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Inside Dentistry
October 2017
Volume 13, Issue 10

MTA Repair HP

Leandro A. P. Pereira, DDS, MSc, PhD

The last several decades have been marked by great progress in endodontics. The evolution of technology and equipment has simplified the specialty, making it safer, easier, and more predictable. However, there is more to endodontics than just equipment and technique. Its essence is biologic. The desired results of an endodontic treatment are also dependent on the patient’s immune response. For tissue repair to occur, the materials used must be compatible with the tissues surrounding the treated area. These so-called “biocompatible” materials may be inert or active. They may be present without affecting the surrounding tissues (ie, inert), but they can also provoke, induce, or favor a particular positive response (ie, bioactive).

At the start of the 1990s, there was also progress related to materials. MTA Angelus®, a silicate-based sealer, came into the endodontic market demonstrating biologic, physical, and chemical features that could not be matched by existing materials. This new material had better sealing capacity, resulted in lower gaps between material and dentin walls, demonstrated excellent biocompatibility and bioactivity, and could be used in a humid environment. With these properties, it quickly became the material of choice for the treatment of root perforations and endodontic retro fillings.

In the mid-1990s, I had my first clinical experience with MTA and its use in clinical cases for root perforations and retro fillings. The high-quality results were clearly evident. Soon after, I started working with MTA Angelus myself. At each follow-up appointment for the cases that I treated with this material, even complex ones, the treated areas exhibited the anticipated clinical and radiographic response and desired tissue repair. These positive results led me to write my first chapter in a dentistry book, which addressed the treatment of root perforations.

Although it delivered great results, managing MTA was never easy. Its sandy consistency hinders clinical work. But just like the progress in other areas of endodontics, these silicate-based sealers also evolved. MTA Angelus evolved into MTA Repair HP. To achieve high plasticity, the liquid component was modified, incorporating an organic plasticizer. This resulted in significant improvement to the material’s handling without any loss in its biologic response. In addition, with calcium tungstate instead of bismuth oxide, its radiopacity is excellent.

After using MTA Repair HP for the first time, it became my new material of choice for cases involving root perforations and retro fillings, and it is now an integral part of the endodontics that I practice.

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Leandro A. P. Pereira, DDS, MSc, PhD, is a professor of endodontics and the owner and clinical director of the Blantus Endodontic Center.

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