title: Evaluation of Marginal Adaptation of Root-End Filling Materials Using Scanning Electron Microscopy An ex-vivo comparative study of root-end marginal adaptation using grey mineral trioxide aggregate, white mineral trioxide aggregate, and Portland cement under scanning electron microscopy 5-year results comparing mineral trioxide aggregate and adhesive resin composite for root-end sealing in apical surgery. Sealing ability and adaptation of root-end filling materials in cavities prepared with different techniques. Comparison of Mineral Trioxide Aggregate and iRoot BP Plus Root Repair Material as Root‐end Filling Materials in Endodontic Microsurgery: A Prospective Randomized Controlled Study Sealer penetration and marginal permeability after apicoectomy varying retrocavity preparation and retrofilling material. Sealing ability of a mineral trioxide aggregate when used as a root end filling material. Biodentine versus Mineral Trioxide Aggregate versus Intermediate Restorative Material for Retrograde Root End Filling: An Invitro Study A prospective randomized controlled study of mineral trioxide aggregate and super ethoxy-benzoic acid as root-end filling materials in endodontic microsurgery. An In Vitro Comparison of Marginal Adaptation of MTA and MTA-Like Materials in the Presence of PBS at One-Week and Two-Month Intervals Comparative Scanning Electron Microscopic Study of the Marginal Adaptation of Four Root-End Filling Materials in Presence and Absence of Blood Investigation of the marginal adaptation of root-end filling materials in root-end cavities prepared with ultrasonic tips. A prospective clinical study of Mineral Trioxide Aggregate and IRM when used as root-end filling materials in endodontic surgery. A comparative sealability study of different retrofilling materials. Evaluation of different methods for the root-end cavity preparation. Occlusal loading of EBA and MTA root-end fillings in a computer-controlled masticator: a scanning electron microscopic study. A Randomized Controlled Study of Mineral Trioxide Aggregate and Super Ethoxybenzoic Acid as Root-end Filling Materials in Endodontic Microsurgery: Long-term Outcomes. Assessment of marginal adaptation after apicoectomy and apical sealing with Nd:YAG laser. Push-out bond strength of two root-end filling materials in root-end cavities prepared by Er,Cr:YSGG laser or ultrasonic technique. The effect of smear layer on the push-out bond strength of root canal calcium silicate cements.
abstract: Introduction The importance of perfect apical seal in endodontics , more specifically in periradicular surgery , is the motivation/reason for development of root-end filling material s with favorable physical , chemical and biological characteristics . The aim of this in vitro study was to evaluate the marginal adaptation of root-end filling material s using scanning electron microscopy . Material s 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 r and omly assigned to five groups according to the material s tested including IRM , amalgam , ProRoot MTA , Super-EBA and Epiphany/Resilon . Root-end cavities were filled with the material s 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 material s. No significant difference was observed between the tested material s ( P > 0.005 ) . Conclusion ProRoot MTA , IRM , amalgam , Super-EBA and Epiphany/Resilon showed similar marginal adaptation as root-end filling material Context : Where nonsurgical endodontic intervention is not possible , or it will not solve the problem , surgical endodontic treatment must be considered . A major cause of surgical endodontic failures is an inadequate apical seal , so the use of the suitable substance as root-end filling material that prevents egress of potential contaminants into periapical tissue is very critical . Aims : The aim of the present ex-vivo study was to compare and evaluate the three root-end filling material s of mineral trioxide aggregate ( MTA ) family ( white MTA [ WMTA ] , grey MTA [ GMTA ] and Portl and cement [ PC ] ) for their marginal adaptation at the root-end dentinal wall using scanning electron microscopy ( SEM ) . Material s and Methods : Sixty human single-rooted teeth were decoronated , instrumented , and obturated with Gutta-percha .  After the root-end resection and apical cavity preparation , the teeth were r and omly divided into three-experimental groups ( each containing 20 teeth ) and each group was filled with their respective experimental material s. After longitudinal sectioning of root , SEM examination was done to determine the overall gap between retro grade material s and cavity walls in terms of length and width of the gap ( maximum ) at the interface . Descriptive statistical analysis was performed to calculate the means with corresponding st and ard errors , median and ranges along with an analysis of variance and Tukey 's test . Results : The least overall gap was observed in GMTA followed by PC and WMTA . While after statistically analyzing the various data obtained from different groups , there was no significant difference among these three groups in terms of marginal adaptation . Conclusion : GMTA showed the best overall adaptation to root dentinal wall compared to PC and WMTA . Being biocompatible and cheaper , the PC may be an alternative but not a substitute for MTA INTRODUCTION Recent meta-analyses of the outcome of apical surgery using modern techniques including microsurgical principles and high-power magnification have yielded higher rates of healing . However , the information is mainly based on 1- to 2-year follow-up data . The present prospect i ve study was design ed to re-examine a large sample of teeth treated with apical surgery after 5 years . METHODS Patients were recalled 5 years after apical surgery , and treated teeth were classified as healed or not healed based on clinical and radiographic examination . ( The latter was performed independently by 3 observers ) . Two different methods of root-end preparation and filling ( primary study parameters ) were to be compared ( mineral trioxide aggregate [ MTA ] vs adhesive resin composite [ COMP ] ) without r and omization . RESULTS A total of 271 patients and teeth from a 1-year follow-up sample of 339 could be re-examined after 5 years ( dropout rate = 20.1 % ) . The overall rate of healed cases was 84.5 % with a significant difference ( P = .0003 ) when comparing MTA ( 92.5 % ) and COMP ( 76.6 % ) . The evaluation of secondary study parameters yielded no significant difference for healing outcome when comparing subcategories ( ie , sex , age , type of tooth treated , post/screw , type of surgery ) . CONCLUSIONS The results from this prospect i ve nonr and omized clinical study with a 5-year follow-up of 271 teeth indicate that MTA exhibited a higher healing rate than COMP in the longitudinal prognosis of root-end sealing The aim of this study was to evaluate the sealing ability and marginal adaptation of calcium silicate-based cements ( CSCs ) in root-end cavities prepared by ultrasonic and laser tips . A total of 72 extracted human maxillary incisor teeth were r and omly divided as 60 teeth in experimental groups and 6 teeth each for positive and negative control groups . Specimens in experimental groups were obturated , their root-end resections were performed and r and omly divided into six groups ( n = 10 ) as follows : G1 : Ultrasonic retrotip + MTA , G2 : Ultrasonic retrotip + Calcium Enriched Mixture ( CEM ) , G3 : Ultrasonic retrotip + Biodentine , G4 : Er : YAG laser tip + MTA , G5 : Er : YAG laser tip + CEM , G6 : Er : YAG laser tip + Biodentine . The sealing ability was measured by fluid transport method . Six specimens from each experimental group were r and omly selected to analyze marginal adaptation and prepared for scanning electron microscopy ( SEM ) analysis . Micrographs were scored and also analyzed using Image J software . Data were analyzed with ; two-way ANOVA , Bonferroni , Kruskall-Wallis , Mann-Whitney-U , Siegel & Castellan , and Spearman correlation coefficient tests . No significant difference was found between material s regarding the sealing ability and marginal adaptation ( p > 0.05 ) . Significantly greater fluid movement and poor marginal adaptation were seen for material s placed in cavities prepared by laser tips ( p < 0.05 ) . Positive correlation was found between the results of scoring and Image J analysis of SEM images ( r = 0.596 , p < 0.001 ) . Fluid transport method and SEM analysis gave similar results suggesting the use of ultrasonic-retrotips for preparing root-end cavities which are going to be filled with one of these CSCs Introduction : This prospect i ve r and omized controlled study evaluated the clinical and radiographic outcome of endodontic microsurgery when using iRoot BP Plus Root Repair Material ( BP‐RRM ; Innovative BioCeramix Inc , Vancouver , BC , Canada ) or mineral trioxide aggregate ( MTA ) as the retro grade filling material and analyzed the relationship between some potential prognostic factors and the outcome of the surgery . Methods : By using strict inclusion and exclusion criteria , 240 teeth were successfully enrolled and r and omly and equally allocated to either the MTA or BP‐RRM treatment group . A st and ardized surgical procedure was performed by a single operator . The patients were followed up at 1 week , 3 months , 6 months , and 12 months ; follow‐up included clinical and radiographic examination . Clinical and radiographic evaluations acquired at the 12‐month follow‐up were taken as the primary outcome . For the identification of prognostic factors , the dichotomous outcome ( success vs failure ) was taken as the dependent variable . Results : A total of 158 teeth were analyzed at the 12‐month follow‐up , including 87 teeth in the MTA group and 71 teeth in the BP‐RRM group . The success rate in the MTA and BP‐RRM groups was 93.1 % ( 81/87 teeth ) and 94.4 % ( 67/71 teeth ) , respectively ( P > .05 ) . Three significant outcome predictors were identified : quality of root filling ( P < .05 ) , tooth type ( P < .05 ) , and size of the lesion ( P < .05 ) Conclusions : These results suggest that BP‐RRM is comparable with MTA in clinical outcome when used as root‐end filling material s in endodontic microsurgery Apicoectomy failure is generally related to inappropriate marginal sealing of the retrocavity , which allows percolation of microorganisms and their products from root canal system to periapex . This study evaluated tubular penetration of canal sealers and marginal permeability after retrocavity irradiation with Er;Cr : YSGG laser and retrofilling with MTA or cyanoacrylate .  Twenty-two single-rooted teeth were decoronated and endodontically treated , their apical 3 mm were resected and the root ends were retroprepared with a low-speed bur .  Twenty roots were r and omly assigned to 4 groups ( n=5 ) : GI and GII -- retrofilling with MTA and cyanoacrylate , respectively ; GIII and GIV -- retrocavity irradiation with Er;Cr : YSGG laser ( 2.78 microm , 4 W , 20 Hz , 70.8 J/cm(2 ) ) and retrofilling with MTA and cyanoacrylate , respectively . The remaining 2 roots served as positive and negative controls . The analysis of rhodamine B dye infiltration ( p=0.05 ) demonstrated that laser irradiation and MTA retrofilling presented significantly higher permeability rates ( p<0.05 ) . Retrofilling with cyanoacrylate showed significantly lower permeability , either when laser was used or not on retrocavity . SEM analysis depicted more cyanoacrylate penetration through dentinal tubules when compared to MTA , suggesting a more efficient marginal sealing . Based on these results , it may be concluded that cyanoacrylate provided a less permeable retrofilling regardless of the retropreparation method , suggesting a more favorable condition to the establishment of the periapical healing This in vitro study used rhodamine B fluorescent dye and a confocal microscope to evaluate the sealing ability of amalgam , super EBA , and a mineral trioxide aggregate when used as root end filling material s. Thirty single-canal teeth were cleaned , shaped , and obturated with gutta-percha and root canal sealer . After application of nail polish to the external surface , the apical 3 mm of each root was resected and 3-mm deep root end preparations were made . The roots were r and omly divided into three groups and the root end preparations filled with the experimental material s. All roots were then exposed to an aqueous solution of rhodamine B fluorescent dye for 24 h , longitudinally sectioned , and the extent of dye penetration measured using a confocal microscope . Statistical analysis showed that the mineral trioxide aggregate leaked significantly less than amalgam and super EBA Objective The aim of this study was to evaluate the marginal adaptation of Biodentine in comparison with Mineral Trioxide Aggregate ( MTA ) and Intermediate Restorative Material ( IRM ) , as a root end filling material , using Scanning Electron Microscopy ( SEM ) . Material s and Methods : Thirty permanent maxillary central incisors were chemo-mechanically prepared and obturated . Three millimetres of the root end were resected and 3 mm retro cavity preparation was done using ultrasonic retrotips . The sample s were r and omly divided into three groups ( n=10 ) and were restored with root end filling material s : Group I – MTA , Group II – Biodentine , Group III – IRM . The root ends were sectioned transversely at 1 mm and 2 mm levels and evaluated for marginal adaptation using SEM . The gap between dentin and retro filling material was measured at four quadrants . The mean gap at 1 mm level and 2 mm level from the resected root tip and combined mean were calculated . The data were statistically analyzed , using one-way ANOVA and Tukey ’s HSD post hoc test for intergroup analysis and paired t-test for intragroup analysis . Results : The overall results showed no statistically significant difference between MTA and IRM but both were superior when compared to Biodentine . At 1 mm level there was no statistically significant difference among any of the tested material s. At 2 mm level MTA was superior to both IRM and Biodentine . Conclusion : In overall comparison , MTA and IRM were significantly superior when compared to Biodentine in terms of marginal adaptation , when used as retro grade filling material INTRODUCTION The purpose of the present study was to evaluate the clinical outcomes of endodontic microsurgery when super ethoxy-benzoic acid ( Super EBA ; Harry J. Bosworth , Skokie , IL ) and mineral trioxide aggregate ( MTA ) were used as root-end filling material s in a prospect i ve r and omized controlled study . METHODS Of the 388 teeth eligible for endodontic microsurgery , 128 teeth were excluded from the study , and 260 teeth were r and omly assigned to either the Super EBA group or the MTA group with equal numbers using the " minimization method . " Endodontic microsurgical procedures were performed according to the Yonsei protocol reported in a previous study and were carried out by a single operator . The patients were followed up at 3 , 6 , and 12 months . The primary outcome measure was the change in the apical bone density at 12 months , and the secondary outcome measures were the presence of clinical symptoms or abnormal findings at 12 months . RESULTS A total of 192 teeth were examined at the 12-month follow-up ; 102 teeth were in the Super EBA group , and 90 were in the MTA group . The overall success rate was 94.3 % , with a success rate of 95.6 % ( 86/90 teeth ) for MTA and 93.1 % ( 95/102 teeth ) for Super EBA . The statistical analysis of the success rate results did not show any significant difference between the groups ( P = .472 ) . CONCLUSIONS In this prospect i ve r and omized controlled study , there was no significant difference in the clinical outcomes of endodontic microsurgery when Super EBA and MTA were used as root-end filling material Objective : This study compared the marginal adaptation of mineral trioxide aggregate ( MTA ) and MTA-like material s as root-end fillings after incubation in phosphate buffer saline ( PBS ) , a synthetic tissue fluid , for either 1 week or 2 months . Material s and Methods : In this experimental study , seventy-two extracted human single-rooted teeth were prepared and obturated with gutta-percha and AH26 sealer . The apical 3 mm of the roots were resected . Root-end cavities were prepared with an ultrasonic retrotip . The specimens were r and omly divided into three groups ( n=24 ) and filled with either ProRoot MTA , OrthoMTA , or RetroMTA . Half of the specimens in each group were stored in PBS for 1 week the other half for 2 months . Epoxy resin replicas from the resected root-end surfaces and longitudinally sectioned roots were fabricated . The gaps at the material /dentin interface were measured using a scanning electron microscope ( SEM ) . Transversal , longitudinal , and overall gap sizes were measured . The data were analyzed using Kruskal-Wallis and Mann-Whitney tests . The significance level was set at p < 0.05 . Results : There were no significant differences between the marginal adaptation of ProRoot MTA , RetroMTA , and OrthoMTA in both transverse and longitudinal sections after incubation for either 1 week or 2 months ( p > 0.05 ) . In addition , the test groups were not significantly different regarding the overall mean gap values ( p > 0.05 ) . Conclusion : Under the conditions of this study , there was no difference between the marginal adaptation of ProRoot MTA , OrthoMTA , and RetroMTA as root-end filling material s after exposure to PBS for either 1 week or 2 months Objectives : The aim of this study was to evaluate marginal adaptation of mineral trioxide aggregate ( MTA ) , calcium enriched mixture ( CEM ) cement , Biodentine and BioAggregate in presence of normal saline and human blood . Material s and Methods : In this in-vitro experimental study , 80 extracted single-rooted human teeth were instrumented and filled with gutta-percha . After resecting the root-end , apical cavity preparation was done and the teeth were r and omly divided into 4 groups (N=20)(a total of 8 subgroups ) . Root-end filling material s were placed in 3 mm root-end cavities prepared ultrasonically . Half the specimens in each group were exposed to normal saline and the other half to fresh whole human blood . After 4 days , epoxy resin replicas of the apical portion of sample s were fabricated and scanning electron microscopy ( SEM ) analysis was performed to find gaps in the adaptation of the root-end filling material s at their interface with dentin . The Kruskal-Wallis and Mann-Whitney tests were used for statistical analysis of data with P<0.05 as the limit of significance . Results : There were no significant differences in marginal adaptation of the 8 tested groups ( P>0.05 ) . Conclusion : Based on the results , blood contamination does not affect the marginal adaptation of MTA , CEM cement , Biodentine or BioAggregate AIM To compare the surface topography of root apices following ultrasonic root-end preparation , and again after root-end fillings su bmi tted to three different finishing techniques . METHODOLOGY Eighty-one root-end cavities prepared ultrasonically in human canines , were divided at r and om into three test groups of 27 each . The cavities were filled with Super-EBA , IRM , or ProRoot-MTA and finished by ball burnishing . Eighteen roots from each group received a final finish with either a 30-fluted tungsten carbide finishing bur , or a Zekrya carbide 28 mm bur after storage in water at 37 degrees C for 24 h. The root-end surface topographies were reproduced by means of polyvinylsiloxane impressions and epoxy resin replicas . Scanning electron micrography ( SEM ) images of each replica were taken prior to and after root-end filling . An image analysis system was used to compare the alteration of the marginal chipping areas and to calculate the gaps located in the dentine/root-end filling interface . RESULTS When a bur was used to finish the set material s , a significant ( P < 0.05 ) area of marginal chipping was eliminated . The finishing technique did not significantly ( P > 0.05 ) affect the incidence of gaps in groups root-end filled with MTA or IRM . Super-EBA and IRM retrofillings finished with a ball burnisher or a Zekrya bur displayed a significantly ( P < 0.05 ) larger calculated gap area than roots filled with MTA . CONCLUSION Under this in vitro study , the marginal adaptation of MTA was good with or without finishing procedures . Applying a finishing bur over the condensed and set IRM and Super-EBA created better marginal adaptation AIM To assess the success rate of the root-end filling material , Mineral Trioxide Aggregate ( MTA ) . METHODOLOGY Referred adult patients were recruited using strict entry criteria and r and omly allocated to receive MTA or IRM . A st and ardized surgical technique was employed : the root end was resected perpendicularly and a root-end cavity was prepared ultrasonically and filled . A radiograph taken immediately after surgery was compared with those taken at 12 and 24 months . Customised film holders and the paralleling technique were used ; radiographs were assessed by two trained observers using agreed criteria . The results from 122 patients ( 58 in IRM group , 64 in MTA group ) after 12 months and 108 patients ( 47 in IRM group , 61 in MTA group ) for the 24-month review period were analysed using the chi2 test . RESULTS The highest number of teeth with complete healing at both times was observed when MTA was used . When the numbers of teeth with complete and incomplete ( scar ) healing , and those with uncertain and unsatisfactory healing were combined , the success rate for MTA was higher ( 84 % after 12 months , 92 % after 24 months ) compared with IRM ( 76 % after 12 months , 87 % after 24 months ) . However , statistical analysis showed no significant difference in success between material s ( P > 0.05 ) at both 12 and 24 months . CONCLUSIONS In this study , the use of MTA as a root-end filling material result ed in a high success rate that was not significantly better than that obtained using IRM The purpose of this study was to compare the sealing ability of high-copper amalgam , glass ionomer cement , and silver glass ionomer cement as retrofilling material s when used with and without varnish . Seventy extracted human single-rooted anterior teeth were instrumented and the root canals obturated with laterally condensed gutta-percha and sealer . The apical 3 mm of each root was resected and a 2 mm-deep apical Class I preparation cut . The roots were then r and omly allocated to six groups of 10 teeth and retrofilled with one of the experiment material s. Group I comprised high-copper amalgam ; group 2 , high-copper amalgam with cavity varnish ; group 3 , glass ionomer cement without varnish ; group 4 , glass ionomer cement with varnish ; group 5 , silver glass ionomer cement without varnish ; and group 6 , silver glass ionomer cement with varnish . Two groups of five roots each were used as positive and negative controls . The root surfaces were coated with nail polish and specimens immersed in 2 % methylene blue solution for 14 days . After vertical sectioning , dye penetration was examined under a stereomicroscope . The results of the study were analysed statistically . The sealing ability of the conventional glass ionomer cement with varnish was significantly better while dye penetration was higher in silver glass ionomer cement without varnish group than the other groups ( P < 0.01 ) OBJECTIVE The dentinal walls of root-end cavities were examined for the presence of cracks and debris in correlation with the area of the root surfaces that remained after the resection . STUDY DESIGN One hundred extracted single-rooted teeth were endodontically treated , mounted in acrylic resin blocks , and the apical 2 mm of the root-apex was resected . According to the resected root surface area the teeth were divided into 2 groups having large ( > 2 mm(2 ) ) or small ( < 2 mm(2 ) ) surface area . For retro grade cavity preparation 4 devices were used : slow-speed h and piece , diamond coated stainless steel ultrasonic tip , smooth stainless steel ultrasonic tips , and sonic diamond-coated tips . Teeth were examined under a videomicroscope for the presence of fractures , dentin chips , and gutta-percha remnants on cavity walls . Preparation time was also recorded . RESULTS Preparation with smooth stainless steel ultrasonic tips produced few intradentin cracks . Dentin debris was more frequently seen in rotary preparations whereas gutta-percha remnants were seen mainly at ultrasonically prepared teeth . CONCLUSIONS Sonic and ultrasonic devices produced cleaner , well-centered , and more conservative root-end cavities than the rotary instrumentation . Cracks do not correlate directly with the surface area of the root-end surfaces but rather with the type of retrotip used to prepare the root-end cavity AIM The aim of this investigation was to assess the marginal adaptation of Super-EBA ( EBA ) and Pro Root MTA ( MTA ) root-end fillings and the occurrence of microcracks in resected root-ends of extracted teeth before and after occlusal loading for a five-year equivalent period in a computer-controlled masticator . METHODOLOGY Twenty-four molar teeth were root-filled using lateral condensation and their root-ends resected . Root-end cavities were prepared and either EBA or MTA root-end fillings were placed . All surgical procedures were completed in vitro under an operating microscope . Replicas taken of the root-end fillings and resected root-ends were examined using an SEM before and after they were subjected to in vitro chewing cycles in a computer-controlled chewing simulator for the equivalent of 5 years . Marginal adaptation and integrity of the two root-end filling material s were evaluated and the presence of microcracks recorded . RESULTS Before loading , a continuous margin was observed with 99.4 + /- 2.4 % of EBA and 99.2 + /- 1.6 % of MTA root-end fillings . After loading , the percentage of continuous margin decreased to 93.1 + /- 6.6 % and 98.9 + /- 3.2 % for EBA and MTA , respectively . After occlusal loading , 39.5 % of the EBA root-end fillings were overfilled , whilst 52.6 % of the MTA root-end fillings were underfilled . In total , 12.5 % of the resected root-end surfaces showed microcracking before loading and 25 % after occlusal loading . CONCLUSIONS Both EBA and MTA displayed excellent marginal adaptation before masticatory loading . After loading , the amount of continuous margin for both root-end filling material s decreased slightly but was still high INTRODUCTION The purpose of the present study was to evaluate the long-term clinical outcome of endodontic microsurgery when mineral trioxide aggregate ( MTA ) and super ethoxybenzoic acid ( Super EBA ; Harry J. Bosworth , Skokie , IL ) were used as root-end filling material s. Additionally , this study aim ed to compare the clinical outcome of endodontic microsurgery at the 1-year follow-up with that at the 4-year follow-up . METHODS Two hundred sixty teeth were r and omly assigned to either the MTA or Super EBA group in equal numbers using the minimization method . Endodontic microsurgery was performed according to the Yonsei protocol . The previous study of 192 teeth examined at the 1-year follow-up revealed a success rate of 95.6 % for MTA and 93.1 % for Super EBA . Patients were recalled 4 years after surgery , and treated teeth were classified as successes or failures with Molven 's criteria . The Pearson chi-square test and the McNemar test were conducted to analyze and compare the success rates . RESULTS A total of 182 teeth were examined at the 4-year follow-up . The success rate was 91.6 % for MTA and 89.9 % for Super EBA . Statistical analysis of the success rate did not show any significant difference between the 2 material s ( P = .8 ) . The overall success rate at the 4-year follow-up was 89.5 % , which was slightly lower compared with 94.3 % at the 1-year follow-up . However , there was no significant difference between the follow-up periods ( P = .063 ) . CONCLUSIONS This study identified no significant difference in the 4-year success rates of MTA and Super EBA as root-end filling material s in endodontic microsurgery . Additionally , compared with short-term outcomes , long-term follow-up outcomes were not significantly different OBJECTIVE Recurrent periapical disease poses a substantial challenge to the dental practitioner . However , the use of novel methods and material s in periapical surgery has increased the success rates of treatment . The objective of this study was to assess the effects of mineral trioxide aggregate ( MTA ) retrofilling and apical sealing with Nd : YAG laser ( at 10 Hz , 150 mJ , 1.5 W , in 60 sec pulses ) as adjuncts to apicoectomy . METHODS Perpendicular root end resection was performed with diamond-coated burs on 40 canine teeth previously subjected to endodontic treatment . Teeth were r and omly allocated into four groups : group A , apicoectomy alone ; group B , apicoectomy+Nd : YAG laser ; group C , apicoectomy+MTA retrofilling ; group D , apicoectomy+MTA retrofilling+Nd : YAG laser . Specimens were embedded in epoxy resin and sliced lengthwise and crosswise . RESULTS Scanning electron microscopy ( SEM ) analysis showed more homogeneous and canaliculi-free apical surfaces in groups B and D ( p<0.01 ) . Marginal gaps between the dentin surface and filling material were observed in decreasing order of gap size in groups B , A , D , and C ( p<0.01 ) for cross-sectional analysis . Energy-dispersive X-ray spectrometry ( EDS ) revealed greater phosphorus ( p<0.01 ) and lower calcium ( p<0.01 ) ion content in the Nd : YAG-irradiated groups . CONCLUSIONS In this study , Nd : YAG laser irradiation had a positive effect on dentin surface sealing , despite an untoward dimensional effect when associated with MTA retrofilling This study compared the push-out bond strength of mineral trioxide aggregate ( MTA ) and a new endodontic cement ( NEC ) as root-end filling material s in root-end cavities prepared by ultrasonic technique ( US ) or Er , Cr : YSGG laser ( L ) .  Eighty single-rooted extracted human teeth were endodontically treated , apicectomised and r and omly divided into four following groups ( n = 20 ) : US/MTA , US/NEC , L/MTA and L/NEC . In US/MTA and US/NEC groups , root-end cavities were prepared with ultrasonic retrotip and filled with MTA and NEC , respectively . In L/MTA and L/NEC groups , root-end cavities were prepared using Er , Cr : YSGG laser and filled with MTA and NEC , respectively . Each root was cut apically to create a 2 mm-thick root slice for measurement of bond strength using a universal testing machine . Then , all slices were examined to determine the mode of bond failure . Data were analysed using two-way anova . Root-end filling material s showed significantly higher bond strength in root-end cavities prepared using ultrasonic technique ( US/MTA and US/NEC ) ( P < 0.001 ) . The bond strengths of MTA and NEC did not differ significantly . The failure modes were mainly adhesive for MTA , but cohesive for NEC . In conclusion , bond strengths of MTA and NEC to root-end cavities were comparable and higher in ultrasonically prepared cavities INTRODUCTION The aim of this study was to evaluate the effect of smear layer removal on the push-out bond strength between radicular dentin and three calcium silicate cements ( CSC ) in comparison with gutta percha and sealer . METHODS Eighty human anterior extracted teeth were decoronated , cleaned and shaped to size 50/0.05 apically and r and omly divided into 2 major groups : ( A ) smear layer preserved , and ( B ) smear layer removed using irrigation with 17 % EDTA . Roots within each major group were further divided into 4 subgroups according to the obturation material used : ( 1 ) ProRoot MTA , ( 2 ) Biodentine , ( 3 ) Harvard MTA , ( 4 ) Gutta percha and AH-plus sealer . Obturated roots were stored in synthetic tissue fluid for 7 days to allow maximum setting of the root filling material s. Three 2-mm-thick slices were obtained from each root at different section levels ( coronal , middle , apical ) . The canal diameters and slice thickness were measured , and the adhesion surface area for each slice was calculated . Push-out bond strength test was carried out using a universal testing machine . The bond failure mode was assessed under an optical microscope at 40 × . RESULTS The mean push-out bond strength in groups 1A , 2A and 3A were 7.54 ( ±1.11 ) , 7.64 ( ±1.08 ) and 8.79 (±1.55)MPa respectively , while those for groups 1B , 2B and 3B were 6.58 ( ±1.13 ) , 6.47 ( ±1.08 ) , 7.71 (±1.81)MPa , respectively . In the gutta percha and sealer groups the push-out bond strength means were : 1.98 ( ±0.48 ) and 2.09 (±0.51)MPa in the preserved and removed smear layer groups respectively . The push-out strength values were significantly reduced when the smear layer was removed in the CSC groups ( P<0.05 ) while no significant difference was detected in the gutta percha and sealer groups . CONCLUSIONS Based on the conditions of this ex vivo study , it can be concluded that smear layer removal is detrimental to the bond strength between calcium silicate cements and dentin
target: On the basis of available evidence , MTA presented good marginal adaptation to dentine walls .
background: This systematic review analysed the literature comparing marginal adaptation of mineral trioxide aggregate ( MTA ) with other filling material s in root-end cavities .