Biocompatibility of retrograde root filling materials: A review

Operative Dentistry and Endodontics Department, Ondokuz Mayis University Faculty of Dentistry, Kurupelit-Samsun, Turkey.
Australian Endodontic Journal (Impact Factor: 0.59). 05/2008; 34(1):30-5. DOI: 10.1111/j.1747-4477.2007.00085.x
Source: PubMed


The aim of a retrograde filling material is to fill the apical canal space and to obtain a hermetic seal between the periodontium and the root canal system. Several materials have been suggested for root-end filling including: amalgam, gutta-percha, zinc oxide-eugenol cements, glass ionomer cement, gold foil pellets, Cavit, composite resin and mineral trioxide aggregate (MTA). Super-ethoxy benzoic acid and MTA are the most suitable materials and provide better results in apicoectomy procedures than other filling materials. Unfortunately, the ideal material for this purpose has yet to be found. This article is a review of the biocompatibility of retrograde filling materials.

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    • "Although, the ideal material is yet to be found, a number of materials have been suggested for root-end filling including amalgam, composite resin, glass ionomer cement, gold foil, guttapercha , reinforced zinc oxide eugenol based cement, mineral trioxide aggregate (MTA), and calcium enriched mixture (CEM) cement [5] [6] [7] [8]. Amalgam has been a frequently used root-end filling material; it is easy to use, radiopaque and non-resorbable [9]. The characteristics of amalgam as a root-end filling material such as marginal adaptation [10], sealing ability [11], cytotoxicity [12] and biocompatibility [5] have been evaluated. "

    • "Root-end filling materials should ideally be biocompatible, insoluble, induce periapical tissue regeneration, have effective sealing ability, as well as dimensional stability, moisture imperviousness, radiopacity, nontoxicity, non-carcinogenicity, and ease of handling.[12] "
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    ABSTRACT: Objectives: Activation of mineralization process in periradicular tissues following the injuries, is important in repair mechanisms. The objective of this study was to investigate the effects of CEM cement on survival and mineralization of human mesenchymal stem cells (hMSCs) and compare it with MTA. Materials and Methods: hMSCs that were planted on test material extracts and culture media were the experimental and control groups, respectively. The cytotoxicity of these materials was investigated using Methyl thiazol tetrazolium assay. After 7 days, alizarin red staining, alkaline phosphatase (ALP) assays, and qRT-PCR were used to assess the mineralization, expression of ALP, and gene expression (collagen type 1 and osteocalcin), respectively. The results were evaluated by ANOVA analysis and multiple comparisons test. P < 0.05 was considered as statistically significant. Results: Cell viability was not significantly different. Alizarin red and alkaline phosphatase staining showed mineralization in all three groups. In qRT-PCR, the expression of collagen type 1 is not significantly different among the three groups. Osteocalcin gene expression was significantly higher in the CEM group compared to the control (P < 0.05). Conclusion: CEM cement has acceptable toxicity and could induce mineralization process and enhance osteocalcin gene expression which is associated with mineralization in hMSCs.
    Journal of Conservative Dentistry 07/2014; 17(4):349-53. DOI:10.4103/0972-0707.136509
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    • "A) Extensive IERR associated with a periapical lesion; B) Placing inter-appointment calcium hydroxide (CH) dressing after drainage; C) Formation of a sinus tract after one week; D) Radiographic confirmation of accurate tooth replantation after extraoral retrograde root canal filling with CEM cement; E-F) Radiographic healing and formation of new bone after six months (E) and 1 year (F) follow-ups mineral trioxide aggregate (MTA) and calcium enriched mixture (CEM) cement have been used [5] [6] "
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    ABSTRACT: Inflammatory external root resorption (IERR) after orthodontic treatments is an unusual complication. This case report describes a non-vital maxillary premolar with symptomatic extensive IERR (with a crown/root ratio of 1:1) after receiving orthodontic treatment. The first appointment included drainage, chemo-mechanical preparation of the canal and intra-canal medication with calcium hydroxide (CH) along with prescription of analgesic/antibiotic. The subsequent one-week follow-up revealed the persistence of symptoms and formation of a sinus tract. Finally, extraoral endodontic treatment was planned; the tooth was atraumatically extracted and retrograde root canal filling with calcium enriched mixture (CEM) cement was placed followed by tooth replantation. Clinical signs/symptoms subsided during 7 days postoperatively. The sinus tract also resolved after one week. Six-month and one-year follow-ups revealed complete healing and a fully functional asymptomatic tooth. This case study showed favorable outcomes in a refractory periapical lesion associated with orthodontically induced extensive IERR. The chemical as well as biological properties of CEM cement may be a suitable endodontic biomaterial for these cases.
    Iranian Endodontic Journal 03/2014; 9(2):149-52.
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