A retrospective radiographic study of root-end surgery with amalgam and intermediate restorative material

Objective. We sought to compare amalgam with intermediate restorative material in terms of their effectiveness as root-end filling materials during root-end surgeries. Study design. A root-end operation was performed on 228 patients with 262 endodontically treated teeth with periapical lesions. Of these teeth, 122 from 101 patients were available for follow-up. Radiographs were taken immediately postoperatively and again at a mean of 11.25 months (range, 6-45 months) postoperatively. The radiographs were digitized, and the diameter of the periapical lesion was measured by means of a computerized system. The mesiodistal distance at the cementoenamel junction served as an internal standard. Radiographic findings were classified into 1 of 3 groups: complete healing, incomplete healing, or unsatisfactory (no) healing. Results. Complete healing was observed in 44.3% of the teeth, incomplete healing in 21.3%, and unsatisfactory healing in 34.4%. No statistical significance was found for amalgam versus intermediate restorative material, but teeth that underwent additional operations had a significantly worse success rate than those that underwent only first-time operations. No correlation was found between the subjective prognosis by the surgeons and the long-term outcome. Conclusion. As root-end filling materials, amalgam and intermediate restorative material had the same clinical effectiveness. The classic root-end operation is unpredictable. Reoperations should be reconsidered and avoided if possible.