Bioactive endodontic materials for everyday use: a review

Abstract:

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.

METHODOLOGY:
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.

RESULTS:
Despite its smaller particle size compared to some other MTA-type materials (including NeoMTA), EndoSequence BC Sealer did not show superior tubule penetration.

CONCLUSIONS:
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.

GENERAL DENTISTRY. 2018 July, 66(3):48-51.
Ryan M. Walsh, DDS, MS, Jianing He, PhD, DDS, Jordan Schweitzer, DDS, MS, Lynne A, Opperman, PhD, Karl F. Woodmansey, DDS, MA
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NeoMTA Plus is a stainproof, tricalcium silicate-based bioactive cement that can be used universally for vital pulp and other endodontic indications in primary and permanent teeth. NeoMTA Plus is a bioceramic cement that triggers the healing process. With NeoMTA Plus, general dentists, pediatric dentists, and endodontists now have a superior and reasonably priced bioceramic. Dentists praise the multi-use NeoMTA Plus because it mixes more smoothly, is easier to dispense and the unique gel enables more stable placement, washout resistance and faster clinical setting.

New, stain-free light color:

Ideal for pediatric dentistry—won’t discolor teeth
Liquids such as sodium hypochlorite won’t cause discoloration

Multiple indications:

Pulp-capping to base/liner
Pulpotomies to apexification
Sealer to perforation repair
Root-end filling to resorption

Non-cytotoxic

Inhibits bacterial growth* *Tested in vitro. Not a disinfectant

Grey MTA Plus is a bioceramic tricalcium silicate-based Dental Cement, which is slightly more radiopaque than (white) MTA. The light silvery color of MTA Plus is visible during placement. Grey MTA Plus is indicated for both Vital Pulp Therapy and Endodontic procedures. General dentists and endodontists praise the multi-use Grey MTA Plus because it mixes more smoothly and is easier to dispense. The unique gel enables more stable placement, washout resistance and faster clinical setting.

Multiple indications:

Pulp-capping to Base/Liner
Pulpotomies to Apexification
Sealer to Perforation Repair
Root-end Filling to Resorption

New, light grey color:

More radiopaque than the leading white MTAs
Visible for precise placement
Inhibits bacterial growth in vitro of Staphylococcus aureus, Escherichia coli, Enterococcus faecalis, Pseudomonas aeruginosa.
Non-cytotoxic

Better mixing, handling and placement:

Finer powder mixes more easily and smoothly
Dispense as little as 0.1 gm
Unique gel for stable placement
Washout resistant
No special equipment required

Smart, convenient packaging:

Protects fine powder in desiccant-lined bottle
Easy to dispense powder as needed
Dropper-tip gel bottle minimizes waste