MINERAL

TRIOXIDE
AGGREGATE

By Finny
Introduction
MTA dikenalkan oleh by Dr.
Mahmoud Torabinejad dari
Loma Linda University,
California, US dan literature
pertama mengenai material
tersebut muncul pada 1993.
MTA telah diakui oleh FDA
pada 1998.
MTA was introduced by Dr. Mahmoud Torabinejad
at Loma Linda University, California, US and the
first literature about the material appeared in
1993.
MTA has been approved by the US Food and Drug
Administration (FDA) in the year 1998. with its
numerous exciting clinical applications, MTA
promises to be one of the most versatile
matereials of this century in the field of dentistry.
Composition

Terdiri dari dari 3 bubuk, 3 powder ingredients :

Portland cement 75%
Bismuth oxide 20%
Gypsum 5%

termasuk, includes:
Tricalcium silicate
Tricalcium aluminate
Tricalcium oxide
Silicate oxide
Bismuth oxide
 Type of MTA
White MTA
MTA putih
Ferrous oxide diganti magnesium
Ferrous oxide is replaced by
oksida, tidak ada diskolorasin gigi magnesium oxide, so no tooth
Partikel kecil
discoloration
Waktu setting lebih pendek smaller particles with narrower
size distribution
Compressive strength lebih kecil
Shorter setting time
Less compressive strength
MTA abu
Grey MTA
Mengandung tetracalcium
aluminoferrite (ferrous oxide) Contains ferrous oxide, teeth
membuat warna gigi jadi abu-abu, jadi grey discoloration, so its not for
tidak digunakan untuk gigi anterior anterior teeth
Partikelnya besar Larger particles
Waktu setting lebih panjang Longer setting time
Compressive strength lebih besar Greater compressive strength
 Manipulation and setting
reaction
Pasta MTA dibuat dari 3 bagian
bubuk dengan 1 bagian air untuk
menghasilkan konsistensi yg dempul.
Pengadukan dapat dilakukan di kertas
The MTA paste is obtained by mixing 3 parts of powder with 1
atau di kaca menggunakan spatula part of water to obtain putty like consistency (distilled water, local
plastic atau logam. Campurannya anaasthesia, normal saline). Mixing can be done on paper or glass
slab using plastic or metal spatula (<4 minutes). This mix is then
kemudian ditempatkan pada lokasi placed in the desired location and condensed lightly with a
moistened cotton pellet.
yang diinginkan dan di kondensasi
Setting time, grey MTA 2 hours 55 minutes, white MTA 2 hours 20
dengan cotton pellet yang dibasahi minutes. Suggested using accelerators (Na2HPO4 & CaCl2) to reduce
the setting time.
Waktu setting, MTA abu 2 jam 55 Applied MTA should be cover by a damp pellet of cotton for correct
menit, MTA putih 2 jam 20 menit setting moisture. Then the tooth should be capped with a hermetic
dressing for 1-2 days
pengaplikasian MTA harus di tutupi
dengan cotton pellet basah untuk
kelembapan yang tepat. Selanjutnya
gigi di tutup oleh hermatic dressing
Selama 1-2 hari
 Properties of MTA
Compresive strength, dalam 24
jam40.0 Mpa, setelah 21 hari 67.3 Mpa.
MTA abu > MTA putih
PH dan antibakterial, awal 10.2, 3 Compresive strength, within 24 hours 40.0 Mpa after 21
days 67.3 Mpa. Grey MTA > white MTA
jam setelah pencampuran 12.5, PH
PH and antibacterial, intial 10.2, three hours after mmixing
tinggi sebagai agen antibakteri dan 12.5 results as antibacterial and fungidal properties
jamur Radiopacity, MTA is less radiopaque than IRM, super EBA,
amalgam or gutta-percha and similar radiodensity with zinc
Radiopasitas, kurang radiopak dari oxide eugenol

IRM, super EBA, amalgam atau gutta-
percha and radiodensiti yang sama
dengan zinc oxide eugenol
Solubility, no signs of solubility, might increase if more water
is used during mixing.
Marginal adaptation and sealing ability, expand during
setting (excellent sealing ability). MTA thickness about 4mm.

Daya larut, tidak larut, mungkin daya

larut meningkat jika menggunakan
banyak air saat pencampuran
Adaptasi marginal dan kemampuan
 Biokompatibilitas, MTA tidak
mutagenic, tidak sitotoksik serta
menunjukan tidak adanya
kerusakan DNA dan adanya
hubungan baik dengan sel
pembentuk tulang
Reaksi dengan material dental
lain, tidak bereaksi dengan
Tissue regeneration, MTA is
berbagai material restorasi
Regenerasi jaringan, mampu
mengaktivasi cementoblas dan
produksi sementum
Mineralisasi, menginduksi
pembentukan dentin bridge lebih
cepat dengan struktur yg baik,
dan lebih lengkap daripada
calcium hidroxide
Biocompatibility, MTA is not
mutagenic, much less cytotoxic and
showed no DNA damage and good
interaction with bone-forming cells.
Reaction with other dental
materials, MTA does not react or
interfere with any restorative
material
capable of activation of
cementoblasts and production of
cementum
Mineralization,induced dentin
bridge formation, faster with good
structural integrity and more
complete than with calcium
hydroxide.
Radiopacity of MTA
Clinical Applications
Pulp capping
Non vital pulpotomy
Vital pulpotomy (apexogenesis)
Root-end filling
Apical plug (apexification of
non vital of immature roots)
Obturation of the canal
Repair perforation
Repair of fracture
Horixzontal root fracture
Vertical root fracture
BIODENTINE

By Finny
Introduction
Sejak tahu 1928 kalsium hidroksida
(Dycal) telah menjadi material standar
untung mempertahankan vitalitas pulpa
karena mampu menstimulasi
pembentukan dentin tersier. Namun,
memiliki ikatan dengan dentin yang
lemah
Setelah itu, munculah semen hidrolik
kalsium silikat yang menunjukan interaksi
bioaktif dinamis dengan dentin dan
permukaan jaringan pulpa
Tahun 2009, Biodentine dipasarkan oleh
Gilles dan Olivier in corporation dengan
Since 1928, calcium hydroxide (Dycal) has been standard material
for maintaining the vitality of pulp since it is capable of
stimulating tertiary dentine formation. However it has some
drawbacks like poor bonding to dentine, material resorption.
After that, hydraulic calcium silicate cements were available which
showed a bioactive dynamic interaction with dentine and pulp
tissue interface.
In 2009 Biodentine is commercially available by (Gilles and Olivier
in corporation with Septodont's, France).
Biodentine is a new tricalcium silicate (Ca3SiO5). This material is
claimed to possess better physical and biological properties
compared to other tricalcium silicate cements such as mineral
trioxide aggregate (MTA) and Bioaggregate.

Septodont's, France
Biodentin adalah Trikalsium silikat baru
(Ca3SiO5). Meterial ini mengklaim
memiliki property fisik dan biologis yang
lebih baik dibandingkan dengan MTA dan
Composition

Powder: packaged in Liquid: packaged in

capsule (0.7 g) pipette (0.18 ml)

1. Calcium Chloride: as accelerator.

2. Hydrosoluble polymer: (water reducing agent)

maintain the balance between low water content
and consistency of mixture.
1. Tricalcium Silicate: its the main component.
3. 3. Water.
2. Diclacium Silicate: its the second main
component.

3. Calcium Carbonate: as filler.

4. Zirconium Oxide: responsible for radiopacity.

5. Iron Oxide: responsible for shade.I

 Setting Reaction
Kalsium silikat memiliki
kemampuan untuk berinteraksi
dengan air kemudian
menagalami setting dan
pengerasan semen dengan cara :
Gel CSH dianggap sebagai
matriks semen dan kristal
CaCO3 (kasar dan tak
beraturam) mengisi ruang
antar semen
CaCO3 memiliki 2 fungsi
berbeda sebagai agen aktif
(diiplikasikan dalam proses
hidrasi) dan sebagai pengisi
(meningkatkan sifat mekanik
semen)
The calcium silicate has the ability
to interact with water leading to
the setting and hardening of the
cement as following:
CSH gel is considered as the
matrix of the cement, and the
crystals of CaCO3 (rough and
irregular) are filling the spaces
between gel of cement.
Calcite (CaCO3) has two
distinct functions: as an active
agent (implicated in the
process of hydration) and as
filler (improves the
mechanical properties of the
cement).
 Hasil akhir dari reaksi
hidrasi meliputi : The final result of
partikel semen yang hydration reaction
tidak bereaksi includes: unreacted
(mengurangi efek pada particles of cement
reaksi selanjutnya), gel (slowing down the effect
CSH, Ca(OH)2 of further reaction), CSH
gel, Ca (OH)2
Properties of Biodentine
Waktu setting biodentine
sekitar 9-12 menit.
Adhesi lebih tinggi daripada
Dycal dan MTA
Densitas tinggi porositas The setting time of Biodentine is between 9-12 minutes
rendah karena menggunakan Adhesion of Biodentine is higher than Dycal and MTA
polimer hidrosolubel
Biodentine exhibits lower porosity and higher density than
Radiopasitas gambarannya Dycal and MTA.
Biodentine contains zirconium oxide allowing identification on
opak karena mengandung radiographs Biodentine displays radiopacity.
Zrconium Oxide This value becomes quite stable and is in the range of the
compressive strength of natural dentine (297 MPa).
Kekuatan Tekan setelah satu
After 1 month, hardness of Biodentine reach in the same
bulan dapat menyamai dentin range as natural dentine.
(297 Mpa)
Microhardness setelah 1 bulan
kekerasannya menyamai dentin
 Biodentine interfaces lebih
tahan terhadap erosi dan
microleakage disbanding MTA,
dycal, GIC
Pelepasan Ion lebih tinggi dari
MTA dan Dycal, dikorelasikan
dengan adanya kalsium silikat,
kalsium chloride, dan kalsium
Biodentine interfaces, it appeared resistance to erosion
and microleakage more than MTA, Dycal and GIC.
The release of free calcium ion in Biodentine is higher than
MTA and Dycal. The high Ca release of Biodentine can be
correlated with the presence of a calcium silicate component
and calcium chloride and calcium carbonate.

karbonat Antibacterial, during setting phase of Biodentine increases

pH to 12 (alkaliniztion of medium) which inhibits the growth of
microorganisms and can disinfect the dentine.
Antibakteri, saat setting
Stabilization, Biodentine is not as stable as a composite
biodentine meningkatkan pH material, so that Biodentine is not suitable as permanent
enamel replacement. Biodentine is stable enough to find use
hingga 12 (alkalization of as a temporary filling even in the chewing load bearing
medium) yang dapat mencegah region.

pertumbuhan mikroorganisme
dan mendesinfektan dentin
Stabilitas Dalam Rongga
Mulut biodentine tidak sestabil
material komposit, sehingga
Radiopasitas
BIodentine
Mechanism of action
Kunci dari suksesnya terapi pulp
capping adalah kemampuan
melepaskan kalsium , karena
diferensiasi, proliferasi, dan
mineralisasi kalisum dari sel pulpa
(osteblas, sementoblas, dan
odontoblast
Kalsium dan ion hidrokisda
meningkatkan aktivitas
osteopontin, alkalin fosfatase, Bone
Morphogenetic Protein-2 (BMP-2)
The ability to release calcium is a key factor for successful
pulp capping therapies because of the action of calcium on
differentiation, proliferation and mineralization of pulp cells
(osteoblasts, cementoblasts, and odontoblasts).
Ca and hydroxide ions enhances the activity of:
(((Osteopontin, Alkaline Phosphatase, Pyrophosphatase,
Bone Morphogenetic Protein-2(BMP-2) which belongs to the
TGF-))) which helps to maintain dentine mineralization and
the formation of dentine bridge.

turunan dari TGF- yang membantu TGF-1 is responsible for early mineralization of reparative
dentine that secrete from the pulp cells
mengatur mineralisasi dentin dan
embentukan dentine bridge.
TGF- bertanggungjawab pada awal
mineralisasi reoaratif dentin yang
Advantage of biodentine
Untuk indikasi pada
mahkota dan akar
Membantu remineralisai
denitn
Melindungi vitalitas pulpa
dan membantu
mnyembuhkan pulpa
Mengganti dentin asli
dengan ciri mekanis yang
sama
Penanganan dan
manupulasi yang lebih baik
Mengurangi waktu setting
For crown and root
indications.
Helps in remineralization
of dentine.
Preserves pulp vitality
and promotes pulp
healing.
Replaces natural dentine
with the same
mechanical properties.
Better handling and
manipulation.
Reduced setting time.
Clinical aplication
Sebagai pengganti dentin
Sebagai agen pulp capping
Pada vital pulpotomy
Memperbaiki perforasi
Sebagai root and feeling
As a dentin substitute
As a pulp capping agent
In vital pulpotomy
Repair of perforation
As root and feeling