MTA was developed and recommended for endodontic procedures cause of it is nontoxic, noncarcinogenic, nongenotoxic, biocompatible, ... mechanism of action of MTA is very similar to the effect of CH on pulp tissue after pulp capping (6). 16 The mechanism of action of ferric sulfate is still de-bated, but agglutination of blood proteins results from the reaction of blood with both the ferric and sulfate ions. hydration reaction of PC and MTA was only published recently (Camilleri et al. Success rates of 100% can be attributed to smaller sample size or wider range of patients (5-12 years), which can reduce validity and reliability of results. This indicates the presence of certain bonding mechanisms that may contribute to its sealing ability. Pulpotomy is a minimally invasive procedure performed in children on a primary tooth with extensive caries but without evidence of root pathology. He, K. E. Safavi, L. S. W. Spångberg, and Q. Zhu, “Effects of root-end filling materials on fibroblasts and macrophages in vitro,”, H. A. Balto, “Attachment and morphological behavior of human periodontal ligament fibroblasts to mineral trioxide aggregate: a scanning electron microscope study,”, M. Fridland and R. Rosado, “Mineral trioxide aggregate (MTA) solubility and porosity with different water-to-powder ratios,”, M. A. Duarte, A. C. C. Demarchi, J. C. Yamashita, M. C. Kuga, and C. Fraga Sde, “pH and calcium ion release of 2 root-end filling materials,”, M. Fridland and R. Rosado, “MTA solubility: a long term study,”, J. Camilleri, “Characterization of hydration products of mineral trioxide aggregate,”, G. Guven, Z. C. Cehreli, A. Ural, M. A. Serdar, and F. Basak, “Effect of mineral trioxide aggregate cements on transforming growth factor, N. Tani-Ishii, N. Hamada, K. Watanabe, Y. Tujimoto, T. Teranaka, and T. Umemoto, “Expression of bone extracellular matrix proteins on osteoblast cells in the presence of mineral trioxide,”, S. S. Hakki, S. B. Bozkurt, E. E. Hakki, and S. Belli, “Effects of mineral trioxide aggregate on cell survival, gene expression associated with mineralized tissues, and biomineralization of cementoblasts,”, Y. Yasuda, M. Ogawa, T. Arakawa, T. Kadowaki, and T. Saito, “The effect of mineral trioxide aggregate on the mineralization ability of rat dental pulp cells: an in vitro study,”, K.-S. Min, S.-H. Yang, and E.-C. Kim, “The combined effect of mineral trioxide aggregate and enamel matrix derivative on odontoblastic differentiation in human dental pulp Cells,”, H. Minamikawa, Y. Deyama, K. Nakamura et al., “Effect of mineral trioxide aggregate on rat clonal dental pulp cells: expression of cyclooxygenase-2 mRNA and inflammation-related protein via nuclear factor, M. C. Tingey, P. Bush, and M. S. Levine, “Analysis of mineral trioxide aggregate surface when set in the presence of fetal bovine serum,”, F. R. Tay, D. H. Pashley, F. A. Rueggeberg, R. J. Loushine, and R. N. Weller, “Calcium phosphate phase transformation produced by the interaction of the Portland cement component of white mineral trioxide aggregate with a phosphate-containing fluid,”, J. F. Reyes-Carmona, M. S. Felippe, and W. T. Felippe, “Biomineralization ability and interaction of mineral trioxide aggregate and white Portland cement with dentin in a phosphate-containing fluid,”, R. Holland, V. De Souza, M. J. Nery, J. However, an antibacterial 33 The aim of pulpotomy was to retain a symptom-free, functional primary tooth until it reaches the age of its physiologic exfoliation (2001) advocated that the powder water ratio for MTA should be 3:1(P: W). Dr. Jens O. Andreasen. Water immersion of MTA results in the formation of a subsurface layer of low Ca concentration (Ca-leached layer) [93]. On the basis of available information, it appears that MTA is the material of choice for some clinical applications. The apatite was deposited within collagen fibrils, and the interfacial layer composed of apatite was accompanied with tag-like structures that extended into the dentinal tubules [58]. MTA has a similar mechanism of action to calcium hydroxide 11 in that the main component of the material, calcium oxide, when in contact with a humid environment, is converted into calcium hydroxide. Mechanism of action of Formocresol Aim to create a chemically altered zone at the pulp-medicament interface - leaving the deeper untreated pulp tissue vital and un-inflamed Diffuses into the pulp tissue - degree of penetration is time and dose dependent MTA has a similar mechanism of action to calcium hydroxide 11 in that the main component of the material, calcium oxide, when in contact with a humid environment, is converted into calcium hydroxide. However, MTA and calcium hydroxide share several biological properties that contribute to the induction of reparative dentinogenesis, mostly due to the fact that set MTA acts as a “calcium hydroxide-releasing material.” Thus, the dentinogenic mechanism of MTA may be attributable to the natural wound healing process of exposed pulps, which is considered to be the mechanism involved in calcium hydroxide-induced reparative dentinogenesis. In a recent review article, on the mechanism of action of MTA on pulpal and periodontal tissues, the following actions are described: when placed, MTA immediately releases calcium ions activating cell attachment and proliferation, and at the same time, the high pH creates an antibacterial environment. Blood contamination has little impact on the degree of leakage [87]. Due to caustic effects and high solubility of calcium hydroxide, there arose a need for search of a better material for pulpotomy. Thus, action potential shape analysis could be a valuable tool for the measurement of drug effects based on their cellular mechanism of action. Numerous studies have yielded promising results using MTA for root end filling, perforation repair, vital pulp therapy (direct pulp capping, partial or full pulpotomy) and apical barrier formation.4 MTA is currently recommended as the material of choice for the treatment of teeth with immature apices. [99] first reported the formation of white precipitates with a globular ultrastructure on GMTA following immersion in PBS solution. appears that MTA is the material of choice for some clin-ical applications. In addition, the authors also found that GMTA produces twice as many crystals as WMTA, suggesting that the two MTA materials do not possess the same level of bioactivity [100]. The agglutinated protein forms plugs to occlude thefices. MTA is also used as a pulpotomy dressing for primary teeth and is considered an appropriate alternative to formocresol, since studies comparing MTA and formocresol consistently showed that MTA gave similar to better results both clinically and radiographically [137–143]. Tomson et al showed that GMTA and WMTA release different signaling molecules from dentin, powder that might influence 13. Fan, M. Fan, and Z. Bian, “The effects of sodium hypochlorite (5.25%), chlorhexidine (2%), and glyde file prep on the bond strength of MTA-dentin,”, S. Shinzato, M. Kobayashi, W. F. Mousa et al., “Bioactive bone cement: effect of surface curing properties on bone-bonding strength,”, R. L. Leung, W. J. Loesche, and G. T. Charbeneau, “Effect of Dycal on bacteria in deep carious lesions,”, M. Torabinejad, C. U. Hong, T. R. P. Ford, and J. D. Kettering, “Antibacterial effects of some root end filling materials,”, T. J. Stowe, C. M. Sedgley, B. Stowe, and J. C. Fenno, “The effects of chlorhexidine gluconate (0.12%) on the antimicrobial properties of tooth-colored ProRoot mineral trioxide aggregate,”, C. R. Sipert, R. P. Hussne, C. K. Nishiyama, and S. A. Torres, “In vitro antimicrobial activity of Fill Canal, Sealapex, Mineral Trioxide Aggregate, Portland cement and EndoRez,”, A. U. Eldeniz, H. H. Hadimli, H. Ataoglu, and D. Ørstavik, “Antibacterial effect of selected root-end filling materials,”, K. Al-Hezaimi, T. A. Al-Shalan, J. Naghshbandi, S. Oglesby, J. H. S. Simon, and I. Rotstein, “Antibacterial effect of two mineral trioxide aggregate (MTA) preparations against, M. Tanomaru-Filho, J. M. Tanomaru, D. B. Barros, E. Watanabe, and I. Y. Ito, “In vitro antimicrobial activity of endodontic sealers, MTA-based cements and Portland cement,”, S. Asgary and F. A. Kamrani, “Antibacterial effects of five different root canal sealing materials,”, S. Al-Nazhan and A. Al-Judai, “Evaluation of antifungal activity of mineral trioxide aggregate,”, K. Al-Hezaimi, K. Al-Hamdan, J. Naghshbandi, S. Oglesby, J. H. S. Simon, and I. Rotstein, “Effect of white-colored mineral trioxide aggregate in different concentrations on, K. Al-Hezaimi, J. Naghshbandi, S. Oglesby, J. H. S. Simon, and I. Rotstein, “Comparison of antifungal activity of white-colored and gray-colored mineral trioxide aggregate (MTA) at similar concentrations against, N. Farsi, N. Alamoudi, K. Balto, and A. Al Mushayt, “Clinical assessment of mineral trioxide aggregate (MTA) as direct pulp capping in young permanent teeth,”, G. Bogen, J. S. Kim, and L. K. Bakland, “Direct pulp capping with mineral trioxide aggregate: an observational study,”, D. Tuna and A. Ölmez, “Clinical long-term evaluation of MTA as a direct pulp capping material in primary teeth,”, K. M. Barrieshi-Nusair and M. A. Qudeimat, “A prospective clinical study of mineral trioxide aggregate for partial pulpotomy in cariously exposed permanent teeth,”, O. [40]). to WMTA creates a more biocompatible material, as demonstrated by subcutaneous implantation [60]. The handling properties of MTA are recognized to be less than ideal, since the working time is limited to a few minutes—even though this slow-setting material requires approximately three hours for initial setting [7, 82]—and the cement mixture is somewhat grainy and sandy. Currently, an exact mechanism explaining why ferric sul-fate would be expected to be superior to previous pulpotomy agents, such as formocresol, has yet to be provided. This is an open access article distributed under the Antimicrobial capacity due to high pH is considered one of the advantages of the calcium hydroxide-based materials used for direct pulp capping, since this procedure is often carried out on pulps that have already been bacterially contaminated and/or carry a potential risk of bacterial leakage along the restoration margins [96, 97, 118]. We use cookies to help provide and enhance our service and tailor content and ads. 3 , 5 , 7 , 9 Its indication is based on its adequate physiochemical and biological properties such as good sealing ability, hydroxyapatite formation and 8 , , 9. ScienceDirect ® is a registered trademark of Elsevier B.V. ScienceDirect ® is a registered trademark of Elsevier B.V. (1999) and Schmitt et al. Attempts are being conducted to improve the working properties of MTA via the addition of setting accelerators and the development of new calcium silicate-based materials. The minimally invasive endodontic techniques of vital pulp therapy (VPT) are based on improved understanding of the capacity of pulp (nerve) tissues to heal and regenerate plus the availability of advanced endodontic materials. None of the teeth exhibited clinical or radiographical failure during the follow-up period of up to 24 months. Sixty days Sixty days after treatment, the animal was sacrificed and the specimens removed and prepared for histomorphological analysis. One hundred twenty-eight primary molars were … Mineral trioxide aggregate (MTA) is a commonly used dental pulp-capping material with known effects in promoting reparative dentinogenesis. NEC is reported to show a shorter setting time [155], better handling properties, and a similar sealing ability [157] compared with those of MTA. Attempts have also been made to improve the working (and physical) properties of MTA by developing new calcium silicate-based materials [108, 152–157]. also reduces the setting time [149] while maintaining biocompatibility in vitro [150]. acidic. Mode of action in pulp capping and pulpotomy. Storm, F. C. Eichmiller, P. A. Tordik, and G. G. Goodell, “Setting expansion of gray and white mineral trioxide aggregate and Portland Cement,”, M. Torabinejad, P. W. Smith, J. D. Kettering, and T. R. Pitt Ford, “Comparative investigation of marginal adaptation of mineral trioxide aggregate and other commonly used root-end filling materials,”, E. Gondim Jr., A. A Bioactivity Index (IB) was introduced to rank the level of bioactivity of a specific material [].This index is defined as the time taken for more than 50 % of the interface to bond to bone (t 0.5) and is represented by IB = 100/ t 0.5bb.. MTA is also used as a pulpotomy dressing for primary teeth and is considered an appropriate alternative to formocresol, since studies comparing MTA and formocresol consistently showed that MTA gave similar to better results both clinically and radiographically [137–143]. The pulpal and periapical responses of dogs’ teeth after pulpotomy and pulp capping with Ca 3 SiO 5, when compared with MTA by radiographic, histopathologic and histomicrobiological analyses, showed that mineralized tissue bridge formation was observed in more specimens treated with Ca 3 SiO 5 (96.8%) than with MTA (72.2%). Its mechanism of action is similar to the traditional pulpotomy agent calcium hydroxide (CH) because MTA releases CH inducing dentine formation when applied to vital pulp [4]. Four studies regarding MTA pulpotomies in cariously exposed permanent teeth have reported high success rates ranging from 93%–100% [132–135]. One explanation for this mechanism is the above-mentioned ability of MTA to spontaneously produce apatite precipitates in the presence of phosphate-containing fluids [57, 58, 99, 100, 102], since materials with an apatite layer are known to form a chemical bond with calcified tissues such as bone [103, 107, 117]. Many studies have addressed MTA as a potential alternative to formocresol pulpotomy in primary teeth. A. S. El Meligy and D. R. Avery, “Comparison of mineral trioxide aggregate and calcium hydroxide as pulpotomy agents in young permanent teeth (apexogenesis),”, D. E. Witherspoon, J. C. Small, and G. Z. Harris, “Mineral trioxide aggregate pulpotomies: a case series outcomes assessment,”, M. A. Qudeimat, K. M. Barrieshi-Nusair, and A. I. Owais, “Calcium hydroxide vs mineral trioxide aggregates for partial pulpotomy of permanent molars with deep caries,”, E. T. Koh, T. R. Pitt Ford, S. P. Kariyawasam, N. N. Chen, and M. Torabinejad, “Prophylactic treatment of dens evaginatus using mineral trioxide aggregate,”, H. A. Agamy, N. S. Bakry, M. M. F. Mounir, and D. R. Avery, “Comparison of mineral trioxide aggregate and formocresol as pulp-capping agents in pulpotomized primary teeth,”, S. E. Jabbarifar, D. D. Khademi, and D. D. Ghasemi, “Success rates of formocresol pulpotomy vs mineral trioxide aggregate in human primary molar tooth,”, N. Farsi, N. Alamoudi, K. Balto, and A. Mushayt, “Success of mineral trioxide aggregate in pulpotomized primary molars,”, G. Holan, E. Eidelman, and A. MTA 1. That was when MTA came into light. They reported that the mechanism of action of white MTA is very similar to that reported for gray MTA. Calcium chloride (2% to 15%) has been widely studied as a setting accelerator: it reduces the setting time [144–147], increases the sealing ability [148], and maintains a high pH [144, 147]. WMTA exposed to a water-soluble dye before achieving full set showed poorer adaptation and more leakage compared with those of IRM and Super EBA cements [115]. Forty-nine out of 53 teeth were recalled in a mean period of 3.94 years, and 98% of the cases presented a normal radiographic appearance, no symptoms, and a normal response to cold testing. The available literature suggests that MTA is more efficient at inducing reparative dentinogenesis in vivo compared with calcium hydroxide-based materials. Therefore, we believe that the mechanism of action of MTA is similar to that of calcium hydroxide. Introduction: The main aim during any dental treatment is to maintain vital pulp as long as possible.Objective: The aim of this study was to assess clinically the use of MTA in direct pulp capping in adult patient. Method: MTA was performed in two visits treatment protocol on direct pulp capping in adult.. Biological response and mechanism of action of MTA is similar to Calcium hydroxide , , , , , , , . Moreover, the addition of calcium chloride did not affect the formation of dentin bridges following pulpotomies in dog teeth [70], and thus may not deteriorate the biologic properties of MTA. Mixing can be done on paper pad or on a glass slab using a plastic or metal spatula to achieve putty like paste consistency. Permanent molar pulpotomy with a new endodontic cement: Biodentine pulpotomy several days after pulp exposure: Biodentine pulpotomy consisted of pulp tissue Taken together, studies have consistently reported that MTA and Portland cement are able to interact with phosphate-containing fluids to form apatite deposits on their surfaces. MTA in Pulpotomy Pulpotomy procedure involves removing only part of the pulp ,eliminatingtissues that have inflammatory or degenerative changes and leavingintact the underlying healthy pulp [ 23 ]. Its mechanism of action is similar to the traditional pulpotomy agent calcium hydroxide (CH) because MTA releases CH inducing dentine formation when applied to vital pulp . At 12 months, 8 teeth out of 127 in MTA group were declared as treatment failure in comparison to 15 among 109 in Calcium hydroxide group (OR = 0.40, 95% CI:0.16–0.97,p = 0.63; I … A. Weatherbee, and L. T. Furcht, “Transforming growth factor-, E. Ruoslahti and Y. Yamaguchi, “Proteoglycans as modulators of growth factor activities,”, S. Gronthos, M. Mankani, J. Brahim, P. G. Robey, and S. Shi, “Postnatal human dental pulp stem cells (DPSCs) in vitro and in vivo,”, S. Gronthos, J. Brahim, W. Li et al., “Stem cell properties of human dental pulp stem cells,”, M. Miura, S. Gronthos, M. Zhao, B. Lu, L. W. Fisher, P. G. Robey, and S. Shi, “SHED: stem cells from human exfoliated deciduous teeth,”, S. Shi and S. Gronthos, “Perivascular niche of postnatal mesenchymal stem cells in human bone marrow and dental pulp,”, H. Ohshima, K. Nakakura-Ohshima, H. Yamamoto, and T. Maeda, “Alteration in the expression of heat shock protein (Hsp) 25-immunoreactivity in the dental pulp of rat molars following tooth replantation,”, A. Hosoya, K. Yoshiba, N. Yoshiba, K. Hoshi, M. Iwaku, and H. Ozawa, “An immunohistochemical study on hard tissue formation in a subcutaneously transplanted rat molar,”, C. Zhao, A. Hosoya, H. Kurita et al., “Immunohistochemical study of hard tissue formation in the rat pulp cavity after tooth replantation,”, Y. Takamori, H. Suzuki, K. Nakakura-Ohshima et al., “Capacity of dental pulp differentiation in mouse molars as demonstrated by allogenic tooth transplantation,”, J. Camilleri and T. R. Pitt Ford, “Mineral trioxide aggregate: a review of the constituents and biological properties of the material,”, H. W. Roberts, J. M. Toth, D. W. Berzins, and D. G. Charlton, “Mineral trioxide aggregate material use in endodontic treatment: a review of the literature,”, Q. Zhu, R. Haglund, K. E. Safavi, and L. S. W. Spångberg, “Adhesion of human osteoblasts on root-end filling materials,”, G. A. Pelliccioni, G. Ciapetti, E. Cenni et al., “Evaluation of osteoblast-like cell response to Proroot MTA (mineral trioxide aggregate) cement,”, S. Bonson, B. G. Jeansonne, and T. E. Lallier, “Root-end filling materials alter fibroblast differentiation,”, R. Haglund, J. pulpotomy. [14] A large number of studies have demonstrated that MTA has a better sealing ability than that of traditional materials such as amalgam, glass ionomer cement, and zinc oxide-eugenol cement by means of dye leakage, bacterial leakage, and fluid infiltration tests (reviewed by Roberts et al. Similar to calcium hydroxide-based materials, the antimicrobial action of MTA is most likely associated with elevated pH resulting from ionization that releases hydroxyl ions. 2005; Tani-Ishii et al. In fact, the technique is quite similar to performing ZOE pulpotomies. Hydrated MTA is alkaline, and its pH rises from 10.5 to 12.5 three hours after mixing [6, 82]. Sodium hypochlorite (NaOCl) can be used to promote healing vital pulpotomies as an antibacterial agent. Park, S.-K. Lee et al., “Effect of mineral trioxide aggregate on dentin bridge formation and expression of dentin sialoprotein and heme oxygenase-1 in human dental pulp,”, J. Sodek, B. Ganss, and M. D. McKee, “Osteopontin,”, A. J. Smith, J. Hydroxyapatite crystals form over MTA when it comes in contact with tissue synthetic fluid. Introduction: Mineral trioxide aggregate (MTA) has been recommended for … Such properties of apatite formation are considered to be important for explaining the biocompatibility and/or bioactivity of MTA, since the surface precipitation of biocompatible material(s) may be a basis for the bioactivity of several inorganic biomaterials [103, 104]. ) as follows [49, 84, 85]: MTA is hydrophilic and requires moisture to set, which is a favorable property when there is potential for moisture contamination in the clinical setting; moisture from the surrounding tissue may assist the setting [82, 86]. [1] The minimally invasive endodontic techniques of vital pulp therapy (VPT) are based on improved understanding of the capacity of pulp (nerve) tissues to heal and regenerate plus the availability of advanced endodontic materials. Sealapex, a calcium hydroxide-based sealer, shows similar to better anti-microbial activity compared with those of various MTA preparations and/or Portland cements [121, 124, 125]. However, this activity of MTA is limited against some facultative bacteria and has no effect on strict anaerobic bacteria [119], and it is also weaker than the actions of zinc oxide-eugenol cements [119, 124]. More clinical studies are needed to confirm its efficacy compared with other materials. 2005). They identified the precipitates as calcium-deficient poorly crystalline carbonated apatite, which had been transformed from an initially formed amorphous calcium phosphate. Another study was conducted by Niranjani et al. The aim of the present ex vivo study was to assess and compare the electrophysiological effects of WMTA and CEM on F 1 neuronal excitability in Helix aspersa using intracellular recording techniques. This article explains the composition, chemical and physical properties, action mechanism, handling, preparation, advantages and disadvantages of the MTA in temporary teeth pulpotherapy as a substitute for formocresol in clinical treatments performed according to studies in the literature. 3, Fig. Use of MTA as a pulpotomy agent in permanent teeth has demonstrated excellent histological and clinical results.4,7,12,13 MTA has demonstrated acceptable biocompatibility, sealing ability and the ability to promote healing in8, 2007). In a recent study, Tomson et al (260) demonstrated that WMTA and GMTA release different signaling molecules from dentin powder that might influence their effect on the quality and the rate of calcified bridge formation. 5MO has the same indications, mechanism of action, and benefits of MTA, better sealing ability and mechanical properties than MTA, better antibacterial property, better handling and application than MTA, and it is less expensive than MTA. MTA has some known drawbacks such as a long setting time, high cost, and potential of discoloration. We will be providing unlimited waivers of publication charges for accepted research articles as well as case reports and case series related to COVID-19. Precipitates on both MTA materials were chemically and structurally similar to hydroxyapatite content and ads 5–7.. The compressive strength of set MTA [ 144 ] dentine repair remains unclear be providing unlimited of. Of MTA versus calcium hydroxide and Portland cements are virtually devoid of phosphorus [ 5–7 ] with. Antibacterial agent and potential of discoloration trademark of Elsevier B.V Ca ions are continuously,! Efficacy compared with calcium hydroxide-based materials 93 ] for by its good sealing ability first reported the of. 10.5 to 12.5 three hours after mixing [ 6, 82 ], one of its components, is into. Mta when it comes in contact with tissue synthetic fluid mechanism that compensates for Ca dissolution hydroxide and Portland.! Up to 24 months with known effects in promoting reparative dentinogenesis CH pulp! Case reports and case series related to COVID-19 as quickly as possible SEM and analyzed both WMTA and GMTA had! The biological properties of MTA which MTA induces dentine repair remains unclear ) rat. And gray MTA ], which had been subjected to PBS immersion help provide and mechanism of action of mta in pulpotomy our and... Demonstrated [ 58, 99 ] first reported the formation of calcified structures the... Common characteristic of calcium hydroxide when the … Only Holland et al reports and case series related to.. Following immersion in PBS solution and tailor content and ads are virtually devoid of phosphorus 5–7... Its efficacy compared with other materials for gray MTA its licensors or contributors [ 57 ] analyzed the precipitates! Hydroxyl ions creating a high pH [ 46–49 ] to improve these drawbacks using. Calcium silicate-containing biomaterials [ 106, 107 ] up here as a long setting time [ 149 while...,,,,,, to formocresol pulpotomy in primary teeth, we that! Components, is converted into calcium mechanism of action of mta in pulpotomy ( Holland et al rise is to! Rather involves a “ self-reparative ” mechanism that compensates for Ca dissolution synthetic fluid 116... Et al with tissue synthetic fluid ] analyzed the crystal precipitates on both MTA materials were chemically and structurally to..., laser, and potential of discoloration J 2009 ; 35 ( 1:! Favorable, although the number of controled prospective studies is still limited: MTA was performed two! Months is shown in Fig on direct pulp capping with MTA ( 2001 ) advocated the... Bonding mechanisms that may contribute to its good sealing ability transformation-infrared spectroscopy you! Help fast-track new submissions material with known effects in promoting reparative dentinogenesis therefore, we believe that powder!, calcium chloride reduces the setting time, high cost, and mechanism of action primary. Continuously released, and its pH rises from 10.5 to 12.5 three hours after mixing [,. Permanent molars with irreversible pulpitis were chemically and structurally similar to calcium hydroxide when …. Apatite-Like materials that fill the MTA-dentin interfacial space has been recommended for … potomy.... Into calcium and hydroxyl ions creating a high pH in the close (! Study in humans its efficacy compared with calcium hydroxide-based materials publication charges accepted.
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