UltraCal XS vs. MTAFlow: Choosing a Calcium Hydroxide Paste

Quick answer

UltraCal XS is a radiopaque, aqueous calcium hydroxide paste intended for intracanal medicament use between appointments. MTAFlow is a bioactive cement for vital pulp therapy and perforation repair. They are not interchangeable: choose UltraCal XS when you need a temporary antimicrobial dressing, and MTAFlow when you need a permanent bioactive seal.

What each material is actually for

UltraCal XS is formulated as an aqueous, radiopaque calcium hydroxide paste. That combination matters because radiopacity lets you confirm placement and complete removal on a radiograph, while the aqueous base makes it easy to deliver and later irrigate out. It is designed as a temporary intracanal medicament, not a definitive filling material.

MTAFlow is a bioactive cement. It is used for vital pulp therapy procedures such as pulp capping and pulpotomy, and for repair of perforations. It sets to provide a seal and support hard-tissue formation. Because it is a setting cement, it stays in place as part of the final restoration rather than being removed.

Handling and placement differences

UltraCal XS comes as a paste in a syringe, so you can deliver it directly into the canal. Its aqueous nature means it does not set hard, which simplifies removal at the next visit. If you leave it in place too long without a coronal seal, it can wash out or dissolve, so temporization matters.

MTAFlow requires mixing and placement into a dry field. Moisture control is critical because the material needs to set without being diluted. Once placed, it should not be disturbed. If you are working in a bleeding field, achieve hemostasis first. The trade-off is that MTAFlow demands more chair time and precision than a paste you simply syringe in and later rinse out.

Indications and clinical decision points

Use UltraCal XS when the goal is disinfection between appointments, such as in a necrotic pulp case or when you need to medicate a canal and bring the patient back. It is not a substitute for a permanent root canal filling or a bioactive pulp cap.

Use MTAFlow when the goal is to preserve vital pulp or repair a communication. It is indicated for vital pulp therapy and perforation repair, where a bioactive set material is required. It is not intended as a removable intracanal medicament.

If you are unsure, ask what the final state of the tooth requires. A temporary antimicrobial effect points to UltraCal XS. A permanent bioactive barrier points to MTAFlow.

Trade-offs at a glance

• Temporary vs. permanent: UltraCal XS is a temporary intracanal medicament that you remove later. MTAFlow is a permanent bioactive cement that sets in place. Choose based on whether you need a removable dressing or a definitive seal.
• Delivery and removal: UltraCal XS comes in a syringe and is easy to irrigate out. MTAFlow requires mixing, moisture control, and stays where placed. If you want simplicity and reversibility, UltraCal XS fits. If you need a set barrier, MTAFlow fits.
• Radiographic confirmation: UltraCal XS is radiopaque, so you can see it on a radiograph. MTAFlow is also radiopaque as a cement, but its purpose is different. Use radiographs to confirm placement and removal for UltraCal XS, and to check adaptation for MTAFlow.

Product facts

• UltraCal™ XS-35% Calcium Hydroxide Paste: UltraCal XS calcium hydroxide paste is uniquely formulated to be both aqueous and radiopaque. Aqueous means easy delivery and removal; radiopaque means you can verify placement and complete cleanup on a radiograph.
• BFC3™ Powered Impression Gun-Dental Impression Material Delivery System: BFC3 Powered Impression Gun is Ultradent's first cordless impression gun with adjustable flow rate and an anti-drip feature. If your indirect restorative workflow includes impressions, this gun gives you cordless control and less waste, though it is not used for intracanal medicament placement.

Which should you choose?

Best for

• Clinicians needing a temporary intracanal medicament between appointments
• Cases where you want a radiopaque, aqueous paste that is easy to remove
• Endodontic disinfection protocols requiring a calcium hydroxide dressing

Not for

• Vital pulp therapy or perforation repair where a bioactive set material is required
• Situations where you need a permanent seal rather than a temporary dressing