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Tuesday, March 27, 2012

Use MTA in Your Endodontic cases [Simplified Guide]

Many Dentists have written a lot about MTA and there are tons of theory in the books and 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 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 increased the chances of failure.

Composition-   Tricalcium  Silicate
                      Tricalcium aluminate
                      Tricalcium Oxide
                      Silicate Oxide
                      Bismuth Oxide- radio opaque
                      Small amount of other mineral oxide
On hydration of this powder it forms colloidal gel, on solidification this mass forms a impermiable 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
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 cotton pulg 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 - what ever suits you to place it and condense it with condenser. Remove excess moisture.
MTA have approximately 5 - 15 minutes' working time and 4 - 6 hours' setting time.
              mixing with sterile water                                                      smooth creamy mix

Excellent sealing ability
Low solubility
High pH- 12.5
Allows normal healing response
Allows formation of new cementum
Allows formation of new dentin
Least leakage

Cost vise high in compare to CaoH
irreversible application

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