Evaluation of the radiopacity of some commercial and experimental root-end filling materials Rodrigo R. Vivan, DDS, MSc, a Ronald Ordinola-Zapata, DDS, a Clóvis M. Bramante, DDS, MSc, PhD, b Norberti Bernardineli, DDS, MSc, PhD, b Roberto B. Garcia, DDS, MSc, PhD, b Marco Antonio Hungaro Duarte, DDS, MSc, PhD, b and Ivaldo Gomes de Moraes, DDS, MSc, PhD, b Bauru, Brazil UNIVERSITY OF SÃO PAULO Objective. The aim of the present study was to evaluate the radiopacity of 5 root end filling materials (white MTA Angelus, MTA Bio, light-cured MTA, Sealepox RP, and Portland cement clinker with bismuth oxide and calcium sulfate). Method. Five specimens, 10 mm in diameter and 1 mm in thickness according to specification ISO 6876:2001 were fabricated from each material and radiographed using Insigth occlusal films close to a graduated aluminum step-wedge (2 to 16 mm in thickness). Radiographs were digitized and compared to the aluminum step-wedge. The radiographic density data were converted into millimeters of aluminum (mm Al), using the Digora 1.51 software. Results were evaluated statistically using the analysis of variance (ANOVA) followed by Tukey test. The level of significance was set at 5% (P .05%). Results. Radiopacity values ranged from 1.21 mm Al (light-cured MTA) to 6.45 mm Al (MTA Angelus). Comparison between materials showed significant difference (P  .05) between MTA Angelus and all other materials, between Sealepox RP and MTA Bio, and between light-cured MTA and Portland cement clinker. Light-cured MTA was significantly less radiopaque than all other materials. No significant difference (P  .05) was found between MTA Bio and Portland cement clinker. Conclusions. All retrograde filling materials evaluated showed greater radiopacity than dentin. All the materials, except light-cured MTA met the minimum radiopacity standards of 3 mm Al recognized by the ISO 6876:2001 and ADA n.57. (Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2009;108:e35-e38) Root end filling is a routinely performed surgical procedure that aims to seal the root canal after apico- ectomy. 1,2 To verify the correct filling of the cavity and to facilitate the follow-up of the case, the retrograde filling material should present sufficient radiopacity. This property is necessary to distinguish the material from the surrounding anatomical structures as tooth and bone. 3,4 In recent years, retrograde filling materials have un- dergone great changes. Silver amalgam was commonly used in the past, but clinical failures were frequent because of poor marginal adaptation and inadequate seal. 5 Currently, new materials are available for retro- grade filling purposes, including root canal sealers, 6,7 zinc oxide and eugenol-based cements, 8,9,10 and min- eral trioxide aggregate (MTA). 2,11 MTA has been considered as the ideal root-end fill- ing material because of its low solubility, low cytotox- icity, tissue biocompatibility, and ability to induce min- eralized tissue formation. 11 MTA Angelus (Angelus, Londrina, PR, Brazil) is produced by adding bismuth oxide to Portland cement to improve its radiopacity. This cement shows properties, such as alkaline pH and calcium ion release, that are similar to those found in ProRoot MTA (Dentsply Tulsa Dental, Tulsa, OK), as previously demonstrated. 12 MTA Bio (Angelus, Londrina, PR, Brazil), an experi- mental MTA-based material, has been recently developed. According to the manufacturer, the goal of this new for- mulation is to reduce the presence and release of arsenic, commonly found in other MTA-based materials. 13,14 An experimental light-cured MTA (Bisco, Itasca, IL), con- taining 44.5% of the active ingredients found in conven- tional MTA, has been tested for its biological properties. 15 In addition to MTA-based materials, a new experimental epoxy resin– based cement with the addition of calcium hydroxide (Sealepox RP) is being developed as an alter- native for root-end filling purposes. a Postgraduate Student of Endodontics, Department of Operative Den- tistry, Dental Materials and Endodontics, Dental School of Bauru, University of São Paulo, Bauru, Brazil. b Professor of Endodontics, Department of Operative Dentistry, Den- tal Materials and Endodontics, Dental School of Bauru, University of São Paulo, Bauru, Brazil. Received for publication Jul 2, 2009; accepted for publication Jul 21, 2009. 1079-2104/$ - see front matter © 2009 Published by Mosby, Inc. doi:10.1016/j.tripleo.2009.07.037 e35