The success of a root canal treatment depends not only on many factors but also on preventing reinfection of the root canal space. The ultimate goal of root canal treatment is to prevent or cure apical periodontitis. To achieve this goal, the use of biologically active materials or bioceramics to seal root canal systems has been widely proposed in modern endodontics.

Ceramics is one of its ingredients. These materials have been engineered to be biocompatible with human tissue and are widely used in the repair and replacement of musculoskeletal organs.

Based on the microstructure and low composition, these materials can be roughly divided into bioinert, bioactive and bioresorbable.

Bioactivated materials, on the other hand, have osteoinductive and osteoconductive properties. They are porous and form a barrier and bind to hard tissue. Hydroxyapatites, bioactive glasses and glass-ceramics are examples of bioceramics in this class.

All of these sealants must be extruded with a needle, usually tapered, made of polymer, and of various sizes depending on the consistency of the sealants.

The first endodontic application of this class of material was lag in the form of aggregate mineral trioxide (MTA), which is used to repair holes and fill root ends.

However, MTA has disadvantages including a long setting time and low cohesive strength and poor handling properties. The reason for biocompatibility is due to heavy metal leaching and crown discoloration.

With the growing body of evidence demonstrating the biomineralizing properties of tricalcium silicates, it makes sense to expand MTA to be used as a root canal sealer.

Although the basic composition of MTA Plus is similar to the original MTA, there are two main differences: MTA Plus powder is finer and it is recommended to mix MTA powder with a patented water-based gel if that material is to be used as a root canal sealant.