Mineral Trioxide Aggregate in Endodontics: A Review

Mineral trioxide aggregate (MTA) is a calcium silicate–based material widely used in endodontics due to its biocompatibility, bioactivity, and capacity to induce hard-tissue formation. Since its development in the 1990s, MTA has been regarded as one of the reference materials for a range of clinical indications, including vital pulp therapies, apexification, perforation repair, and apical surgery.
The physicochemical properties of MTA are associated with calcium hydroxide formation following hydration reactions, a high alkaline pH, and hydroxyapatite deposition. These characteristics contribute to the material’s sealing ability and biological performance. In addition, MTA can promote mineralization and may exhibit antimicrobial effects.
Clinical evidence indicates that MTA is associated with favorable outcomes across a broad spectrum of endodontic applications. Although more favorable results have been reported compared with calcium hydroxide, similar clinical performance has been documented for Biodentine and other calcium silicate–based materials. Nevertheless, certain limitations such as a prolonged setting time and handling difficulties have contributed to the development of newer-generation bioceramic materials.