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Practical How To: NeoMTA

This post was prepared in collaboration with Endo/tech

On an experimental basis, we have asked a limited number of companies to provide us with practical “How To” answers to clinical questions. We were prompted to conduct this experiment when dental team members told us that they visit company websites and consult company representatives for practical clinical information. We look forward to receiving your feedback on this experiment.

 

NeoMTA from Avalon Biomed is a bioactive tricalcium silicate-based cement. This bioceramic material delivers a wide range of therapeutic clinical applications. It has been proven to provide superior results in both direct and indirect pulp capping, pulpotomies and endodontic applications. NeoMTA is appropriate for use in both primary and permanent teeth.

Endo/Tech is proud to bring NeoMTA to the Canadian market.  Rarely do we see a product that has been so clearly shown to improve clinical results.  NeoMTA fits perfectly into the company culture of delivering high quality products that help clinicians deliver the highest quality of care.

What is MTA?

Mineral Trioxide Aggregate (MTA) is a bioactive ceramic powder used in dentistry. That is, the powder is entirely ceramic, with no resin. The main components of the powder are tricalcium silicate and dicalcium silicate. Included in MTA-type products are radiopaque powders. The powders vary in the inert radiopaque component; however, bismuth oxide in MTA products is known to darken over time when exposed to some medicaments or light. Bismuth oxide containing products are inappropriate for primary teeth, except under stainless steel crowns.

When mixed with water the two ceramic powders (tricalcium silicate and dicalcium silicate) react and set (harden) forming a strong silicate matrix, embedded with calcium hydroxide. The calcium hydroxide reaction product is the source of MTA’s bioactivity. A reaction occurs when MTA is placed in vivo or immersed in phosphate-containing solutions such as phosphate-buffered saline (PBS). Hydroxide ions released from the surface of MTA, which are antimicrobial and raise the pH (alkaline) on the MTA surface. Some calcium ions are also released which react with the phosphate ions present in tissue fluids and precipitate on the surface of the MTA. The precipitate is carbonated-hydroxyapatite (HA), the form of calcium phosphate similar to bone/enamel/dentine. The absence of shrinkage during setting and the HA precipitate create a superior seal by the MTA.

The hydroxyapatite layer on the surface of the MTA shields the underlying cement from the tissue. This shield reduces the potential for an inflammatory response or cytotoxicity, and improves MTA’s biocompatibility compared to other dental materials. Biological connective tissue responds to MTA by stimulating M2 macrophages wound healing/tissue repair processes. In vitro studies show that MTA possesses the capacity to stimulate hard tissue-forming cells to induce matrix formation and mineralization. MTA causes the induction of osteogenic phenotypes such as alkaline phosphatase, osteonectin, osteopontin, and osteonidgen, stimulates the production of bone morphogenetic protein (BMP-) 2 and TGF-β, and upregulates type I collagen and osteocalcin mRNA expression.

Mechanism of Action

MTA stimulates matrix formation and mineralization during dentinogenesis.

The hydrated calcium silicate matrix leads to a thin zone of coagulation necrosis and a wider zone of reparative dentinogenesis in pulpal contact.

Progenitor cells proliferate, migrate, and differentiate into odontoblast-like cells. A natural healing process and reparative dentinogenesis occurs following MTA pulp contact. Histologically, MTA consistently allows for cementum to reform apically, as well as reparative dentin on the pulp. Thus, MTA has been regarded as “the current gold standard material”, for in vivo pulp and periapical tissue contact procedures.

Benefits

  • Ultra-finely milled granular structure and mixing liquid allows mixing to any consistency for specific applications – excellent handling properties
  • Clinician-controlled consistency allows for multiple bioactive uses from one product
  • NeoMTA is non-toxic
  • 100% biocompatible
  • No discolouration over time
  • Triggers hydroxyapatite crystal formation and matrix creation for hard tissue bridging

Features

  • Cost-effective as the cost/gram is lower than other MTAs
  • A unique desiccant-lined bulk packaging system reduces waste, clinician uses only what is required for each application
  • Excellent mixing, handling and placement due to the combination of ultrafine powder and proprietary gel, enables proper positioning of MTA without movement
  • Wash-out resistant upon placement and faster setting than other MTAs
  • Increased radiopacity over other MTAs, readily visible on radiographs
  • Ideal for use under zirconia crowns or composites
  • Restorations can be placed directly over the material without waiting for setting
  • Available as: 7.0g Professional Kit (70+ applications) or 2.5g Starter Kit (25+ applications)

 

Note: The video is for the Grey MTA Plus not the NeoMTA; however, they handle and mix in an exactly similar manner. 

 

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