Background and Aim: The main goal of endodontic treatments is eliminating the etiologic factors of pulpal and periapical diseases as well as maintaining this condition via providing a hermetic seal between periodontium and root canal system. If these were not possible through orthograde approach, periradicular surgery and root-end filling are indicated. Review of Literature: Different materials have been used as root-end fillings. Amalgam, in 1884, and some other materials were used thereafter for root-end filling. A search in medical data bank provides hundreds of articles related to endodontic surgeries and root-end filling materials; however, there are less than 10 review articles which compare these materials and also there is just one systematic review in this field. Additionally, there is no Meta-analysis with reference to this subject due to scarcity of Randomized Clinical Trials. In this article, we focus on favorable properties of root-end fillings as well as introducing different types of these materials and the ideal choice for endodontic surgeries.Conclusion: Dentists should be informed about different properties of an ideal root-end filling so that they can choose and utilize a favorable material in endodontic surgeries. Since the histological evidences declare successful treatment results for MTA and CEM cement, due to cementogenesis over their surfaces, these biomaterials are recommended for clinical use.

Background and Aim: Apical seal is one of the most important factors in successful endodontic surgery. Apicoectomyand Retrofill are a way the canal selecting a suitable Retrofill material has an important role in apical seal. Material and Methods: In this Invitro study 129 single root of human teeth wererandomly chosen and prepared by step back technique. Following root-end resection, retrograde cavity with 2mm of depth was prepared at the end of the roots. The cavity of study group was filled with MTA, Zinc free amalgam, and Ceramic in sterile condition. In this 60 days, study the number of the days required for Staphylococcusepidermidis to penetrate 2 mm of various root-end filling material (MTA, Amalgam and Cold Ceramic)was determined. Results: All samples filled with zinc-free amalgamshowed leakageduring 5 to 39 days. 22 samples among those teeth filled with cold ceramic had leakage during 7 to 53 days. IS cases ofMTA group didn"t show any leakage, while 15 remaining samples had at 8 to 55 days. Conclusion: The study has proved that cold ceramic is a suitable material form the point of sealing ability, but there should be more studies on other feature of this material.

Introduction: The provision of an effective apical seal is an essential factor when choosing an appropriate material for success of root-end surgeries. Root-end resection, preparation and obturation should provide an adequate apical seal. The aim of this in vitro study was to investigate bacterial and dye microleakage of four different root-end filling materials and compare the efficacy of these two methods.Materials and Methods: Fifty-six single-rooted teeth with intact and straight roots were randomly assigned into four study groups of 12 each and two control groups of three each. After decoronation, root canals were prepared up to file size #40 using step back technique; then, they were filled with gutta-percha and AH26 sealer. Root-ends were resected 3 mm above the root-end and 3 mm deep cavities were prepared. Root-end cavities were filled with amalgam, Root Mineral Trioxide Aggregate (Root MTA), White ProRoot MTA (WMTA), and calcium enriched mixture (CEM) cement. Bacterial leakage was investigated in Trypticase Soy Broth (containing Enterococcus faecalis) after 70 days and 1% methylene blue dye leakage was assessed after 72 hours. Complete dye leakage was checked using stereomicroscope (X40). Data were statistically analyzed using Fisher Exact test. For pair comparison between the two methods Kapa agreement was utilized.Results: After 70 days there was 100% bacterial leakage in amalgam, and CEM cement, 91.7% in WMTA, and 75% in Root MTA. This difference was not significantly different. The difference in complete dye leakage was also not significant (WMTA and CEM cement 16.7%, Amalgam and Root MTA 33.3%).Conclusion: There was no significant measure of agreement between dye and bacterial penetration along root-end fillings. CEM cement was not significantly different from currently used retrofilling materials e.g. WMTA.

Statement of problem: Periapical surgery has been performed to remove irritant factors and seal the end of the root. So, selections of retrograde filling materials which can produce hermetic seal and are easily available with reasonable prices seem to be necessary.Purpose: The aim of this in-vitro study was to compare the sealing ability of Pro Root MTA, Root- MTA and Portland cement.Materials and Method: In this experimental in-vitro study, 40 intact mandibular first premolar teeth were selected and cut from the site of cemento-enamel junction (CEJ). The canals were prepared using step back method and obturated with Gutta-Percha and sealer by lateral condensation technique. The 3 mm of the apical portion of the roots were cut with a 45 angle to the long axis of the teeth. Thirty six teeth were divided into three experimental groups and the 4 remaining teeth were considered as control groups. Cavities randomly with 3 mm depth were prepared in the apical of the canals by a ½ round bar, and in the experimental groups they were filled with pro-root MTA, root MTA and/or Portland cement. The surfaces of the roots were covered by nail polish. After incubations, the teeth were kept in %2 methylen blue solution for 24 hours. Then, the teeth were cut longitudinally and the depths of color penetration were evaluated by a stereo microscope. The data were analyzed using one-way ANOVA and Mann-Whitney U test.Results: In the positive control group, the dye had penetrated the total cavity; in the negative control group, microleakage was not found. There was no significant differences between the Pro Root MTA and Root MTA (p>0.05), but Pro Root MTA and Root MTA had significant differences with Portland cement (p<0.05). Pro-root MTA had the lowest apical microleakage followed by root MTA and Portland cement respectively. Conclusion: Considering the results of this study, Portland cement cannot be replaced with Pro-root MTA in retrograde fillings, but using Root MTA as a substitute for Pro Root MTA needs more investigations.

Introduction: The importance of perfect apical seal in endodontics, more specifically in periradicular surgery, is the motivation/reason for development of root-end filling materials with favorable physical, chemical and biological characteristics. The aim of this in vitro study was to evaluate the marginal adaptation of root-end filling materials using scanning electron microscopy.Materials and Methods: Twenty five human maxillary anterior teeth were prepared using a K-File #50 to 1 mm short of the apical foramen and filled with gutta-percha and Sealapex using the lateral compaction technique. The apical 3 mm of the roots were sectioned perpendicularly to the long axis of the teeth. A 3-mm-deep root-end cavity was prepared using ultrasonic tips powered by an Enac ultrasonic unit. The teeth were randomly assigned to five groups according to the materials tested including IRM, amalgam, ProRoot MTA, Super-EBA and Epiphany/Resilon. Root-end cavities were filled with the materials prepared according to the manufacturers’ instructions. The root apices were carefully prepared for sputter coating and later evaluation using Scanning Electron Microscope (SEM). The images of root-end fillings were divided into four quadrants and distributed into five categories according to the level of marginal adaptation between the root-end material and the root canal walls. The Fisher exact test with Bonferroni correction was used for statistical analysis. The level of significance was set at P=0.005.Results: SEM images showed the presence of gaps in the root-end filling materials. No significant difference was observed between the tested materials (P>0.005).Conclusion: ProRoot MTA, IRM, amalgam, Super- EBA and Epiphany/Resilon showed similar marginal adaptation as root-end filling materials.

Purpose: This study was carried out for comparison of MTA and Root MTA (RMTA) by scanning electron microscope and energy dispersive spectrometer X-ray analysis.Method & Materials: In this research two resin discs were used and in each disc three cavities with three mm depth were prepared. In each disc the cavities were filled with one type of MTA and incubated in 37C for 48 hours. Then, they were polished, carbon coated, observed and analyzed by the scanning electron microscope and the X-ray energy dispersive spectrometer.Results: In both types of the cements results showed that calcium oxide (lime-CaO), silica (SiO2) and bismuth oxide (Bi2O3) were the most component respectively. The amount of minor elements (Al2O3, MgO and FeO) was very lower in RMTA in comparison with MTA. There were some similarity and differences in the amount of trace elements in both types of cements.Conclusion: There is a slit difference between the amounts of major elements in both types of MTA cements, but the amount of minor elements has a significant difference.

Background and Aim: To date, several materials have been used for root end filling in endodontic surgery. Optimal properties of MTA in invitro and invivo studies have been proven. On the other hand, based on some of the studies, Root MTA (Iranian MTA) and Portland cement are similar to MTA in physical and biologic properties. The aim of this investigation was to assess the marginal adaptation of Gray Pro root MTA, White Pro root MTA, Root MTA and Portland cement Type I root-end fillings under scanning electron microscope.Methods & Materials: Eighty extracted single-rooted teeth were selected. After canal preparation and root-end resection, root-end cavities were prepared ultrasonically. They were divided at random into four test groups of 20 each. The cavities were filled with Gray & White Pro root MTA, Root MTA and Portland cement. The root-end surface topographies were reproduced by means of polyvinylsiloxane impressions and epoxy resin replicas. Then scanning electron micrography (SEM) images of each replica were taken. The material-tooth interface on each photograph was divided into 16 equidistant areas and maximum gap size was recorded in each area. The means of 16 numbers of each photographs was calculated. The means of calculated numbers related to each group were counted. Statistical analysis was performed using ANOVA test.Results: Gap sizes at calculated points were smallest in Portland cement root-end fillings and largest in White Pro root MTA group. Calculated gap sizes for White Pro root MTA, Root MTA and Gray Pro root MTA and Portland cement group were subsequently 16.3975, 15.4185, 12.8880 and 11.3150 mm. Portland cement produced a significantly superior marginal adaptation to Root MTA and White Pro root MTA, and the gap size in Gray Pro root MTA group was significantly smaller than White Pro root MTA (P<0.0001).Conclusion: under this study, the marginal adaptation of both Portland cement and Root MTA was good. After performing more invitro and invivo studies we hope to use Portland cement, which is very economic.