Abstract
Objective: To evaluate the clinical efficacy of polycarboxylate cement as retrograde filling material. Design: A prospective clinical study was made of 25 patients subjected to periapical surgery with ultrasound and magnifying loupes, in which polycarboxylate cement was used as retrograde filling material. Measurements were made of the area and diameter of the lesions pre- and postoperatively, and 6 and 12 months after the operation. The apical resection and retrograde filling areas were also measured, and the prognosis following surgery was recorded. Results: A total of 23 patients with 31 apicoectomized teeth were studied (2 patients being lost to follow-up). The mean area of the periapical lesions before surgery was 52.25 mm2, with a mean major diameter of 6.1 mm and a mean lesser diameter of 4.8 mm. The success rate after 12 months was 54.7%, according to the criteria of Von Arx and Kurt. The prognosis was poorer in females, in larger lesions, and in cases with larger retrograde filling areas. Conclusions: Polycarboxylate cement offers good results, with important bone regeneration after periapical surgery. Key words: Periapical surgery, endodontic treatment, polycarboxylate cement.
Highlights
Polycarboxylate cement was developed by Smith in 1968 (1)
The present study evaluates the outcome of periapical surgery with ultrasound, using polycarboxylate cement as retrograde filling material
No significant differences were observed between guttapercha and silver amalgam, though Durelon® was seen to afford comparatively poorer sealing than the other two materials
Summary
Polycarboxylate cement was developed by Smith in 1968 (1). Its main advantage is strong adhesion to dentin (1). This cement is composed of an aqueous solution of polyacrylic acid and inorganic salts, with zinc oxide as the main ingredient. Zinc is an essential element, since it is needed for cell growth and differentiation (2); it exhibits relative toxicity related to its absorption and excretion (3). In vitro studies (4) have demonstrated the sealing capacity and biocompatibility of polycarboxylate cement. Following calcium hydroxide, it is the cement which preserves the largest presence of odontoblasts in the vicinity of the restorations (5) – justifying its use in periapical surgery (6). The present study evaluates the outcome of periapical surgery with ultrasound, using polycarboxylate cement as retrograde filling material
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