Healing of the periapical lesion in posterior teeth with mineral trioxide aggregate using orthograde technique - Two case reports

Postoperative pain of single-visit endodontic treatment with gutta-percha versus MTA filling: a randomized superiority trial

BACKGROUND

Postoperative pain has remained a challenge for clinicians. This randomized superiority trial compared the levels of postoperative pain following the use of gutta-percha (GP) and sealer or mineral trioxide aggregate (MTA) as root canal filling materials in teeth with asymptomatic apical periodontitis.

METHODS

A total of 119 patients were initially evaluated in this two-arm, parallel-group, single-blind, superiority randomized trial. The inclusion criteria were participants aged 18-65 years with single-canal premolars diagnosed with asymptomatic apical periodontitis. The participants were finally divided into two groups using the permuted block randomization method. In the GP group (N = 46), the cleaned and shaped root canals were filled with gutta-percha and AH Plus sealer, while in the MTA group (N = 48), the cleaned and shaped root canals were filled with an MTA apical filling and a coronal gutta-percha and sealer. Patient pain level was measured 6, 12, 24, 48, and 72 h postoperatively using a 10-point visual analog scale (VAS). The data were analyzed by the chi-square, independent t, Friedman, and Mann-Whitney U tests.

RESULTS

The mean of VAS scores decreased significantly over time in both groups (P < 0.001). The mean VAS scores were significantly lower in the MTA filling group than in the other group (P < 0.05). Female patients reported higher VAS scores at 6- and 12-hour periods in both groups (P < 0.05).

CONCLUSION

MTA as a root canal filling material might be a valuable option for clinicians due to its low postoperative pain.

TRIAL REGISTRATION

The trial protocol was registered at the Registry of Clinical Trials (IRCT20191104045331N1).

Mineral trioxide aggregate and other bioactive endodontic cements: an updated overview - part II: other clinical applications and complications

Mineral trioxide aggregate (MTA) is a dental material used extensively for vital pulp therapies (VPT), protecting scaffolds during regenerative endodontic procedures, apical barriers in teeth with necrotic pulps and open apices, perforation repairs as well as root canal filling and root-end filling during surgical endodontics. A number of bioactive endodontic cements (BECs) have recently been introduced to the market. Most of these materials have calcium and silicate in their compositions; however, bioactivity is a common property of these cements. These materials include the following: BioAggregate, Biodentine, BioRoot RCS, calcium-enriched mixture cement, Endo-CPM, Endocem, EndoSequence, EndoBinder, EndoSeal MTA, iRoot, MicroMega MTA, MTA Bio, MTA Fillapex, MTA Plus, Neo MTA Plus, Ortho MTA, Quick-Set, Retro MTA, Tech Biosealer, and TheraCal LC. It has been claimed that these materials have properties similar to those of MTA but without the drawbacks. In Part I of this review, the available information on the chemical composition of the materials listed above was reviewed and their applications for VPT was discussed. In this article, the clinical applications of MTA and other BECs will be reviewed for apexification, regenerative endodontics, perforation repair, root canal filling, root-end filling, restorative procedures, periodontal defects and treatment of vertical and horizontal root fractures. In addition, the literature regarding the possible drawbacks of these materials following their clinical applications is reviewed. These drawbacks include their discolouration potential, systemic effects and retreatability following use as a root filling material. Based on selected keywords, all publications were searched regarding the use of MTA as well as BECs for the relevant clinical applications. Numerous publications were found regarding the use of BECs for various endodontic applications. The majority of these investigations compared BECs with MTA. Despite promising results for some materials, the number of publications using BECs for various clinical applications was limited. Furthermore, most studies had several methodological shortcomings and low levels of evidence.

Effect of temperature on the setting time of Mineral Trioxide Aggregate (MTA)

Introduction: Mineral trioxide aggregate (MTA) has numerous applications in dentistry due to various advantages. However, its long setting time has still remained a problem. The current study was conducted to investigate the effect of temperature (ambient and distilled water temperature) on the setting time of mineral trioxide aggregate (MTA). Materials and methods: This experimental study comprised of two parts. In the first part, MTA and distilled water samples were kept at ambient temperature for 24 hours (before mixing: effect of distilled water temperature on the setting time of MTA and after mixing: effect of distilled water and ambient temperature on the setting time of MTA), and analyzed and divided into three groups: group 1 (4°C), group 2 (37°C) and group 3 (90°C). The mixed samples were placed in the glass cylinders with an internal diameter of 8 mm and a height of 10 mm, and kept at 37°C temperature and 100% humidity. In the second part, the samples were prepared the same as those of the first part and divided into three groups according to the terms of maintenance: group 1 (4°C), group 2 (37°C) and group 3 (75°C). The mixed samples were then put in glass cylinders with an internal diameter of 8 mm and a height of 10 mm and the samples of groups 1, 2 and 3 were kept at 4, 37 and 75 °C, respectively. At the end of each part, the primary and final setting times were measured by Gilmore needle. Data were analyzed by SPSS using Kruskal-Wallis test (p<0.05). Results: The findings of this study showed a significant reduction of the primary and final setting time of MTA for the samples of both parts of the study with an increase in ambient temperature (p<0.05). Conclusion: This study indicated that increased ambient temperature caused a reduction in the setting time of MTA.