Hints & Tips

• What is MTA?
  Mineral Trioxide Aggregate. MTA is a bioactive material mainly composed of calcium and silicate. Essentially, it is a Portland cement! MTA is being used in dentistry as a REPAIR material, it means that MTA promotes biostimulation of the exposed tissue (pulp or periodontal), stimulating a natural organic repair. Basic formula is a tricalcium silicate powder combined with bismuth oxide powder for radiopacity. The Ultradent MTAFlow is a powder and liquid/gel system that consists of an extremely fine, radiopaque, inorganic powder which sets with a gel for improved placement. The Ultradent MTAFlow provides excellent handling, faster setting time and is wash out resistant (resistance to be washed by organic fluids, like blood). It is the only MTA Repair material that can be delivered in the thin consistency using a Navitip and Skini Syringe.
• What are the indications for use for the MTA Flow?
  The MTAFlow cement is intended for use as a REPAIR material for pulp and periradicular tissues. It protects and stimulates healing by inducing the formation of a hard tissue (hydroxyapatite layer). It is not a root canal filler, but a repair cement.
• What procedures will use MTA Flow?
  Pulpotomy, Direct or indirect pulp capping, Root-end filling, Apexification and Apexogenesis, Apical Plug, Perforation repair and Root resorption.
• What is the working time for MTA Flow?
  During the mixing phase, the operator will choose the appropriate consistency following the suggestions on the technical guide. More or less flow can be achieved by controlling the amount of gel/power. Different consistencies can be achieved by using less powder or more liquid anytime during the mixing procedure. MTA Flow can dehydrate, so quick mixing is best. As a general rule, MTA Flow mixed and placed inside the clear Skini syringe can be used for up to 15 minutes after mixing. Be sure no air is present inside the syringe to avoid dehydration.
• How long does it take for MTA Flow to be fully cured?
  The initial set is 5 minutes, complete set is 1 hour. Complete cure and strengthening is 4 weeks.
• How should MTA Flow be stored?
  MTA Flow powder and gel must be kept well sealed. Only open the bottle immediately prior to use. MTA Flow powder is sensitive to humidity. Close the bottle tightly after use. Do not contaminate the powder or gel with an unclean or moist instrument. Store at room temperature. Do not refrigerate. Moisture will reduce the shelf life of the powder. If you leave the MTA Flow powder exposed, the cement particles will combine with the water in the air to produce large pre-hydrated, semi-set cement particles leaving you with a cement which is clumpier, harder to mix and less likely to properly set. Do not store your MTA Flow in the fridge. The simple science is, the colder your MTA Flow, the slower it will react with the gel increasing the risk of fluid contamination and hence weaker properties. Only remove the bottle gel cap prior to use. After use, close the bottle with the cap immediately. Exposure of gel to air could cause the gel to thicken. Exposure of the gel will cause drying and possibly formation of a film at the bottle tip.
• Why does our MTAFlow kit include a proprietary gel for mixing instead of just water?
  Unlike other MTA cements that use water and have a coarse sandy consistency, MTA Flow cement will be creamy and homogeneous after mixing using the proprietary gel. This provides much better handling especially when expressed through our black micro tips and NaviTips.
• Why is it important to be able to mix your own consistency?
  Depending on the procedure, you will want a thick, thin, or putty type consistency. Some competitive cement comes pre-mixed so you don’t have a choice of consistency. There is also a lot of waste with competitive product that does not allow you to mix just the amount needed.
• Are there any contra-indication for this product?
  Hypersensitivity against caustic (high pH) solutions, not for root canal disinfection.
• How many applications can you anticipate per MTA Flow Kit?
  Depending on the procedure, you should be able to complete 8-10 applications.
• What tips work best to deliver our MTA Flow?
  - 29 gauge NaviTip for delivering MTA Flow in intracanal areas. Resorption, Apexification and Apical Plug. - Black Micro 22g. tip for more coronal applications (direct pulp capping, pulpotomy, pulp chamber perforations). - Any other tip bigger than 29g.
• What does it mean that MTA Flow is Non-cytotoxic?
  It means it won’t kill human cells.
• What does it mean that MTA Flow is Antibacterial?
  It inhibits bacterial growth in vitro of staphylococcus aureus, Escherichia coli, Enterococcus faecalis (found in endo infections) and Pseudomonas aeruginosa.
• What is the chemical reaction that promotes healing with MTA Flow?
  Bones and teeth are made of calcium phosphate known as hydroxyapatite. When MTA Flow meets body fluids it creates a layer of hydroxyapatite on the surface. The body recognises this hydroxyapatite and starts the healing process. MTA isn’t bone, but it’s chemically close enough to bone that bone will grow onto the surface of MTA… that is the “healing effect”.
• What is the difference between MTA Flow and UltraCal XS?
  UltraCal XS is Calcium Hydroxide premixed paste. UltraCal XS is used inter-appointment as an intracanal medicament due to its antibacterial effect. It becomes inactive after 2 to 3 weeks and eventually disappear from inside the canal. MTA Flow is a permanent material, and will release calcium hydroxide for a longer period.
• Is there tooth staining with MTA Flow?
  The majority of MTA on the market will potentially stain the crown if erroneously left at the pulp chamber level. Staining has nothing to do with the color of the MTA. Whether the MTA is dark or light gray, white or yellow, all MTA products contain a Bismuth Oxide radiopacifier which is the chemical element that will stain the crown. MTA should be used in the bone level of the tooth, below the crown. There is no reason to leave the pulp chamber filled with MTA, even if using MTA as a pulp capping, you cover it with a composite (etch, adhesive and composite, i.e.) For direct or indirect pulp capping, it is recommended to cover the MTA with a layer of UltraCem or PermaFlo. If it is an esthetic area (it means that MTA will internally contact directly dentin at the buccal surface of the crown), MTA can be substituted by UltraBlend Plus.
• What is the shelf life of the MTA Flow?
  2 year shelf life.
• Does the area where MTA is applied need to be dry?
  Yes. Any moisture will increase water at the mixture and postpone setting time, but it will still set.
• Can MTA be used during or after implants as a bone repair material?
  Bone repair materials are commonly used in implants when a bone defect or even more bone is needed at the site. Bone repair materials could be biodegradable materials, including polymers, magnesium alloys and ceramics. Even being a bioceramic material, MTA is not considered a bone repair material due to the high PH and not being resorbed by the body. Check the IFU and indications of MTA Flow and you will notice that is just for areas inside the tooth.
• Is there resin in our MTA?
  No. There is no resin in our MTA
• Can our EndoREZ sealer be used after placing MTA?
  Yes. There is no chemical reaction from the EndoREZ sealer that will affect the MTA after it is used for apical seal.
• How can MTAFlow cement be removed?
  Endo-Eze MTA Flow cement can be removed using standard mechanical retreatment techniques. Ultrasonification. With proper retreatment, ultrasonic tips is recommended.
• How is it possible to have water soluble silicone gel? Silicone is hydrophobic!
  Silicone is a generic chemical term, just like alcohol. We generally use it to describe ethanol but there are many other types, just as an example. The best example of hydrophilic silicone comes from dentistry, hydrophilic impression materials made from silicone.