Endodontology Research Center, School of Dentistry, Kerman University of Medical Sciences, Kerman, Iran.
Department of Endodontics, School of Dentistry, Loma Linda University, Loma Linda, CA, USA.
Int Endod J. 2018 Feb;51(2):177-205. doi: 10.1111/iej.12841. Epub 2017 Sep 21.
Mineral trioxide aggregate (MTA) is a bioactive endodontic cement (BEC) mainly comprised of calcium and silicate elements. The cement was introduced by Torabinejad in the 1990s and has been approved by the Food and Drug Administration to be used in the United States in 1997. A number of new BECs have also been introduced to the market, including BioAggregate, Biodentine, BioRoot RCS, calcium-enriched mixture cement, Endo-CPM, Endocem, EndoSequence, EndoBinder, EndoSeal MTA, iRoot, MicroMega MTA, MTA Bio, MTA Fillapex, MTA Plus, NeoMTA Plus, OrthoMTA, Quick-Set, RetroMTA, Tech Biosealer and TheraCal LC. It has been claimed that these materials have properties similar to those of MTA without its drawbacks. In this article, the chemical composition and the application of MTA and other BECs for vital pulp therapy (VPT), including indirect pulp cap, direct pulp cap, partial pulpotomy, pulpotomy and partial pulpectomy, have been reviewed and compared. Based on selected keywords, all papers regarding chemical composition and VPT applications of BECs had been reviewed. Most of the materials had calcium and silicate in their composition. Instead of referring to the cements based on their chemical compositions, we suggest the term 'bioactive endodontic cements (BECs)', which seems more appropriate for these materials because, in spite of differences in their chemical compositions, bioactivity is a common property for all of them. Numerous articles were found regarding use of BECs as VPT agents for indirect and direct pulp capping, partial pulpotomy and cervical pulpotomy. Most of these investigations used MTA for VPT. In most studies, newly introduced materials have been compared to MTA. Some of the BECs have shown promising results; however, the number of their studies compared to investigations on MTA is limited. Most studies had several methodological shortcomings. Future investigations with rigorous methods and materials are needed.
矿物三氧化物聚合体（MTA）是一种生物活性根管封闭剂（BEC），主要由钙和硅元素组成。该水泥由 Torabinejad 于 20 世纪 90 年代引入，并于 1997 年获得美国食品和药物管理局批准在美国使用。市场上还推出了许多新型 BEC，包括 BioAggregate、Biodentine、BioRoot RCS、钙强化混合水泥、Endo-CPM、Endocem、EndoSequence、EndoBinder、EndoSeal MTA、iRoot、MicroMega MTA、MTA Bio、MTA Fillapex、MTA Plus、NeoMTA Plus、OrthoMTA、Quick-Set、RetroMTA、Tech Biosealer 和 TheraCal LC。据称，这些材料具有与 MTA 相似的性能，而没有其缺点。本文综述并比较了 MTA 及其他 BEC 材料在活髓保存治疗（VPT）中的应用，包括间接盖髓术、直接盖髓术、部分活髓切断术、活髓切断术和部分牙髓切除术。根据选定的关键词，对所有关于 BEC 化学成分和 VPT 应用的论文进行了综述。大多数材料的组成中都含有钙和硅。我们建议使用“生物活性根管封闭剂（BEC）”这一术语来描述这些材料，而不是基于其化学成分来命名，因为尽管它们的化学成分不同，但生物活性是它们共有的一个特性。有许多关于 BEC 作为间接和直接盖髓术、部分活髓切断术和颈活髓切断术的 VPT 制剂的应用的文章。这些研究大多使用 MTA 进行 VPT。在大多数研究中，新引入的材料与 MTA 进行了比较。一些 BEC 表现出了有希望的结果，但与 MTA 相关研究相比，它们的研究数量有限。大多数研究都存在一些方法学上的缺陷。需要进行更多具有严格方法和材料的未来研究。
