• 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.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.

• Restorative Dentistry and Endodontics
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• v.15 no.1
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• pp.97-105
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• 1990

When conventional root canal treatment is failed or contraindicated, retrograde root canal filling following apicoectomy is a valuable procedure, aimed at hermetically sealing the root canal against leakage of irritants from the canal into the periapical tissue. In this in vitro investigation, to analyze apical microleakage electrochemically in teeth with different retrograde filling materials and preparation types, single - rooted tooth was cut 2mm from the apex and each Class I and Slot preparation was prepared. Experimental groups : Group 1. Amalgam filling with cavity varnish in Class I preparation Group 2. Scotchbond 2+Silux filling in Class I preparation Group 3. Gutta percha filling with ZOE cement in Class I preparation Group 4. Amalgam filling with cavity varnish in Slot preparation Group 5. Scotchbond 2+Silux filling in Slot preparation Each specimens was immersed in 1% solution of KCl, and applied a potential of 9V external power supply. Measurements of the current flow were obtained at 1, 2, 3, 7, 9, 12, 14, 18, 21, 25 and 28 day after immerson. Marginal microleakage were compared and evaluated. The results were as follows ; 1. The group filled with composite resin with dentin bonding agent shows lower apical microleakage value than the group filled with amalgam following varnish application (P<0.01). 2. In the group filled with gutta percha, apical microleakage value was the hightest 3. There was no significant difference between Class I cavity and Slot type cavity regardless of the used materials.

• 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.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.25 no.1
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• pp.63-70
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• 2000

The properties of ideal retrograde filling materials include the ability to seal the root canal system in three dimensions and well tolerated by periradicular tissues. Biocompatibility testing has been done mainly with cytotoxicity tests using cell culture. Little attention has been paid to the potential adverse influence on the inflammatory and immune reaction in the periapical tissue. The purpose of this study was to investigate the effects of retrograde filling materials on human mononuclear cells in vitro. Freshly mixed and set specimens from six materials (Z100, Tetric Ceram, Fuji II, Fuji II LC, F2000, Compoglass Flow, and ZOE) were eluated with cell culture medium for 24 hours. Cytotoxic effects of these extracts were evaluated by determining cell viability and enzyme activity using MTT and lactate dehydrogenase (LD). The production of inflammatoy bone resorptive cytokine, TNF-${\alpha}$ was measured from human peripheral blood mononuclear cells (PBMC) exposed to the extracts by means of Endogen Human TNF-${\alpha}$ ELISA kit (Wobrun, MA, U.S.A.). Eluates and diluted (1 : 10) eluates with cell culture medium from freshly mixed Fuji IT had cytotoxic effects on mononuclear cells using MTT and LD. However, eluates from set Fuji II were not cytotoxic. Eluates form set ZOE exhibited cytotoxicity with LD test. TNF-${\alpha}$ levels were high in eluates from freshly mixed Fuji II and Z100. Diluted eluates from freshly mixed Z100 and F2000 stimulated the production of TNF-${\alpha}$. However, there were no significant difference in TNF-${\alpha}$ levels compared to controls. These results indicate that some materials could possibly stimulate bone resorption in the periapical tissue by means of the production of bone resorptive cytokine.

• 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).

• 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.43 no.2
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• pp.23.1-23.9
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• 2018

Objectives: This study evaluated the effect of ultrasonic agitation of mineral trioxide aggregate (MTA), calcium silicate-based cement (CSC), and Sealer 26 (S26) on adaptation at the cement/dentin interface and push-out bond strength. Materials and Methods: Sixty maxillary canines were divided into 6 groups (n = 10): MTA, S26, and CSC, with or without ultrasonic activation (US). After obturation, the apical portions of the teeth were sectioned, and retrograde cavities were prepared and filled with cement by hand condensation. In the US groups, the cement was activated for 60 seconds: 30 seconds in the mesio-distal direction and 30 seconds in the buccal-lingual direction, using a mini Irrisonic insert coupled with the ultrasound transducer. After the materials set, 1.5-mm thick sections were obtained from the apexes. The presence of gaps and the bond between cement and dentin were analyzed using low-vacuum scanning electron microscopy. Push-out bond strength was measured using a universal testing machine. Results: Ultrasonic agitation increased the interfacial adaptation of the cements. The S26 US group showed a higher adaptation value than MTA (p < 0.05). US improved the push-out bond strength for all the cements (p < 0.05). Conclusions: The US of retrograde filling cements enhanced the bond to the dentin wall of the root-end filling materials tested.

• Restorative Dentistry and Endodontics
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• v.33 no.2
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• pp.107-114
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• 2008

This study was performed to assess the radiopacity of a variety of canal filling and retrograde root-end filling materials according to the specification concerning root canal obturation materials. Ten materials including Gutta-percha pellets, amalgam, Fuji II LC, $Dyract^{(R)}$ AP, Super $EBA^{(R)}$, $IRM^{(R)}$, AH $26^{(R)}$, $Sealapex^{TM}$, Tubli-$Seal^{TM}$, and dentin were evaluated in this study. In the first part, densitometric reading of an each step of aluminum step wedge on occlusal film were performed at 60 kVp (0.2, 0.3, 0.4 s), 70 kVp (0.2, 0.3, 0.33 s) to decide appropriate voltage and exposure time. In the second part, ten specimens which are 5 mm in diameter and 0.5, 1.0, 1.5, 2.0, 2.5, 3.0 mm in thickness, were fabricated from each material studied. The specimens were radiographed simultaneously with an aluminum step wedge under decided condition (60 kVp, 0.2 s). The mean radiographic density values of the materials were transformed into radiopacity expressed equivalent thickness of aluminum (mm Al). The following results were obtained. 1. Among the various conditions including 0.2 s, 0.3 s, 0.4 s at 60 kVp and 0.2 s, 0.3 s, 0.33 s at 70 kVp, the appropriate voltage and exposure time that meet the requirement of density from 0.5 to 2.0 was 0.2 s at 60 kVp. 2. All of the materials in this study had greater radiopacity than the minimun level recommended by ISO No. 4049 standards. 3. Most of the materials had greater radiopacity than 3 mm Al requirement of ANSI/ADA specification No. 57 (2000) and ISO No. 6876 (2001) standards except for Fuji II LC and Dyract. It suggests that all experimental canal filling and retrograde root-end filling materials have a sufficient radiopacity that meet the requirement concerning root canal obturation materials except for Fuji II LC and Dyract.