Case series proves MTA is superior long-term sealant
Italy: Mineral trioxide aggregate (MTA) is highly regarded and widely used in endodontics to seal perforations because of its biocompatibility and sealability. A new series of case studies, conducted at the Department of Endodontics at the University of Florence, proves the long term sucess of furcal perforations sealed with MTA.
In all cases, the perforations were cleaned with NaOCl, EDTA, and ultrasonic tips and sealed with MTA without internal matrix. The teeth were then endodontically treated and coronally restored. Clinical and radiographic follow-ups were done at 6 months, 1 year, 2 years, and 5 years. The research team, led by Drs Riccardo Pace and Valentina Giuliani found that after 5 years there was a maintained absence of periradicular radiolucent lesions, pain and swelling along with functional tooth stability. The results confirmed that MTA without matrix provides an effective seal of root perforations and clinical healing of the surrounding periodontal tissue.
For Drs Pace and Giuliani, the most significant outcomes of this study is that the use of MTA to repair furcal perforation without periodontal defect improves the functional performance of teeth which, without correct therapy, would normally be extracted. “The most important characteristic of MTA that makes it a reliable sealant of furcal perforation is the ability to set in presence of moisture and its slight expansion during setting,” Dr Pace adds.
Although a reliable sealant, technique and application are very important to ensuring the succes of such restorations. “Inadequate technique could influence the application of MTA; the application of MTA for a furcal perforation should only be done once the tooth is isolated with a rubber dam and the coronal restoration is built up, so as to prevent the superinfection of perforation area,” Pace says. For the same reason, the defect must be carefully cleaned with ultrasonic tips and disinfected by irrigants such as sodium hypoclorite and EDTA. Moreover the preparation of the defect should make provision for a depth cavity of at least 2 mm to ensure the retention of MTA cement and to prevent overfilling.
An endogun is the recommended delivery device of MTA into perforation sites. “Another important step is the adaptation of MTA cements at the walls of the cavity, which can be achieved by means of lateral condensation, avoiding pressure in direction of furcal area of the tooth,” he concludes.
Full article
‘Mineral Trioxide Aggregate as Repair Material for Furcal Perforation: Case Series’
Journal of Endodontics