-vacuum (LV) versus high-vacuum (HV) SEM study.

AIM: To compare the marginal adaptation of mineral trioxide aggregate (MTA) or amalgam root-end fillings in extracted teeth under low-vacuum (LV) versus high-vacuum (HV) scanning electron microscope (SEM) viewing conditions. METHODOLOGY: Root-end fillings were placed in 20 extracted single-rooted maxillary teeth. Ten root ends were filled with MTA and the other 10 root ends were filled with amalgam. Two 1 mm thick transverse sections of each root-end filling were cut 0.50 mm (top) and 1.50 mm (bottom) from the apex. Gap size was recorded at eight fixed points along the dentine-filling material interface on each section when uncoated wet (LV wet (LVW)) and dry under LV (0.3 Torr) in a JEOL JSM-5800 SEM and backscatter emission (LV dry uncoated (LVDU)). The sections were then air-dried, gold-coated and gap size was recorded once again at the fixed points under HV (10(-6) Torr; HV dry coated (HVDC)). Specimen cracking, and the size and extent of the crack were noted. RESULTS: Gap sizes at fixed points were smallest under LVW and largest under HVDC SEM conditions. Gaps were smallest in MTA root-end fillings. A General Linear Models Analysis, with gap size as the dependent variable, showed significant effects for extent of crack in dentine, material and viewing condition (P = 0.0001). CONCLUSIONS: This study showed that MTA produced a superior marginal adaptation to amalgam, and that LVW conditions showed the lowest gap size. Gap size was influenced by the method of SEM viewing. If only HV SEM viewing conditions are used for MTA and amalgam root-end fillings, a correction factor of 3.5 and 2.2, respectively, may be used to enable relative comparisons of gap size to LVW conditions.

Aluminum Compounds↗

PubMed2005

Perforation repair with mineral trioxide aggregate: a modified matrix concept.

AIM: To present a modified matrix concept for repair of root perforations using mineral trioxide aggregate (MTA). SUMMARY: Root perforations may occur during preparation of endodontic access cavities or during post-space preparation. The perforation creates the potential for an inflammatory reaction in the periodontal ligament. A concept for the repair of root perforations is presented using a matrix of resorbable collagen. This matrix reconstructs the outer shape of the root and facilitates the adaptation of MTA. The indications for the use of MTA are discussed. Two clinical cases of 5-year successful root perforation repair using the technique are presented. KEY LEARNING POINTS: Long-term perforations with periodontal inflammation can be successfully treated with MTA. Matrices for MTA placement can be developed with commercially available collagen. Infection control within the root canal and at the perforation site is required for satisfactory perforation repair and healing.

Aluminum Compounds↗

PubMed2005

Longitudinal study on microleakage of three root-end filling materials by the fluid transport method and by capillary flow porometry.

AIM: (i) To compare the root-end sealing ability of IRM Caps (IRM), Fuji IX Capsules (Fuji IX) and Pro Root MTA Tooth-Coloured Formula (MTA) in teeth obtained from cadavers. (ii) Further research on leakage study methodology by means of comparison of the fluid transport method (FTM) and capillary flow porometry (CFP). METHODOLOGY: Root canal treatment was performed on 33 cadaver teeth in situ 2 weeks prior to root resection and ultrasonic retropreparation (S12/90 degrees D-tip on Suni-Max), after which the teeth were retrieved from the cadavers. Two teeth were kept as positive and negative controls. The other teeth were divided in three different groups at random, with each group receiving one of the retrofill materials. Retrofills were exposed to water 5 min after placement. The teeth were stored at 37 degrees C for 12 h after which the root filling was removed. Microleakage (L in microL day(-1)) was measured for 24 h under a pressure of 1.2 atm using FTM and recorded as L = 0, 0 < L < or = 10, L > 10. The measurements were repeated after 1 and 6 months. After 6 months, leakage was also assessed by CFP in order to measure through pores and their diameters. Results were analysed statistically using nonparametric Kruskal-Wallis and Mann-Whitney U-tests, and Spearman correlation coefficients between the results of both methods were calculated. The level of significance was set at 0.05. RESULTS: (i) A statistically significant difference could be demonstrated between Fuji IX and IRM at 1 month with FTM. FTM revealed a significant difference between Fuji IX and the other materials at 6 months, whereas CFP did not. However, using both methods, Fuji IX showed the best result. (ii) When comparing both techniques, CFP demonstrated through pores in all teeth, whereas with FTM in only 14 of the 31 teeth could through pores be demonstrated. A positive correlation between both methods was demonstrated. CONCLUSIONS: Under the conditions of this study (i) the conventionally setting glass-ionomer cement Fuji IX showed the best results when used as a root-end material and (ii) CFP appeared to be a useful method for leakage evaluation of through pores in endodontics.

Aluminum Compounds↗

PubMed2005

Calcium release and pH-characteristics of calcium hydroxide plus points.

AIM: To evaluate calcium ion release and pH-characteristics of calcium hydroxide plus points (CHPP), conventional calcium hydroxide points (CHP, both Coltène/Whaledent, Langenau, Germany) and aqueous calcium hydroxide suspension (CHS) (Calxyl, OCO, Dirmstein, Germany). METHODOLOGY: Ten CHPP or CHP of size 50 were immersed into 5 mL isotonic sodium chloride solution. Conventional Ca(OH)2-free gutta-percha points served as negative control. Calcium release was measured up to 44 days by means of complexometric titration. Time dependent pH behaviour of all points in comparison with CHS was determined immersing 30 points of size 50 into 2.3 mL 0.9% wt NaCl-solution at time intervals of 0.5-72 h by a microelectrode measuring chain and a pH-meter. The surface morphologies of new and used gutta-percha points were evaluated qualitatively under a scanning electron microscope. Statistical evaluation was carried out using Kolmogorov-Smirnov-tests, Mann-Whitney-tests and multifactorial anova. RESULTS: For CHPP, a threefold greater calcium release was measured compared with CHP. Both types of points as well as CHS showed a maximum pH of approximately 12. Differences between groups were statistically significant for calcium release and pH (multifactorial anova; P < 0.001). Both types of points showed porous surfaces after usage, with a rougher surface for CHPP. CONCLUSIONS: CHPP and CHP increased the pH of isotonic sodium chloride >11 within 3 min. CHPP had a greater release of Ca2+ compared with CHP.

Analysis of Variance↗

PubMed2006

A comparative study of selected properties of ProRoot mineral trioxide aggregate and two Portland cements.

AIM: To compare solubility, microhardness and radiopacity of ProRoot mineral trioxide aggregate (MTA) with two Portland cements (PC: CEM I and CEM II). METHODOLOGY: Solubility: for standardized samples (n = 12/group) ring moulds were filled with the cements. These samples were immersed in double-distilled water for 1 min, 10 min, 1 h, 24 h, 72 h, and 28 days. Mean loss of weight was determined. Microhardness: five samples of each cement were produced. All samples were loaded with a diamond indenter point with a weight of 100 g for 30 s. Radiopacity: five samples per cement were produced. These samples were tested according to the ISO standards to compare their radiodensity to that of an aluminium step wedge (1-9 mm). Differences between the three materials with respect to their solubility, microhardness and radiopacity were analysed using ANOVA and Student-Newman-Keuls. RESULTS: After 28 days MTA was of low solubility (0.78%) compared with CEM I (31.38%) and CEM II (33.33%). At exposure times >1 min the two PCs were significantly more soluble than MTA (P < 0.05). The microhardness for MTA was significantly higher (39.99 HV; P < 0.001) compared with the two PC (CEM I: 16.32 HV; CEM II: 13.51 HV). MTA was significantly more radiopaque (5.34 mm Al) than CEM I (3.32 mm Al) and CEM II (2.52 mm Al) (P < 0.05), whereas CEM I was significantly more radiopaque than CEM II (P < 0.05). CONCLUSIONS: Mineral trioxide aggregate displayed superior material properties than both Portland cements.

Aluminum Compounds↗

PubMed2006

MTA versus Portland cement as repair material for furcal perforations: a laboratory study using a polymicrobial leakage model.

AIM: To compare the ability of Portland cement and mineral trioxide aggregate (MTA) to prevent coronal leakage through repaired furcal perforations in molar teeth. METHODOLOGY: The pulp chambers of 36 human mandibular molar teeth were accessed and the root canal orifices were located. The roots were horizontally sectioned in the middle third. Composite resin was used to fill the root canal orifices and the apical end of the roots. Perforations were created in the centre of the pulp chamber floor using a size 3 round bur. Thirty teeth were divided into two groups (n = 15) and a further six teeth served as controls. In G1, all 15 perforation defects were repaired with MTA while in G2, Portland cement was used. Each tooth was inserted in a silicone tube (bacterial reservoir) with the region containing the perforation protruding through the end. The system was sterilized and placed in a glass flask containing sterile brain heart infusion medium (BHI). The reservoirs were filled with human saliva mixed in BHI and system was incubated at 37 degrees C and checked daily for the appearance of turbidity in the BHI broth during the following 50 days. The leakage data were analysed statistically by a log-rank test (P < 0.05). RESULTS: Eight (53%) of the 15 samples of the MTA group (G1) and nine (60%) of the 15 samples of the Portland cement group (G2) were fully contaminated at 50 days. There was no statistically significant difference between the two groups (P > 0.05). CONCLUSION: Portland cement and MTA demonstrated a similar ability to seal furcal perforations.

Aluminum Compounds↗

PubMed2004

Direct pulp capping with mineral trioxide aggregate in a primary molar: a case report.

A case is presented in which pulp capping was performed on a right first mandibular primary molar in a 7-year-old male patient. An alkaline cement powder based on mineral trioxide aggregate (MTA) was used for pulp capping. There were no pathological findings either on a radiograph taken after one year or on clinical examination after 18 months, and the right first mandibular primary molar remained vital after capping with MTA. Further clinical investigation of MTA for direct pulp capping of primary teeth should be performed.

Aluminum Compounds↗

PubMed2005

Assessment of a novel alternative to conventional formocresol-zinc oxide eugenol pulpotomy for the treatment of pulpally involved human primary teeth: diode laser-mineral trioxide aggregate pulpotomy.

OBJECTIVE: The purpose of this study was to investigate whether a diode laser pulpotomy with mineral trioxide aggregate (MTA) sealing could be an acceptable alternative to the conventional formocresol pulpotomy and zinc oxide eugenol (ZOE) sealing in human primary teeth. METHODS: A randomized, single-blind, split-mouth study was used with a sample of 16 children aged from 3 to 8 years (mean age=5.10 years). A total of 26 pairs of teeth from these 16 patients were selected based on clinical and radiographic criteria. One tooth from each pair was randomly assigned to either the laser-MTA pulpotomy group or the formocresol-ZOE pulpotomy group. All teeth were followed up clinically and radiographically at 2.3, 5.2, 9.5 and 15.7 months. All extracted failures were sectioned and photographed to assess possible reasons for this. RESULTS: A total of seven laser-MTA-treated teeth were deemed to be radiographic failures (mean time until failure=9.1 months) compared to three formocresol-ZOE treated teeth (mean time until failure=12.5 months). These results were not significant using Fisher's exact test (P>0.05). Six of the laser-MTA failures and all three formocresol-ZOE failures exhibited furcal and/or periapical radiolucencies with or without pathologic root resorption. One of the laser-MTA failures displayed premature root resorption and is being observed for exfoliation. Analysis of photographs of teeth available for extraction revealed errors in clinical technique in addition to expected signs of a disease process such as the presence of granulation tissue and areas of pathologic root resorption. CONCLUSIONS: The laser-MTA pulpotomy showed reduced radiographic success rates compared to the formocresol-ZOE pulpotomy at 15.7 months; however, these results were not statistically significant. Improved success rates among a larger patient sample and a longer follow-up period would be required for the laser-MTA pulpotomy to be considered a routine alternative to the conventional formocresol-ZOE procedure. Meticulous restorative techniques must be followed to ensure the success of laser-MTA pulpotomies.

Aluminum Compounds↗