Amalgam versus MTA as root and filling material in apicoectomyzed roots: A long term longitudinal study

Objectives: The success of the apicoectomy is well docu- mented in the first 4 years from the date of the surgery, but a few studies take into consideration the long term success. The purpose of this long term longitudinal study was to com- pare the outcomes of endodontic surgery carried out with two different materials (amalgam and MTA). Materials and methods: Two cohorts of consecutive patients (45 for amalgam and 131 for MTA) have been fol- lowed for 8 years after the root and endodontic surgery. The same operator performed all the surgeries with the same instruments and technique; the only difference was the filling material used. The group treated with amalgam was surger- ized from 1997 to 2002 and the group treated with MTA from 2002 to 2010. For each patient were scheduled recalls at 3, 6 months, and then every year. During each control an X-ray examination and a clinical examination of the surgicalized tooth were performed. 2-tailed Fisher exact test and chi square -test were used for the comparisons of the outcomes between the two groups at each recall time; alfa level was set at 0.05. Results: No significant difference was observed between amalgam and MTA at each recall. Only two unfavourable outcomes were observed with MTA (success percentage = 98.5%) and 3 with amalgam (success percentage: 91.1%). Conclusions: The percentage of favourable outcome was high for both materials and no difference was statistically significant between them at each recall. Unfortunately the compliance of the patients to the recall was low; more than half of the subjects were lost to follow up at each recall time.