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    After placement of MTA in the tooth, body fluids infiltrate the paste to cause setting.

    During this process, calcium and hydroxide ions are released from the MTA, promoting hydroxyapatite (HA) formation on the MTA surfaces.

    When HA coats the surface, it hides the underlying MTA to minimize foreign body reactions and support healing responses of the pulpal or periapical tissue.

    Calcium phosphate precipitated crystals scattered on the hydrated tricalcium silicate cement surface1.

    High magnification image of the calcium phosphate crystals1.

    MTA-Based BioActivity
    Hydroxyapatite forms to ensure BioActive sealing.

    A. Preoperative view of carious No. 17 with signs and symptoms of irreversible pulpitis.

    B. Pulpotomy with NeoPUTTY after hemostasis with 2.5% NaOCl. The cavity margins were surrounded by sound enamel, and the tooth was restored with acid-etch composite resin.

    C. 7-month post-operative view showing resolution of periapical radiolucency and increase in root dimensions. Note advanced apical closure.

    Courtesy of Zafer C. Cehreli, DDS, PhD