Thomas R. Pitt Ford

Histologic assessment of mineral trioxide aggregate as a root-end filling in monkeys

Mineral Trioxide Aggregate (MTA) has been shown in a number of experiments to be a potential root-end filling material. The purpose of this study was to examine the periradicular tissue response of monkeys to MTA and amalgam as root-end fillings. The pulps were removed from all the maxillary incisors of three monkeys. The root canals were prepared and filled with laterally condensed guttapercha and sealer, and the access cavities were restored with amalgam. Buccal mucoperiosteal flaps were raised, and root-end resections were performed before root-end cavity preparation with burs. The root-end cavities in half of the teeth were filled with MTA, while amalgam was placed in the other cavities. After 5 months the periradicular tissue response was evaluated histologically. The results showed no periradicular inflammation adjacent to five of six root ends filled with MTA; also five of six root ends filled with MTA had a complete layer of cementum over the filling. In contrast, all root ends filled with amalgam showed periradicular inflammation, and cementum had not formed over the root-end filling material, although it was present over the cut root end. Based on these results and previous investigations, MTA is recommended as a root-end filling material in man.

Investigation of mineral trioxide aggregate for root-end filling in dogs

Numerous compounds have been used as root-end filling materials. Based on the results of in vitro and intraosseous implantation tests, mineral trioxide aggregate (MTA) seems to have potential as a root-end filling material. The purpose of this study was to examine the periradicular tissue response of dogs to MTA and amalgam. Lesions were developed in periradicular tissues of 46 roots in six beagle dogs. The canals on half of the roots were instrumented and obturated with gutta-percha and sealer, and their access cavities were sealed with MTA. The remaining root canals were instrumented and obturated with gutta-percha and sealer, and their access cavities were sealed with MTA. The remaining root canals were instrumented and obturated with gutta-percha without root canal sealer. The access cavities of the teeth in this group were left open to the oral cavity. After surgical resection of roots, half of the root-end cavities were filled with amalgam and the rest with MTA. The periradicular tissue response of the dogs was evaluated histologically 2 to 5 and 10 to 18 wk following periradicular surgery. Statistical analysis of the results showed less periradicular inflammation and more fibrous capsules adjacent to MTA, compared with amalgam. In addition, the presence of cementum on the surface of MTA was a frequent finding. The results show that MTA can be used as a root-end filling material.

Dye leakage of four root end filling materials: Effects of blood contamination

The purpose of this study was to compare the amount of dye leakage (in the presence versus absence of blood) in root end cavities filled with amalgam, Super EBA, IRM, and a mineral trioxide aggregate. After removing the anatomical crowns of 90 extracted human teeth, their roots were instrumented and obturated. Except for their apical 2 mm, the root surfaces were sealed with nail polish. After removal of the apical 2 to 3 mm of each root, a standardized root end cavity was prepared. Five root ends were filled with gutta-percha and no sealer, and another five root ends were filled with sticky wax. These served as positive and negative controls, respectively. The remaining 80 roots were divided into four equal groups and filled with the test materials. For each material, half of the root end cavities were dried prior to placing the filling material. The remaining half were filled after they were contaminated with blood. All 90 roots were then immediately placed in 1% methylene blue dye for 72 h. Finally, the roots were split and linear dye penetration was measured and statistically analyzed (analysis of variance). Presence or absence of blood had no significant effect on the amount of dye leakage. However, the results showed that there was a significant leakage difference between the root end filling materials (p < 0.0001). Mineral trioxide aggregate leaked significantly less than other materials tested with or without blood contamination of the root end cavities.

Cellular response to mineral trioxide aggregate

This investigation studied the cytomorphology of osteoblasts in the presence of Mineral Trioxide Aggregate (MTA) and examined cytokine production. MTA and Intermediate Restorative Material (IRM) were prepared and placed in separate Petri dishes. Osteoblasts (cell-line MG-63), grown to confluence in Hams F12/Dulbeccos modified Eagles medium, were seeded into the dishes, which were incubated for 1 to 7 days. The specimens were viewed by scanning electron microscopy. For cytokine evaluation, cells were grown either alone or in other dishes containing the test materials for 1 to 144 h. Media were removed for ELISA analysis of interleukin (IL)-1 alpha, IL-1 beta, IL-6, and macrophage colony-stimulating factor. Scanning electron microscopy revealed healthy cells in contact with MTA at 1 and 3 days; in contrast, cells in the presence of IRM appeared rounded. The ELISA assays revealed raised levels of all ILs at all periods when cells were grown in the presence of MTA; in contrast, cells grown alone or with IRM produced undetectable amounts. The macrophage colony-stimulating factor was produced by cells irrespective of the group. It seems that MTA offers a biologically active substrate for bone cells and stimulates IL production.

Bacterial leakage of mineral trioxide aggregate as a root-end filling material

Previous dye leakage studies have shown that mineral trioxide aggregate leaks significantly less than other commonly used root-end filling materials. This study determined the time needed for Staphylococcus epidermidis to penetrate a 3-mm thickness of amalgam, Super-EBA, Intermediate Restorative Material (IRM), or mineral trioxide aggregate (MTA) as root-end filling materials. Fifty-six single-rooted extracted human teeth were cleaned and shaped using a step-back technique. Following root-end resection, 48 root-end cavities were filled with amalgam, Super-EBA, IRM, or MTA. Four root-end cavities were filled with thermoplasticized gutta-percha without a root canal sealer (+ control), and another four were filled with sticky wax covered with two layers of nail polish (- control). After attaching the teeth to plastic caps of 12-ml plastic vials and placing the root ends into phenol red broth, the set-ups were sterilized overnight with ethylene dioxide gas. A tenth of a microliter of broth containing S. epidermidis was placed into the root canal of 46 teeth (40 experimental, 3 positive, and 3 negative control groups). In addition, the root canals of two teeth with test root-end filling materials and one tooth from the positive and negative control groups were filled with sterile saline. The number of days required for the test bacteria to penetrate various root-end filling materials was determined. Most samples whose apical 3 mm were filled with amalgam, Super-EBA, or IRM began leaking at 6 to 57 days.(ABSTRACT TRUNCATED AT 250 WORDS)

Use of mineral trioxide aggregate for repair of furcal perforations

The histologic response to intentional perforation in the furcations of 28 mandibular premolars in seven dogs was investigated. In half the teeth, the perforations were repaired immediately with either amalgam or mineral trioxide aggregate; in the rest the perforations were left open to salivary contamination before repair. All repaired perforations were left for 4 months before histologic examination of vertical sections through the site. In the immediately repaired group, all the amalgam specimens were associated with inflammation, whereas only one of six with mineral trioxide aggregate was; further, the five noninflamed mineral trioxide aggregate specimens had some cementum over the repair material. In the delayed group, all the amalgam specimens were associated with inflammation; in contrast only four of seven filled with the aggregate were inflamed. On the basis of these results, it appears that mineral trioxide aggregate is a far more suitable material than amalgam for perforation repair, particularly when used immediately after perforation.

Comparative investigation of marginal adaptation of mineral trioxide aggregate and other commonly used root-end filling materials

This study investigated the marginal adaptation of mineral trioxide aggregate (MTA) as a root-end filling material, compared with commonly used root-end filling materials by scanning electron microscopy (SEM). Eighty-eight single-rooted freshly extracted human teeth were cleaned, shaped, and obturated with gutta-percha and root canal sealer. Following root-end resection and cavity preparation, the root-end cavities were filled with amalgam, Super-EBA, Intermediate Restorative Material (IRM), or MTA. Using a slow-speed diamond saw, 40 roots were longitudinally sectioned into two halves. Resin replicas of resected root ends of the remaining nonsectioned roots were also prepared. After mounting longitudinal sections of roots and resin replicas of resected roots on aluminum stubs, the distance between the test root-end filling materials and surrounding dentin was measured at four points under SEM. Examination of the original samples showed numerous artifacts in the longitudinal sections of the specimens. In contrast, the resin replicas of resected and filled root ends had no artifacts. Statistical analysis of data comparing gap sizes between the root-end filling materials and their surrounding dentin shows that MTA had better adaptation compared with amalgam, Super-EBA, and IRM.

Ultrasonic debridement of root canals: acoustic streaming and its possible role.

Light microscopic comparisons were made of acoustic streaming generated by Cavi-Endo endosonic files of varying sizes at different power settings. To estimate power generated by the files, measurements of the transverse displacement amplitude were carried out. The optimum parameters established from these findings were used in a subsequent study which compared the effectiveness of ultrasonic debridement of two techniques, the one advocated by the manufacturer and a modified technique developed by us. The results indicated that smaller files generated relatively greater acoustic streaming, the velocity of which tended to increase with increases in power. Canals instrumented using the modified technique exhibited cleaner surfaces. It is proposed that in the modified technique, acoustic streaming was freely generated and played an important role in debridement.

Tissue reaction to implanted super-EBA and mineral trioxide aggregate in the mandible of guinea pigs: A preliminary report

In vitro sealing ability and biocompatibility tests on mineral trioxide aggregate (MTA) have shown similar or better properties for this material than for existing root-end filling substances. The purpose of this study was to examine the tissue reaction of implanted Super-EBA and MTA in the mandibles of guinea pigs. After anesthetizing seven guinea pigs, raising a tissue flap and preparing two bony cavities, the test materials were placed in Teflon cups and implanted in the mandibles. Two bony cavities without implanted materials were left to heal and used as negative controls. The presence of inflammation, predominant cell type, and thickness of fibrous connective tissue adjacent to each implant was recorded. The tissue reaction to MTA implantation was slightly than that observed with Super-EBA implantation. Based on these results , it seems that both Super-EBA and MTA are biocompatible.

Tissue reaction to implanted root-end filling materials in the tibia and mandible of guinea pigs

The purpose of this study was to examine the tissue reaction to implanted mineral trioxide aggregate (MTA), amalgam, Intermediate Restorative Material, and Super-EBA in the tibias and mandibles of guinea pigs. After anesthetizing 20 guinea pigs, raising tissue flaps, and preparing bony cavities, the test materials were placed in Teflon cups and implanted in the tibias and 10 days later in the mandibles. The animals were euthanized 80 days later and the tissues prepared for histological examination. The presence of inflammation, predominant cell type, and thickness of fibrous connective tissue adjacent to each implant were recorded. The tissue reaction to MTA implantation was the most favorable observed at both sites; as in every specimen, it was free of inflammation (p < 0.01). In the tibia, MTA was the material most often observed with direct bone apposition. Based on these results, MTA seems to be a biocompatible material.