Mineral trioxide aggregate and other bioactive endodontic cements: An updated overview- Part I: Vital pulp therapy

Abstract

Mineral trioxide aggregate (MTA) is a bioactive endodontic cement (BEC) mainly comprised of calcium and silicate elements. The cement was introduced by Torabinejad in the 1990s and has been approved by the Food and Drug Administration (FDA) to be used in the U.S. in 1997. A number of new Bioactive Endodontic Cements (BECs) have also been introduced to the market, including BioAggregate, Biodentine, BioRoot RCS, calcium enriched mixture (CEM) cement, CAPSEAL, Endo-CPM, Endocem, EndoSequence, EndoBinder, EndoSeal MTA, iRoot, MicroMega MTA, MTA Bio, MTA Fillapex, MTA Plus, Neo MTA Plus, Ortho MTA, Quick-Set, Retro MTA, Tech Biosealer, and TheraCal. It has been claimed that these materials have properties similar to those of MTA without its drawbacks. In this article, chemical composition and the application of MTA and other BECs for vital pulp therapy (VPT) including indirect pulp cap, direct pulp cap, partial pulpotomy, pulpotomy, and partial pulpectomy, have been reviewed and compared. Based on selected key words all papers regarding chemical composition and VPT applications of BECs had been reviewed.

Most of the materials had calcium and silicate in their composition. Instead of referring to the cements based on their chemical compositions, we suggest the term "bioactive endodontic cements (BECs)," which seems more appropriate for these materials because, in spite of differences in their chemical compositions, bioactivity is a common property for all of them. Numerous articles were found regarding use of BECs as VPT agents for indirect pulp capping, partial pulpotomy, and cervical pulpotomy. Most of these investigations used MTA for VPT.

In most studies, newly introduced materials have been compared to MTA. Some of the BECs have shown promising results; however, the number of their studies compared to investigations on MTA is very limited. Most studies have had several methodological shortcomings. Future investigations with rigorous methods and materials are needed.

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