Histological responses of the periodontium to MTA: a systematic review

• Published in: Journal of clinical periodontology 2013-04, Vol.40 (4), p.334-344
• Main Authors: Katsamakis, Sokratis, Slot, Dagmar Else, Van der Sluis, Luc W. M., Van der Weijden, Fridus
• Format: Article
• Language: English
• Subjects: Aluminum Compounds - pharmacology; Aluminum Compounds - therapeutic use; Animals; Bone Regeneration - drug effects; Calcium Compounds - pharmacology; Calcium Compounds - therapeutic use; Cementogenesis - drug effects; cementum; Dentistry; Dogs; Drug Combinations; Gum disease; Haplorhini; Histology; mineral trioxide aggregate; Oxides - pharmacology; Oxides - therapeutic use; periodontal ligament; Periodontal Ligament - drug effects; periodontium; Rats; Regeneration - drug effects; Root Canal Filling Materials - pharmacology; Root Canal Filling Materials - therapeutic use; Root Canal Therapy; Silicates - pharmacology; Silicates - therapeutic use; Systematic review
• ISSN: 0303-6979; 1600-051X
• DOI: 10.1111/jcpe.12058

Aim The purpose of this systematic review was to investigate whether a mineral trioxide aggregate (MTA) restoration of an endodontic‐periodontal communication leads to regeneration of the adjacent periodontal tissues. Methodology The databases MEDLINE‐PubMed, Cochrane‐CENTRAL, and EMBASE were searched, up to July 2012. In vivo studies that reported on the histological response of the periodontium to MTA were selected. Results The screening of 98 title‐s, full‐text reading, and hand searches in literature lists yielded 24 papers. All of them involved animals. There were no studies reporting on human histology. Study protocols presented heterogeneity regarding treated lesions, intervention, and reported outcomes. The histological results of the animal studies showed minimal inflammatory reactions, bone healing, periodontal ligament presence, and consistent cementum formation. Time lapse after mixing, bacterial contamination, root canal disinfection, and inflammation influenced MTA's cementoconductive properties. Conclusions Within the limitations of the selected papers concerning inhomogeneous study protocols and low methodological quality scores, their findings were consistent with regard to MTA's biocompatibility and cementogenic ability. Experimental animal studies show that MTA can promote healing towards regeneration. There is now a distinct need to examine the clinical performance of MTA in well‐controlled prospective human cohort studies.