Clinical results with two different methods of root-end preparation and filling in apical surgery: mineral trioxide aggregate and adhesive resin composite.
BACKGROUND
The aim of apical surgery is to hermetically seal the root canal system after root-end resection, thereby enabling periradicular healing. The objective of this nonrandomized prospective clinical study was to report results of 2 different root-end preparation and filling methods, ie, mineral trioxide aggregate (MTA) and an adhesive resin composite (Retroplast).


METHODS
The study included 353 consecutive cases with endodontic lesions limited to the periapical area. Root-end cavities were prepared with sonic microtips and filled with MTA (n = 178), or alternatively, a shallow concavity was prepared in the cut root face, with subsequent placement of an adhesive resin composite (Retroplast) (n = 175). Patients were recalled after 1 year. Cases were defined as healed when no clinical signs or symptoms were present and radiographs demonstrated complete or incomplete (scar tissue) healing of previous radiolucencies.


RESULTS
The overall rate of healed cases was 85.5%. MTA-treated teeth demonstrated a significantly (P = .003) higher rate of healed cases (91.3%) compared with Retroplast-treated teeth (79.5%). Within the MTA group, 89.5%-100% of cases were classified as healed, depending on the type of treated tooth. In contrast, more variable rates ranging from 66.7%-100% were found in the Retroplast group. In particular, mandibular premolars and molars demonstrated considerably lower rates of healed cases when treated with Retroplast.


CONCLUSIONS
MTA can be recommended for root-end filling in apical surgery, irrespective of the type of treated tooth. Retroplast should be used with caution for root-end sealing in apical surgery of mandibular premolars and molars.
von Arx
Thomas
T
Department of Oral Surgery and Stomatology, School of Dental Medicine, University of Bern, Bern, Switzerland. thomas.vonarx@zmk.unibe.ch
Hänni
Stefan
S
Jensen
Simon Storgård
SS
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D017607:Aluminum Compounds / Q000627:therapeutic use*; D001047:Apicoectomy / Q000379:methods*; D001641:Bicuspid / Q000473:pathology / Q000601:surgery; D017438:Bisphenol A-Glycidyl Methacrylate / Q000627:therapeutic use; D017610:Calcium Compounds / Q000627:therapeutic use*; D002648:Child; D003481:Cuspid / Q000473:pathology / Q000601:surgery; D004338:Drug Combinations; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007180:Incisor / Q000473:pathology / Q000601:surgery; D008297:Male; D008875:Middle Aged; D008963:Molar / Q000473:pathology / Q000601:surgery; D010087:Oxides / Q000627:therapeutic use*; D011446:Prospective Studies; D019279:Resin Cements / Q000627:therapeutic use*; D019233:Retreatment; D012184:Retrograde Obturation / Q000295:instrumentation / Q000379:methods*; D012387:Root Canal Filling Materials / Q000627:therapeutic use*; D017640:Silicates / Q000627:therapeutic use*; D016896:Treatment Outcome; D014945:Wound Healing / Q000502:physiology; D055815:Young Adult
D017607:Aluminum Compounds; D017610:Calcium Compounds; D004338:Drug Combinations; D010087:Oxides; D019279:Resin Cements; D012387:Root Canal Filling Materials; D017640:Silicates; C086631:mineral trioxide aggregate; D017438:Bisphenol A-Glycidyl Methacrylate