Comparison of mineral trioxide aggregate's composition with Portland cements and a new endodontic cement.

Department of Endodontics, Iranian Center for Endodontic Research, Dental Research Center, Dental School, Shahid Beheshti University M.C., Tehran, Iran.
Journal of endodontics (Impact Factor: 2.95). 03/2009; 35(2):243-50. DOI: 10.1016/j.joen.2008.10.026
Source: PubMed

ABSTRACT The aim of this study was to compare the compositions of mineral trioxide aggregates (MTAs), Portland cements (PCs), and a new endodontic cement (NEC). Our study also investigated the surface characteristics of MTA and NEC root-end fillings when immersed in normal saline. For part I, we prepared samples of 9 brands of MTAs, PCs, and NEC. The materials were imaged and analyzed by scanning electron microscopy (SEM) and energy dispersive x-ray analysis (EDXA). In part II, 3-mm-deep root-end preparations were filled with MTA or NEC and stored in normal saline for 1 week. Samples were imaged and analyzed by SEM and electron probe microanalysis (EPMA). EDXA investigations revealed differences in the dominant compounds of NEC, PCs, and MTAs. The major components of MTA and PC are the same except for bismuth. The most significant difference was the presence of higher concentrations of Fe (minor element) in gray MTA and PC when compared with white ones. EPMA results revealed remarkably different elements in MTA compared with surrounding dentin, whereas in the NEC group the distribution patterns of calcium, phosphorous, and oxygen were comparable. NEC differs chemically from MTAs and PCs and demonstrates comparable surface composition with adjacent dentin as a root-end filling material.

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    ABSTRACT: This article presents the successful surgical management of a failed mineral trioxide aggregate (MTA) orthograde obturation of a tooth with a history of impact trauma and perforated internal root resorption. A symptomatic maxillary lateral incisor with a history of perforation due to internal root resorption and nonsurgical repair using MTA was referred. Unintentional overfill of the defect with MTA had occurred 4 yr before the initial visit. The excess MTA had since disappeared, and a radiolucent lesion adjacent to the perforation site was evident radiographically. Surgical endodontic retreatment was performed using calcium enriched mixture (CEM) cement as a repair material. Histological examination of the lesion revealed granulation tissue with chronic inflammation, and small fragments of MTA encapsulated within fibroconnective tissue. At the one and two year follow up exams, all signs and symptoms of disease had resolved and the tooth was functional. Complete radiographic healing of the lesion was observed two years after the initial visit. This case report illustrates how the selection of an appropriate approach to treatment of a perforation can affect the long term prognosis of a tooth. In addition, extrusion of MTA into a periradicular lesion should be avoided.
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