Periapical Microsurgery: An In-vivo Evaluation of Endodontic Root-end Filling Materials

The purpose of this study was to assess the efficacy of three apical sealing materials (IRM(TM), GeristoreRTM and MTA(TM)) following apical microsurgery in an animal model. Periradicular healing was evaluated using radiographic and histologic indicators. Eighty mandibular premolar roots of beagle dogs were instrumented and intentionally infected. Apical microsurgeries were performed after thirty days without prior disinfection of the root canals. The root ends were resected, apical preparations were made and the retrofill materials were placed with the aid of a Surgical Operating Microscope. After a healing period of six months, the periradicular areas in question were assessed using digital radiographic images and prepared histologic sections. Although Geristore showed no radiographic difference when compared to the other groups, it demonstrated the least favorable healing results in the histologic evaluation. IRM achieved the most favorable healing response both radiographically and histologically but these results were not statistically different from MTA.