Effect of Different Mixing Methods on Physicochemical Properties of Mineral Trioxide Aggregate: A Systematic Review

Abstract

Background. Mineral trioxide aggregate (MTA) is a commonly used endodontic biomaterial. The physicochemical properties of MTA have a crucial role in designating clinical outcome, and different factors can affect these properties. Various methods have been used for mixing MTA, including manual, mechanical, and ultrasonic. The aim of this systematic review was to evaluate the effect of different mixing methods on the physicochemical properties of MTA. Materials and Methods. Electronic databases including PubMed, Embase, Web of Science, and Scopus were searched up to May 2022. In order to cover gray literature, the ProQuest and Google Scholar databases were also searched to detect theses and conference proceedings. For quality assessment of the included studies, we used a modified version of the Cochrane risk of bias tool for randomized controlled trials (RCTs). Experimental studies which had assessed at least one property of MTA and compared at least two different mixing methods of MTA were included in this study. All animal studies, reviews, case reports, and case series were excluded. Results. Fourteen studies were included. The results showed that the ultrasonic mixing method significantly improved some MTA characteristics, including microhardness, flowability, solubility, setting time, and porosity. However, the mechanical mixing method improved other properties including flowability, solubility, push-out bond strength, and hydration. The manual mixing method showed inferior results compared to other mixing methods in terms of microhardness, flowability, solubility, setting time, push-out bond strength, porosity, and hydration. Different mixing methods had a similar effect on compressive strength, sealing ability, pH and calcium ion release, volume change, film thickness, and flexural strength of MTA. Conclusion. Mechanical and ultrasonic mixing methods are superior to the manual mixing method in terms of improving physicochemical properties of MTA. No report of selection bias and varieties in methodologies were limitations of evidence.

Revascularization Revisited with Modified Triple Antibiotic Paste and NeoPutty MTA®

“…Despite these drawbacks, MTA continues to play a significant role in endodontics, and its selection should be based on careful consideration of individual patient cases and the clinician’s experience and judgment. [ 15 16 ] To overcome these drawbacks of MTA, NeoPutty MTA (Nusmile, USA) has been introduced recently. NeoPutty MTA offers several advantages that make it a valuable choice in various clinical applications.…”

Evaluation of Setting Time, Solubility, and Compressive Strength of Four Calcium Silicate-Based Cements

“…The properties of CSCs can only be examined after they are set, and the setting time of these cements is influenced by various factors, such as temperature, humidity, experimental environment, mixing method, quantity of water used, and packing force [25,26]. The ideal setting time for pulp capping materials can vary depending on the specific material and clinical application.…”

Freeze casting of hydroxyapatite‐titania composites for bone substitutes

“…Phase segregation was minor, given the even distribution of HA and TiO 2 particles through the structure, as seen in all images. This mixing could likely be attributed to the use of ultrasonication 53,54 and the use of the Dynol 604 dispersant 29,41 to ensure particles are properly dispersed. Initial particle sizes before sintering would have caused the larger grains that are present in the scaffold walls.…”