الفهرس 
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Abstract
This study was designed to evaluate and compare clinical outcomes, biocompatibility and adaptability of three root end filling materials namely TotalFill, MTA and IRM.
Twenty four patients were included in this study. All the procedures were performed under local anesthesia. A buccal mucoperiosteal tissue flap was raised and sufficient bone was removed to expose the apex. Affected roots were then resected approximately 3 mm from the apex. Root end cavities were prepared with ultrasonic tip and were retrofilled with the tested materials. The patients were recalled every 3 months for 1 year to assess the clinical and radiographic signs of healing. Twenty four patients were divided into three equal groups of 8 patients each according to the material used.
group I: Root end cavities filled with TotalFill.
group II: Root end cavities filled with MTA.
group III: Root end cavities filled with IRM.
Twenty four old male rats were used in this study. The dorsal skins of the animals were shaved under ether anesthesia and disinfected with 5% iodine solution. Four incisions were made on the back of each rat. Freshly mixed tested materials were placed in clean, sterile polyethylene tubes. One polyethylene tube was placed
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in each rat as a control. The skin was closed with 3/0 silk suture. The evaluations were made at 3, 7, and 21 days after surgical implantation. In each examination period, 8 animals were sacrificed by administrating high doses of anesthetics. The tubes and surrounding tissues were removed in blocks, fixed, sections and stained with hematoxylin and eosin for histological examination under a light microscope.
Thirty single rooted freshly extracted human teeth with mature apices were selected. Clinical crowns were sectioned at the cement-enamel junction to create a standardized length of about 16 mm. The root canals were instrumented in a crown down technique by using Protaper rotary nickel titanium files. After completion of the instrumentation, the smear layer was removed with 17 % EDTA for 3 minutes followed by 5.25% NaOCl. Finally the canal was flushed with distilled water then dried with paper points. Root canals were obturated with Gutta-percha and resin based sealer. The root-ends were then resected perpendicular to the long axes of the teeth using a high speed handpiece and air water spray with a tapered fissure bur and ultrasonically prepared to receive a retrofilling. Under scanning electron microscopy, the gaps between the material and dentinal wall were measured. Thirty teeth were divided into three equal groups of 10 teeth each according to the material used.
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group I: Root end cavities filled with TotalFill.
group II: Root end cavities filled with MTA.
group III: Root end cavities filled with IRM.
The results of the present study could be summarized as follows:
1 - Radiologic evaluation and clinical examination revealed 87.5 % success rate for the IRM group, 100 % for the MTA group and 100 % for the TotalFill group. There was no statistical significance in the healing outcome between the 3 groups
2- Control group showed the lowest median inflammatory cell score followed by TotalFill group followed by MTA group while IRM group recorded the highest median inflammatory cell score at the three observation periods.
3- In all Groups there was decrease in median inflammatory cell score by time.
4- The maximum mean gap measurements were found in IRM, whereas the minimum mean gap measurements were found in TotalFill.