An ex-vivo comparative study of root-end marginal adaptation using grey mineral trioxide aggregate, white mineral trioxide aggregate, and Portland cement under scanning electron microscopy Biodentine versus Mineral Trioxide Aggregate versus Intermediate Restorative Material for Retrograde Root End Filling: An Invitro Study Comparative Scanning Electron Microscopic Study of the Marginal Adaptation of Four Root-End Filling Materials in Presence and Absence of Blood An In Vitro Comparison of Marginal Adaptation of MTA and MTA-Like Materials in the Presence of PBS at One-Week and Two-Month Intervals A prospective clinical study of Mineral Trioxide Aggregate and IRM when used as root-end filling materials in endodontic surgery. Push-out bond strength of two root-end filling materials in root-end cavities prepared by Er,Cr:YSGG laser or ultrasonic technique. Periradicular regeneration after endodontic surgery with calcium-enriched mixture cement in dogs. Influence of the thickness of mineral trioxide aggregate on sealing ability of root-end fillings in vitro. Evaluation of the bond strength of root-end placed mineral trioxide aggregate and Biodentine in the absence/presence of blood contamination Clinical results with two different methods of root-end preparation and filling in apical surgery: mineral trioxide aggregate and adhesive resin composite. Investigation of the marginal adaptation of root-end filling materials in root-end cavities prepared with ultrasonic tips. Comparison of Mineral Trioxide Aggregate and iRoot BP Plus Root Repair Material as Root‐end Filling Materials in Endodontic Microsurgery: A Prospective Randomized Controlled Study Occlusal loading of EBA and MTA root-end fillings in a computer-controlled masticator: a scanning electron microscopic study. Comparison of push-out bond strength of mineral trioxide aggregate and calcium enriched mixture cement as root end filling materials A prospective randomized controlled study of mineral trioxide aggregate and super ethoxy-benzoic acid as root-end filling materials in endodontic microsurgery. Randomized clinical trial of root-end resection followed by root-end filling with mineral trioxide aggregate or smoothing of the orthograde gutta-percha root filling--1-year follow-up. Evaluation of Marginal Adaptation of Root-End Filling Materials Using Scanning Electron Microscopy A Randomized Controlled Study of Mineral Trioxide Aggregate and Super Ethoxybenzoic Acid as Root-end Filling Materials in Endodontic Microsurgery: Long-term Outcomes. A prospective clinical study of periradicular surgery using mineral trioxide aggregate as a root-end filling. Sealing ability of a mineral trioxide aggregate when used as a root end filling material.
Context : Where nonsurgical endodontic intervention is not possible , or it will not solve the problem , surgical endodontic treatment must be considered . A major cause of surgical endodontic failures is an inadequate apical seal , so the use of the suitable substance as root-end filling material that prevents egress of potential contaminants into periapical tissue is very critical . Aims : The aim of the present ex-vivo study was to compare and evaluate the three root-end filling material s of mineral trioxide aggregate ( MTA ) family ( white MTA [ WMTA ] , grey MTA [ GMTA ] and Portl and cement [ PC ] ) for their marginal adaptation at the root-end dentinal wall using scanning electron microscopy ( SEM ) . Material s and Methods : Sixty human single-rooted teeth were decoronated , instrumented , and obturated with Gutta-percha .  After the root-end resection and apical cavity preparation , the teeth were r and omly divided into three-experimental groups ( each containing 20 teeth ) and each group was filled with their respective experimental material s. After longitudinal sectioning of root , SEM examination was done to determine the overall gap between retro grade material s and cavity walls in terms of length and width of the gap ( maximum ) at the interface . Descriptive statistical analysis was performed to calculate the means with corresponding st and ard errors , median and ranges along with an analysis of variance and Tukey 's test . Results : The least overall gap was observed in GMTA followed by PC and WMTA . While after statistically analyzing the various data obtained from different groups , there was no significant difference among these three groups in terms of marginal adaptation . Conclusion : GMTA showed the best overall adaptation to root dentinal wall compared to PC and WMTA . Being biocompatible and cheaper , the PC may be an alternative but not a substitute for MTA Objective The aim of this study was to evaluate the marginal adaptation of Biodentine in comparison with Mineral Trioxide Aggregate ( MTA ) and Intermediate Restorative Material ( IRM ) , as a root end filling material , using Scanning Electron Microscopy ( SEM ) . Material s and Methods : Thirty permanent maxillary central incisors were chemo-mechanically prepared and obturated . Three millimetres of the root end were resected and 3 mm retro cavity preparation was done using ultrasonic retrotips . The sample s were r and omly divided into three groups ( n=10 ) and were restored with root end filling material s : Group I – MTA , Group II – Biodentine , Group III – IRM . The root ends were sectioned transversely at 1 mm and 2 mm levels and evaluated for marginal adaptation using SEM . The gap between dentin and retro filling material was measured at four quadrants . The mean gap at 1 mm level and 2 mm level from the resected root tip and combined mean were calculated . The data were statistically analyzed , using one-way ANOVA and Tukey ’s HSD post hoc test for intergroup analysis and paired t-test for intragroup analysis . Results : The overall results showed no statistically significant difference between MTA and IRM but both were superior when compared to Biodentine . At 1 mm level there was no statistically significant difference among any of the tested material s. At 2 mm level MTA was superior to both IRM and Biodentine . Conclusion : In overall comparison , MTA and IRM were significantly superior when compared to Biodentine in terms of marginal adaptation , when used as retro grade filling material Objectives : The aim of this study was to evaluate marginal adaptation of mineral trioxide aggregate ( MTA ) , calcium enriched mixture ( CEM ) cement , Biodentine and BioAggregate in presence of normal saline and human blood . Material s and Methods : In this in-vitro experimental study , 80 extracted single-rooted human teeth were instrumented and filled with gutta-percha . After resecting the root-end , apical cavity preparation was done and the teeth were r and omly divided into 4 groups (N=20)(a total of 8 subgroups ) . Root-end filling material s were placed in 3 mm root-end cavities prepared ultrasonically . Half the specimens in each group were exposed to normal saline and the other half to fresh whole human blood . After 4 days , epoxy resin replicas of the apical portion of sample s were fabricated and scanning electron microscopy ( SEM ) analysis was performed to find gaps in the adaptation of the root-end filling material s at their interface with dentin . The Kruskal-Wallis and Mann-Whitney tests were used for statistical analysis of data with P<0.05 as the limit of significance . Results : There were no significant differences in marginal adaptation of the 8 tested groups ( P>0.05 ) . Conclusion : Based on the results , blood contamination does not affect the marginal adaptation of MTA , CEM cement , Biodentine or BioAggregate Objective : This study compared the marginal adaptation of mineral trioxide aggregate ( MTA ) and MTA-like material s as root-end fillings after incubation in phosphate buffer saline ( PBS ) , a synthetic tissue fluid , for either 1 week or 2 months . Material s and Methods : In this experimental study , seventy-two extracted human single-rooted teeth were prepared and obturated with gutta-percha and AH26 sealer . The apical 3 mm of the roots were resected . Root-end cavities were prepared with an ultrasonic retrotip . The specimens were r and omly divided into three groups ( n=24 ) and filled with either ProRoot MTA , OrthoMTA , or RetroMTA . Half of the specimens in each group were stored in PBS for 1 week the other half for 2 months . Epoxy resin replicas from the resected root-end surfaces and longitudinally sectioned roots were fabricated . The gaps at the material /dentin interface were measured using a scanning electron microscope ( SEM ) . Transversal , longitudinal , and overall gap sizes were measured . The data were analyzed using Kruskal-Wallis and Mann-Whitney tests . The significance level was set at p < 0.05 . Results : There were no significant differences between the marginal adaptation of ProRoot MTA , RetroMTA , and OrthoMTA in both transverse and longitudinal sections after incubation for either 1 week or 2 months ( p > 0.05 ) . In addition , the test groups were not significantly different regarding the overall mean gap values ( p > 0.05 ) . Conclusion : Under the conditions of this study , there was no difference between the marginal adaptation of ProRoot MTA , OrthoMTA , and RetroMTA as root-end filling material s after exposure to PBS for either 1 week or 2 months AIM To assess the success rate of the root-end filling material , Mineral Trioxide Aggregate ( MTA ) . METHODOLOGY Referred adult patients were recruited using strict entry criteria and r and omly allocated to receive MTA or IRM . A st and ardized surgical technique was employed : the root end was resected perpendicularly and a root-end cavity was prepared ultrasonically and filled . A radiograph taken immediately after surgery was compared with those taken at 12 and 24 months . Customised film holders and the paralleling technique were used ; radiographs were assessed by two trained observers using agreed criteria . The results from 122 patients ( 58 in IRM group , 64 in MTA group ) after 12 months and 108 patients ( 47 in IRM group , 61 in MTA group ) for the 24-month review period were analysed using the chi2 test . RESULTS The highest number of teeth with complete healing at both times was observed when MTA was used . When the numbers of teeth with complete and incomplete ( scar ) healing , and those with uncertain and unsatisfactory healing were combined , the success rate for MTA was higher ( 84 % after 12 months , 92 % after 24 months ) compared with IRM ( 76 % after 12 months , 87 % after 24 months ) . However , statistical analysis showed no significant difference in success between material s ( P > 0.05 ) at both 12 and 24 months . CONCLUSIONS In this study , the use of MTA as a root-end filling material result ed in a high success rate that was not significantly better than that obtained using IRM This study compared the push-out bond strength of mineral trioxide aggregate ( MTA ) and a new endodontic cement ( NEC ) as root-end filling material s in root-end cavities prepared by ultrasonic technique ( US ) or Er , Cr : YSGG laser ( L ) .  Eighty single-rooted extracted human teeth were endodontically treated , apicectomised and r and omly divided into four following groups ( n = 20 ) : US/MTA , US/NEC , L/MTA and L/NEC . In US/MTA and US/NEC groups , root-end cavities were prepared with ultrasonic retrotip and filled with MTA and NEC , respectively . In L/MTA and L/NEC groups , root-end cavities were prepared using Er , Cr : YSGG laser and filled with MTA and NEC , respectively . Each root was cut apically to create a 2 mm-thick root slice for measurement of bond strength using a universal testing machine . Then , all slices were examined to determine the mode of bond failure . Data were analysed using two-way anova . Root-end filling material s showed significantly higher bond strength in root-end cavities prepared using ultrasonic technique ( US/MTA and US/NEC ) ( P < 0.001 ) . The bond strengths of MTA and NEC did not differ significantly . The failure modes were mainly adhesive for MTA , but cohesive for NEC . In conclusion , bond strengths of MTA and NEC to root-end cavities were comparable and higher in ultrasonically prepared cavities INTRODUCTION The aim of this in vivo study was to compare the response of periradicular tissues to mineral trioxide aggregate ( MTA ) and calcium-enriched mixture ( CEM ) cement as root-end fillings and to analyze hard tissue healing after periradicular surgery . METHODS Intentional periradicular lesions were induced in 32 premolar teeth in 4 beagle dogs . The root canals were prepared , dried , and obturated with laterally condensed gutta-percha with sealer , and the coronal access cavities were filled with amalgam . After surgical exposure of the apices , 2 - 3 mm of the apical root was resected , and root-end cavities were ultrasonically prepared . The root-end cavities were r and omly filled with MTA or CEM cement . After 2 months , the animals were killed ; tissue blocks were removed and prepared for histologic examination . Hard tissue healing including cementum and new bone formation in addition to concentration and extent of inflammation were evaluated . RESULTS Eight sample s were excluded . The major finding was the cementum deposition adjacent to MTA in 11 of 12 sample s and CEM cement in 10 of 12 sample s. With one-way analysis of variance , no significant difference was observed between the periradicular tissue response to tested material s. CONCLUSIONS CEM cement and MTA were associated with regenerative periapical tissue response when used as root-end filling bio material The purpose of this study was to compare the ability of different thicknesses of mineral trioxide aggregate ( MTA ) to prevent apical leakage through the use of a protein-dye complex with Coomassie Brilliant Blue G. Sixty-four teeth were divided into 4 groups , then filled with MTA to depths of 1 , 2 , 3 , or 4 mm . Two teeth served as the positive controls . Another 2 teeth served as the negative controls . Root-filled teeth were mounted in an apparatus and then challenged with protein solution . The evaluation was conduced at 24-hour intervals for 60 days . The 1-mm-thick MTA was the least effective in preventing apical leakage ( P < .05 ) . No significance difference was found between 2- and 3-mm-thick MTA ( P > .05 ) . Four-millimeter-thick MTA was significantly more effective than the other thicknesses tested ( P < .05 ) . The results of this study suggest that the thickness of 4 mm is most adequate for the use of MTA as a root-end filling material Objective : Mineral trioxide aggregate ( MTA ) has been accepted as an appropriate root-end filling material in endodontic microsurgery because of setting ability in the wet environment . The aim of this study was to assess the bond strength of root-end placed MTA and Biodentine ( Septodont , Saint Maur des Fossés , France ) in the absence/presence of blood contamination . Material s and Methods : Forty-eight single-rooted maxillary incisors were used . subsequent to root-end resection and apical preparation using ultrasonic retro-tips , the specimens were r and omly separated into two groups according to the root-end filling material s : MTA ( Cerkamed Medical Company , Stalowa , Pol and ) or Biodentine . The specimens were then separated into two subgroups according to storage condition ( absence/presence of blood ) ( n = 12 ) . After obtaining 2.0 ± 0.1 mm slices , push-out tests were performed . Each slice was examined under a stereomicroscope to evaluate the failure mode . The data were analyzed using two-way analysis of variance and Tukey 's post hoc test for multiple comparisons . The failure modes were analyzed using the Chi-square test ( P = 0.05 ) . Results : The bond strength was significantly affected by the presence of blood contamination and root-end filling material type ( P < 0.001 ) . Biodentine had better bond strength than MTA ( P < 0.001 ) . The most common failure type was adhesive failure . According to the Chi-square test , there were no statistically significant differences among the groups ( P = 0.394 ) . Conclusions : Biodentine had better bond strength values compared to MTA , and the bond strength of both MTA and Biodentine as root-end filling material s was negatively affected by the presence of blood INTRODUCTION 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 nonr and omized prospect i ve 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 , m and ibular 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 m and ibular premolars and molars AIM To compare the surface topography of root apices following ultrasonic root-end preparation , and again after root-end fillings su bmi tted to three different finishing techniques . METHODOLOGY Eighty-one root-end cavities prepared ultrasonically in human canines , were divided at r and om into three test groups of 27 each . The cavities were filled with Super-EBA , IRM , or ProRoot-MTA and finished by ball burnishing . Eighteen roots from each group received a final finish with either a 30-fluted tungsten carbide finishing bur , or a Zekrya carbide 28 mm bur after storage in water at 37 degrees C for 24 h. The root-end surface topographies were reproduced by means of polyvinylsiloxane impressions and epoxy resin replicas . Scanning electron micrography ( SEM ) images of each replica were taken prior to and after root-end filling . An image analysis system was used to compare the alteration of the marginal chipping areas and to calculate the gaps located in the dentine/root-end filling interface . RESULTS When a bur was used to finish the set material s , a significant ( P < 0.05 ) area of marginal chipping was eliminated . The finishing technique did not significantly ( P > 0.05 ) affect the incidence of gaps in groups root-end filled with MTA or IRM . Super-EBA and IRM retrofillings finished with a ball burnisher or a Zekrya bur displayed a significantly ( P < 0.05 ) larger calculated gap area than roots filled with MTA . CONCLUSION Under this in vitro study , the marginal adaptation of MTA was good with or without finishing procedures . Applying a finishing bur over the condensed and set IRM and Super-EBA created better marginal adaptation Introduction : This prospect i ve r and omized controlled study evaluated the clinical and radiographic outcome of endodontic microsurgery when using iRoot BP Plus Root Repair Material ( BP‐RRM ; Innovative BioCeramix Inc , Vancouver , BC , Canada ) or mineral trioxide aggregate ( MTA ) as the retro grade filling material and analyzed the relationship between some potential prognostic factors and the outcome of the surgery . Methods : By using strict inclusion and exclusion criteria , 240 teeth were successfully enrolled and r and omly and equally allocated to either the MTA or BP‐RRM treatment group . A st and ardized surgical procedure was performed by a single operator . The patients were followed up at 1 week , 3 months , 6 months , and 12 months ; follow‐up included clinical and radiographic examination . Clinical and radiographic evaluations acquired at the 12‐month follow‐up were taken as the primary outcome . For the identification of prognostic factors , the dichotomous outcome ( success vs failure ) was taken as the dependent variable . Results : A total of 158 teeth were analyzed at the 12‐month follow‐up , including 87 teeth in the MTA group and 71 teeth in the BP‐RRM group . The success rate in the MTA and BP‐RRM groups was 93.1 % ( 81/87 teeth ) and 94.4 % ( 67/71 teeth ) , respectively ( P > .05 ) . Three significant outcome predictors were identified : quality of root filling ( P < .05 ) , tooth type ( P < .05 ) , and size of the lesion ( P < .05 ) Conclusions : These results suggest that BP‐RRM is comparable with MTA in clinical outcome when used as root‐end filling material s in endodontic microsurgery AIM The aim of this investigation was to assess the marginal adaptation of Super-EBA ( EBA ) and Pro Root MTA ( MTA ) root-end fillings and the occurrence of microcracks in resected root-ends of extracted teeth before and after occlusal loading for a five-year equivalent period in a computer-controlled masticator . METHODOLOGY Twenty-four molar teeth were root-filled using lateral condensation and their root-ends resected . Root-end cavities were prepared and either EBA or MTA root-end fillings were placed . All surgical procedures were completed in vitro under an operating microscope . Replicas taken of the root-end fillings and resected root-ends were examined using an SEM before and after they were subjected to in vitro chewing cycles in a computer-controlled chewing simulator for the equivalent of 5 years . Marginal adaptation and integrity of the two root-end filling material s were evaluated and the presence of microcracks recorded . RESULTS Before loading , a continuous margin was observed with 99.4 + /- 2.4 % of EBA and 99.2 + /- 1.6 % of MTA root-end fillings . After loading , the percentage of continuous margin decreased to 93.1 + /- 6.6 % and 98.9 + /- 3.2 % for EBA and MTA , respectively . After occlusal loading , 39.5 % of the EBA root-end fillings were overfilled , whilst 52.6 % of the MTA root-end fillings were underfilled . In total , 12.5 % of the resected root-end surfaces showed microcracking before loading and 25 % after occlusal loading . CONCLUSIONS Both EBA and MTA displayed excellent marginal adaptation before masticatory loading . After loading , the amount of continuous margin for both root-end filling material s decreased slightly but was still high Background : The purpose of this study was to compare the push-out bond strength of mineral trioxide aggregate ( MTA ) and calcium enriched mixture ( CEM ) as root end filling material s. Material s and Methods : A total of 40 root dentin slices ( 1 ± 0.2 mm ) were prepared from freshly extracted human maxillary central teeth and their lumens were enlarged to 1.3 mm . The slices were r and omly divided into two groups ( n = 20 ) . MTA and CEM cement were mixed according to manufacturer 's instruction and introduced into the lumens . The specimens were wrapped in pieces of wet gauze soaked in distilled water and incubated at 37 ° C for 3 days . The push-out bond strength was measured using a universal testing machine . The slices were then examined under a light microscope at ×10 magnification to determine the nature of bond failure . The data were analyzed using Mann-Whitney test ( P < 0.001 ) . Results : The mean push-out bond strength for CEM cement and MTA were 1.68 ± 0.9 and 5.94 ± 3.99 respectively . The difference was statistically significant ( P < 0.001 ) . The bond failure was predominantly of adhesive type in MTA group and cohesive type in CEM group . Conclusion : CEM cement showed significantly lower bond strength to the dentinal wall compared to MTA INTRODUCTION The purpose of the present study was to evaluate the clinical outcomes of endodontic microsurgery when super ethoxy-benzoic acid ( Super EBA ; Harry J. Bosworth , Skokie , IL ) and mineral trioxide aggregate ( MTA ) were used as root-end filling material s in a prospect i ve r and omized controlled study . METHODS Of the 388 teeth eligible for endodontic microsurgery , 128 teeth were excluded from the study , and 260 teeth were r and omly assigned to either the Super EBA group or the MTA group with equal numbers using the " minimization method . " Endodontic microsurgical procedures were performed according to the Yonsei protocol reported in a previous study and were carried out by a single operator . The patients were followed up at 3 , 6 , and 12 months . The primary outcome measure was the change in the apical bone density at 12 months , and the secondary outcome measures were the presence of clinical symptoms or abnormal findings at 12 months . RESULTS A total of 192 teeth were examined at the 12-month follow-up ; 102 teeth were in the Super EBA group , and 90 were in the MTA group . The overall success rate was 94.3 % , with a success rate of 95.6 % ( 86/90 teeth ) for MTA and 93.1 % ( 95/102 teeth ) for Super EBA . The statistical analysis of the success rate results did not show any significant difference between the groups ( P = .472 ) . CONCLUSIONS In this prospect i ve r and omized controlled study , there was no significant difference in the clinical outcomes of endodontic microsurgery when Super EBA and MTA were used as root-end filling material AIM To compare healing after root-end resection with a root-end filling of mineral trioxide aggregate ( MTA ) or smoothing of the ortho grade gutta-percha ( GP ) root filling . METHODOLOGY Forty-four patients ( consisting of 52 teeth with periapical infection ) , average age of 54.6 years ( range 30 - 77 ) participated in a r and omized clinical trial ( RCT ) comparing the MTA and GP treatment methods . Radiographs produced 1-week and 12 months post-operatively were compared after blinding for treatment method , and healing was assessed as complete , incomplete , uncertain , or unsatisfactory . RESULTS Six teeth were not available for the 12-month follow-up : three teeth ( GP ) had been re-operated because of pain and two teeth ( one GP , one MTA ) had been extracted because of root fracture ( these five teeth were classified as failures ) . One patient ( GP ) was not available for recall . In the GP group , seven teeth ( 28 % ) showed complete healing , six teeth ( 24 % ) incomplete healing , six teeth ( 24 % ) uncertain healing and two teeth ( 8 % ) unsatisfactory healing after 1 year . In the MTA group , 22 teeth ( 85 % ) showed complete healing , three teeth ( 12 % ) incomplete healing , and none were scored as uncertain or unsatisfactory healing after 1 year . The difference in healing between the GP and the MTA groups was significant ( P < 0.001 ) . CONCLUSIONS The results from this RCT emphasize the importance of placing a root-end filling after root-end resection . Teeth treated with MTA had significantly better healing ( 96 % ) than teeth treated by smoothing of the ortho grade GP root filling only ( 52 % ) Introduction The importance of perfect apical seal in endodontics , more specifically in periradicular surgery , is the motivation/reason for development of root-end filling material s with favorable physical , chemical and biological characteristics . The aim of this in vitro study was to evaluate the marginal adaptation of root-end filling material s using scanning electron microscopy . Material s and Methods Twenty five human maxillary anterior teeth were prepared using a K-File # 50 to 1 mm short of the apical foramen and filled with gutta-percha and Sealapex using the lateral compaction technique . The apical 3 mm of the roots were sectioned perpendicularly to the long axis of the teeth . A 3-mm-deep root-end cavity was prepared using ultrasonic tips powered by an Enac ultrasonic unit . The teeth were r and omly assigned to five groups according to the material s tested including IRM , amalgam , ProRoot MTA , Super-EBA and Epiphany/Resilon . Root-end cavities were filled with the material s prepared according to the manufacturers ’ instructions . The root apices were carefully prepared for sputter coating and later evaluation using Scanning Electron Microscope ( SEM ) . The images of root-end fillings were divided into four quadrants and distributed into five categories according to the level of marginal adaptation between the root-end material and the root canal walls . The Fisher exact test with Bonferroni correction was used for statistical analysis . The level of significance was set at P = 0.005 . Results SEM images showed the presence of gaps in the root-end filling material s. No significant difference was observed between the tested material s ( P > 0.005 ) . Conclusion ProRoot MTA , IRM , amalgam , Super-EBA and Epiphany/Resilon showed similar marginal adaptation as root-end filling material INTRODUCTION The purpose of the present study was to evaluate the long-term clinical outcome of endodontic microsurgery when mineral trioxide aggregate ( MTA ) and super ethoxybenzoic acid ( Super EBA ; Harry J. Bosworth , Skokie , IL ) were used as root-end filling material s. Additionally , this study aim ed to compare the clinical outcome of endodontic microsurgery at the 1-year follow-up with that at the 4-year follow-up . METHODS Two hundred sixty teeth were r and omly assigned to either the MTA or Super EBA group in equal numbers using the minimization method . Endodontic microsurgery was performed according to the Yonsei protocol . The previous study of 192 teeth examined at the 1-year follow-up revealed a success rate of 95.6 % for MTA and 93.1 % for Super EBA . Patients were recalled 4 years after surgery , and treated teeth were classified as successes or failures with Molven 's criteria . The Pearson chi-square test and the McNemar test were conducted to analyze and compare the success rates . RESULTS A total of 182 teeth were examined at the 4-year follow-up . The success rate was 91.6 % for MTA and 89.9 % for Super EBA . Statistical analysis of the success rate did not show any significant difference between the 2 material s ( P = .8 ) . The overall success rate at the 4-year follow-up was 89.5 % , which was slightly lower compared with 94.3 % at the 1-year follow-up . However , there was no significant difference between the follow-up periods ( P = .063 ) . CONCLUSIONS This study identified no significant difference in the 4-year success rates of MTA and Super EBA as root-end filling material s in endodontic microsurgery . Additionally , compared with short-term outcomes , long-term follow-up outcomes were not significantly different A prospect i ve outcome study of  periradicular surgery  using microsurgical techniques and root-end filling with mineral trioxide aggregate ( MTA ) was performed . Nonhealing endodontically treated teeth ( n = 321 ) were included in the study . Surgery was completed under local anesthesia using a st and ardized clinical protocol . Patients were recalled periodically and examined for signs and symptoms of failure . Thirty-nine teeth were lost from recall . Of the 276 teeth examined , 163 showed complete healing radiographically with no other signs and symptoms ; 82 teeth had no symptoms but incomplete or uncertain healing , and 31 teeth showed nonhealing ( three had persistent pain despite evidence of complete radiologic healing and eight teeth did not heal for reasons unrelated to the surgical treatment ) . The overall success rate was 88.8 % , including all teeth with no clinical symptoms . In this study , the use of MTA as a root-end filling , following microsurgical techniques , showed a high success rate This in vitro study used rhodamine B fluorescent dye and a confocal microscope to evaluate the sealing ability of amalgam , super EBA , and a mineral trioxide aggregate when used as root end filling material s. Thirty single-canal teeth were cleaned , shaped , and obturated with gutta-percha and root canal sealer . After application of nail polish to the external surface , the apical 3 mm of each root was resected and 3-mm deep root end preparations were made . The roots were r and omly divided into three groups and the root end preparations filled with the experimental material s. All roots were then exposed to an aqueous solution of rhodamine B fluorescent dye for 24 h , longitudinally sectioned , and the extent of dye penetration measured using a confocal microscope . Statistical analysis showed that the mineral trioxide aggregate leaked significantly less than amalgam and super EBA
On the basis of available evidence , MTA presented good marginal adaptation to dentine walls .
This systematic review analysed the literature comparing marginal adaptation of mineral trioxide aggregate ( MTA ) with other filling material s in root-end cavities .