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Gray mineral trioxide aggregate (GMTA) is a bioactive endodontic cement used primarily in restorative dentistry and endodontics. It is composed of a mixture of dicalcium silicate, tricalcium silicate, tricalcium aluminate, and bismuth oxide, which is added to provide radiopacity. GMTA is distinguished from its white counterpart (WMTA) by the inclusion of tetracalcium aluminoferrite, which provides its characteristic gray color but can also lead to tooth discoloration. When mixed with water, GMTA hydrates to form a highly alkaline paste that releases calcium hydroxide. This alkaline environment facilitates the formation of hydroxyapatite and induces the development of mineralized tissue barriers, such as dentin bridges. Its primary clinical applications include pulpotomy in primary teeth, apexification of immature permanent teeth, repair of root perforations, and use as a retrograde filling material in apicoectomies.
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