Metaanalysis of filler materials in periapical surgery

Abstract

Our purpose was to evaluate the success and failure, apical sealing and biocompatibility of silver amalgam, IRM®, SuperEBA® and MTA as retrograde filler materials. A metaanalysis was made of filler materials in periapical surgery, evaluating a total of 30 articles published in recent years. Percentage success with silver amalgam was 76.5% and slightly inferior to that afforded by IRM®. Performance in turn increased considerably when the materials used were SuperEBA® or MTA. As regards marginal leakage, MTA with a mean leakage time of 65.5 days afforded the best results, followed by SuperEBA®, IRM® and silver amalgam. MTA was the most biocompatible of the materials studied, with practically no inflammatory response, while inflammation proved mild or moderate with SuperEBA®, mild with IRM®, and moderate to severe in the case of silver amalgam. Tissue regeneration was only observed with MTA, in the same way as cement appositioning. Bone neoformation was observed with all four filler materials. In conclusion, MTA appears to be an ideal material, though the results obtained require confirmation by in vivo studies.