Mineral trioxide aggregate: present and future developments

Portland cement is used in the building industry to make concrete.  It is hydraulic and thus it develops its properties well in the presence of moisture.  The oral environment is inherently wet, however, all dental materials need a dry field for optimal performance.  A mixture of Portland cement and busmuth oxide was developed and marketed as mineral trioxide aggregate (MTA).  The first formulation was gray in color followed by a white version and eventually by various similar materials, which are all composed of a tricalcium silicate-based cement and radiopacifier.  The MTA was originally suggested for particular clinical uses, such as root-end filling and perforation repair, where maintenance of a dry field is difficult.  The suggested uses were extended to apexification and dressing over pulpotomies, pulp capping and also as a sealer cement.  The multipurpose use of MTA neccessitated the development of improved formulations where material additives were included to the original cement/radiopacifier formulation.  These additives supposedly enhance the material’s properties and improve its function.  Furthermore, the original Portland cement formulation was replaced with tricalcium silicate to avoid the inclusion of an aluminum phase and eliminate the inclusion of trace elements.  The bismuth oxide was also replaced with alternative radiopacifiers.  The multifaceted use of MTA allows the material to come into contact with different oral environmental conditions, including blood, saliva, tissue fluids, dental restorative materials, tooth structure and even air.  These different conditions affect the properties and setting of the material.  Future developments should further investigate the material’s interactions and strive to create materials which are suited to a specific use.  (Camilleri, J. (2015), Mineral trioxide aggregate: present and future developments. Endodontic Topics, 32: 31–46. doi: 10.1111/etp.12073)

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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