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Abdullah Alqedairi [1] and Carlos A. Muñoz-Viveros [2] and Eugene A. Pantera Jr. [3] and Marc Campillo-Funollet [2] and Hussam Alfawaz [1] and Ensanya Ali Abou Neel [4; 5; 6] and Tariq S. Abuhaimed [4]

Academic Editor: Shinn-Jyh Ding

1, Division of Endodontics, Department of Restorative Dental Sciences, King Saud University, Riyadh, Saudi Arabia, ksu.edu.sa

2, Department of Restorative Dentistry, SUNY at Buffalo, Buffalo, NY, USA, buffalo.edu

3, Division of Endodontics, Department of Periodontics and Endodontics, SUNY at Buffalo, Buffalo, NY, USA, buffalo.edu

4, Division of Biomaterials, Operative Dentistry Department, King Abdualziz University, Jeddah, Saudi Arabia, kau.edu.sa

5, Biomaterials Department, Faculty of Dentistry, Tanta University, Tanta, Egypt, tanta.edu.eg

6, Division of Biomaterials and Tissue Engineering, UCL Eastman Dental Institute, 256 Gray’s Inn Road, London WC1X 8LD, UK, ucl.ac.uk

Received Jul 8, 2017; Revised Sep 16, 2017; Accepted Sep 24, 2017

This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

1. Introduction

Portland cement (PC) is a mixture of di- and tricalcium silicate, tricalcium aluminate, and tetracalcium aluminoferrite [1]. Mineral trioxide aggregate (MTA) is a type I PC that contains 50–75 wt% calcium oxide (CaO) and 15–25 wt% silicon dioxide (SiO2) [2, 3]. MTA was developed by Lee and coworkers 1993 [4] and FDA approved as vital pulp capping material in 1997 [5] and as a perforation repair material and apical plug during apexification in 1998 [6]. Furthermore, the FDA supported the safety and effectiveness of MTA as a root-end filling material [7]. MTA was initially available in the market as a grey-colored ProRoot MTA (GMTA). Due to aesthetic concerns with GMTA, a white ProRoot MTA (WMTA) formulation was introduced in 2002 [8]. Unlike PC, both GMTA and WMTA contain 20% bismuth oxide as radiopacifier [9] and calcium sulfate (CaSO4, 5 wt%) to regulate their setting time [10, 11].

Despite its good sealing ability [12], osteoconductivity [13], and high biocompatibility [14], MTA has some disadvantages such as long setting time, high degradation, and low compressive strength [15]. Due to its long setting time and the need for water to complete the hydration (setting) reaction, a wet cotton pellet is usually placed next to MTA;...

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