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20 I I clinical report _ apical microsurgery series rial (except amalgam), but will generalise and relate my—andthoseofothers—experienceofandopinions about their applications. Amalgam and IRM were used for many years as the only commonly available retro-fill materials. However, in almost every leakage study published during the past few years, amalgam has proven to be the worst offender, exhibiting the most leakage.2,3 This fact, accompanied by the general controversy about mercury in amalgam, strongly suggests that there is no valid reason to continue its use as a retro- fill material. The only real advantage to amalgam is its favourable radiopacity (Fig. 1a). In fact, of all REF materials commonly in use today, none of them compare to the radiopacity of amalgam. Since the advent of the anatomically correct, ultrasonic REP, one of the most popular REF materi- alsstillinusetodayisSEBA.Arecentfollow-upstudy demonstrated a success rate of 91.5% using SEBA.4 The author used SEBA routinely in the early nineties with full confidence in its sealing capabilities. To some, the major drawback of SEBA is its tech- nique sensitivity. The surgical assistant has to mix it until it is sufficiently thick to roll into a thin tapered point with the consistency of dough. For even a well-trained assistant, this is often the most stressful part of the microsurgical procedure. The dough-like tapered end of the thin SEBA roll is then segmented withaninstrument,suchasasmallHollenbackCarver. Thesmallcone-shapedendpieceistheninsertedinto the retro-preparation and gently compacted coro- nallywiththeappropriateplugger.Twotofiveofthese small segments are usually necessary to overfill the retro-preparation slightly. Another problem experi- enced by many is that SEBA is unpredictable as to its setting time, sometimes setting too quickly and at other times, taking much too long for the tired sur- geon. At any rate, after the REF has been completed, an instrument and/or bur is used to smooth the resected surface, producing the final finish. A mild etchant is then used to remove the smear layer pro- duced during the final finishing process. SEBA has a radiopacity comparable to that of gutta-percha, so it is necessary to inform the referring doctor that aretro-fillhadindeedbeenperformed(Fig.1b).How- ever, in some recent studies, SEBA has been shown to haveabettersealingabilitythanIRMbutdoesnotseal as well as MTA.2,3 Bonding, using composite retro-fill materials, is nowpossiblebecausesurgeonscanhavetotalcontrol over the apical environment utilising good crypt management procedures. Many different materials areavailableforuseasanREF.OptiBondandGeristore roots2_2010 Fig. 2b Fig. 2c Fig. 2a_The Lee MTA Pellet Forming Block has multiple sized grooves for MTA. Fig. 2b_MTA is removed with an instrument to be delivered to the REP. Fig. 2a