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J Clin Periodontol. 2013 Apr;40(4):334-44. doi: 10.1111/jcpe.12058. Epub 2013 Feb 14.

Histological responses of the periodontium to MTA: a systematic review.

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Department of Periodontology, Academic Center for Dentistry (ACTA), University of Amsterdam and VU University Amsterdam, Amsterdam, The Netherlands.



The purpose of this systematic review was to investigate whether a mineral trioxide aggregate (MTA) restoration of an endodontic-periodontal communication leads to regeneration of the adjacent periodontal tissues.


The databases MEDLINE-PubMed, Cochrane-CENTRAL, and EMBASE were searched, up to July 2012. In vivo studies that reported on the histological response of the periodontium to MTA were selected.


The screening of 98 title-abstracts, full-text reading, and hand searches in literature lists yielded 24 papers. All of them involved animals. There were no studies reporting on human histology. Study protocols presented heterogeneity regarding treated lesions, intervention, and reported outcomes. The histological results of the animal studies showed minimal inflammatory reactions, bone healing, periodontal ligament presence, and consistent cementum formation. Time lapse after mixing, bacterial contamination, root canal disinfection, and inflammation influenced MTA's cementoconductive properties.


Within the limitations of the selected papers concerning inhomogeneous study protocols and low methodological quality scores, their findings were consistent with regard to MTA's biocompatibility and cementogenic ability. Experimental animal studies show that MTA can promote healing towards regeneration. There is now a distinct need to examine the clinical performance of MTA in well-controlled prospective human cohort studies.

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