Hello Guys

I've observed more that 12 Apicectomy operations here in Guy's Hospital, they don's use Amalgam anymore as a retrograde filling material, and they use IRM (a material likes Eugenol and ZnO) as the recomended material for sealing the apix after the the Apicectomy

Cheers,

السلام عليكم..
حلو كتير ما شاء الله.. والله يزيد الفائدة..
أنا شخصياً ما اقتنعت طاول باستعمال الأملغم في بتر الذروة متل ما درسنا.. يعني مو معقول بعد كل هالعملية الجراحية وفتح شريحة وتجريف عظم وبتر ذروة نجي نستعمل مادة بيجوز تسبب لنا مشاكل أكتر من الفائدة المتوقعة منها..
بتمنالك التوفيق بهالستاج.. شد الهمة.. اشتقنالك..

IRM is a zinc oxide-eugenol composition with polymer reinforcement.



Clinical Information

IRM is a Reinforced Zinc Oxide Eugenol, indicated as a temporary restorative material or base/liner material. Among the many applications are:

* Restoration of deciduous teeth (when permanent teeth are two years or less from eruption)
* Restorative emergencies
* Caries management programme

IRM is available as bottles of powder & liquid as well as capsules. IRM has a mixing time of 1 minute, a working time of 4 minutes and a setting time of 8 minutes, with a self-cure mode of setting. The physical properties are as follows:

* Compressive strength of 10,300 psi
* Solubility of 0.04%
* Film thickness of 60 Microns
* Radiopaque

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I did some research about the subject an got some interresting results on www.PUBMED.gov.
here are some the results :

Periapical tissue response to retrograde fillings of amalgam and IRM
were compared in the mandibular canine of the adult male ferret.
Teeth were cleaned and shaped with a standard technique and obturated with gutta-percha.
The root apex was then exposed and retrofillings were placed.
The animals were grouped according to observation periods of 5, 10, and 15 weeks.
At the proper time the animals were killed and the lower canine tooth along with the surrounding bone was removed.
The tissue blocks were examined clinically, radiographed, and prepared for histologic examination.
The clinical and radiographic examination indicated both materials to be well tolerated by periapical tissues. Microscopic examination of amalgam specimens showed a decrease in inflammation and the formation of a fibrous capsule over the 15-week period. IRM specimens showed persistent inflammation and slower healing potential.

The cytotoxicity of potential retrograde root-filling materials
was assessed using the Millipore filter method.
A light-cured glass ionomer cement, Vitrebond (VB), and three reinforced zinc oxide-eugenol cements, Kalzinol, IRM and ethoxybenzoic acid (EBA) cement, were compared with amalgam.
Twenty standardized pellets of each material, 10 fresh and 10 aged by storage in sterile distilled water for 72 h were produced.
Ten filters were included as controls: five filters with a cell monolayer, but without test specimens, and another five without cells but with test specimens.
Fresh IRM exhibited the most pronounced cytotoxic effect and the difference was statistically significant compared with all the other materials.
There was no statistically significant difference between fresh VB, Kalzinol, EBA cement and amalgam.
When aged, Kalzinol was the most cytotoxic and the difference was statistically significant compared with the other materials.
Aged IRM was the second most cytotoxic material and this too was statistically different.
The cytotoxicity of VB, EBA, and amalgam did not differ significantly from one another.

Take this way too : Sealing ability of amalgam, super EBA cement, and MTA when used as retrograde filling materials[/URL

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