• Journal of Dental Rehabilitation and Applied Science
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• v.39 no.1
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• pp.45-51
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• 2023

Apical sealing with proper retrograde filling material and technique is the key factor for successful apical surgery. In order to provide impeccable apical sealing and healing, various mechanical and chemical characteristics of retrograde filling material is required. MTA has been used as the gold standard of retrograde filling due to its unprecedented advantages. As MTA has long setting time and difficult handling properties, premixed putty type bioceramic material has been newly developed. For efficient retrofilling with premixed putty type biocreamic material, 'Lid technique' was also proposed. The following cases present apical surgery using newly developed premixed putty type bioceramic material with Lid technique.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.32 no.3
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• pp.236-241
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• 2010

Purpose: The purpose of this retrospective clinical study was to monitor the outcomes of periapical surgery in periapically infected tooth with or without retrograde filling materials (MTA or IRM). Patients and Methods: A total of 85 teeth in 63 patients were included in the study between November 2004 and August 2008. Randomly, MTA or IRM was used as a retrograde filling material or only apical resection without retrograde filling. Teeth with advanced periodontal bone loss or presence of root fracture were excluded from the study. The patients were subjected to a minimum follow-up period of 12 months, with a mean of 17.1 months. Results: Successful healing was observed in 83.3% of the MTA-treated teeth, 80% of the IRM-treated teeth and 75% of the teeth which was not retrograde filling. Doubtful healing was seen 9.3% (MTA), 13.3% (IRM), 12.5% (no retro-filling). The success rate of upper incisors (92%) was higher than lower lincisor and molars (66.7% and 50%, respectively). Conclusion: In this study, periapical surgery including retrograde filling improves the prognosis. And, no statistically significant differences were found between retrograde filling materials (MTA or IRM).

• Restorative Dentistry and Endodontics
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• v.26 no.5
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• pp.379-386
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• 2001

This study was performed to evaluate the sealing ability of various retrograde filling materials by using bacterial penetration and dye penetration test. One hundred and forty extracted human teeth with single, straight canals and mature apiece were collected and used for this study. All canals were instrumented using an engine driven Ni-Ti file (ProFile). After removing 3mm from the apex of tooth, a standardized 3mm root end cavity was prepared using an ultrasonic instrument. The 70 teeth were randomly divided into 7 groups : 6 groups for retrograde filling using Super-EBA, ZOE, Chelon-Silver, IRM, ZPC and amalgam. The 7th group was used as a negative control. Nail varnish was applied to all external root surfaces to the level of the reseated root ends to prevent lateral microleakages. The specimens were then sterilized in an ethylene oxide sterilizer for 24 hours. 2 mm of the reseated root was immersed in a culture chamber containing a Tripticase Soy Broth with a phenol red indicator. The coronal access of each specimen was inoculated every 72 hours with suspension of Proteus vulgaris. The culture media were observed every 24hours for color change indicating bacterial contamination. The specimens were observed for 4weeks. The remaining 70 teeth were submitted to a dye penetration test. The canals of all teeth were first sealed with AH26 and obturated using an Obtura II system. Root resection, root end preparation and retrograde filling was performed as above. All specimens were suspended in 2% methylene blue dye for 72 hours before being ion gitudinally split. The degree of dye penetration was then measured using a stereomicroscope at 10 magnification and evaluated. The results were as floows : 1. In the bacterial penetration, the degree of leakage was the lowest in the Super-EBA, followed by, in ascending order, ZOE, Chelon-Silver IRM and ZPC. The amalgam showed highest bacterial leakage of all(p<0.01). 2. In the dye penetration, the degree of microleakage was the lowest in the Chelon-Silver and Super-EBA, followed by, in ascending order, IRM, ZPC. The ZOE and amalgam showed the highest microleakage of all (p<0.05). These results suggested that the eugenol based cement, Super-EBA, have excellent sealing ability as a retrograde filling material.

• Restorative Dentistry and Endodontics
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• v.11 no.1
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• pp.53-61
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• 1985

This study was conducted to evaluate and compare the apical leakage in the following retrograde techniques; apicoectomys, retrograde filling with zinc oxide eugenol cement, non-zinc and zinc amalgam, and cold-burnished gutta-percha method. One hundred twenty five upper anterior and lower premolar teeth were divided into five above mentioned groups and each tooth was individually prepared for its particular group. The specimens were incubated at $37^{\circ}C$ for 14 days and then were infiltrated by 2% methylene blue for 24 hours. The apical leakage was evaluated by measuring the degree of dye penetration between the filling material and the canal wall. The results were as follows: 1. The cold-burnished gutta-percha group showed the least amount of apical leakage and the apicoectomy group showed the greastest amount of apical leakage. 2. Statistics showed that there were significant differences among the groups (P<0.05), however there was no difference between the zinc oxide eugenol cement retrograde filling group and the non-zinc amalgam retrograde filling group (P>0.05).

• Restorative Dentistry and Endodontics
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• v.14 no.1
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• pp.97-105
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• 1989

This study was conducted to evaluate and compare the apical leakage among the retrograde filling materials; retrograde filling with non-zinc amalgam, cavity varnish and non-zinc amalgam, z.o.e cement, Glass Ionomer cement, scotch bond and silux. Sixty single rooted teeth were divided into six groups and each tooth was individually prepared for its particular group. The specimens were incubated at $37^{\circ}C$ for 24 hrs and then were infiltrated by 2% methylene blue for 7 days. Apical leakage was evaluated by measuring the degree of dye penetration between the filling material and the canal wall. The results were as follows: 1. The scotch bond and silux group showed the least amount of apical leakage and the control group showed the greatest amount of apical leakage. 2. The groups retrofilled with cavity varnish and amalgam, glass-Ionomer cement, scotch bond and silux showed significantly good apical seal than control group. 3. The groups retrofilled with glass Ionomer cement, scotchbond and silux showed significantly good apical seal than the groups retrofilled with Amalgam and Zinc oxide eugenol cement.

• Restorative Dentistry and Endodontics
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• v.19 no.2
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• pp.409-428
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• 1994

Endodontic surgery is performed when conventional endodontic therapy fails or is contraindicated. In such cases, retrograde filling materials including amalgam, composite resin, and various cements have been used. Biocompatibilty and margin sealing ability of retrograde filling materials are important for the long term success of endodontic surgery. In vitro cell culture is frequently used as the method of measuring the biocompatibilty of dental materials. The purpose of this study was to evaluate the cytotoxicity of six kinds of retrograde filling materials including newly developed light curing glass ionomer cements. Each material was mixed according to. the manufacture's instruction and evaluated as : freshly mixed, 24-hour after mixing, and 168-hour after mixing respectively. The elution solution was extracted after 24-hour contact with materials using media. Cytotoxicity was evaluated by direct contact, or elution contact. Test results of radiochromium($^{51}Cr$) release, cell viability using tetrazolium dye (3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyl dimethyltetrazolium bromide(MTT) test and lactate dehydrogenase(LD) of damaged L929 cells were analyzed. In the $^{51}Cr$ release of direct contact, all experimental retrograde filling materials except amalgam and glass ionomer cement showed increased cytotoxicity compared to control. In the $^{51}Cr$ release of elution solution, the released $^{51}Cr$ was so minimal that it was impossible. to evlauate the cytotoxicity exactly. The elution solutions of glass ionomer cement and IRM showed marked cytotoxicity in MTT test. LD enzyme activity was highest in tests of direct contact with composite, light curing composite, and light curing glass ionomer cement and IRM. Amalgam revealed least cytotoxicity while IRM showed cytotoxicity using all three methods. Composite, light curing composite and light curing glass iomomer cement were cytotoxic in the tests of $^{51}Cr$ release and LD activity. Glass ionomer cement showed cytotoxic effect only in the MTT method. From these results it is suggested that the standardization and optimization of cytotoxicity testing, especially using elution solutions, should be strongly advised.

• Journal of Korean Dental Science
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• v.5 no.2
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• pp.60-67
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• 2012

Purpose: To test the apical leakage prevention performance of three different materials through protein leakage procedures using bovine serum albumin (BSA) and Bradford protein reagent. Materials and Methods: A total of 60 human single-rooted teeth were divided into 4 groups, and conventional root canal filling was done. The root was cut 3 mm from the apex, and a cavity was formed. Proroot MTA (MTA), Fuji II LC (GI), Fuji II LC with XP bond (GIA), and Caviton (CA) were used as experimental materials to fill the cavity in a retrograde filling manner. The extent of BSA leakage was then measured with a ultraviolet visible spectrophotometer 24, 48, and 72 hours after filling. Result: After 24 hours, among the 15 teeth of each group, 2 in MTA, 4 in GI, 3 in GIA, and 7 in CA showed leakage. After 48 hours, 3 in MTA, 5 in GI, 5 in GIA, and 10 in CA had leakage and discoloration. After 72 hours, among the 15 teeth of each group, 3 in MTA, 6 in GI, 5 in GIA, and 10 in CA showed leakage. The leakage in the CA group was greater than that in the MTA group at 48 and 72 hours based on Fisher's exact test (P=0.025), and the difference was statistically significant. Similarly, the leakage in the CA group was greater than that in the MTA group over time based on the Kaplan-Meier survival estimate (P=0.011), and the difference was statistically significant. Conclusion: Glass ionomer, glass ionomer after adhesive application, and MTA all showed leakage. Caviton showed greater leakage compared to MTA 48 and 72 hours after filling, and the difference was statistically significant; thus suggesting that Caviton is not appropriate as retrograde filling material considering its sealing ability.

• Restorative Dentistry and Endodontics
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• v.19 no.2
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• pp.499-512
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• 1994

The purpose of this study was to evaluate the microleakage electrochemically using different retrograde filling materials, different root resection angle, and different cavity preparation instruments. 104 extracted single-rooted teeth were selected for this study. 100 teeth were used as experimental groups and four was used as controls. Anatomical crowns were resected, root canals were prepared, and the apical 2 mm of roots were removed. The experimental roots were randomly divided into five equal groups. Experimental groups : Group 1. no bevel, cavity preparation with ultrasonic instruments, amalgam filling Group 2. no bevel, cavity preparation with ultrasonic instruments, SuperEBA cement filling Group 3. no bevel, cavity preparation with ultrasonic instruments, desiccated ZOE filling Group 4. $45^{\circ}$ bevel, cavity preparation with ultrasonic instruments, amalgam filling Group 5. no bevel, cavity preparation with conventional bur, amalgam filling Microleakage was measured once a day for 30 days using electrochemical method and were analyzed statistically. The results were as follows : 1. The group with Super EBA cement filling showed the least marginal leakage from second to fourth day(p<0.05), there was no significant difference between the group with amalgam filling during eighth to eighteenth day(p>0.05), but after the nineteenth day here was a higher marginal leakage than the group with amalgam filling(p<0.05). 2. The group with desiccated ZOE filling demostrated that the highest marginal leakage, started on the eighth day(p<0.05). 3. The group using ultrasonic instrument showed lower marginal leakage than the group using bur until the nineteenth day(p<0.05), but there was no significant differnce with the group using bur after twentythird day(p>0.05). 4. The group without bevel showed lower marginal leakage than the group with bevel (p<0.05). 5. Whether bevel or nor had much more effect on marginal leakage than with cavity perparation instrument when the cavity was retrogrdefilled with amalgam(stepwise regression).

• The Journal of the Korean dental association
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• v.54 no.11
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• pp.865-873
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• 2016

Background/Purpose: The purpose of this study was to evaluate the effect of Nd:YAG irradiation on adherence of retrograde filling materials (mineral trioxide aggregate [MTA] and Super-EBA) by micro-computed tomography (CT) measurement and to observe the dentinal surface after irradiation by scanning electron microscopy (SEM). Materials and methods: Forty retrofilling models using extracted human teeth were divided into four groups according to the material and method used: ProRoot MTA (MTA group), Super-EBA (EBA group), MTA with Nd:YAG laser irradiation (LMTA group), and Super-EBA with Nd:YAG laser irradiation (LEBA group). All specimens were stored in 100% humidity for 24 hours until micro-CT was performed. The gap volume of the tooth/material interface was measured using the CTAn program. In six samples, the laser-irradiated dentin surface was observed using SEM. Results: The mean percent difference in gap volume was not statistically significant between the Nd:YAG laser-irradiated groups and non-irradiated in both materials(P > 0.05). The gap volume in the MTA group was significantly lower than that in the EBA group (P < 0.05). Examination of the non-irradiated specimens by SEM showed patent dentinal tubules. In contrast, alterations in the texture of the dentin surface and obliteration of the dentinal tubules were evident in the Nd:YAG laser-irradiated specimens. Conclusion: In this study, changes in the dentinal surface after Nd:YAG irradiation did not affect adherence between the apical filling material and the dentin wall.

• Restorative Dentistry and Endodontics
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• v.45 no.2
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• pp.11.1-11.9
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• 2020

Objectives: This study compared the flow and filling of several retrograde filling materials using new different test models. Materials and Methods: Glass plates were manufactured with a central cavity and 4 grooves in the horizontal and vertical directions. Grooves with the dimensions used in the previous study (1 × 1 × 2 mm; length, width, and height respectively) were compared with grooves measuring 1 × 1 × 1 and 1 × 2 × 1 mm. Biodentine, intermediate restorative material (IRM), and mineral trioxide aggregate (MTA) were evaluated. Each material was placed in the central cavity, and then another glass plate and a metal weight were placed over the cement. The glass plate/material set was scanned using micro-computed tomography. Flow was calculated by linear measurements in the grooves. Central filling was calculated in the central cavity (㎣) and lateral filling was measured up to 2 mm from the central cavity. Results: Biodentine presented the least flow and better filling than IRM when evaluated in the 1 × 1 × 2 model. In a comparison of the test models, MTA had the most flow in the 1 × 1 × 2 model. All materials had lower lateral filling when the 1 × 1 × 2 model was used. Conclusions: Flow and filling were affected by the size of the test models. Higher grooves and materials with greater flow resulted in lower filling capacity. The test model measuring 1 × 1 × 2 mm showed a better ability to differentiate among the materials.