الفهرس 
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Abstract
Objectives: this study intended to evaluate the cytotoxicity of Biodentine and MTA materials to fibroblast cell lines (laboratory) and to investigate the healing following periradicular surgery with the use of Biodentine and MTA as retrograde root-filling materials (clinically).Materials and methods: Laboratory part: MRC5 and BHK-21 fibroblast cell lines were incubated for 1 day in the extracts of MTA and Biodentine materials (1, 3, and 7 days extracts) and directly with fresh set materials immersed in culture medium. Cytotoxicity was evaluated by MTT assay. Concentration of calcium ion was measured in each extract using colorimetric assay. Clinical study: twenty patients eligible for endodontic surgery were selected for this study. 2 groups (according to type of retrograde filling) patients (n=10) were subjected to Endodontic microsurgical procedures that included root end resection followed with ultrasonic root end cavity preparation and retrograde filling application. The patients were followed up at 3, 6, 9, and 12 months. The primary outcome measure was the change in the apical bone density; evaluated with periapical radiographs; in conjunction with presence or absence of clinical signs and symptoms at 12 months. The secondary outcome measures were the change in lesion volume and bone density after 1 year of the surgical procedure and were evaluated via the use of CBCT. Data obtained were analyzed using chi- square test and T-test at significance level p< 0.05. Results: MTT viability assay revealed that MTA preserved cell viability better than Biodentine. 7th day extract significantly showed higher number of cells than 1st and 3rd days extracts (P < .05). Biodentine extracts (1, 3 and 7 days extracts) revealed significant higher concentration of calcium ions than MTA extracts. Results of clinical study revealed no significant differences between MTA and Biodentine regarding healing of periapical tissues. Conclusion: in this study, Biodentine revealed more cytotoxicity than MTA, however, both materials exhibited biocompatible properties and can be used in contact with living cells. Clinically, the use of Biodentine as root end filling material resulted in high success rate that was not significantly better than that obtained using MTA.