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INVITED REVIEW Table of Contents   
Year : 2008  |  Volume : 11  |  Issue : 4  |  Page : 141-143
The chemical composition of mineral trioxide aggregate

Department of Building and Civil Engineering, Faculty of Architecture and Civil Engineering, Department of Dental Surgery, Faculty of Dental Surgery, University of Malta, Malta

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Date of Submission10-Nov-2008
Date of Decision10-Nov-2008
Date of Acceptance09-Dec-2008


Mineral trioxide aggregate (MTA) is composed of Portland cement, with 4:1 addition of bismuth oxide added so that the material can be detected on a radiograph. The cement is made up of calcium, silicon and aluminium. The main constituent phases are tricalcium and dicalcium silicate and tricalcium aluminate. There are two commercial forms of MTA, namely the grey and the white. The difference between the grey and the white materials is the presence of iron in the grey material, which makes up the phase tetracalcium alumino-ferrite. This phase is absent in white MTA. Hydration of MTA occurs in two stages. The initial reaction between tricalcium aluminate and water in the presence of calcium sulphate results in the production of ettringite. Tricalcium and dicalcium silicate react with water to produce calcium silicate hydrate and calcium hydroxide, which is leached out of the cement with time.

Keywords: Mineral trioxide aggregate; Portland cement; chemical composition.

How to cite this article:
Camilleri J. The chemical composition of mineral trioxide aggregate. J Conserv Dent 2008;11:141-3

How to cite this URL:
Camilleri J. The chemical composition of mineral trioxide aggregate. J Conserv Dent [serial online] 2008 [cited 2022 Aug 16];11:141-3. Available from:

   Introduction Top

Mineral trioxide aggregate (MTA) was developed at Loma Linda University, in the 1990s, as a root-end filling material. It is used primarily to seal lateral root perforations [1],[2] and as a root-end filling material. [3],[4],[5],[6] The use of MTA as a root-end filling material was identified because the material is hydraulic and sets in the presence of water. Mineral trioxide aggregate (MTA) received acceptance by the US Federal Drug Administration and became commercially available as ProRoot MTA (Tulsa Dental Products, Tulsa, OK, USA). Until recently, two commercial forms of MTA were available (ProRoot MTA), in either the grey or white forms. Recently MTA-Angelus (Angelus Soluηυes Odontológicas, Londrina, Brazil) has become available.

   MTA patent Top

The MTA patent [7] stated that 'MTA consists of 50-75% (wt) calcium oxide and 15-25% silicon dioxide. These two components together comprise 70-95% of the cement. When these raw materials are blended, they produce tricalcium silicate, dicalcium silicate, tricalcium aluminate, and tetracalcium aluminoferrite. On addition of water, the cement hydrates, forming silicate hydrate gel.' Also 'MTA is Type 1 Portland cement (American Society for Testing Materials), with a fineness (Blaine number) in the range of 4500-4600 cm 2 /g. A radiopacifier (bismuth oxide) is added to the cement for dental radiological diagnosis.' [7]

   Grey and white MTA Top

Commercial MTA exists in both grey and white forms (Dentsply, Tulsa Dental Products, Tulsa, OK, USA). Recently, a Brazilian company produced MTA-Angelus (Angelus Soluηυes Odontológicas, Londrina, Brazil). The difference between the grey MTA and the white MTA has been reported to be in the lack of iron in the white version. [8],[9]

   MTA and Portland cement Top

The similarity of MTA with Portland cement was reported only in 2000. [10] Further studies comparing white MTA (White MTA, Dentsply, Tulsa Dental Products, Tulsa, OK, USA) with white Portland cement showed the cements to have similar constituent elements, except for the bismuth oxide in the MTA. [8],[9],[11],[12] Similar results were obtained when comparing MTA Angelus with Portland cement. [13] Both MTA and Portland cement were biocompatible, as the composition of both materials was similar. [14] Further investigation of both Portland cement and MTA showed some differences between the materials. Scanning electron microscopy of the polished sections of both MTA and Portland cement showed that the aluminate phase normally present in Portland cement was scarce in MTA. [15] The MTA had a lower level of tricalcium silicate and a higher level of dicalcium silicate, when compared to white Portland cement. There was no tricalcium aluminate present in the MTA, suggesting that the material was not prepared in a rotary kiln, as is customary for the manufacture of Portland cement. Less calcium sulphate was found in MTA. Portland cement had a total of 4.9% calcium sulphate present as di- and hemi-hydrate and anhydrite. Mineral trioxide aggregate (MTA) had only 2.2% calcium sulphate and the di-hydrate was absent. [16]

   Chemical composition of MTA powder Top

Energy dispersive analysis with X-ray (EDAX) demonstrated that MTA was composed of calcium, silicon, aluminium and bismuth. [8],[9] Scanning electron microscopy (SEM) of the polished section showed that MTA consisted of particles ranging between <1 µm to approximately 30 µm in size, containing impure tricalcium silicate and impure dicalcium silicate. Particles (10 µm - 30 µm) of bismuth oxide were numerous. Scattered particles of limestone or hydrated lime, gypsum and potassium aluminium silicate were also present.

Deficiency of alumina was seen in MTA. [15] An X-ray diffraction (XRD) analysis showed the presence of a completely crystalline material composed mainly of tricalcium and dicalcium silicate and bismuth oxide. [8],[9] Precise quantitative analysis of MTA, using Rietveld XRD, showed that MTA was composed of tricalcium and dicalcium silicate, tricalcium aluminate and calcium sulphate, which was present in the hemi-hydrate and anhydrite form. In addition, MTA contained 21.6% bismuth oxide. [16] This is similar to what was reported in the MTA patent. [3]

   Hydration of MTA Top

The hydration of MTA has been reported to consist of two separate reactions. The initial reaction was between tricalcium aluminate and water, which, in the presence of gypsum found in small quantities in MTA, resulted in the production of ettringite, which later formed monosulphate, once the gypsum was depleted. The low levels of alumina reported in MTA affected the production of ettringite and monosulphate, usually formed on hydration of Portland cement. [15] The main reaction between the tricalcium and dicalcium silicate and water resulted in the production of calcium silicate hydrate gel, which is poorly crystalline, and calcium hydroxide. [15] Set MTA was composed of numerous residual un-hydrated cement grains, which had a dense rim of hydration product, made up of pure calcium silicate hydrate. There was very little ettringite or monosulphate present. Un-reacted bismuth oxide particles and calcium hydroxide were also detected. The calcium silicate hydrate had taken up bismuth, which replaced the silica in the calcium silicate hydrate structure. [15]

Bismuth oxide, added to enhance the radio-opacity of MTA, was reported to be present only in 8.4% level in set MTA, as against the 21.6% in the unset material. [16] The bismuth formed a part of the structure of the calcium silicate hydrate gel and also affected the precipitation of calcium hydroxide in the hydrated paste. [15] Both bismuth and calcium were leached out from MTA. The calcium leached out decreased over a five-week period, while the bismuth oxide levels increased. [16]

The production of calcium hydroxide by MTA would explain the similar mode of tissue reaction to MTA and calcium hydroxide reported previously. [17],[18] It has been reported that MTA released calcium ions [19],[20] and promoted an alkaline pH. [21],[22] MTA has been shown to leach calcium ions several days after the initiation of hydration and setting of the material. [16] These calcium ions diffuse through the defects in the dentin in root canals filled with MTA, and the concentration increases with time. [23] The physicochemical basis for the biological properties of MTA had recently been attributed to the production of hydroxyapatite, when the calcium ions released by the MTA came into contact with tissue fluid. [24],[25] When in contact with tissue fluid, an amorphous calcium phosphate phase initially formed, which later transformed to an apatite phase, with the latter consisting of calcium-deficient, poorly crystalline, B-type carbonated apatite crystallites. Amorphous calcium phosphate is a key intermediate that precedes biological apatite formation in skeletal calcification. [26]

   References Top

1.Lee SJ, Monsef M, Torabinejad M. Sealing ability of a mineral trioxide aggregate for repair of lateral root perforations. J Endod 1993;19:541-4.  Back to cited text no. 1  [PUBMED]  
2.Pitt Ford TR, Torabinejad M, McKendry DJ, Hong CU, Kariyawasam SP. Use of mineral trioxide aggregate for repair of furcal perforations. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 1995;79:756-63.  Back to cited text no. 2    
3.Torabinejad M, Hong CU, Lee SJ, Monsef M, Pitt Ford TR. Investigation of mineral trioxide aggregate for root-end filling in dogs. J Endod 1995;21:603-8.  Back to cited text no. 3  [PUBMED]  
4.Torabinejad M, Pitt Ford TR, McKendry DJ, Abedi HR, Miller DA, Kariyawasam SP. Histologic assessment of mineral trioxide aggregate as a root-end filling in monkeys. J Endod 1997;23:225-8.  Back to cited text no. 4  [PUBMED]  
5.Chong BS, Pitt Ford TR, Hudson MB. A prospective clinical study of Mineral Trioxide Aggregate and IRM when used as root-end filling materials in endodontic surgery. Int Endod J 2003;36:520-6.  Back to cited text no. 5  [PUBMED]  [FULLTEXT]
6.Saunders WP. A prospective clinical study of periradicular surgery using mineral trioxide aggregate as a root-end filling. J Endod 2008;34:660-5.   Back to cited text no. 6  [PUBMED]  [FULLTEXT]
7.Torabinejad M, White DJ. Tooth filling material and use. US Patent Number 5,769,638, 1995.  Back to cited text no. 7    
8.Camilleri J, Montesin FE, Brady K, Sweeney R, Curtis RV, Pitt Ford TR. The constitution of mineral trioxide aggregate. Dent Mat 2005a;21:297-303.  Back to cited text no. 8    
9.Camilleri J, Montesin FE, Di Silvio L, Pitt Ford TR. The chemical constitution and biocompatibilility of accelerated Portland cement for endodontic use. Int Endod J 2005b;38:834-42.   Back to cited text no. 9  [PUBMED]  [FULLTEXT]
10.Estrela C, Bammann LL, Estrela CR, Silva RS, Pecora JD. Antimicrobial and chemical study of MTA, Portland cement, calcium hydroxide paste, Sealapex and Dycal. Braz Dent J 2000;11:3-9.  Back to cited text no. 10    
11.Funteas UR, Wallace JA, Fochtman EW. A comparative analysis of mineral trioxide aggregate and portland cement. Aust Dent J 2003;29:43-4.  Back to cited text no. 11    
12.Asgary S, Parirokh M, Eghbal MJ, Brink F. A comparative study of white mineral trioxide aggregate and white Portland cements using X-ray microanalysis. Aust Endod J 2004;30:89-92.  Back to cited text no. 12  [PUBMED]  
13.Oliveira MG, Xavier CB, Demarco FF, Pinheiro AL, Costa AT, Pozza DH. Comparative chemical study of MTA and Portland cements. Braz Dent J 2007;18:3-7.  Back to cited text no. 13  [PUBMED]  [FULLTEXT]
14.Saidon J, He J, Zhu Q, Safavi K, Spangberg LS. Cell and tissue reactions to mineral trioxide aggregate and Portland cement. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2003;95:483-9.  Back to cited text no. 14    
15.Camilleri J. Hydration mechanisms of mineral trioxide aggregate. Int Endod J 2007;40:462-70.   Back to cited text no. 15  [PUBMED]  [FULLTEXT]
16.Camilleri J. Characterization of hydration products of mineral trioxide aggregate. Int Endod J 2008;41:408-17.  Back to cited text no. 16  [PUBMED]  [FULLTEXT]
17.Holland R, de Souza V, Nery MJ, Otoboni Filho JA, Bernabe PF, Dezan Junior E. Reaction of rat connective tissue to implanted dentin tubes filled with mineral trioxide aggregate or calcium hydroxide. J Endod 1999;25:161-6.  Back to cited text no. 17    
18.Holland R, de Souza V, Nery MJ, Faraco Junior IM, Bernabe PF, Otoboni Filho JA, et al . Reaction of rat connective tissue to implanted dentin tube filled with mineral trioxide aggregate, Portland cement or calcium hydroxide. Braz Dent J 2001;12:3-8.   Back to cited text no. 18    
19.Lee YL, Lee BS, Lin FH, Yun Lin A, Lan WH, Lin CP. Effects of physiological environments on the hydration behaviour of mineral trioxide aggregate. Biomaterials 2004;25:787-93.  Back to cited text no. 19  [PUBMED]  [FULLTEXT]
20.Holland R, de Souza V, Nery MJ, Bernabι FE, Filho JA, Junior ED, et al . Calcium salts deposition in rat connective tissue after the implantation of calcium hydroxide-containing sealers. J Endod 2002;28:173-6.  Back to cited text no. 20    
21.Duarte MA, Demarchi AC, Yamashita JC, Kuga MC, Fraga Sde C. pH and calcium ion release of 2 root-end filling materials. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2003;95:345-7.  Back to cited text no. 21  [PUBMED]  [FULLTEXT]
22.Santos AD, Moraes JC, Araujo EB, Yukimitu K, Valerio Filho WV. Physico-chemical properties of MTA and a novel experimental cement. Int Endod J 2005;38:443-7.   Back to cited text no. 22    
23.Ozdemir HO, Ozηelik B, Karabucak B, Cehreli ZC. Calcium ion diffusion from mineral trioxide aggregate through simulated root resorption defects. Dent Traumatol 2008;24:70-3.  Back to cited text no. 23    
24.Sarkar NK, Caicedo R, Ritwik P, Moiseyeva R, Kawashima I. Physicochemical basis of the biologic properties of mineral trioxide aggregate. J Endod 2005;31:97-100.  Back to cited text no. 24  [PUBMED]  [FULLTEXT]
25.Bozeman TB, Lemon RR, Eleazer PD. Elemental analysis of crystal precipitate from gray and white MTA. J Endod 2006;32:425-8.  Back to cited text no. 25  [PUBMED]  [FULLTEXT]
26.Tay FR, Pashley DH, Rueggeberg FA, Loushine RJ, Weller RN. Calcium phosphate phase transformation produced by the interaction of the portland cement component of white mineral trioxide aggregate with a phosphate-containing fluid. J Endod 2007;33:1347-51.  Back to cited text no. 26  [PUBMED]  [FULLTEXT]

Correspondence Address:
Josette Camilleri
Department of Building and Civil Engineering, Faculty of Architecture and Civil Engineering, University of Malta, Msida MSD 2080
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/0972-0707.48834

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