Mineral trioxide aggregate and other bioactive endodontic cements: an updated overview – part I: vital pulp therapy

<jats:title>Abstract</jats:title><jats:p>Mineral trioxide aggregate (<jats:styled-content style="fixed-case">MTA</jats:styled-content>) is a bioactive endodontic cement (<jats:styled-content style="fixed-case">BEC</jats:styled-content>) mainly comprised of calcium and silicate elements. The cement was introduced by Torabinejad in the 1990s and has been approved by the Food and Drug Administration to be used in the United States in 1997. A number of new <jats:styled-content style="fixed-case">BEC</jats:styled-content>s have also been introduced to the market, including BioAggregate, Biodentine, <jats:italic>BioRoot <jats:styled-content style="fixed-case">RCS</jats:styled-content></jats:italic>, calcium‐enriched mixture cement, Endo‐<jats:styled-content style="fixed-case">CPM</jats:styled-content>, Endocem, EndoSequence, EndoBinder, EndoSeal <jats:styled-content style="fixed-case">MTA</jats:styled-content>,<jats:styled-content style="fixed-case"> iR</jats:styled-content>oot, MicroMega <jats:styled-content style="fixed-case">MTA</jats:styled-content>,<jats:styled-content style="fixed-case"> MTA</jats:styled-content> Bio, <jats:styled-content style="fixed-case">MTA</jats:styled-content> Fillapex, <jats:styled-content style="fixed-case">MTA</jats:styled-content> Plus, Neo<jats:styled-content style="fixed-case">MTA</jats:styled-content> Plus, Ortho<jats:styled-content style="fixed-case">MTA</jats:styled-content>, Quick‐Set, Retro<jats:styled-content style="fixed-case">MTA</jats:styled-content>, Tech Biosealer and TheraCal LC. It has been claimed that these materials have properties similar to those of <jats:styled-content style="fixed-case">MTA</jats:styled-content> without its drawbacks. In this article, the chemical composition and the application of <jats:styled-content style="fixed-case">MTA</jats:styled-content> and other <jats:styled-content style="fixed-case">BEC</jats:styled-content>s for vital pulp therapy (<jats:styled-content style="fixed-case">VPT</jats:styled-content>), including indirect pulp cap, direct pulp cap, partial pulpotomy, pulpotomy and partial pulpectomy, have been reviewed and compared. Based on selected keywords, all papers regarding chemical composition and <jats:styled-content style="fixed-case">VPT</jats:styled-content> applications of <jats:styled-content style="fixed-case">BEC</jats:styled-content>s had been reviewed. Most of the materials had calcium and silicate in their composition. Instead of referring to the cements based on their chemical compositions, we suggest the term ‘bioactive endodontic cements (<jats:styled-content style="fixed-case">BEC</jats:styled-content>s)’, which seems more appropriate for these materials because, in spite of differences in their chemical compositions, bioactivity is a common property for all of them. Numerous articles were found regarding use of <jats:styled-content style="fixed-case">BEC</jats:styled-content>s as <jats:styled-content style="fixed-case">VPT</jats:styled-content> agents for indirect and direct pulp capping, partial pulpotomy and cervical pulpotomy. Most of these investigations used <jats:styled-content style="fixed-case">MTA</jats:styled-content> for <jats:styled-content style="fixed-case">VPT</jats:styled-content>. In most studies, newly introduced materials have been compared to <jats:styled-content style="fixed-case">MTA</jats:styled-content>. Some of the <jats:styled-content style="fixed-case">BEC</jats:styled-content>s have shown promising results; however, the number of their studies compared to investigations on <jats:styled-content style="fixed-case">MTA</jats:styled-content> is limited. Most studies had several methodological shortcomings. Future investigations with rigorous methods and materials are needed.</jats:p>