ISSN : 0376-4672
MTA(mineral trioxide aggregate) 는 치아와그 주위조직간에 개통이 생겼을 때에 - 의원성(iatrogenic) 또는 병적인 원인에 의해 - 그 개통된부분을 메워주기(sealing) 위한 목적으로, 1993년Loma Linda 대학교의 Torabinejad 등에 의해 개발되었다1). 그 이후로 MTA 에 대해 많은 연구를 거듭한 결과 MTA는 생체친화적(biocompatible)이고,sealing 능력이 뛰어나며, 항균효과가 좋고, 돌연변이를 유발하지 않으며, 광화조직(mineralized tissue)의 형성을 촉진시키고, 치주인대의 재생을 돕는 등의성질, 즉 치과재료가 가져야 하는 이상적인 성질을 다수 지니고 있다는 것이 밝혀졌고2), 이에 따라 MTA는치수복조술, 치수절단술, 치근천공의 수복, 치근첨 형성술, 치근단 역충전, 근관충전 등에 광범위하게 사용되어지기 시작했다3). 하지만, 이러한 많은 장점에도 불구하고, MTA에도한계점이 존재한다. 즉, 다루기 힘들고, 작업시간이 짧고(4분 이내), 경화시간은 길며(연구에 따라 75분에서72시간까지), 치아를 변색시킬수 있고, 독성물질을 함유하고 있으며, 일단 경화된 다음엔 제거하기가 힘들다는 점 등이 그 한계점이라 할수 있겠다4~7). 따라서 근관치료 영역의 거의 전 영역에 걸쳐서 우수한 재료로 인정되어 거의 만병통치약처럼 여겨지며 사용되어지고 있는 MTA 의 한계점에 대해 연구한 논문들과 그 한계점을 극복하기 위한 여러가지 노력들에 대한 논문을 고찰하여 MTA 의 임상적용에 도움이 되고자 한다.
1. Lee SJ, Monsef M, Torabinejad M. Sealing ability of a mineral trioxide aggregate for repair of lateral root perforations. J Endod 1993;19:541-544.
2. Queiroz AM, Assed S, Leonardo MR, Nelson-Filho P, Silva LA. MTA and calcium hydroxide for pulp capping. J Appl Oral Sci 2005;13:126-130.
3. Parirokh M, Torabinejad M. Mineral trioxide aggregate: a comprehensive literature review-Part I; chemical, physical, and antibacterial properties. J Endod 2010;36:16-27.
4. Torabinejad M, Hong CU, McDonald F, Pitt Ford TR. Physical and chemical properties of a new root-end filling material. J Endod 1995;21:349-353.
5. Matt GD, Thorpe JR, Strother JM, McClanahan SB. Comparative study of white and gray mineral trioxide aggregate (MTA) simulating a one- or two-step apical barrier technique. J Endod 2004;30:876-879..
6. Maroto M, Barberia E, Planells P, Garcia Godoy F. Dentin bridge formation after mineral trioxide aggregate (MTA) pulpotomies in primary teeth. Am J Dent 2005;18:151-4.
7. Wiltbank KB, Schwartz SA, Schindler WG. Effect of selected accelerants on the physical properties of mineral trioxide aggregate and Portland cement. J Endod 2007;33:1235-1238.
8. Kogan P, He J, Glickman GN, Watanabe I. The effects of various additives on setting properties of MTA. J Endod 2006;32:569.72.
9. Ber BS, Hatton JF, Stewart GP. Chemical modification of Proroot MTA to improve handling characteristics and decrease setting time. J Endod 2007;33:1231- 1234.
10. Autunes Bortoluzzi E, Juarez Broon N, Antonio Hungaro Duarte M, de Oliveira Demarchi AC, Monteiro Bramante C. The use of a setting accelerator and its effect on pH and calcium ion release of mineral trioxide aggregate and white Portland cement. J Endod 2006;32:1194-1197.
11. Midy V, Dard M, Hollande E. Evaluation of the effect of three calcium phosphate powders on osteoblast cells. J Mater Sci Mater Med 2001;12:259-265.
12. Watts JD, Holt DM, Beeson TJ, Kirkpatrick TC, Rutledge RE. Effects of pH and mixing agents on the temporal setting of tooth-colored and gray mineral trioxide aggregate. J Endod 2007;33:970-973.
13. Boutsioukis C, Noula G, Lambrianidis T. Ex vivo study of the efficiency of two techniques for the removal of mineral trioxide aggregate used as a root canal filling material. J Endod 2008;34:1239-1242.
14. Duarte MA, De Oliveira Demarchi AC, Yamashita JC, Kuga MC, De Campos Fraga S. Arsenic release provided by MTA and Portland cement. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2005;99:648- 650.
15. Mishra D, Farrell J. Evaluation of mixed valent iron oxides as reactive adsorbents for arsenic removal. Environ Sci Technol 2005;39:9689-9694.
16. Ling J, Xu Q, Wei X. Microscopic management of teeth with open apices using mineral trioxide aggregate. Pract Proced Aesthet Dent 2008;20:49-51.
17. Smith JB, Loushine RJ, Weller RN et al. Metrologic evaluation of the surface of white MTA after the use of two endodontic irrigants. J Endod 2007;33:463-467.
18. Nekoofar MH, Oloomi K, Sheykhrezae MS, Tabor R et al. An evaluation of the effect of blood and human serum on the surface microhardness and surface microstructure of mineral trioxide aggregate. Int Endod J 2010;43:849-858.
19. Nekoofar MH, Stone DF, Dummer PM. The effect of blood contamination on the compressive strength and surface microstructure of mineral trioxide aggregate. Int Endod J 2010;43:782-91.
20. Vanderweele RA, Schwartz SA, Beeson TJ. Effect of blood contamination on retention characteristics of MTA when mixed with different liquids. J Endod 2006;32:421?4.
21. Guiliani V, Nieri M, Pace R, Pagavino G. Effects of pH on surface hardness and microstructure of mineral trioxide aggregate and Aureoseal : an in vitro study. J Endod 2010;36:1883-6.
22. Saghiri MA, Shokouhinejad N, Lotfi M, Aminsobhani M, Saghiri AM. Push-out bond strength of mineral trioxide aggregate in the presence of alkaline pH. J Endod 2010;36:1856-9.
23. Nekoofar MH, Adusei G, Sheykhrezae MS, Hayes SJ, Bryant ST, Dummer PM. The effect of condensation pressure on selected physical properties of mineral trioxide aggregate. Int Endod J 2007;40:453?61.
24. Nekoofar MH, Asseley Z, Dummer PM. The effect of various mixing techniques on the surface microhardness of mineral trioxide aggregate. Int Endod J 2010;43:312-320.
25. Saghiri MA, Lotfi M, Joupari MD, Aeinehchi M, Saghiri AM. Effects of storage temperature on surface hardness, microstructure, and phase formation of white mineral trioxide aggregate. J Endod 2010;36:1414-1418.
26. Bidar M, Disfani R, Gharagozloo S, Khoynezhad S, Rouhani A. Medication with calcium hydroxide improved marginal adaptation of mineral trioxide aggregate apical barrier. J Endod 2010;36:1679-1682.
27. Jessie F. Reyes-Carmona, Mara S. Felippe, Wilson T. Felippe. A Phosphage-buffered saline intracanal dressing improves the biomineralization ability of mineral trioxide aggregate apical plugs. J Endod 2010;36:1648-52.
