A standard for radiopacity of root-end (retrograde) filling materials is urgently needed

Aim: To assess the radiopacity of materials used, or recommended for use, as apical root-end (retrograde) fillings. Methodology: The radiopacity of 14 materials falling into the category of root-end filling materials was measured in equivalent millimetres of aluminium (mm Al) using a new computerized method. These included temporary or intermediate sealing materials; composite, compomer and GIC filling materials; EBA-derived cements; amalgam, etc. Gutta-percha cone material was added as a control. Samples of 1 mm thickness were radiographed on periapical film alongside an aluminium step wedge calibrated in millimetres, and the opacity of the materials, in greyscale or pseudocolour, was compared with the equivalent step. Results: The radiopacity ranged from 1.75 mm Al to > 10 mm Al. The lower range appears insufficient for routine clinical detection when it is compared with the minimal requirement for intracanal fillings. Conclusions: Because of the proliferation of root-end filling materials with a broad range of radiopacity, an international standard stipulating the required minimal radiopacity, as well as other properties, is needed urgently. It should be based on in vitro results and on large-scale clinical radiographic surveys.