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Endod Dent Traumatot 1994: 10: 276-281Printed in Denmark . AU
rights reserved Copyrighl Munksgnurcl Endodon tics &Dental
TraumatoloISSN 0109-2502
A r a d io g r a p h ic s t u d y o f t h e e f fe c t o f v a r
io u sr e t r o g r a d e f i l l i n g s o n p e r ia p ic a i h e
a l in g a f te rr e p l a n t a t i o nAndreasen J O , Pitt Ford
TR. A radiographic study of the effect ofvarious retrograde
fillings on periapicai healing after replantation.Endod Dent
Traumatol 1994; 10: 276-281. Munksgaard, 1994.Abstract An effective
retrograde sealing procedure places greatdemands upon both
technique and materials. Prevention of micro-leakage,
biocompatibility and stability of the material in the apicaltissues
are very important. To evaluate potential retrograde
fillingmaterials, a replantation model has been developed in which
ex-traeted permanent molars were replanted in monkeys after
ap-icectomy of each root, preparation of a 2-mm deep retrograde
cav-ity and its sealing with various dental materials. Prior to
retro-fiUing the remaining pulp was exposed to saliva. Apicected
molarswhich were infected and did not receive retrograde fillings
ser\'edas positive controls. Periapicai healing was evaluated
radiographi-cally after 8 weeks based on planimetric measurements
of the sizeof the periapicai radiolucency. The following dental
materials weretested: amalgam, glass ionomer cement,
calcium-hydroxide lining ce-ment, AH 26 root canal sealer, various
zinc oxide-eugenol eements,Caxdt, and gutta-percha with various
sealers. The materials whichwere associated with better apical
healing than the infected controlswere glass ionomer cement, Ca\it,
and the zinc oxide-eugenol ce-ments. When plain zinc oxide-eugenol
or IRM were combinedwith a gutta-percha core, healing was best and
not statisticallydifferent from normal apices. It was concluded
that radiographicassessment at 8 weeks of molar teeth retrograde
filled prior toreplantation could be a valuable method for
discrimination of po-tentially useful materials i n vivo.
J . 0. Andreasen\ T. R.Departments of 'Oral Surgery and Oral
MediciNational Hospital (Rigshospitalet), CopenhageDenmark.
^Conservative Dental Surgery, UMDGuy's Hospital, Lo nijon,
England
Key words: periapicai tiealing; retrograde fillingreplantationI
R. Piff Ford, Department of Conservafive DeSurgery, United Medical
and Dental Schools,Guy's Hospifal, London SE1 9RT, EnglandAccepfed
April 14, 1994
The primary intention ofa retrograde rootfillingma-terial is to
seal a root canal which cannot otherwisebe filled by a standard
non-surgical approach. Thusthe main indications arise when a root
canal is ob-structed by a post or is obliterated by
calcification.The root canal contents in these cases are
necroticand usually infected (1). The function ofa
retrogradetechnique is therefore to obturate the apical orifice
ofthe canal with a material w^hich does not allow leak-age of
bacteria, their toxins or decomposition prod-
i n vivo and i n vitro; this has been reviewed by Frie(2). ^The
most common in vitro procedure has beefill retrograde cavities in
extracted teeth which hbeen apicected, immerse the teeth in a dye
solutand then measure the distance of discoloration alothe
interface of the retrograde material and the dtinal walls (2-4).
However, this method of predictleakage of bacteria, their toxins or
autolytic produreaching the root end from the canal has been s
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Radiographic healing after retregrade fiias potential
retrograde
the solubility of these ma-is a matter which has raised concern
(27).
e.g. EBA andhave had their solubility reduced by the ad-of
various components (10). These modified
(5).and
has not been widely practised, but in selectedhas achieved good
results clinically (28, 29).a combination with the use of plain
zinc ox-
or IRM achieved the best results in thisto the extent that the
area of the root-end
was not dissimilar from that of the nor-has been taken to imply
that bone
in that part of the socket formerly oc-by the apex.
it could be a satisfactory screen-for potential retrograde root
filling ma-
It is intended to look at selected materials bythe results and
com-
the methods.
- We would like to thank Fraserfbr performing the statistical
analysis.
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