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A previous report demonstrated 96.8% healing within 1 yr after apical surgery was performed with the surgical operating microscope and Super-EBA as the root-end filling material. The purpose of this paper is to report on the long-term follow-up of those cases that were considered healed at the short term. Clinical examinations were made and radiographs were evaluated 5 to 7 yr after the case had first been considered healed. Criteria for determining healed cases were the same as those used in the first report. Of the 59 roots evaluated, 54 (91.5%) remained healed, whereas 5 (8.5%) showed evidence of apical deterioration.

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The purpose of this study was to compare the periapical tissue responses and cementum regeneration in response to three widely used root-end filling materials, amalgam, SuperEBA, and Mineral Trioxide Aggregate (MTA). These materials were placed using modern microsurgical techniques on endodontically treated dog premolars and molars. After 5 months, the cell and tissue reactions of surface-stained un-decalcified ground sections were evaluated by light microscopy and statistically analyzed. The major difference in the tissue responses to the three retrofilling materials were the degree of inflammation and types of inflammatory cells, number of fibrous capsule formations, cementum neoformation over these materials, osseous healing and resulting periodontal ligament thickness. MTA showed the most favorable periapical tissue response, with neoformation of cemental coverage over MTA. SuperEBA was superior to amalgam as a root-end filling material.

Introduction: The extrusion of irrigation solutions beyond the apical constriction may result in postoperative pain. Sodium hypochlorite can cause severe tissue irritation and necrosis outside the root canal system if extruded into the periodontal ligament (PDL) space. Different delivery techniques were discussed to reduce this potential risk. The aim of this study was to compare the postoperative level of pain after root canal therapy using either endodontic needle irrigation or a negative apical pressure device. Material and Methods: In a prospective randomized clinical trial, 110 asymptomatic single-rooted anterior and premolar teeth were treated endodontically with two different irrigation techniques. The teeth were randomly assigned to two groups. In the MP group (n = 55), procedures were performed using an endodontic irrigating syringe (Max-i-Probe; Dentsply Rinn, Elgin, IL). The EV group (n = 55) used an irrigation device based on negative apical pressure (EndoVac; Discus Dental, Culver City, CA). Postoperatively, the patients were prescribed ibuprofen 200 mg to take every 8 hours if required. Pain levels were assessed by an analog scale questionnaire after 4, 24, and 48 hours. The amount of ibuprofen taken was recorded at the same time intervals. Results: During the 0-to 4-, 4-to 24-, and 24-to 48-hour intervals after treatment, the pain experience with the negative apical pressure device was significantly lower than when using the needle irrigation (p < 0.0001 [4, 24, 48 hours]). Between 0 and 4 and 4 and 24 hours, the intake of analgesics was significantly lower in the group treated by the negative apical pressure device (p < 0.0001 [0-4 hours], p = 0.001 [4-24 hours]). The difference for the 24-to 48-hour period was not statistically different (p = 0.08). The Pearson correlation coefficient revealed a strongly positive and significant relationship for the MP group (r = 0.851, p < 0.001) and the EV group (r = 0.596, p < 0.0001) between pain intensity and the amount of analgesics. Conclusion: The outcome of this investigation indicates that the use of a negative apical pressure irrigation device can result in

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