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Title: In-vitro investigation of the performance of Mineral Trioxide Aggregate (MTA) as an orthograde obturation material
Author: El-Ma'Aita, Ahmad
Awarding Body: University of Manchester
Current Institution: University of Manchester
Date of Award: 2013
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Fluid-tight obturation of the root canal space is an important requirement for successful root canal treatment. Gutta percha, used as a core material in combination with different sealers, is the most commonly used root filling material and is considered the gold standard. However, it does not possess all the properties of the ideal obturation material. Mineral trioxide aggregate (MTA) is a cement material based on calcium silicates (CSC). It sets by hydration, provides excellent sealing ability, is biocompatible/bioactive and has performed successfully in different clinical applications. The use of MTA as an orthograde obturation material has been proposed. However, MTA is difficult to handle and very little is known about the most appropriate technique to ensure good compaction within the shaped root canal. This research aims to investigate the performance of MTA when used as an orthograde obturation material. The effect of different times of ultrasonic activation of unset material on the incidence of voids in root canals was investigated. Manual compaction of MTA using hand pluggers without ultrasonic activation resulted in minimal void formation. Ultrasonic activation resulted in significantly higher incidence of voids. The removal of the smear layer prior to obturation with MTA resulted in a significantly reduced push-out bond strength between the MTA and radicular dentine. The apical sealing ability of MTA orthograde filling was assessed in comparison with gutta percha and sealer using a dye leakage model. It was concluded that MTA provides a better apical seal against dye penetration over a 30-day observation period. The ability of MTA to reinforce the remaining root structure in comparison with gutta percha and sealer was investigated. MTA significantly increased the resistance to vertical root fracture after one month of storage in synthetic tissue fluid. The radiopacity of MTA together with new calcium silicate cements was assessed and it was concluded that MTA was more radiopaque than gutta percha but less radiopaque than AH-plus sealer. The use of MTA as an orthograde obturation material has shown some potential of enhanced clinical performance in comparison with gutta percha and sealer in terms of sealing ability and bioactivity. However, there are certain disadvantages for obturation with this category of materials in its present form. It is important to point out that MTA is still in its early stages of development. With further improvements to its physical properties, MTA can present a valuable option for obturation of the root canal space.
Supervisor: Watts, David ; Qualtrough, Alison Sponsor: Not available
Qualification Name: Thesis (Ph.D.) Qualification Level: Doctoral
EThOS ID:  DOI: Not available
Keywords: obturation ; Calcium silicate cement ; Mineral trioxide aggregate ; MTA