Himachal Dental


Mineral Trioxide : Material Of Choice for Endodontic Application

Mineral Trioxide Aggregate (MTA) is a relatively new material that has become the material of choice for certain endodontic applications like Pulp Capping, Perforation Repair ,Root end fillings.
A significant problem in restorative dentistry and endodontics is isolation of operative feild for moisture control. The root canal system to be obturated must be dry in order to obtain a good good seal and comunication with blood must be avoided.During the direct pulp capping procedure ,hemorrhage must be controlled.When attempting to seal a root perforation,a dry field isĀ  essential.Further during apical surgery,the retro preparation must be absolutely dry.
Recently , Torabinejad and colleagues developed anew cement named Mineral Trioxide Aggregate(MTA), which appears to have all the characteristics of an ideal cement to seal communication between the root canal system and the oral cavity and between root canal system and the periodontium. MTA is an endodontic cement that is extremely bio compatible,capable of stimulating healing and osteogenesis, and is hydrophilic. In simple terms it has a powder which sets in presence of moisture.The cement is different because of its biocomatability, antibacterial properties sealing properties and hydrophilic nature.
Recently the prognosis of the teeth with a perforation has improved with use of operating microscope and the introduction of MTA.Primarily because the MTA is hydrophilic ,it today can be considered the ideal material to seal perforations.In fact,cementum has been shown to grow over MTA,allowing for normal attachment of the periodontal ligament.Furthermore , MTA doesn’t require a barrier,it is not affected by moisture or blood contamination, and seals better than any other material in use today.
The operating sequence to treat a perforation of root or of the floor of the pulp chamber is completed in two visits.The operating field is isolated and perforation site is cleaned.In case of bacterial infection calcium hydroxide is applied for 1 week otherwise 2-3mm MTA is applied and checked radio graphically for position of the material .A wet cotton pallet is applied and temporarily cemented. After 24 hours in second visit the temporary cement is removed and MTA setting is checked.

Criteria For Assessing Success
To be able to state that success has been achieved following treatment of perforation ,the treated tooth must meet following requirements:
* Absence of symptoms such as spontaneous pain or pain on percussion
* Absence of excessive mobility
* Absence of communication between the perforation and the gingival crevice
* Absence of fistula
* Normal Function
* Absence of radiolucency adjacent to perforation
* Thickness of PDL adjacent to obturating material no more than double the thickness of adjacent ligament.If even one of these criteria is lacking the therapy is not successful.

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