MTAD: Is it the right "solution"? – An overview

Introduction: A plethora of chemical irrigants exists that is used for the elimination of residual microbes and endotoxins in root canals accompanied by mechanical instrumentation. However, due to complex root canal systems, the mechanical instrumentation and established irrigants still reach their limits and pathogenic microorganisms remain. Therefore, new irrigants with a wider spectrum are required. Materials/Methods: The aim of this article was to summarize and discuss the available information concerning the irrigant MTAD (mixture of tetracycline isomer, acid and detergent) introduced in 2003 with its wider spectrum regarding antibacterial properties and the ability to remove the smear layer. A literature search was performed from English-language papers published until September of 2018. Results: This review of literature focused on particular advantages of MTAD such as the antimicrobial efficacy, the ability of removing the smear layer and the effect on dentine structure. Also disadvantages were found, regarding the effect of MTAD on the dentine degeneration and the sealing properties of root-end filling materials. Conclusion: MTAD could represent an effective complementary irrigant, specifically in combination with NaOCl. Further research is required to establish MTAD as a potent irrigant against more bacterial species, not only against Enterococcus faecalis. Keywords: E. faecalis, MTAD, endodontic final irrigant, smear layer