LECTURE-ON-DEMAND
Presenter:
Dr. Arnaldo Castellucci (bio)
Lecture Length:
Approx. 88 minutes
About the presenter:
Dr. Castellucci graduated in Medicine at the University of Florence in 1973 and specialized in Dentistry at the same University in 1977. From 1978 to 1980 he attended continuing education courses on Endodontics at Boston University School of Graduate Dentistry with Prof. Herbert Schilder. As well as running a practice limited to Endodontics in Florence, Dr. Castellucci is Past President of the Italian Endodontic Society, Past President of the International Federation of Endodontic Associations, an Active Member of the European Society of Endodontology, Active Member of the American Association of Endodontists, and a Visiting Professor of Endodontics at the University of Florence Dental School. He is editor of The Italian Journal of Endodontics and of The Endodontic Informer, Founder and President of The Warm Gutta Percha Study Club and The Micro-Endodontic Training Center, Editor in Chief of Endo Tribune. An international lecturer, he is the author of the text EndodonticS, which is now available in English.
Content:
Recently, Dr. Mahmoud Torabinejad of Loma Linda University, California, has developed a new cement named Mineral Trioxide Aggregate which appears to have all of the characteristics requested of the ideal cement to seal pathways of communications between the pulp and the oral cavity (mechanical and carious pulp exposures), and between the root canal system and the periodontium (iatrogenic perforations, open apices, resorbed apices, root-end preparations).
MTA is an endodontic cement that is extremely biocompatible, capable of stimulating healing and osteogenesis, and is hydrophilic. MTA is a powder that consists of fine trioxides (Tricalcium oxide, Silicate oxide, Bismute oxide) and other hydrophilic particles (Tricalcium silicate, Tricalcium aluminate, responsible for the chemical and physical properties of this aggregate), which set in the presence of moisture. Hydration of the powder results in formation of a colloidal gel with a pH of 12.5, that solidifies to a hard solid structure in approximately three-four hours. This cement is different from other materials currently in use because of its biocompatibility, antibacterial properties, marginal adaptation and sealing properties, and its hydrophilic nature.
The characteristic that distinguishes MTA from other materials used to date in endodontics is its hydrophilic properties. Materials used to repair perforations, to seal the retro-preparation in surgical endodontics, to close open apices, or to protect the pulp in direct pulp capping, are inevitably in contact with blood and other tissue fluids. Moisture may be an important factor due to its potential effects on the physical properties and sealing ability of the restorative materials. As shown by Torabinejad et al., MTA is the only material that is not affected by moisture or blood contamination: the presence or absence or blood seems not to affect the sealing ability of the mineral trioxide aggregate.
During the presentation, several cases of treatment with MTA will be showed. Aim of the presentation is to show the indications and the technique for the correct use of this relatively new material: how to seal an open apex, how to repair a strip-perforation under the microscope, how to protect a pulp exposure to perform a direct pulp capping, how to use MTA during surgery to seal the retroprep.
In conclusion, the viewers should be able to appreciate the advantages of this material, which made our treatments more predictable and gave us the possibility to save teeth otherwise condemned to extraction.
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