Bioceramic materials are at the forefront of modern dentistry. Bioactive bioceramic endodontic materials promote pulpal and periapical tissue healing and are easy to use. Dentists can choose among many endodontic materials, depending on their needs. This article highlights the major differences among commercially available bioactive tricalcium silicate bioceramics, commonly known as mineral trioxide aggregate materials, to enable dentists to make appropriate decisions in the selection of these materials.
To circumvent the handling challenges of the powder-water mixture, some newer products have introduced alternative mixing solutions. MTA Plus (Prevest DenPro), Grey MTA Plus (Avalon Biomed), NeoMTA Plus (Avalon Biomed), and MTA Flow (Ultradent Products) may be mixed with sterile water, but each kit includes a water-based gel. Mixing the gel with the powder allows a clinician to vary the consistency from a puttylike mixture to a thinner viscosity, such as that found AH Plus Sealer (Dentsply Sirona). With these products, the handling of the material is improved. Washout resistance has also been demonstrated for some of these products.
Despite its smaller particle size compared to some other MTA-type materials (including NeoMTA), EndoSequence BC Sealer did not show superior tubule penetration.
With nearly equivalent tubule penetration in both the middle and apical thirds of canals, both EndoSequence BC Sealer and NeoMTA were found to be suitable for endodontic obturation. NeoMTA contains tantalum oxide and does not discolor dentin, even with exposure to sodium hypochlorite. Having an understanding of the properties, advantages, and disadvantages of various tricalcium silicate-based materials will enable dentists to make informed treatment decisions.