Ortho MTA www befrest com Cases by Dr

Ortho. MTA www. befrest. com

Cases by Dr. Yoo 1. Perforation 2. C-shaped Canal 3. File Separation 4. Re-Endo www. befrest. com

1. Perforation While enlarging the root canal, the file went… No Problem! Just do Biofilling with Ortho. MTA. After the treatment www. befrest. com

2. C-shaped Canal This is a cross cut image of C-shaped canal. This is a C-shaped canal filled with Ortho. MTA. www. befrest. com

3. File Separation File separation filled with Ortho. MTA.

4. Re-Endo The patient received treatment from other dental clinic with commercially available MTA but he felt pain. I had to removed the MTA and did re-endo with Ortho. MTA. First Visit Years Follow-up 3 2 Months Follow-up

Concept of Ortho. MTA 1. Physcial Sealing 2. Chemical Sealing 3. Biological Sealing www. befrest. com

1. Physical Sealing - Physically obturate the root canal using biofilling technique You can see that the dye did not permeate through. This is because apical plug has been created at the apical foramen by biofilling using Ortho. MTA. www. befrest. com

2. Chemical Sealing Short tags of C-S-H obturate the opening of the dentinal tubules which induces entombing effect. Long tags of hydroxyapatite formed achieve fossilization of bacteria. www. befrest. com

Entombment & Fossilzation of Bacterium in Dentinal Tubules �Hydroxyapatite formation 1. Interfacial surface 2. Dentinal tubules www. befrest. com

Interfacial Surface Dentine Ortho. MTA This slide shows zero micron contact at the interfacial surface. www. befrest. com

Interfacial Surface Dentin Ortho. MTA Interfacial layer between MTA and Dentin It is chemical bonding between Ortho. MTA and dentine wall.

Interfacial Surface This view confirms chemical bonding. Actual mono block can be achieved by Biofilling with Ortho. MTA. This is a 5 -year view in vivo samples.

Orifice of Dentinal Tubules Entombment by CSH In the case of infected dentinal tubules by E. fecalis, Total bacterial entombment will occur. Complete eradication of an infectious bacteria is possible by Biofilling.

Lumen of Dentinal Tubules Fossilization by CDHA In the case of infected lumen of dentinal tubules, all bacteria can be fossilized by calcium deficient hydroxy apatite after all.

This image is a 4 -week view in vitro study in International Journal of Oral science, 2014.

The space of infected dentinal tubules by E. faecalis was completely obliterated by calcium deficient hydroxy apatite. Therefore, leaving no space for bacteria to live or reproduce.

3. Biological Sealing The arrow shows the new cementum sealing the apical foramen. According to Ortho. MTA cell culture experiment, it was observed that the production of osteonectin and osteopontin increased. Not only that, level of alkaline phosphatase increased as well. Therefore, these results show that after biofilling, biological sealing occurs at the apical foramen.