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8/27/2021

MTA Flow

Ultradent’s MTA Flow (Mineral Trioxide Aggregate) is a repair cement made especially for pulpotomies, pulp capping, rootend filling, apexification, perforation repair, and root resorption. MTA Flow is a bioactive powder and liquid/gel system consisting of an extremely fine, radiopaque, inorganic powder of tricalcium and dicalcium silicate that sets with a water-based gel. When set, the repair cement forms a layer of hydroxyapatite, which induces a healing reaction. The powder/gel combination also gives the clinician a variety of mixing options needed for an effective, nongritty, easy-to-deliver MTA. Its quick setting time also makes it possible to rinse or air-dry without washing away the MTA within 5 minutes of application.

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With bioactive properties that promote healing, mineral trioxide aggregate (MTA) has proven to be an excellent repair material in endodontic treatment. But MTA cements are not known for their ease of use, often proving difficult to mix, handle, and deliver without sticking to instruments or making a huge mess. To address these concerns, Ultradent formulated MTA Flow dental repair cement with ultrafine-grained powder and an exclusive water-based gel mixing medium. The combination quickly and easily mixes to a smooth consistency and desired thickness and is easy to express through a very small tip.

When endodontist Grace Chu agreed to try Ultradent’s MTA Flow dental repair cement for this Dental Product Shopper evaluation, she was hoping the material would be easier to deliver than some other MTA cements. She discovered, “The particle size was very fine and allowed a smoother flow of the material when inserted to the fine gauge tip sizes of the syringes,” adding that the low viscosity of the material allowed her to use a finer tip, which improved the efficiency of the delivery, especially when inserting into the apical third of the root.

Mixing & Delivery/Placement
MTA Flow mixes quickly, smoothly, and easily into the right consistency for a variety of procedures. It can be mixed to various textures by changing the ratio of the powder to water-based gel and is delivered using Ultradent’s syringes and tips, ensuring precise placement. When mixing an MTA material, Dr. Bruce Schulman said he normally has a lot of variation in formulating a consistent mix. After mixing MTA Flow, he called the consistency “amazing, with much more consistent mixes.” From apical plugs to retrograde fillings to perforation repairs, Dr. Schulman was “so much more efficient in arriving at a consistent mix for variable uses.” Calling it a “faster, easier material to mix,” Dr. Alan Sedell used MTA Flow for several lower molar apicos and shared, “It made the apicoectomy procedure a bit less stressful due to its ease of use.” Dr. Anthony Gadbois said it was a “much easier way to dispense MTA,” Dr. Jeremy Lowell lauded its “wonderful delivery system,” and Dr. Nathaniel Behrents said the different mixing possibilities allowed him to adapt the product to his needs.

Handling & Viscosity
The powder’s small particles (less than 10 microns) combine with the water-based gel to form a smooth, non-gritty consistency. The mixing ratio of the powder and gel is adaptable with a thick consistency for pulp capping, pulp chamber perforation, and pulpotomy; a thin consistency for resorption, apexification, and apical plug; or a putty consistency for root end filling.

Several endodontists praised the flowability of MTA Flow dental repair cement, including a San Francisco doctor who noted, “The flowability was maintained even when exposing to heat during the obturation using warm vertical condensation technique.” He said the flowability was especially helpful when filling a root canal irregularity or any root resorption defect, but he would like it to flow better into lateral canals and apical ramifications of the root canals. Calling it much easier to manipulate than other MTAs, Dr. Schulman said MTA Flow was especially useful for “apical plugs in wide open apices.”
Setting Time & Overall Procedure Time
The quick setting time was Dr. Sedell’s favorite feature, who said MTA Flow is definitely an improvement to conventionally mixed MTA. “The product sets faster than many others so it worked well,” shared Dr. Albert Clark, who explained his success using the material for a perforation repair. “In the past, this simple concept has been difficult because the material would not stay in place, stuck to instruments, made a huge mess, and I was never sure it was adequately placed. This time it was simple! Under the microscope, I prepared the area, injected the material, condensed with wet cotton, and was done.”

While most evaluators appreciated the quick setting time, Dr. Chu said she sometimes had to make two mixes – one flowable and one putty-like. “It didn’t give me much working time when I had to use ultrasonics every few increments and condensed the material,” she shared. Dr. Lowell said he spent less chair time delivering the dental repair cement, another dentist said it reduced the overall treatment time, while Dr. Behrents pointed out that the tube was difficult to load.
Bruce D. Schulman, DDS; Boynton Beach, FL
“IT’S SO MUCH MORE EFFICIENT IN ARRIVING AT A CONSISTENT MIX FOR VARIABLE USES - FROM APICAL PLUG, TO RETROGRADE, TO PERFORATION REPAIR.”
Overall Satisfaction
Calling the color of the material “great for esthetic zones when repairing resorptive defects,” Dr. Chu said the MTA Flow was particularly helpful in “internal resorption cases especially located in the middle and apical third of the root.” Another endodontist, Dr. Schulman, praised MTA Flow for having much less waste than other products with a much more predictable result. “It’s the best of all of the MTA products that I have encountered,” he added. Applauding the manufacturer of MTA Flow, Dr. Lowell concluded, “Ultradent, as a company, has time and time again, shown itself to deliver a superior product to others on the market. Love it!”
takeaways
Fine powder mixes with gel to form smooth, non-gritty mixture
Mixing ratio of powder and gel is adaptable depending on the procedure
Material is easy to express and deliver with a very small tip
Quick setting time, improved overall procedure time
Allows for consistent, predictable results
evaluation snapshot

MTA Flow

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Products are evaluated by dental professionals who use the products in their practices for about 4 weeks. The final score is calculated by combining an individual criteria average with an overall satisfaction average. All products are rated on a 5 to 1 scale.
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