Evaluation of three silicone-based materials as potential retrograde fillings in surgical endodontics

Endodontic therapy has played an important role in maintaining the integrity of the natural dentition as a fully functional and esthetic masticatory apparatus. Although the sealing of the root canal system is usually accomplished by the conservative endodontic approach, cases which have failed or which involve perforations, broken instruments, or post-crown restorations are almost always treated surgically by using zinc-free amalgam as a retrograde filling material. However, the literature is controversial concerning the health risks and benefits of this material. For this reason, the study presented here was initiated to evaluate the potential of (a) a medical grade silicone-titanium mesh compound; (b) Endo-Fill (Lee Pharmaceuticals, El Monte, CA); and (c) an experimental expanding Endo-Fill (Lee Pharmaceuticals) as alternatives to amalgam. The three silicone-based materials and amalgam were compared for linear apical dye leakage. The leakage study involved 80 teeth which were instrumented, obturated, and prepared surgically for one of the four test materials. Either the teeth were placed immediately into 1% methylene blue dye or the material was allowed to set for 24 h before placement into the dye. Endo-Fill showed significantly less leakage than did the other materials in both the immediately placed and the 24-h set groups. On the other extreme, the experimental expanding Endo-Fill allowed significantly more dye penetration than did amalgam and the other silicone variations.