• Restorative Dentistry and Endodontics
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• v.38 no.3
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• pp.119-127
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• 2013

The purpose of a root-end filling is to establish a seal between the root canal space and the periradicular tissues. As root-end filling materials come into contact with periradicular tissues, knowledge of the tissue response is crucial. Almost every available dental restorative material has been suggested as the root-end material of choice at a certain point in the past. This literature review on root-end filling materials will evaluate and comparatively analyse the biocompatibility and tissue response to these products, with primary focus on newly introduced materials.

• Restorative Dentistry and Endodontics
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• v.43 no.3
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• pp.24.1-24.12
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• 2018

Objectives: The aim of this in vitro study was to evaluate the biocompatibility of newly proposed root-end filling materials, Biodentine, Micro-Mega mineral trioxide aggregate (MM-MTA), polymethylmethacrylate (PMMA) bone cement, and Smart Dentin Replacement (SDR), in comparison with contemporary root-end filling materials, intermediate restorative material (IRM), Dyract compomer, ProRoot MTA (PMTA), and Vitrebond, using human periodontal ligament (hPDL) fibroblasts. Materials and Methods: Ten discs from each material were fabricated in sterile Teflon molds and 24-hour eluates were obtained from each root-end filling material in cell culture media after 1- or 3-day setting. hPDL fibroblasts were plated at a density of $5{\times}10^3/well$, and were incubated for 24 hours with 1:1, 1:2, 1:4, and 1:8 dilutions of eluates. Cell viability was evaluated by XTT assay. Data was statistically analysed. Apoptotic/necrotic activity of PDL cells exposed to material eluates was established by flow cytometry. Results: The Vitrebond and IRM were significantly more cytotoxic than the other root-end filling materials (p < 0.05). Those cells exposed to the Biodentine and Dyract compomer eluates showed the highest survival rates (p < 0.05), while the PMTA, MM-MTA, SDR, and PMMA groups exhibited similar cell viabilities. Three-day samples were more cytotoxic than 1-day samples (p < 0.05). Eluates from the cements at 1:1 dilution were significantly more cytotoxic (p < 0.05). Vitrebond induced cell necrosis as indicated by flow cytometry. Conclusions: This in vitro study demonstrated that Biodentine and Compomer were more biocompatible than the other root-end filling materials. Vitrebond eluate caused necrotic cell death.

• The Journal of the Korean dental association
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• v.55 no.8
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• pp.556-564
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• 2017

Endodontic surgery is a procedure to treat apical periodontitis or abscess in cases that did not heal after nonsurgical treatment or retreatment. This might include situations with persistent intracanal infection after root canal treatment. Other reasons might be found in extraradicular infection, such as bacterial biofilm on the apical root surface or bacteria within the lesion. For many years, the treatment standard was the traditional approach with surgical burs and amalgam for root-end filling. Endodontic microsurgery is the most recent step in the evolution of endodontic surgery, applying not only ultrasonic tip and biocompatible filling materials but also incorporating high-power magnification and illumination. Although many studies have been published that advocate the use of modern technique, the traditional techniques are still widely used in the surgery community. The purpose of this study was to demonstrate the endodontic microsurgery procedure including the root-end preparation and filling with the use of a surgical operating microscope.

• Restorative Dentistry and Endodontics
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• v.24 no.1
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• pp.76-87
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• 1999

The effect of retrograde root-end filling materials(IRM, Super-EBA, Vitremer, MTA) on human periodontal ligament fibroblasts and osteoblasts was observed. The cell activities were evaluated by MTT assay, protein assay and alkaline phosphatase activity examination. The results as follows ; 1. After 24hrs culture, both E1 cells & PDL fibroblast adding root-end filling materials were suppressed cell activities but after 48hrs, cell activities were recovered. 2. Cell activity was lowest in Vitremer followed by IRM, MTA, Super-EBA. 3. Cell activity depression by Vitremer was not concerned with pH changes. 4. Protein synthesis by root-end filling materials were not significant difference in Both E1 cell & PDL fibroblasts but protein synthesis were a little increased by Super-EBA. 5. Alkaline phosphatase activity was increased in E1 cell by Super-EBA & MTA but was not significant differences in E1 cell by IRM & Vitremer. Alkaline phosphatase activity was a little depressed in PDL fibroblast by Vitremer. This findings suggest that these root-end filling materials may have important roles in promotion of PDL healing and consequently may be useful for clinical application in apical surgery.

• Restorative Dentistry and Endodontics
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• v.28 no.6
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• pp.449-456
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• 2003

The purpose of this study is to evaluate the sealing effect of several root-end filling materials using spectrophotometric analysis. 180 single root teeth with one canal were instrumented and canal filled. Root resected and root end preparation was made. Teeth were randomly classified to S experimental group(MTA, EBA, IRM, TCP, ZOE) and 1 control group according to root-end filling material MTA group used PRO ROOT MT A, EBA group used Super EBA. TCP group used NEW APATITE LINER TYPE II main component of which is ${\alpha}-tricalcium$ phosphate (TCP). According to manufacture's instruction experimental material was mixed and retrfilled. After 2% methylene blue solution penetration absorbance for each test sample was measured with spectrophotometer (JASCO UV-530, Japan). The mean absorbance of control and experimental group was as follows; MTA: 0.092, IRM: 0.226, Super EBA: 0.255, ZOE: 0.374, Control: 0.425, TCP: 0.501 and the result analyzed by Turkey test at P=0.05 level. Conclusions of this study are as follows; 1. The absorbance increase in following sequence MTA, IRM, Super EBA, ZOE, Control. TCP. 2. MTA showed the least leakage but was not significant with IRM or Super EBA and was significant with control or TCP(p<0.05). 3. TCP had the most leakage and was not significant with control group.

• Restorative Dentistry and Endodontics
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• v.20 no.1
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• pp.17-32
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• 1995

The purpose of this study was to examine the response of periradicular tissues to amalgam, IRM, Ketac-silver and MTA(Mineral trioxide aggregate) used as a root end fillings. The lower third and fourth premolars of 5 mongrel dogs were used. Each root was resected, followed by root end fillings with experimental materials. The animals were sacrificed after 16 weeks and radiographic and histologic results were evaluated. The results were as follows : 1. Severe inflammation around apex and disruption of cortical were noted in relation to the amalgam. 2. With IRM, there was severe infiltration of inflammatory cells around filling material, but healing of cortical bone was noted. 3. With Ketac-silver, mild inflammation and thick band of fibrous connetive tissue around filling material were seen, with a cortical bone healing. 4. In case of MTA, complete regeneration of cortical bone was seen, and free MTA was surrounded with newly formed bone tissue.

• Journal of Dental Rehabilitation and Applied Science
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• v.23 no.1
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• pp.85-93
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• 2007

The purpose of this study was to evaluate the microleakage of root-end filling material filled in blood contaminated root-end cavity and self-etching adhesive placed over blood contaminated resected root apices without root-end preparation. Extracted, human maxillary incisors, canines and mandibular premolar were randomly divided into four groups of 15 teeth each. After canal preparation, resection of the apex and root-end preparation, MTA and IRM were filled in the root-end cavity (A and B group). After canal preparation and resection of the apex, Clearfil SE Bond and Prompt L-Pop were applied over the contaminated root-end surfaces (C and D group). The roots were then subjected to 15cm of water pressure to simulate periapical microleakage stress. Data were analyzed using one-way ANOVA. The results were as follows : 1. All groups showed a tendency of decreasing microleakage in process of time after 2weeks later except IRM group. 2. After 2 weeks and 1 month, MTA group showed less microleakage significantly than other groups(p<0.05). After 2 months, Prompt L-Pop group showed less microleakage significantly than other groups(p<0.05). 3. After 9 months, there were no significant differences among four groups(p>0.05). Thus it is considered that apical sealing using adhesives system without root-end preparation is good method in endodontic surgery.

• Restorative Dentistry and Endodontics
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• v.39 no.1
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• pp.39-44
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• 2014

Objectives: The purpose of this study was to evaluate in vitro cytotoxicity of the pozzolan cement and other root-end filling materials using human periodontal ligament cell. Materials and Methods: Endocem (Maruchi), white ProRoot MTA (Dentsply), white Angelus MTA (Angelus), and Super EBA (Bosworth Co.) were tested after set completely in an incubator at $37^{\circ}C$ for 7 days, Endocem was tested in two ways: 1) immediately after mixing (fresh specimens) and 2) after setting completely like other experimental materials. The methods for assessment included light microscopic examination, cell counting and WST-1 assay on human periodontal ligament cell. Results: In the results of microscopic examination and cell counting, Super EBA showed significantly lower viable cell than any other groups (p < 0.05). As the results of WST-1 assay, compared with untreated control group, there was no significant cell viability of the Endocem group. However, the fresh mixed Endocem group had significantly less cell viability. The cells exposed to ProRoot MTA and Angelus MTA showed the highest viability, whereas the cells exposed to Super EBA displayed the lowest viability (p < 0.05). Conclusions: The cytotoxicity of the pozzolan cement (Endocem) was comparable with ProRoot MTA and Angelus MTA. Considering the difficult manipulation and long setting time of ProRoot MTA and Angelus MTA, Endocem can be used as the alternative of retrofilling material.

• Restorative Dentistry and Endodontics
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• v.35 no.3
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• pp.222-228
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• 2010

The purpose of this study was to compare mineral trioxide aggregate (MTA; Dentsply, Tulsa Dental, Tulsa, OK, USA), which is widely used as root-end filling material, with DiaRoot BioAggregate (DB; Innovative BioCaramix Inc, Vancouver, BC, Canada), newly developed product, by using MG63 osteoblast-like cells. MTA, DB, and Intermediate Restorative Material (IRM; Dentsply Caulk, Milford, DE, USA) were used for root-end filling material while tissue culture plastic was used for control group. Each material was mixed and, the mixtures were left to set for 24 hours. MG63 cells were seeded to each group and then they were cultured for attachment for 4 hours. Following the attachment of cells to the root-end filling material, early cellular response was observed. After another 12 hours'culture, the level of attachment between cells and material was observed and in order to identify the effect of each material to bone formation, transforming growth factor beta1 ($TGF{\beta}1$) and osteocalin (OC) were estimated by using enzyme-linked immunosorbent assay (ELISA), and the amount of alkaline phosphatase (ALP) was also measured. The data were analyzed using one-way ANOVA. As a result, only at OC and the number of cells which were attached to materials, there was no statistical difference between MTA and DB. At other items, there was statistically significant difference in all groups. Although DB has not shown exactly the same cellular response like that of MTA, the number of attached cells shows that biocompatibility of the material and OC indicates bone formation rate. Therefore, if DB is used for root end filling material, it is expected to lead to similar results to MTA.

• Restorative Dentistry and Endodontics
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• v.27 no.1
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• pp.24-33
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• 2002

Leakage studies have been performed frequently, since a fluid-tight seal provided by various dental fill-ing materials has been considered clinically important. The leakage of the various root-end filling materials has been widely investigated mostly dye penetration method. These dye studies cannot offer any information about the quality of the seal of a test material over a long period of time The purpose of this study was to evaluate the microleakage of root end cavities in blood contamination filed amalgam, intermediate restorative material(IRM), light cured glass ionomer cement(GI) and mineral trioxide aggregate(MTA) by means of a modified fluid transport model. Fifty standard human root sections, each 5mm high and with a central pulp lumen of 3mm in diameter, were and filled with our commonly used or potential root end fill ing materials after they were contaminated with blood. At 24h. 72h, 1, 2, 4, 8, and 12 weeks after filling, leakage along these filling materials was determined under a low pressure of 10KPa(0.1atm) using a fluid transport model. The results were as follows : 1 MTA group showed a tendency of decreasing percent of gross leakage (20m1/day) in process of time, whereas the other materials showed a tendency of increasing in the process time. 2. At the all time interval, GI group leaked significantly less than amalgam group and IRM group (p＜0.05). 3. At the 4 weeks, the percentage of gross leakage in MTA group decreased to 0% thereafter, the low per-centage of gross leakage was maintained in MTA group until the end of the experiment, whereas the percentage in IRM group increased to 100% 4. At the 12 weeks, percentage of gross leakage was significantly low in MTA group(0%), comparison with GI group(40%), amalgam group(90%) and IRM group(100%), but there was no significant difference between latter two materials.