Title Application of Dentin Bonding Agent to Prevent MTA-Related Tooth Discoloration in a Regenerative Endodontic Treatments
Clinical Question How to prevent or minimize tooth discoloration produced by MTA during regenerative procedures?
Clinical Bottom Line Application of dentin bonding agent (DBA) in the access cavity before using either white (WMTA) or gray (GMTA) in a regenerative endodontic treatment reduces tooth discoloration.
Best Evidence  
PubMed ID Author / Year Patient Group Study type
(level of evidence)
22114601Akbari/201150 extracted maxillary anterior teethRandom controlled bench-top study
Key resultsThe teeth in (WMTA/GMTA) groups showed significantly more discoloration than (DBA + WMAT/GMTA) and control groups. No significant difference between DBA+WMAT/GMTA and control groups.
Evidence Search MTA Tooth discoloration
Comments on
The Evidence
Groups were clearly defined with exposures and outcomes measured identically in all groups. Teeth were randomly assigned to treatment and control groups. Evaluation time was long enough.
Applicability One of the challenges in regenerative endodontic therapy is to eliminate the MTA-related tooth discoloration commonly observed in this procedure. The clinician should avoid leaving remaining MTA particles in the access cavity after its placement. It has been demonstrated that application of DBA producing a surface, which seals the dentinal tubules in the pulp chamber reducing the undesirable staining. However, more research will be needed to evaluate the effect of DBA on the properties MTA.
Specialty (Endodontics) (General Dentistry)
Keywords MTA, Tooth discoloration, Dentin bonding agent.
ID# 2301
Date of submission 08/03/2012
E-mail austah@livemail.uthscsa.edu
Author Obadah Austah
Co-author(s) e-mail
Faculty mentor Fabricio Teixeira, DDS, MS, PhD
Faculty mentor e-mail fabricio-teixeira@uiowa.edu
Basic Science Rationale
(Mechanisms that may account for and/or explain the clinical question, i.e. is the answer to the clinical question consistent with basic biological, physical and/or behavioral science principles, laws and research?)
by Obadah Austah (San Antonio, TX) on 09/17/2012
The mechanism of MTA related tooth discoloration has no solid scientific explanation yet. There are some possible factors proposed in the literature. Some authors (PMID: 19627674) stated that the discoloration might be related to Bismuth oxide (an element added to improve the radiopacity of both WMTA/GMTA). While, Others (PMID: 15671818) showed that Iron and manganese as possible elements responsible for the discoloration.
Comments and Evidence-Based Updates on the CAT
None available