ROEN0210

18 I I clinical report _ apical microsurgery series _The operator is now at a stage in the micro- surgical procedure at which the tissues have been atraumatically retracted, the crypt is well managed, the REP is acid etched, rinsed, dried and ready to be filled. By removing the smear-layer barrier, exposing the organic component (collagen fibrils) of the re- sected cementum and dentine, has been shown to enhance cemento-genesis and is one of the keys to dento-alveolar healing.1 There are several retro-fill materials currently available:amalgam,IRM,SuperEBA(SEBA;Bosworth), bonded composites (OptiBond, Sybron Dental), glass ionomers (Geristore, Den-Mat) and, more recently, Mineral Trioxide Aggregate (MTA; DENTSPLY Tulsa Dental). The number of publications in the literature regarding research on the above materials is exten- sive; thus, only a few of these are mentioned. I do not wish to recommend or condemn any retro-fill mate- roots2_2010 Apical microsurgery— Part V: REF materials and techniques Author_ Dr John J. Stropko, USA Fig. 1a Fig. 1b Fig. 1c In Parts I to IV, the necessary steps and procedures were presented, enabling the operator to atraumatically and predictably allow the root-end preparation (REP) to be sealed using any accepted root-end fill (REF) material.The surgical crypt should be clean and dry so that vision is clear and unobstructed. Remember, the steps must be followed completely in order to achieve as predictable a result as humanly possible. If, for some reason, crypt management is not com- plete or the REP is not clean and finished, it will be necessary to repeat a step, or two, to achieve the desired result. The importance of having total control at this point in the apical microsurgi- cal procedure cannot be over-emphasised. Fig. 1a_Amalgam is the most radiopaque REF material, but its use is highly controversial. Fig. 1b_SEBA has a radiopacity similar to that of gutta-percha. Fig. 1c_MTA has a radiopacity just slightly better than gutta-percha.

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