Use of MTA for Direct Pulp Capping

[Anonymous]

Direct pulp capping is an effort to maintain the vitality of a dental pulp following exposure during excavation and thereby avoid endodontic therapy. The formation of a dentinal bridge over the exposed pulp surface is the goal while maintaining pulpal vitality.

Conventional pulp capping treatment included medicating the exposed pulp with calcium hydroxide (ie. Dycal) prior to restoration. Calcium hydroxide is known to cause an inflammatory reaction of the dental pulp. Appication of adhesive resins has also been attempted. Incomplete dentinal bridges has been found with a lack of published long term clinical results.

It has been reported that MTA induces the formation of dentinal bridging with little or no inflammation. MTA is known for it’s biocompatibility and lack of cytotoxicity. Tani-Ishii et. al. reported that MTA upregulated the expression of type I collagen and osteocalcin in osteoblasts.

Bone morphogenic proteins (BMP’s) are crucial to bone and collagen formation. BMP-2 and it’s receptor are expressed in the dental pulp. BMP-2 has been shown to accelerate the differentiation of human pulp cells into odontoblasts. This study hypothesized that BMP-2 is involved in the MTA induced mineralization.

This study found that MTA significantly stimulated mineralization (in rat dental pulp cells) by 60% compared to the controls. MTA and Dycal both significantly upregulated by 2-fold the level of BMP-2 mRNA compared with the controls. MTA increased the BMP-2 protein production by 40% while Dycal significantly reduced it. The authors suggest that BMP-2 may play an important role in mineralization stimulated by MTA.

MTA has shown promise as a direct pulp capping agent which may improve the success of direct pulp capping over convention calcium hydroxide techniques.

Source : Journal of Endodontics

        

[Anonymous]

With Dycal setting to fast there is always a drawback with its workability and application ., ., considering the inflammatory characteristics MTA definitely seems to be a better option ., ,. how better is it compared to Dycal in terms of the workability ? ?

        

[Drsumitra]

ProRoot MTA (Mineral Trioxide Aggregate) Root Repair Material, in both original gray and tooth-colored formulas, provides the predictable results and healing response clinicians know and trust.

Made of fine hydrophilic particles that set in the presence of water, ProRoot MTA seals off all pathways between the root canal system and surrounding tissues, significantly reducing bacterial migration1,2. Its excellent compatibility with the dentinal wall allows for a predictable clinical healing response3, 4. And its water-based chemistry permits normal setting in the presence of moisture.

ProRoot MTA is ideal for creating an apical plug during apexification, repairing root perforations during root canal therapy and treating internal root resorption. Use it as both a root-end filling material and pulp-capping material.

Each packet of ProRoot MTA comes with a pre-measured unit dose of sterilized water for fast preparation. Once the material is mixed, it quickly reaches a working consistency for efficient application.

The ProRoot MTA Delivery System simply makes achieving the material’s predictable results even faster and easier with improved material handling and more precise placement.

 

        

[DrAnil]

 I am curious to know why is the use of MTA not so prevalent in practice? Is it only because it is comparatively expensive?

        

[Drsumitra]

 It is expensive but the glitch is that it is very technique sensitive…Though manipulating it is easy, carriers for MTA are not as easy to maneuver and place in the desired place

        

[Author]

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