Obturation

A biocompatible material is used to produce a hermetic seal that can prevent the percolation of bacteria or their products between the root canal system and periradicular tissues.

Comment

The characteristics of an ideal retrofilling cement would be:

• sticks and adapts to the walls of the preparation
• easy to use
• dimensionally stable
• moisture-resistant
• insoluble in tissue fluids
• prevents leakage of micro-organisms and their products to the periradicular tissues
• bactericidal or bacteriostatic
• biocompatible and cementogenesis promotor
• radiopaque.

However, no ideal retrofilling cement exists. Preventing bacteria and their products from leaving or entering the canal in the long term is the most important property, due to the fact that the apical seal is totally related to apicoectomy success rate. Another important property is biocompatibly and cementogenesis promotion, in order to promote the biological seal of the resected root and retrofilling material.

Armamentarium

• IRM (Intermediate Restorative Material, Caulk/Dentsply, Milford, DE, USA)
• SuperEBA cement (Bosworth, Skokie, IL, USA)
• MTA (mineral trioxide aggregate; ProRoot, Dentsply, Tulsa, OK, USA)
• MTA carriers or Messing gun (MAP System, PD, Vevey, Switzerland)
• West's microspatula (Hartzell & Son)
• Microexplorers, micromirrors, and micropluggers (Hartzell & Son), Buchanan pluggers (Sybron Endo)
• Fine diamond or ETUF930 finishing burs.

The microscope is set at medium magnification (10-16x).