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ePaper created 2016-03-31, 16:35:38 | version 1.38.0
use of MTA case report | 31roots1 2016 Literature review MTA is a biocompatible material with numerous clinicalapplicationsinendodontics.Itwasfirstused experimentally by Lee and Monsef.1 However, ap proval of its use in humans by the American Dental Federation was not granted until 1998.2 It is composed primarily of tricalcium silicate, tricalcium aluminate, tricalcium oxide and silicate oxide, as well as a small quantity of other mineral oxides and the addition of bismuth oxide, which is responsible for the material’s radiopacity. The prin cipal molecules present in MTA are calcium and phosphorus ions, which are also the main compo nentsofdentaltissue,givingMTAexcellentbiocom patibility when in contact with cells and tissue.3 MTA has been investigated as an alternative mate rial in endodontics and can be used in retro-filling of rootcanals.Althoughtheretro-fillingmaterialisvery important, good sealing of the suitable apex is made for this purpose. According to Assis et al., many tech niques and instruments have been recommended for carrying out apical preparations.4 Both brands of MTA have been significantly evalu ated and no other material has shown more progres sive results.5 According to Pozza et al., the use of MTA in cavity walls, unlike other materials, achieves the best seal against infiltrations.6 Different materials have been used to seal the paths connecting the root canalandthepara-endodontictissue.However,none of them have achieved results as promising as those of MTA, and various studies have proven that MTA is the best on the market today.7 According to Leal, MTA cement has effective sealing capacity.8 According to Bernabé et al., conventional endo dontictreatmentisnotabletoresolvesomecasesand para-endodonticsurgeryisrequiredtoobtainagood result.9 The filling material used must not be toxic or mutagenic, and has to be biocompatible and insolu ble. The material used in retro-filling distinguishes agoodpara-endodonticsurgeryfromabadone.MTA achieves the best result specifically for sealing be tween the tooth and external surface. Endodontic treatment has become more practical owing to the new methods and techniques, with the emergence of materials with excellent physical and biologicalproperties.Theliteraturedealswithvarious materialsusedinretro-filling,butgenerallyspeaking these materials do not have all the requisite proper ties to be able to remain in the cavity, such as biocompatibility,radiopacity,insolubilityinperiapical fluids,easycompounding,non-stainingoftheperira diculartissue,goodadaptationandsealingcapacity.10 Anidealmaterialtoreplaceamalgamshouldofferad hesion, promote hermetic sealing, be biocompatible, be radiopaque, be easy to compound and provide for an environment favourable for tissue regeneration.11 According to Hellwig et al., para-endodontic sur geries expose and remove dental apices, promote retro-cavitations along the axis of the root canals, Fig.6: Supra-periosteal anaesthesia. Figs.7 & 8: Detachment of the flap. Fig.9: Cutting of the root apex with a high-rotation drill. Fig.6 Fig.8 Fig.7 Fig.9