Mineral trioxide aggregate material use in endodontic treatment: a review of the literature.
OBJECTIVE
The purpose of this paper was to review the composition, properties, biocompatibility, and the clinical results involving the use of mineral trioxide aggregate (MTA) materials in endodontic treatment.


METHODS
Electronic search of scientific papers from January 1990 to August 2006 was accomplished using PubMed and Scopus search engines (search terms: MTA, GMTA, WMTA, mineral AND trioxide AND aggregate).


RESULTS
Selected exclusion criteria resulted in 156 citations from the scientific, peer-reviewed dental literature. MTA materials are derived from a Portland cement parent compound and have been demonstrated to be biocompatible endodontic repair materials, with its biocompatible nature strongly suggested by its ability to form hydroxyappatite when exposed to physiologic solutions. With some exceptions, MTA materials provide better microleakage protection than traditional endodontic repair materials using dye, fluid filtration, and bacterial penetration leakage models. In both animal and human studies, MTA materials have been shown to have excellent potential as pulp-capping and pulpotomy medicaments but studies with long-term follow-up are limited. Preliminary studies suggested a favorable MTA material use as apical and furcation restorative materials as well as medicaments for apexogenesis and apexification treatments; however, long-term clinical studies are needed in these areas.


CONCLUSIONS
MTA materials have been shown to have a biocompatible nature and have excellent potential in endodontic use. MTA materials are a refined Portland cement material and the substitution of Portland cement for MTA products is presently discouraged. Existing human studies involving MTA materials are very promising, however, insufficient randomized, double-blind clinical studies of sufficient duration exist involving MTA for all of its clinical indications. Further clinical studies are needed in these areas.
Roberts
Howard W
HW
USAF Dental Evaluation and Consultation Service, Dental Biomaterials Evaluation, Great Lakes, IL, United States. Howard.roberts@med.navy.mil
Toth
Jeffrey M
JM
Berzins
David W
DW
Charlton
David G
DG
D017607:Aluminum Compounds / Q000737:chemistry / Q000627:therapeutic use*; D000818:Animals; D001672:Biocompatible Materials / Q000737:chemistry; D017610:Calcium Compounds / Q000737:chemistry / Q000627:therapeutic use*; D003738:Dental Cements / Q000737:chemistry; D003763:Dental Leakage / Q000517:prevention & control; D003785:Dental Pulp Capping; D004338:Drug Combinations; D017886:Durapatite / Q000737:chemistry; D006801:Humans; D010087:Oxides / Q000737:chemistry / Q000627:therapeutic use*; D011672:Pulpotomy; D016032:Randomized Controlled Trials as Topic; D012387:Root Canal Filling Materials / Q000737:chemistry / Q000627:therapeutic use*; D017640:Silicates / Q000737:chemistry / Q000627:therapeutic use*
D017607:Aluminum Compounds; D001672:Biocompatible Materials; D017610:Calcium Compounds; D003738:Dental Cements; D004338:Drug Combinations; D010087:Oxides; D012387:Root Canal Filling Materials; D017640:Silicates; C086631:mineral trioxide aggregate; D017886:Durapatite