title: A retrospective radiographic study of root-end surgery with amalgam and intermediate restorative material.
abstract: OBJECTIVE
  We sought to compare amalgam with intermediate restorative material in terms of their effectiveness as root-end filling materials during root-end surgeries.
  
  
  METHODS
  A root-end operation was performed on 228 patients with 262 endodontically treated teeth with periapical lesions. Of these teeth, 122 from 101 patients were available for follow-up. Radiographs were taken immediately postoperatively and again at a mean of 11.25 months (range, 6-45 months) postoperatively. The radiographs were digitized, and the diameter of the periapical lesion was measured by means of a computerized system. The mesiodistal distance at the cementoenamel junction served as an internal standard. Radiographic findings were classified into 1 of 3 groups: complete healing, incomplete healing, or unsatisfactory (no) healing.
  
  
  RESULTS
  Complete healing was observed in 44.3% of the teeth, incomplete healing in 21.3%, and unsatisfactory healing in 34.4%. No statistical significance was found for amalgam versus intermediate restorative material, but teeth that underwent additional operations had a significantly worse success rate than those that underwent only first-time operations. No correlation was found between the subjective prognosis by the surgeons and the long-term outcome.
  
  
  CONCLUSIONS
  As root-end filling materials, amalgam and intermediate restorative material had the same clinical effectiveness. The classic root-end operation is unpredictable. Reoperations should be reconsidered and avoided if possible.
authors.affiliation: Department of Oral and Maxillofacial Surgery, The Maurice and Gabriela Goldschleger School of Dental Medicine, Tel-Aviv University, Israel. dubish@post.tau.ac.il
authors.forename: Devorah
authors.initials: D
authors.lastname: Schwartz-Arad
authors.forename: Noam
authors.initials: N
authors.lastname: Yarom
authors.forename: Joseph P
authors.initials: JP
authors.lastname: Lustig
authors.forename: Israel
authors.initials: I
authors.lastname: Kaffe
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001861:Bone Regeneration; D016009:Chi-Square Distribution; D003723:Dental Amalgam; D019232:Dental Restoration Failure; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D008768:Methylmethacrylates; D008875:Middle Aged; D010486:Periapical Tissue / Q000000981:diagnostic imaging* / Q000473:pathology; D019252:Radiography, Dental, Digital; D012086:Reoperation; D012184:Retrograde Obturation / Q000009:adverse effects / Q000379:methods; D012189:Retrospective Studies; D012387:Root Canal Filling Materials; D014945:Wound Healing; D015035:Zinc Oxide-Eugenol Cement
chemical_list: D008768:Methylmethacrylates; D012387:Root Canal Filling Materials; D015035:Zinc Oxide-Eugenol Cement; C031667:IRM cement; D003723:Dental Amalgam