Pulp Therapy

Pulp Therapy Materials

When decay or a knock exposes the pulp, the tooth does not always need extracting or a full root canal — the pulp can often be capped, treated, and sealed. These are the materials that do it. MTA and other calcium-silicate bioceramics seal an exposure and set even against moisture and blood. Calcium hydroxide liners protect the pulp and prompt reparative dentine, and pulpotomy medicaments fix the pulp in a primary tooth. Much of this work sits within paedodontics, where saving a young tooth matters most.

MTA and bioceramics

The core of the category is MTA and its cousins:

• MTA powder cements — Dentsply ProRoot and Angelus MTA, mixed to a putty for capping, apexification, and perforation repair.
• Premixed MTA putty — ready-to-use e-MTA that skips the mixing step for a faster placement.
• MTA-based sealer — Angelus MTA Fillapex, a bioceramic root-canal sealer used in obturation.

MTA sets in the presence of moisture, seals tightly, and is well tolerated by tissue, which is why it crosses into endodontics for root-end and repair work.

Liners and pulpotomy agents

The rest of the category protects or fixes the pulp:

• Calcium hydroxide liners — RC Cal, Calform, and light-cure Ca(OH)₂ liners placed under a restoration to shield the pulp and stimulate dentine.
• Formocresol — the traditional medicament for a primary-tooth pulpotomy, fixing the remaining radicular pulp.

Calcium hydroxide overlaps with the wider cavity liners range used under everyday fillings.

Choosing what you need

Match the material to the procedure:

• Direct/indirect pulp cap — MTA or a calcium hydroxide liner over the exposure.
• Pulpotomy — MTA or formocresol on the amputated pulp, sealed with a sealer or restoration on top.
• Apexification / perforation — MTA to form a barrier or plug the defect.
• Format — powder-and-liquid MTA to mix, or premixed putty for speed.

What is MTA used for in dentistry?

MTA (mineral trioxide aggregate) is a calcium-silicate cement used to seal and repair the pulp and root. It is placed for direct pulp capping, pulpotomy, apexification in an immature tooth, perforation repair, and root-end filling in surgery. Because it sets in moisture and seals well against tissue, it is the material of choice where a durable, biocompatible barrier is needed against the pulp or bone.

What is the difference between MTA and calcium hydroxide?

Both protect the pulp and encourage healing, but they behave differently. Calcium hydroxide is cheaper, sets faster, and has long been used to line cavities and cap pulps, though it can dissolve over time. MTA seals more reliably, resists moisture, and gives a more predictable hard-tissue barrier, but costs more and sets slowly. Many clinicians use calcium hydroxide for routine lining and MTA for more demanding pulp and root repairs.

What is a pulpotomy and which material is used?

A pulpotomy removes the inflamed coronal pulp of a tooth while keeping the healthy root pulp alive, most often in a primary tooth. The remaining pulp is then treated with a medicament — traditionally formocresol, and increasingly MTA — before the tooth is sealed and restored. The aim is to keep the baby tooth in place and functioning until it is naturally lost.

Should I choose powder MTA or premixed putty?

It depends on your workflow. Powder-and-liquid MTA (ProRoot, Angelus) lets you mix the exact amount and control the consistency, and it is economical for regular use. Premixed MTA putty comes ready to place, saving mixing time and giving a consistent mix, which suits quick single applications. Both do the same job; the choice is about convenience versus cost and control.

How is MTA placed and how long does it take to set?

The exposure or defect is cleaned and dried of gross contamination, then MTA is mixed (or taken from the premixed syringe) and carried to the site with a suitable applicator and gently condensed. Traditional MTA sets slowly, often over a few hours, so it is usually covered with a moist cotton pellet and a temporary seal, then restored at a later visit. Always follow the specific product's instructions.