Subtleties of using Metapaste for temporary filling of tooth canals

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Among the variety of dental preparations, I often want to understand in more detail the differences and practical purposes of each, especially when there are many analogues.

The goal of a self-respecting dentist is to choose the most effective, appropriate composition for a specific situation.

Among the latest developments among materials for temporary filling of dental canals, Metapaste deserves special attention.

General overview

Metapaste is a water-soluble material for temporary filling of canals made of calcium hydroxide with the addition of barium sulfate.

The drug is produced by the South Korean company Meta Biomed Company LTD.

Calcium hydroxide (tasteless and odorless white powder with a highly alkaline pH of up to 12.5) is not new to the market and has been used in dentistry since the 90s of the last century.

Metapaste was developed due to the inconsistency of many previously used materials with the requirements of modern medicine.

It takes into account all the difficulties of working with such materials, tissue reactions, adhesion processes of compositions, and maximizes ease of use and patient safety.

And also the most important problem of cleaning the canals after temporary filling has been solved, both before the final closure of the canals, and in the process of long-term treatment of inflammatory processes.

The sales kit includes:

• 2.2 g of ready-to-use paste, packed in a working syringe;
• disposable sterile tips;
• rotating tip direction control ring - 1 pc.

Package weight 83 g, size 228*61*22 mm. The kit may include 1 or 2 syringes with the drug.

Plastic syringes with cannulas are intended for single use; the material in one package is enough to fill up to 75 infected canals.

What's in a first aid kit?

According to the recommendations of the Ministry of Health, the first aid kit does not contain medicines. This is explained by several reasons:

• By law, only organizations or individual entrepreneurs licensed to carry out medical or pharmaceutical activities can store medicines;
• the use of medications requires accurate diagnosis; without a doctor’s prescription and supervision, taking them can pose a health hazard, for example, cause an allergic reaction;
• It is not always possible for an enterprise to create optimal conditions for storing medicines.

Composition of a first aid kit, approved by Order No. 1331n

The order prohibits the use of sterile medical products from a first aid kit if their packaging is damaged, as well as the repeated use of products and instruments contaminated with blood or biological fluids.

Therapeutic effect

The therapeutic effect of the drug is manifested in the effective and reliable isolation of the root canals from infected tissues after the lumen is closed.

The material forms a hard protective layer, by creating a high PH environment , it quickly disinfects infected tissues and prevents the infection from spreading.

Moreover, the antibacterial effect has high resistance rates in deep and medium forms of caries.

After several procedures for applying metapaste, radiography shows a serious reduction in the size of inflammatory foci, acceleration of healing processes and the construction of new tissue.

Histological research results, and then practical application, have given extremely positive results, which is why many clinics are switching to working with Metapaste.

Efficiency indicators, water solubility, as well as the important absence of iodine preparations in the composition make the doctor’s work much more convenient and reduce the time spent by the patient directly in the dental chair.

In what cases is the use of intrapulpal anesthesia and the peculiarities of its implementation justified?

Come here to get acquainted with analogues of Neoconus used in dentistry.

A protocol for treating a tooth infection is proposed at this address https://www.vash-dentist.ru/lechenie/zubyi/infektsii-nyuansyi.html.

First aid kit placement

The medications included in the first aid kit may be kept in a case or bag at a special sanitary station. As a rule, this is an open cabinet or a cabinet with doors that cannot be locked with a key. First aid kits can be made portable, which is especially important for organizations that involve traveling. Near the location of the stationary first aid kit there must be a corresponding sign (white cross on a green background) or an inscription, in addition, it is indicated on the evacuation plan.

Every organization, business or office should have at least one first aid kit. Their number can be increased depending on the number of employees, the presence of several premises, workshops, offices for professional activities, remote from each other. The first aid kit must be available to all employees of the enterprise throughout the day.

Indications and restrictions

Metapaste is indicated for use in several cases:

• Accidental exposure of the pulp during pulpotomy.
• Channel leakage.
• In the process of treating periodantal cysts, periodontitis, cystogranuloma.
• As a material for the formation of temporary hard tissue (apesfixation).
• Internal or external resorption of root canals.
• As a temporary filling material for infected root canals.
• As a therapeutic pad in the presence of deep caries.
• Restoration of the original dentin structure in cases of moderate caries.
• Restoration of the dental lining during deformation.

In addition to its expiration date, the paste should not be used in the treatment of patients with hypersensitivity to barium sulfate. In this case, it is replaced with analogues.

Advantages and disadvantages

Metapaste is distinguished from other materials by several very significant advantages:

• The most powerful antibacterial effect of high durability. After installation in an infected canal, it kills 99% of pathogenic microflora within 48 hours by creating a high PH environment.
• Ready-to-use drug in a convenient syringe.
• Easy insertion and extraction from root canals.
• No cross-infection due to disposable tips.
• High contrast on x-rays.
• Water solubility.

The only drawback can be considered a stretch: the requirement for hermetic storage.

This is due to the fact that upon contact with air, calcium hydroxide loses its therapeutic properties and turns into calcium carbonate, the paste separates and dries out, which makes the entire volume remaining in the syringe unusable.

The disadvantage is controversial and of little significance if the dentist follows the work instructions.

Step-by-step instruction

Correct and economical use of the drug is ensured by following a few simple rules of sequence of actions:

1. Preparation of a dental unit.
2. The root canal should be thoroughly cleaned and dried after treatment. After this, work directly with the drug begins.
3. The rotating ring on the syringe changes the direction of the tip.
4. A disposable tip is inserted into the root canal.
5. The channel is filling. To do this, gently press the syringe plunger while slowly withdrawing the tip. If the piston is pressed too hard, the material may overflow the channel and leave the working area. In this case, it can be easily and safely removed.
6. Excess Metapaste is removed with a sterile cotton swab.
7. The used tip is removed, a new one is put on and secured with a ring.
8. The paste can be capped and stored.
9. Dispose of disposable caps and empty syringes after use.

Metapaste is absolutely safe for the environment, so the disposal of residual paste on cotton rolls, used packaging and plastic syringes is carried out along with other medical waste without restrictions.

Instructions for use

Metapaste is used according to the following scheme:

• initial preparation is carried out;
• after preparation, it is necessary to thoroughly clean the canal;
• then follows the drying stage;
• a disposable tip and a rotating ring are installed on the syringe;
• the tip is carefully inserted into the root canal;
• the cavity is completely filled with filling material;
• gently pressing on the syringe, the tip must be slowly removed;
• use a cotton swab to remove excess paste;
• Remove and discard the used tip, put a new one in its place and close the syringe with a cap.

Precautionary measures

Precautions for using metapaste are quite simple:

• Storage. The drug should be stored exclusively in a hermetically sealed syringe, in a cool, dry place at a temperature of 10 to 250C, away from direct sunlight.
  Maintaining the tightness of the syringe and the temperature regime are categorical requirements; if they are not met, the paste delaminates and dries out. Such material cannot be used further, even if the delamination is not visible, and the dried part can be removed.
• Best before date. Do not use after the expiration date (2 years from the date of manufacture).
• Restrictions on application. When filling the canal, you must not go beyond the apex.
• The paste is used exclusively in dentistry and is not suitable for other purposes.
• Do not use if the patient is sensitive to barium sulfate.

The essence of endodontic treatment of a tooth and the instruments used.

In this article we will talk about the classification of desensitizers in dentistry.

Here https://www.vash-dentist.ru/lechenie/zubyi/elektroodontometriya.html we will tell you the purpose of electrical odontometry of teeth.

Responsibility for the presence/absence of a first aid kit

The employee responsible for storing and using the first aid kit is appointed by the organization's management. He must take a first aid course. The duties of the responsible employee also include:

• checking the expiration date of products included in the first aid kit;
• disposal of products that have expired;
• drawing up an application for the purchase of the necessary components of a first aid kit;
• timely replenishment of the contents of the first aid kit.

Not mandatory, but recommended by Rostrud letter No. PG/8351-3-5

dated November 7, 2012, maintaining a log of product use. After each use of a first aid kit or a completed inspection, a corresponding entry is made in the log.

The presence of a first aid kit at an enterprise can be checked by the State Labor Inspectorate or Rospotrebnadzor. Failure to do so will result in a fine being imposed on the employer.

Side effects and effectiveness

An excellent characteristic of the substance is the complete absence of side effects. Therefore, it can be used for dental treatment during pregnancy and breastfeeding, in childhood without any consequences.

The drug has an exclusively local antiseptic effect, does not enter the bloodstream or breast milk, has low adhesive ability, but allows the construction of durable hard tissue pads and barriers.

Often during pregnancy and breastfeeding, drugs of exclusive local action that do not enter the blood during treatment remain the only option not to affect the processes of the mother’s body.

The material is hypoallergenic , but has a clear contraindication for patients with barium sulfate intolerance.

The effectiveness of the drug is absolutely the same for patients of any age and complexity of the disease. With timely replacement of the paste in the canal, a lasting therapeutic effect is observed without complications or provocations of negative reactions.

Practical application notes the absence of patient complaints, irritation of the tissues around the apex or their inflammation. taken during treatment show a noticeable reduction in the inflammatory focus and stimulation of osteogenesis .

In some cases, the paste is placed into the dental canals several times; this is a normal process; it covers and protects open tooth cavities from infection, and has a therapeutic effect until the dental unit is completely ready for the installation of a permanent filling.

Maximum security

No possible adverse reactions to the use of the substance have been identified. There are no complaints from patients.

If the paste in the canal is replaced in a timely manner, no complications are noted. Metapaste does not cause irritation or inflammation in the tissues surrounding the apex.

There were also no complaints 12 months after treatment. The mucous membrane had its characteristic color, was dense and did not produce a painful reaction when pressed. Radiographs showed that the focus of inflammation was noticeably reduced and osteogenesis was stimulated.

Analogs and price

The drug is produced in two forms, with and without the addition of iodoform. Particularly popular ones are listed, but not all analogues.

The cost of Metapaste in free sale varies from 560 to 1500 rubles.

The video describes in detail the properties and features of one of the Metapaste analogues.

Cost and analogues

There are a number of products in dentistry that work on the same principle as Metapaste:

• Biocalex (Spad);
• Calcetin (Technodent).

To enhance the bactericidal effect, some manufacturers add the antiseptic iodoform to pastes. Among these means the following can be noted:

• Metapex;
• Vitapex;
• Calcept-Yodo;
• Apexdent containing iodoform.

The price of Metapaste, like its analogues, varies from 1000 to 1500 rubles.

Reviews

If you use Metapaste in your work, have encountered unusual manifestations of reactions, or have accumulated any statistics on practice and are ready to share it, we are happy to welcome your comments on the article.

We also welcome your comments if you, as a patient, have experienced the effects of the drug. Share your impressions of the process and the consequences of treatment.

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