10.

5005/jp-journals-10026-1057
Manjusha Rawtiya et al
REVIEW ARTICLE

MTA-Based Root Canal Sealers

Manjusha Rawtiya, Kavita Verma, Shweta Singh, Swapna Munuga, Sheeba Khan

ABSTRACT presented better results than the association of gutta-percha

Mineral trioxide aggregate (MTA) has been recommended for with conventional sealers.
pulp capping, pulpotomy, apical barrier formation in teeth with Most conventional root canal sealers have demonstrated
open apexes, repair of root perforation and root canal obturation. inadequate biological activity and been cytotoxic in cultures
Since, its introduction in 1993 by Torabinejad numerous studies
especially when freshly mixed.4-8 The direct contact of
have been published regarding various aspects of this material.
The aim of this review was to consider MTA as root canal sealer sealers with periapical tissues may cause cellular
and various laboratory experiments and clinical studies of MTA- degeneration and delayed wound healing.4,7 Moreover,
based root canal sealers. An extensive search of the endodontic clinical practice suggests that fluid and blood contamination
literature was made to identify publications related to MTA-based
root canal sealers. The articles were assessed for the outcome in the apical region of root canal and dentin wetness (water
of laboratory and clinical studies on their biological properties into dentinal tubules) may be expected in teeth with apical
and physical characteristics. Comparative studies with other resorption or immature apices and after poor root canal
sealers were also considered. Several studies were evaluated
shaping. So this humid environment and residual moisture
covering different properties of MTA-based sealers including
physical properties, biocompatibility, leakage, adhesion, may affect the sealing of conventional hydrophobic root
solubility, antibacterial properties and periapical healing effect. canal sealers and the effective bonding to a wet substrate
Comparative studies reveal their mild cytotoxicity, but their such as root dentine remains a challenge.9,10
antibacterial effects are variable. Further research is required
to establish the role of MTA as root canal sealers. MTA was developed by Torabinejad in the early
1990s;11 the first study on this material was published by
Keywords: Mineral trioxide aggregate sealer, Fillapex, MTA
Obtura, CPM sealer, ProRoot Endo Sealer. Lee et al in 1993.12 The main components of MTA are
tricalcium oxide, tricalcium silicate, bismuth oxide,
How to cite this article: Rawtiya M, Verma K, Singh S, Munuga
S, Khan S. MTA-Based Root Canal Sealers. J Orofac Res tricalcium aluminate, tricalcium oxide, tetracalcium
2013;3(1):16-21. aluminoferrite and silicate oxide. In addition, there are a
Source of support: Nil few other mineral oxides, which are responsible for the
chemical and physical properties of MTA.
Conflict of interest: None declared
Because calcium silicate cements set in the presence of
INTRODUCTION moisture, such as blood and other fluids13-16 with a great
clinical advantage, it appeared interesting to develop
Root canal sealers are used to attain impervious seal between
endodontic sealers based on calcium silicate hydraulic
the core material and root canal walls.1 They can be grouped
cements.17-19
according to their basic components, such as zinc oxide
eugenol, calcium hydroxide, resin, glass ionomer, iodoform MTA AS ROOT CANAL SEALER
or silicon and recently mineral trioxide aggregate (MTA)-
based root canal sealers. In 1999 study by Holland et al20 compared glass ionomer
A desirable property of root canal sealer is to have good root canal sealer (Ketac Endo) with MTA as a sealer and
sealing ability.2 A good sealer must adhere both to dentin concluded that MTA induces closure of main canal foramen
and to core material.3 They must also have cohesive strength by new cementum formation with absence of inflammatory
to hold the obturation together,3 should have low viscosity cells after 6 months. In 2007 Holland et al21 examined
and good wetting properties to flow into the irregularities influence of the extent of obturation on apical and periapical
on the wall of the root canal and fill the space between the tissue after filling root canal with MTA and concluded that
gutta-percha cones and surface of the root canal. It should it can be used as root canal sealer. When MTA is used as
have appropriate biologic and physicochemical properties. root canal sealer and is compacted against dentin a dentin
It must not irritate the periradicular tissues. Ideally, it would MTA interfacial layer forms in the presence of phosphate.
be desirable that it stimulates reparation and biologic sealing This adherent interstitial layer resembles hydroxylapatite
by mineralized tissue deposition in the apical foramen. in composition and structure when examined under X-ray
Every year, new endodontic materials are developed to diffraction and SEM analysis. However, the calcium to
fulfill the objective of 3-dimensional sealing of root canal phosphorus ratio varies slightly to actual hydroxylapatite.
system with hopes of revolutionizing the endodontic This interface demonstrates superior marginal adaptation.
obturation technique, but none of these materials have Moreover, particle size of MTA can occlude and penetrate

16
JAYPEE
 JOFR

MTA-Based Root Canal Sealers

dentinal tubules that might harbor microorganism after 11. It is radiopaque and nonshrinking.
cleaning and shaping. 12. It is not sensitive to moisture and blood contamination.
The moisture (i.e. biological fluids) is essential to allow
the setting reaction and to induce bioactivity process with Disadvantages
the formation of apatite precipitates.22-25 Moreover, their 1. MTA sealer may cause discoloration due to release of
hydration forms a sticky/gluey calcium silicate hydrate ferrous ions.
(CSH) gel that may adhere to a gutta-percha cone in 2. Long setting time about 2 hours 45 minutes.
endodontic filling procedure. 3. Working time is less than 4 minutes.
Various hydration products form in the hydration reaction, 4. Improper handling properties.
such as porous CSH colloidal gel, portlandite (calcium 5. Compressive strength is inadequate.
hydroxide), ettringite (hexacalcium aluminate trisulphate 6. No known solvent for MTA, Bio Pure MTAD partially
hydrate), and calcium monosulfoaluminate or calcium dissolve MTA when used it remains in contact with
monocarboaluminate. Porous CSH hardens to form a solid the material for 5 minutes therefore it is difficult to
network within 4 to 6 hours and with complete setting after remove from root canal.
several days.14,25 This relatively long setting time and the
maturation of the cement may explain the improved sealing Different MTA-based root canal sealers are:
ability of MTA sealers. 1. ProRoot Endo Sealer (Dentsply Tulsa Dental Specialties,
The final irrigation with NaOCl performed at the end of Dentsply/Maillefer, Ballaigues, Switzerland).
instrumentation acts as antibacterial and tissue-dissolving 2. Fillapex (Angelus).
agent to dissolve collagen and pulpal tissue, leaving an 3. CPM Sealer (EGEO SRL, MTM Argentina SA, Buenos
alkaline environment suitable for calcium silicate cement Aires, Argentina).
hydration.26 Precisely, a final treatment with acidic irrigants 4. MTA Obtura (Angelus, Angelus Odontologica,
(such as citric or phosphoric acid) negatively affects MTA Londrina, PR, Brazil).
cements causing an increase in porosity with deterioration 5. MTAS experimental sealer MTAS (an association
and impairment of the microstructure.26 Equally, a final between 80% of white Portland cement and 20% of
irrigation with EDTA negatively interferes with the bismuth oxide) with and addition of water soluble
hydration of MTA.27 polymers.
6. F-doped MTA cements.
Advantages of Using MTA as Root Canal Sealer
ProRoot Endo Sealer
1. Sealers containing MTA are highly biocompatible and
(Dentsply Tulsa Dental Specialities)
stimulate mineralization.18
2. They are bioactive, i.e. hard tissue inductive by ProRoot Endo Sealer is calcium silicate-based endodontic
encouraging differentiation and migration of hard sealer to be used in conjunction with root filling material in
tissue producing cells.28 either cold lateral warm vertical or carrier-based filling
3. They have antimicrobial activity against M. luteus, S. technique. The major components of the powder of ProRoot
aureus, E. coli, P. aeruginosa, C. albicans and E. Endo Sealer are tricalcium silicate and dicalcium silicate,
faecalis by its alkaline pH.29 with inclusion of calcium sulfate as setting retardant,
4. It modulates cytokinin production.28 bismuth oxide as radiopacifier and a small amount of
5. They form a hydroxyapatite (or carbonated apatite) on tricalcium aluminate. The bismuth was incorporated with
the MTA surface and provide biologic seal.22 C-S-H structure. The liquid component consists of viscous
6. They also exhibit a higher adhesiveness to dentin than aqueous solution of water soluble polymer. The addition of
conventional zinc oxide/eugenol-based cements and polymer did not seem to affect biocompatibility of material.
sealing ability similar to epoxy resin-based cements. It is mixed in a liquid in a powder ratio of 1:2.31
7. Forms calcium hydroxide that releases calcium ions The water soluble polymer added to MTA to modify
for cell attachment and proliferation. properties of MTA had a fluidifying effect and thus
8. MTA is a nonmutagenic and non-neurotoxic. increases the flow even at high powder to liquid ratio. It
9. It does not produce a side effect on microcirculation involves adsorption and dispersion in the cement water
despite the fact that it can influence vessel contraction. system. The rapid adsorption of polymer molecule on to
10. MTA as a sealer provide effective seal against dentin cement particles combined with dispersion effect exposes
and cementum and promotes biologic repair and an increase in surface area of cement grains to react with
regeneration of periodontal ligament.30 water. It does not alter the hydration characteristics of MTA.19

Journal of Orofacial Research, January-March 2013;3(1):16-21 17

Manjusha Rawtiya et al

It exhibit biocompatibility when in contact with Half of MTA Fillapex paste:paste formula contains
physiologic solution.17,32 ProRoot MTA sealer exhibit 13.2% MTA. MTA known for its biocompatibility, yields
spherical amorphous calcium phosphate like phase along an impressive, hermetic seal in which the MTA particles
the sealer dentin interface and within the remnants fractured expand, preventing microinfiltration. The other half of MTA
sealers that transformed into carbonated apatite like phases Fillapex paste:paste formula contains biologically
(Gadaleta et al 1991) after immersion in phosphate compatible salicylate resin (1,3 butylene glycol disalicylate
containing SBF. resin) which is tissue friendly and therefore a better choice
There is also release of calcium and hydroxyl ions from over epoxy-based resins, which have been shown to have
the set sealer liquid.23,33 Similar to other calcium silicate mutagenic and more cytotoxic effects.
containing biomaterial, MTA sealer produce calcium MTA Fillapex two pastes combine in a homogenous mix
hydroxide on reaction with water. These phenomena may to form a rigid, but semipermeable structure with excess
account for in vitro bioactivity of ProRoot MTA sealer. MTA dispersed throughout. The MTA activity is possible
Cytotoxicity: According to Bryan et al 31 it possesses because of its permeability.37
favorable cytotoxicity profile that was established under
extended time periods after setting. The eluent derived from Physical Properties
the sealer has comparatively mild toxic effects on the Flow: MTA Fillapex has a high flow rate (27 mm) and
preosteoblast cells when compared with commercially a low film thickness, so it easily penetrates the lateral
available sealers under the testing conditions. There is also and accessory canals. Regardless of the obturation
minimum inhibition of the osteogenic potential of the technique, MTA Fillapex confidently delivers high
preosteoblast cells. Thus, it is minimally tissue irritant even sealing capability that, unlike other sealers, is not
when it is inadvertently extruded through the apical adversely affected by heat.
constriction. Ideal work time: 35 minutes perfect for cases with
Pushout bond strength: According to Huffman et al32 the multiple roots canals.
dislocation resistance of proroot was independent of location Antibacterial properties: It has excellent antibacterial
of radicular dentin and was more than AH Plus and pulp properties, as solubility is extremely low (0.1%), thus,
canal sealer. This may be due to hardness of calcium silicate- it does not erode with time like the other sealers making
based sealer after setting in 100% relative humidity. As the root susceptible to microgaps that allow bacteria to
natural root canal cannot be completely dehydrated34,35 due re-enter the canal. Furthermore, it exhibits a high pH
to retention of moisture within dentinal tubules similar for extended antibacterial action and tendency toward
hardening should be expected of the set sealer. Continuous maintaining the calcium releasing relatively constant
maturation of sealer may also have increase dislocation until 14 days.
resistance.32 MTAs radiopacity exceeds recommended ISO values,
An investigation comparing ProRoot sealer with AH Plus so radiographic diagnosis will never be a question mark.
and pulp canal sealer reported higher pushout bond strength.36 And, should retreatment be necessary, it is easily
Microleakage studies of ProRoot MTA sealer showed removed.38
similar sealing ability to epoxy resin-based sealer superior It should be only used as endodontic sealer, mainly in
to zinc oxide eugenol-based root canal sealers when endodontic accidents of difficult access, since its
evaluated using fluid filtration system.36 physicochemical characteristics differ from gray and white
MTA. Notwithstanding, the material presents an alkaline
MTA Fillapex Root Canal Sealer (Angelus) pH similar to that of the clinically and scientifically well-
A MTA endodontic sealer (MTA Fillapex , Angelus established sealers.29
Solues Odontolgicas, Londrina, PR, Brazil) was recently
CPM Sealer (EGEO SRL, MTM Argentina SA,
created. According to the manufacturer, its composition after
Buenos Aires, Argentina)
mixture is basically MTA, salicylate resin, natural resin,
bismuth and silica.37 In 2004, CPM sealer was developed in Argentina (EGEO
MTA Fillapex is first paste:paste MTA-based salicylate SRL, Buenos Aires, Argentina), in an attempt to combine
resin root canal sealer, versatile for every obturation method. the sealing and physiochemical properties of root canal
It delivers easily and without waste, and exhibits excellent sealer with biological properties of MTA. Considering that
handling properties with an efficient setting time.37 MTA is composed basically of Portland cement (Estrela et

18
JAYPEE
 JOFR

MTA-Based Root Canal Sealers

al 2000) additives used in civil engineering may be MTA Obtura

considered to improve its clinical deficiency. Powder
This sealer was developed by replacing saline with a liquid
consists of fine hydrophilic particles that form a colloidal
resin as cure initiator. The composition of the powder in
gel in presence of moisture. The main components are
this cement is similar to gray MTA Angelus, consisting of
tricalcium silicate, tricalcium oxide, tricalcium aluminate
Portland cement clinker and bismuth oxide. The
and other oxides. The liquid solution consists of saline
development of MTA Obtura aimed at the achievement of
solution and calcium chloride (Schware T Ley Joe 20028
an endodontic sealer combining the biological and sealing
749). It becomes solid and forms a hard sealer in 1 hour.39
properties of MTA. This sealer presented very stable leakage
The composition after mixing is reported to be 50%
values at 15 and 30 days, as expected for an MTA-based
MTA (SiO2, K2O, A12O3, SO3, CaO and Bi2O3), 7% SiO2,
material. Its performance reproduced the good sealing ability
10% CaCO3, 10% Bi2O3, 10% BaSO4, 1% propylene glycol
of MTA as repair material 26, 27. However, at 60 days MTA
alginate, 1% propylene glycol, 1% sodium citrate and 10%
Obtura exhibited a considerable increase in leakage.
calcium chloride.19
Study, conducted by Bernardes et al,45 MTA Obtura
Presented as a white modified Portland cement-based
presented the lower flow rate (27.65 mm). Because of this
material, its most significant difference is the presence of
property, MTA Obtura will probably penetrate with more
large amount of calcium carbonate, which intends to
difficulty in ramifications and irregularities of root canal
increase the release of calcium ions and offer good sealing
walls than the other sealers tested. However, it was superior
properties, adhesion to dentinal walls adequate flow rate,
to the minimum demanded by ADA specification
and biocompatibility. Addition of calcium carbonate reduces
no. 57.38,46,47
pH from 12.5 to 10 after setting. This way surface necrosis
in contact with material is restricted which allows action of MTAS Experimental Sealer
alkaline phosphatase. According to Vasconselos et al,40
Endo CPM sealer has an alkaline pH and an ability to release It was developed by the authors at discipline of Endo
calcium ions. Araraquara Dental School UNESP, University of Estadual
Studies have demonstrated that addition of calcium Paulista, Sao Paulo, Brazil. It is composed of 80% white
chloride to MTA reduces setting time,41 improve its sealing Portland cement, zirconium oxide as radio opacifying agent,
ability and facilitate insertion into cavities without calcium chloride as additive, and resinous vehicle. It is
interfering with its biocompatibility.14 prepared using powder to liquid ratio of 5:3 by weight which
When analyzing the Endo CPM sealer regarding its was determined in previous pilot studies. It has similar initial
sealing ability on apical plugs, it was observed that there is and final setting time to those of AH Plus sealer. According
no difference between grey MTA Angelus (Angelus to Tanomaru et al (2011) MTAS showed higher calcium
Solucoes Odontologicas, Londrina, PR, Brazil) and Endo release than MTA and Portland cement except for 14 days
CPM sealer.36 period. This may be due to incorporation of calcium chloride
It has good antimicrobial activity (Tanomaru 2008) and to the sealer. This also favors calcium ion release. The pH
satisfactory radiopacity.29 Moreover, culture with fibroblast of MTAS sealer was significantly higher up to 48-hour
revealed that it is not cytotoxic.29 CPM sealer is able to period and was statistically similar to MTA and Portland
release calcium and hydroxyl ions and is therefore cement. This indicates that MTAS has strong capacity of
biocompatible. release of hydroxyl ions.
The study of Bramante et al (2006)42 allows comparison
F-doped MTA Cements
between the results obtained with CPM sealers and those
of the present results. According to those authors, CPM Powder-White Portland cement, bismuth oxide, anhydrite,
sealers have dimensional adhesion stability through time, sodium fluoride (Carlo Erba, Italy).
among other properties. However, the results observed for Liquid consist of Alphacaine SP solution. Sodium
this material with regard to sealing ability were not so good, fluoride was included in FMTA as an expansive and
with a mean overall leakage of 4.00 1.00 mm. No retardant agent. It has been recently demonstrated (Gandolfi
significant difference between CPM sealer, AGMTA and et al 2009) that Portland-based cement containing fluorine
MBP sealer in leakage was shown.27,43 had a significant expansion in water and in PBS. The
CPM sealer show higher ratio of leakage as compare to expansion of Portland-based cements is a water-dependent
AH Plus and Sealapex. Conversely, in a recent study by mechanism because of water uptake because when
Silva Neto and Moraes (2003),44 MTA was not considered immersed in hexadecane oil, no expansion occurred.16
as a good sealer. Moreover, the formation of ettringite, which is responsible
Journal of Orofacial Research, January-March 2013;3(1):16-21 19
Manjusha Rawtiya et al

for expansion, is accelerated in fluorine-doped cements. 5. Bouillaguet S, Wataha JC, Lockwood PE, Galgano C, Golay A,
Older sodium fluoride was included in the experimental Krejci I. Cytotoxicity and sealing properties of four classes of
endodontic sealers evaluated by succinic dehydrogenase activity
cement.48 FMTA for its expansive properties and prolonged confocal scanning microscopy. Europ J Oral Sci 2004;112:
setting time and its activity on bone and dental pulp cells.16 182-87.
Osteoconductive activity is an important property in a sealer 6. Bonson S, Jeansonne BG, Lallier TE. Root-end filling materials
for biological response and new bone tissue formation and after fibroblast differentiation. J Dent Res 2004;83:408-13.
7. Sousa CJA, Montes CRM, Pascon EA, Loyola AM, Versiani
repair because the extrusion of sealer from the apex is a
MA. Comparison of the intraosseous biocompatibility of AH
frequent occurrence in clinical practice. So the fluoride- plus, endoREZ, and Epiphany root canal sealer. J Endod
containing cement revealed a better sealing ability likely 2006;32:656-62.
because of greater expansion.48 Moreover, fluorine ions from 8. Lee DH, Kim NR, Lim BS, Lee YK, Hwang KK, Yang HC.
the cement may penetrate into the dentine and enhance the Effect of root canal sealers on lipopolysaccharide induced
expression of cyclooxygenase-2 mRNA in murine macrophage
mineralization of dentine and may also plug and close
cells. J Endod 2007a;33:1329-33.
dentinal tubules. The setting reaction of the cement involves 9. Schwartz RS. Adhesive dentistry and endodontics. Part 2:
the continuous formation of hydration products that Bonding in the root canal system. The promise and the problems:
contribute to reducing the microchannels in the cement A review. J Endod 2006;32:1125-34
10. Roggendorf MJ, Ebert J, Petschelt A, Frankenberger R. Influence
bulk.25 The hydration products may react with dentinal ions
of moisture on the apical seal of root canal fillings with five
(Ca and P)23 and reduce marginal gaps, improving the seal different types of sealer. J Endod 2007;33:31-33.
of the apical third by calcium phosphate precipitate 11. Torabinejad M, White DJ. Tooth filling material and use. US
formation. The hydration products may also provide the Patent Number 5 1995 May;769:638.
mechanical interlock of the dentine interface and the 12. Lee SJ, Monsef M, Torabinejad M. Sealing ability of a mineral
trioxide aggregate for repair of lateral root perforations. J Endod
obliteration of dentinal tubules in absence of smear layer, 1993;19(11):541-44.
previously removed by EDTA irrigation.49 13. Vanderweele RA, Schwartz SA, Beeson TJ. Effect of blood
The large amount of portlandite formed during the contamination on retention characteristics of MTA when mixed
hydration of tricalcium silicate causes the early increase in with different liquids. J Endod 2006;32:421-24.
14. Camilleri J. Hydration mechanisms of mineral trioxide
pH up to 12 that may play a protective role in preventing
aggregate. Int Endod J 2007;40:462-70.
bacteria recontamination of a filled root canal. The formation 15. Gandolfi MG, Ciapetti G, Perut F, et al. Biomimetic calcium-
of calcium hydroxide during the hydration process increases silicate cements aged in simulated body solutions. Osteoblasts
the potential for their clinical use as sealers in orthograde response and analyses of apatite coating. J Applied Biomater
Biomech 2009;7:160-70.
endodontic therapy.
16. Gandolfi MG, Iacono F, Agee K, et al. Setting time and
expansion in different soaking media of experimental accelerated
CONCLUSION calcium-silicate cements and ProRoot MTA. Oral Surg Oral Med
Oral Pathol Oral Radiol Endod 2009;108:e39-45.
This review of MTA -based root canal sealers shows that
17. Weller RN, Tay KCY, Garrett LV, et al. Microscopic appearance
these materials do not fulfil all the criteria described by and apical seal of root canals filled with gutta percha and ProRoot
Grossman. Most studies are laboratory based or in animal Endo Sealer after immersion in a phosphate-containing fluid.
models, which may differ from the clinical situation. The Int Endod J 2008;41:977-86.
antibacterial effects of MTA based sealers are variable. 18. Gomes-Filho JE, Watanabe S, Estrada Bernabe PF, de Moraes
Costa MT. A mineral trioxide aggregate sealer stimulated
Cytotoxicity appears to be milder than for other groups of mineralization. J Endod 2009;35:256-60.
sealers. Thus, MTA based Sealers are favorable alternative 19. Camilleri J. Evaluation of selected properties of mineral trioxide
as compare to other sealers. aggregate sealer cement. J Endod 2009;35:1412-17.
20. Holland R, Souza V. Reaction of dogs teeth to root canal filling
REFERENCES with mineral trioxide aggregate or a glass ionomer sealer. J
Endod 1999;25:728-30.
1. Gutmann JL, Kuttler S, Niemczyk SP. Root canal obturation: 21. Holland R, Otoboni Filho JA, Souza V, Nery MJ, Bernabe PFE,
An update. Academy of General Dentistry 2010;1-11. Dezan Junior E. Mineral trioxide aggregate repair of lateral root
2. Brainstetter J, Von Fraunhofer A. The physical properties and perforations. J Endod 2001;27:281-84.
sealing action of endodontic sealer cements: A review of the 22. Bozeman B, Lemon RR, Eleazer PD. Elemental analysis of
literature. J Endod 1982;8(7):312-16. crystal precipitate from gray and white MTA. J Endod
3. SpDngberg LSW. Instruments, materials and devices. In: Cohen 2006;32:425-28.
S, Burns RC (Eds). Pathways of the pulp (7th ed). St. Louis: 23. Tay FR, Pashley DH, Rueggeberg FA, Loushine RJ, Weller
Mosby Inc.1998;510. RN. Calcium phosphate phase transformation produced by the
4. Huang TH, Yang JJ, Li H, Kao CT. The biocompatibility interaction of the Portland cement component of white mineral
evaluation of epoxy resin-based root canal sealers in vitro. trioxide aggregate with a phosphate-containing fluid. J Endod
Biomaterials 2002;23:77-83. 2007;33:1347-51.

20
JAYPEE
 JOFR

MTA-Based Root Canal Sealers

24. Colemann NJ, Nicholson JW, Awosanya K. A preliminary 42. Bramante CM, Bramante AS, Moraes IG, et al. CPM y MTA:
investigation of the in vitro bioactivity of white Portland cement. Nuevos materiales de uso en endodoncia. Rev de La Fac Odontol
Cements Concrete Res 2007;37:1518-23. Una 2006;20:7-10.
25. Girao AV, Richardson IG, Porteneuve CB, Brydson RMD. 43. Yildirim T, Oruolu H, Cobankara FK. Long-term evaluation
Composition, morphology and nanostructure of C-SH in white of the influence of smear layer on the apical sealing ability of
Portland cement pastes hydrated at 55C. Cements Concrete MTA. J Endod 2008;34:1537-40.
Res 2007;37:1571-82. 44. Orosco FA, Bramante CM, Garcia RB, Bernadineli N, Moraes
26. Namazikhah MS, Nekoofar MH, Sheykhrezae MS, et al. The IG. Sealing ability of gray MTA Angelus TM, CPM TM and
effect of pH on surface hardness and microstructure of mineral MBPc used as apical plugs. J Appl Oral Sci 2008;16:50-54.
trioxide aggregate. Int Endod J 2008;41:108-16. 45. Bernardes RA, Campelo AA, Silva DS. Evaluation of the flow
27. Lee YL, Lin FH, Wang WH, Ritchie HH, Lan WH, Lin CP. rate of 3 endodontic sealers: Sealer 26, AH Plus, and MTA
Effects of EDTA on the hydration mechanism of mineral trioxide Obtura. Oral Surg Oral Med Oral Pathol Oral Radiol Endod
2010;109:e47-49.
aggregate. J Dent Res 2007;86:534-38.
46. Torabinejad M, Smith PW, Kettering JD, Pitt Ford TR.
28. Taddei P, Tinti A, Gandolfi MG, Rossi PL, Prati C. Vibrational
Comparative investigation of marginal adaptation of mineral
study on the bioactivity of Portland cement based materials for
trioxide aggregate and other commonly used root end filling
endodontic use. J Mol Struct 2009;924-26:548-54.
material. J Endod 1995; 21:295-99.
29. Tanomaru JMG, Leonardo MR, Tanomaru Filho M. In-vitro
47. Torabinejad M, Watson TF, Pitt Ford TR. Sealing ability of an
antimicrobial activity of endodontic sealers, MTA based cements MTA when used as a root end filling material. J Endod
and Portland cement. J Oral Sci 2007;49(1):41-45 1993;19:591-95.
30. Bogen G, Kuttler S. Mineral trioxide aggregate obturation: A 48. Gandolfi MG, Prati C. MTA and F-doped MTA cements used
review and case series. J Endod 2009;35(6):777-90. as sealers with warm gutta-percha. Long-term study of sealing
31. Bryan T, Khechen K, Brackett MG. In vitro osteogenic potential ability. Int Endod J 2010;43:889-901.
of an experimental calcium silicate-based root canal sealer. J 49. Gandolfi MG, Taddei P, Tinti A, Dorigo De Stefano E, Rossi
Endod 2010;36(7):1163-69. PL, Prati C. Kinetics of apatite formation on a calcium silicate
32. Huffman BP, Pinna L, Weller RN. Dislocation resistance of cement for root-end filling during ageing in physiological-like
ProRoot Endo Sealer: A calcium silicate-based root canal sealer, phosphate solutions. Clin Oral Investig 2010 Dec;14(6):659-68.
from radicular dentin. Int Endod J 2009;42:34-46.
33. Sarkar NK, Caicedo R, Ritwik P, et al. Physicochemical basis
of the biologic properties of mineral trioxide aggregate. J Endod ABOUT THE AUTHORS
2005;31:97-100 Manjusha Rawtiya (Corresponding Author)
34. Amyra T, Walsh LT, Walsh LJ. An assessment of techniques
for dehydrating root canals using infrared laser radiation. Aust Senior Lecturer, Department of Conservative Dentistry and
Endod J 2000;26:78-80. Endodontics, Peoples College of Dental Sciences, Bhopal, Madhya
35. Hosoya N, Nomura M, Yoshikubo A. Effect of canal drying Pradesh, India, e-mail: manju27mona@gmail.com
methods on the apical seal. J Endod 2000;26(5):292-94.
36. Torabinejad M, Parirokh M. Mineral trioxide aggregate: A Kavita Verma
comprehensive literature reviewpart II: Leakage and Senior Lecturer, Department of Conservative Dentistry and
biocompatibility investigations. J Endod 2010;36:190-202. Endodontics, Saraswati Dental College, Lucknow, Uttar Pradesh, India
37. Kuga CM, Edson Campos EA. Hydrogen ion and calcium
releasing of MTA Fillapex and MTA-based formulations. 2011
Shweta Singh
Jul-Sep;8(3):271-76.
38. Gomes-Filho JE, Watanabe S, Lodi CS, Cintra LTA, Nery MJ, Senior Lecturer, Department of Pedodontics, Dental College
Filho JAO, et al. Rat tissue reaction to MTA Fillapex. Dent Azamgarh, Uttar Pradesh, India
Traumatol 2012 Dec;28(6):452-56.
39. Scarparo RK, Haddad D, Acasigua GA. Mineral trioxide Swapna Munuga
aggregate-based sealer: Analysis of tissue reactions to a new
Senior Lecturer, Department of Conservative Dentistry and
endodontic material. J Endod 2010;36(7):1174-78.
Endodontics, Peoples College of Dental Sciences, Bhopal, Madhya
40. Vasconcelos BC, Bernardes RA, Cruz SML, et al. Evaluation
Pradesh, India
of pH and calcium ion release of new root-end filling materials.
Oral Surg Oral Med Oral Pathol Oral Radiol Endod
2009;108:135-39. Sheeba Khan
41. Bortoluzzi EA, Broon NJ, Bramante CM, et al. Sealing ability Senior Lecturer, Department of Conservative Dentistry and
of MTA and radiopaque Portland cement with or without calcium Endodontics, Peoples College of Dental Sciences, Bhopal, Madhya
chloride for root-end filling. J Endod 2006;32:897-900. Pradesh, India

Journal of Orofacial Research, January-March 2013;3(1):16-21 21