human
***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: Introduction The importance of perfect apical seal in endodontics , more specifically in periradicular surgery , is the motivation/reason for development of root-end filling material s with favorable physical , chemical and biological characteristics . The aim of this in vitro study was to evaluate the marginal adaptation of root-end filling material s using scanning electron microscopy . Material s and Methods Twenty five human maxillary anterior teeth were prepared using a K-File # 50 to 1 mm short of the apical foramen and filled with gutta-percha and Sealapex using the lateral compaction technique . The apical 3 mm of the roots were sectioned perpendicularly to the long axis of the teeth . A 3-mm-deep root-end cavity was prepared using ultrasonic tips powered by an Enac ultrasonic unit . The teeth were r and omly assigned to five groups according to the material s tested including IRM , amalgam , ProRoot MTA , Super-EBA and Epiphany/Resilon . Root-end cavities were filled with the material s prepared according to the manufacturers ’ instructions . The root apices were carefully prepared for sputter coating and later evaluation using Scanning Electron Microscope ( SEM ) . The images of root-end fillings were divided into four quadrants and distributed into five categories according to the level of marginal adaptation between the root-end material and the root canal walls . The Fisher exact test with Bonferroni correction was used for statistical analysis . The level of significance was set at P = 0.005 . Results SEM images showed the presence of gaps in the root-end filling material s. No significant difference was observed between the tested material s ( P > 0.005 ) . Conclusion ProRoot MTA , IRM , amalgam , Super-EBA and Epiphany/Resilon showed similar marginal adaptation as root-end filling material Context : Where nonsurgical endodontic intervention is not possible , or it will not solve the problem , surgical endodontic treatment must be considered . A major cause of surgical endodontic failures is an inadequate apical seal , so the use of the suitable substance as root-end filling material that prevents egress of potential contaminants into periapical tissue is very critical . Aims : The aim of the present ex-vivo study was to compare and evaluate the three root-end filling material s of mineral trioxide aggregate ( MTA ) family ( white MTA [ WMTA ] , grey MTA [ GMTA ] and Portl and cement [ PC ] ) for their marginal adaptation at the root-end dentinal wall using scanning electron microscopy ( SEM ) . Material s and Methods : Sixty human single-rooted teeth were decoronated , instrumented , and obturated with Gutta-percha .  After the root-end resection and apical cavity preparation , the teeth were r and omly divided into three-experimental groups ( each containing 20 teeth ) and each group was filled with their respective experimental material s. After longitudinal sectioning of root , SEM examination was done to determine the overall gap between retro grade material s and cavity walls in terms of length and width of the gap ( maximum ) at the interface . Descriptive statistical analysis was performed to calculate the means with corresponding st and ard errors , median and ranges along with an analysis of variance and Tukey 's test . Results : The least overall gap was observed in GMTA followed by PC and WMTA . While after statistically analyzing the various data obtained from different groups , there was no significant difference among these three groups in terms of marginal adaptation . Conclusion : GMTA showed the best overall adaptation to root dentinal wall compared to PC and WMTA . Being biocompatible and cheaper , the PC may be an alternative but not a substitute for MTA INTRODUCTION Recent meta-analyses of the outcome of apical surgery using modern techniques including microsurgical principles and high-power magnification have yielded higher rates of healing . However , the information is mainly based on 1- to 2-year follow-up data . The present prospect i ve study was design ed to re-examine a large sample of teeth treated with apical surgery after 5 years . METHODS Patients were recalled 5 years after apical surgery , and treated teeth were classified as healed or not healed based on clinical and radiographic examination . ( The latter was performed independently by 3 observers ) . Two different methods of root-end preparation and filling ( primary study parameters ) were to be compared ( mineral trioxide aggregate [ MTA ] vs adhesive resin composite [ COMP ] ) without r and omization . RESULTS A total of 271 patients and teeth from a 1-year follow-up sample of 339 could be re-examined after 5 years ( dropout rate = 20.1 % ) . The overall rate of healed cases was 84.5 % with a significant difference ( P = .0003 ) when comparing MTA ( 92.5 % ) and COMP ( 76.6 % ) . The evaluation of secondary study parameters yielded no significant difference for healing outcome when comparing subcategories ( ie , sex , age , type of tooth treated , post/screw , type of surgery ) . CONCLUSIONS The results from this prospect i ve nonr and omized clinical study with a 5-year follow-up of 271 teeth indicate that MTA exhibited a higher healing rate than COMP in the longitudinal prognosis of root-end sealing The aim of this study was to evaluate the sealing ability and marginal adaptation of calcium silicate-based cements ( CSCs ) in root-end cavities prepared by ultrasonic and laser tips . A total of 72 extracted human maxillary incisor teeth were r and omly divided as 60 teeth in experimental groups and 6 teeth each for positive and negative control groups . Specimens in experimental groups were obturated , their root-end resections were performed and r and omly divided into six groups ( n = 10 ) as follows : G1 : Ultrasonic retrotip + MTA , G2 : Ultrasonic retrotip + Calcium Enriched Mixture ( CEM ) , G3 : Ultrasonic retrotip + Biodentine , G4 : Er : YAG laser tip + MTA , G5 : Er : YAG laser tip + CEM , G6 : Er : YAG laser tip + Biodentine . The sealing ability was measured by fluid transport method . Six specimens from each experimental group were r and omly selected to analyze marginal adaptation and prepared for scanning electron microscopy ( SEM ) analysis . Micrographs were scored and also analyzed using Image J software . Data were analyzed with ; two-way ANOVA , Bonferroni , Kruskall-Wallis , Mann-Whitney-U , Siegel & Castellan , and Spearman correlation coefficient tests . No significant difference was found between material s regarding the sealing ability and marginal adaptation ( p > 0.05 ) . Significantly greater fluid movement and poor marginal adaptation were seen for material s placed in cavities prepared by laser tips ( p < 0.05 ) . Positive correlation was found between the results of scoring and Image J analysis of SEM images ( r = 0.596 , p < 0.001 ) . Fluid transport method and SEM analysis gave similar results suggesting the use of ultrasonic-retrotips for preparing root-end cavities which are going to be filled with one of these CSCs Introduction : This prospect i ve r and omized controlled study evaluated the clinical and radiographic outcome of endodontic microsurgery when using iRoot BP Plus Root Repair Material ( BP‐RRM ; Innovative BioCeramix Inc , Vancouver , BC , Canada ) or mineral trioxide aggregate ( MTA ) as the retro grade filling material and analyzed the relationship between some potential prognostic factors and the outcome of the surgery . Methods : By using strict inclusion and exclusion criteria , 240 teeth were successfully enrolled and r and omly and equally allocated to either the MTA or BP‐RRM treatment group . A st and ardized surgical procedure was performed by a single operator . The patients were followed up at 1 week , 3 months , 6 months , and 12 months ; follow‐up included clinical and radiographic examination . Clinical and radiographic evaluations acquired at the 12‐month follow‐up were taken as the primary outcome . For the identification of prognostic factors , the dichotomous outcome ( success vs failure ) was taken as the dependent variable . Results : A total of 158 teeth were analyzed at the 12‐month follow‐up , including 87 teeth in the MTA group and 71 teeth in the BP‐RRM group . The success rate in the MTA and BP‐RRM groups was 93.1 % ( 81/87 teeth ) and 94.4 % ( 67/71 teeth ) , respectively ( P > .05 ) . Three significant outcome predictors were identified : quality of root filling ( P < .05 ) , tooth type ( P < .05 ) , and size of the lesion ( P < .05 ) Conclusions : These results suggest that BP‐RRM is comparable with MTA in clinical outcome when used as root‐end filling material s in endodontic microsurgery Apicoectomy failure is generally related to inappropriate marginal sealing of the retrocavity , which allows percolation of microorganisms and their products from root canal system to periapex . This study evaluated tubular penetration of canal sealers and marginal permeability after retrocavity irradiation with Er;Cr : YSGG laser and retrofilling with MTA or cyanoacrylate .  Twenty-two single-rooted teeth were decoronated and endodontically treated , their apical 3 mm were resected and the root ends were retroprepared with a low-speed bur .  Twenty roots were r and omly assigned to 4 groups ( n=5 ) : GI and GII -- retrofilling with MTA and cyanoacrylate , respectively ; GIII and GIV -- retrocavity irradiation with Er;Cr : YSGG laser ( 2.78 microm , 4 W , 20 Hz , 70.8 J/cm(2 ) ) and retrofilling with MTA and cyanoacrylate , respectively . The remaining 2 roots served as positive and negative controls . The analysis of rhodamine B dye infiltration ( p=0.05 ) demonstrated that laser irradiation and MTA retrofilling presented significantly higher permeability rates ( p<0.05 ) . Retrofilling with cyanoacrylate showed significantly lower permeability , either when laser was used or not on retrocavity . SEM analysis depicted more cyanoacrylate penetration through dentinal tubules when compared to MTA , suggesting a more efficient marginal sealing . Based on these results , it may be concluded that cyanoacrylate provided a less permeable retrofilling regardless of the retropreparation method , suggesting a more favorable condition to the establishment of the periapical healing This in vitro study used rhodamine B fluorescent dye and a confocal microscope to evaluate the sealing ability of amalgam , super EBA , and a mineral trioxide aggregate when used as root end filling material s. Thirty single-canal teeth were cleaned , shaped , and obturated with gutta-percha and root canal sealer . After application of nail polish to the external surface , the apical 3 mm of each root was resected and 3-mm deep root end preparations were made . The roots were r and omly divided into three groups and the root end preparations filled with the experimental material s. All roots were then exposed to an aqueous solution of rhodamine B fluorescent dye for 24 h , longitudinally sectioned , and the extent of dye penetration measured using a confocal microscope . Statistical analysis showed that the mineral trioxide aggregate leaked significantly less than amalgam and super EBA Objective The aim of this study was to evaluate the marginal adaptation of Biodentine in comparison with Mineral Trioxide Aggregate ( MTA ) and Intermediate Restorative Material ( IRM ) , as a root end filling material , using Scanning Electron Microscopy ( SEM ) . Material s and Methods : Thirty permanent maxillary central incisors were chemo-mechanically prepared and obturated . Three millimetres of the root end were resected and 3 mm retro cavity preparation was done using ultrasonic retrotips . The sample s were r and omly divided into three groups ( n=10 ) and were restored with root end filling material s : Group I – MTA , Group II – Biodentine , Group III – IRM . The root ends were sectioned transversely at 1 mm and 2 mm levels and evaluated for marginal adaptation using SEM . The gap between dentin and retro filling material was measured at four quadrants . The mean gap at 1 mm level and 2 mm level from the resected root tip and combined mean were calculated . The data were statistically analyzed , using one-way ANOVA and Tukey ’s HSD post hoc test for intergroup analysis and paired t-test for intragroup analysis . Results : The overall results showed no statistically significant difference between MTA and IRM but both were superior when compared to Biodentine . At 1 mm level there was no statistically significant difference among any of the tested material s. At 2 mm level MTA was superior to both IRM and Biodentine . Conclusion : In overall comparison , MTA and IRM were significantly superior when compared to Biodentine in terms of marginal adaptation , when used as retro grade filling material INTRODUCTION The purpose of the present study was to evaluate the clinical outcomes of endodontic microsurgery when super ethoxy-benzoic acid ( Super EBA ; Harry J. Bosworth , Skokie , IL ) and mineral trioxide aggregate ( MTA ) were used as root-end filling material s in a prospect i ve r and omized controlled study . METHODS Of the 388 teeth eligible for endodontic microsurgery , 128 teeth were excluded from the study , and 260 teeth were r and omly assigned to either the Super EBA group or the MTA group with equal numbers using the " minimization method . " Endodontic microsurgical procedures were performed according to the Yonsei protocol reported in a previous study and were carried out by a single operator . The patients were followed up at 3 , 6 , and 12 months . The primary outcome measure was the change in the apical bone density at 12 months , and the secondary outcome measures were the presence of clinical symptoms or abnormal findings at 12 months . RESULT 
    Output:
    
agent
On the basis of available evidence , MTA presented good marginal adaptation to dentine walls .
***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: Introduction The importance of perfect apical seal in endodontics , more specifically in periradicular surgery , is the motivation/reason for development of root-end filling material s with favorable physical , chemical and biological characteristics . The aim of this in vitro study was to evaluate the marginal adaptation of root-end filling material s using scanning electron microscopy . Material s and Methods Twenty five human maxillary anterior teeth were prepared using a K-File # 50 to 1 mm short of the apical foramen and filled with gutta-percha and Sealapex using the lateral compaction technique . The apical 3 mm of the roots were sectioned perpendicularly to the long axis of the teeth . A 3-mm-deep root-end cavity was prepared using ultrasonic tips powered by an Enac ultrasonic unit . The teeth were r and omly assigned to five groups according to the material s tested including IRM , amalgam , ProRoot MTA , Super-EBA and Epiphany/Resilon . Root-end cavities were filled with the material s prepared according to the manufacturers ’ instructions . The root apices were carefully prepared for sputter coating and later evaluation using Scanning Electron Microscope ( SEM ) . The images of root-end fillings were divided into four quadrants and distributed into five categories according to the level of marginal adaptation between the root-end material and the root canal walls . The Fisher exact test with Bonferroni correction was used for statistical analysis . The level of significance was set at P = 0.005 . Results SEM images showed the presence of gaps in the root-end filling material s. No significant difference was observed between the tested material s ( P > 0.005 ) . Conclusion ProRoot MTA , IRM , amalgam , Super-EBA and Epiphany/Resilon showed similar marginal adaptation as root-end filling material Context : Where nonsurgical endodontic intervention is not possible , or it will not solve the problem , surgical endodontic treatment must be considered . A major cause of surgical endodontic failures is an inadequate apical seal , so the use of the suitable substance as root-end filling material that prevents egress of potential contaminants into periapical tissue is very critical . Aims : The aim of the present ex-vivo study was to compare and evaluate the three root-end filling material s of mineral trioxide aggregate ( MTA ) family ( white MTA [ WMTA ] , grey MTA [ GMTA ] and Portl and cement [ PC ] ) for their marginal adaptation at the root-end dentinal wall using scanning electron microscopy ( SEM ) . Material s and Methods : Sixty human single-rooted teeth were decoronated , instrumented , and obturated with Gutta-percha .  After the root-end resection and apical cavity preparation , the teeth were r and omly divided into three-experimental groups ( each containing 20 teeth ) and each group was filled with their respective experimental material s. After longitudinal sectioning of root , SEM examination was done to determine the overall gap between retro grade material s and cavity walls in terms of length and width of the gap ( maximum ) at the interface . Descriptive statistical analysis was performed to calculate the means with corresponding st and ard errors , median and ranges along with an analysis of variance and Tukey 's test . Results : The least overall gap was observed in GMTA followed by PC and WMTA . While after statistically analyzing the various data obtained from different groups , there was no significant difference among these three groups in terms of marginal adaptation . Conclusion : GMTA showed the best overall adaptation to root dentinal wall compared to PC and WMTA . Being biocompatible and cheaper , the PC may be an alternative but not a substitute for MTA INTRODUCTION Recent meta-analyses of the outcome of apical surgery using modern techniques including microsurgical principles and high-power magnification have yielded higher rates of healing . However , the information is mainly based on 1- to 2-year follow-up data . The present prospect i ve study was design ed to re-examine a large sample of teeth treated with apical surgery after 5 years . METHODS Patients were recalled 5 years after apical surgery , and treated teeth were classified as healed or not healed based on clinical and radiographic examination . ( The latter was performed independently by 3 observers ) . Two different methods of root-end preparation and filling ( primary study parameters ) were to be compared ( mineral trioxide aggregate [ MTA ] vs adhesive resin composite [ COMP ] ) without r and omization . RESULTS A total of 271 patients and teeth from a 1-year follow-up sample of 339 could be re-examined after 5 years ( dropout rate = 20.1 % ) . The overall rate of healed cases was 84.5 % with a significant difference ( P = .0003 ) when comparing MTA ( 92.5 % ) and COMP ( 76.6 % ) . The evaluation of secondary study parameters yielded no significant difference for healing outcome when comparing subcategories ( ie , sex , age , type of tooth treated , post/screw , type of surgery ) . CONCLUSIONS The results from this prospect i ve nonr and omized clinical study with a 5-year follow-up of 271 teeth indicate that MTA exhibited a higher healing rate than COMP in the longitudinal prognosis of root-end sealing The aim of this study was to evaluate the sealing ability and marginal adaptation of calcium silicate-based cements ( CSCs ) in root-end cavities prepared by ultrasonic and laser tips . A total of 72 extracted human maxillary incisor teeth were r and omly divided as 60 teeth in experimental groups and 6 teeth each for positive and negative control groups . Specimens in experimental groups were obturated , their root-end resections were performed and r and omly divided into six groups ( n = 10 ) as follows : G1 : Ultrasonic retrotip + MTA , G2 : Ultrasonic retrotip + Calcium Enriched Mixture ( CEM ) , G3 : Ultrasonic retrotip + Biodentine , G4 : Er : YAG laser tip + MTA , G5 : Er : YAG laser tip + CEM , G6 : Er : YAG laser tip + Biodentine . The sealing ability was measured by fluid transport method . Six specimens from each experimental group were r and omly selected to analyze marginal adaptation and prepared for scanning electron microscopy ( SEM ) analysis . Micrographs were scored and also analyzed using Image J software . Data were analyzed with ; two-way ANOVA , Bonferroni , Kruskall-Wallis , Mann-Whitney-U , Siegel & Castellan , and Spearman correlation coefficient tests . No significant difference was found between material s regarding the sealing ability and marginal adaptation ( p > 0.05 ) . Significantly greater fluid movement and poor marginal adaptation were seen for material s placed in cavities prepared by laser tips ( p < 0.05 ) . Positive correlation was found between the results of scoring and Image J analysis of SEM images ( r = 0.596 , p < 0.001 ) . Fluid transport method and SEM analysis gave similar results suggesting the use of ultrasonic-retrotips for preparing root-end cavities which are going to be filled with one of these CSCs Introduction : This prospect i ve r and omized controlled study evaluated the clinical and radiographic outcome of endodontic microsurgery when using iRoot BP Plus Root Repair Material ( BP‐RRM ; Innovative BioCeramix Inc , Vancouver , BC , Canada ) or mineral trioxide aggregate ( MTA ) as the retro grade filling material and analyzed the relationship between some potential prognostic factors and the outcome of the surgery . Methods : By using strict inclusion and exclusion criteria , 240 teeth were successfully enrolled and r and omly and equally allocated to either the MTA or BP‐RRM treatment group . A st and ardized surgical procedure was performed by a single operator . The patients were followed up at 1 week , 3 months , 6 months , and 12 months ; follow‐up included clinical and radiographic examination . Clinical and radiographic evaluations acquired at the 12‐month follow‐up were taken as the primary outcome . For the identification of prognostic factors , the dichotomous outcome ( success vs failure ) was taken as the dependent variable . Results : A total of 158 teeth were analyzed at the 12‐month follow‐up , including 87 teeth in the MTA group and 71 teeth in the BP‐RRM group . The success rate in the MTA and BP‐RRM groups was 93.1 % ( 81/87 teeth ) and 94.4 % ( 67/71 teeth ) , respectively ( P > .05 ) . Three significant outcome predictors were identified : quality of root filling ( P < .05 ) , tooth type ( P < .05 ) , and size of the lesion ( P < .05 ) Conclusions : These results suggest that BP‐RRM is comparable with MTA in clinical outcome when used as root‐end filling material s in endodontic microsurgery Apicoectomy failure is generally related to inappropriate marginal sealing of the retrocavity , which allows percolation of microorganisms and their products from root canal system to periapex . This study evaluated tubular penetration of canal sealers and marginal permeability after retrocavity irradiation with Er;Cr : YSGG laser and retrofilling with MTA or cyanoacrylate .  Twenty-two single-rooted teeth were decoronated and endodontically treated , their apical 3 mm were resected and the root ends were retroprepared with a low-speed bur .  Twenty roots were r and omly assigned to 4 groups ( n=5 ) : GI and GII -- retrofilling with MTA and cyanoacrylate , respectively ; GIII and GIV -- retrocavity irradiation with Er;Cr : YSGG laser ( 2.78 microm , 4 W , 20 Hz , 70.8 J/cm(2 ) ) and retrofilling with MTA and cyanoacrylate , respectively . The remaining 2 roots served as positive and negative controls . The analysis of rhodamine B dye infiltration ( p=0.05 ) demonstrated that laser irradiation and MTA retrofilling presented significantly higher permeability rates ( p<0.05 ) . Retrofilling with cyanoacrylate showed significantly lower permeability , either when laser was used or not on retrocavity . SEM analysis depicted more cyanoacrylate penetration through dentinal tubules when compared to MTA , suggesting a more efficient marginal sealing . Based on these results , it may be concluded that cyanoacrylate provided a less permeable retrofilling regardless of the retropreparation method , suggesting a more favorable condition to the establishment of the periapical healing This in vitro study used rhodamine B fluorescent dye and a confocal microscope to evaluate the sealing ability of amalgam , super EBA , and a mineral trioxide aggregate when used as root end filling material s. Thirty single-canal teeth were cleaned , shaped , and obturated with gutta-percha and root canal sealer . After application of nail polish to the external surface , the apical 3 mm of each root was resected and 3-mm deep root end preparations were made . The roots were r and omly divided into three groups and the root end preparations filled with the experimental material s. All roots were then exposed to an aqueous solution of rhodamine B fluorescent dye for 24 h , longitudinally sectioned , and the extent of dye penetration measured using a confocal microscope . Statistical analysis showed that the mineral trioxide aggregate leaked significantly less than amalgam and super EBA Objective The aim of this study was to evaluate the marginal adaptation of Biodentine in comparison with Mineral Trioxide Aggregate ( MTA ) and Intermediate Restorative Material ( IRM ) , as a root end filling material , using Scanning Electron Microscopy ( SEM ) . Material s and Methods : Thirty permanent maxillary central incisors were chemo-mechanically prepared and obturated . Three millimetres of the root end were resected and 3 mm retro cavity preparation was done using ultrasonic retrotips . The sample s were r and omly divided into three groups ( n=10 ) and were restored with root end filling material s : Group I – MTA , Group II – Biodentine , Group III – IRM . The root ends were sectioned transversely at 1 mm and 2 mm levels and evaluated for marginal adaptation using SEM . The gap between dentin and retro filling material was measured at four quadrants . The mean gap at 1 mm level and 2 mm level from the resected root tip and combined mean were calculated . The data were statistically analyzed , using one-way ANOVA and Tukey ’s HSD post hoc test for intergroup analysis and paired t-test for intragroup analysis . Results : The overall results showed no statistically significant difference between MTA and IRM but both were superior when compared to Biodentine . At 1 mm level there was no statistically significant difference among any of the tested material s. At 2 mm level MTA was superior to both IRM and Biodentine . Conclusion : In overall comparison , MTA and IRM were significantly superior when compared to Biodentine in terms of marginal adaptation , when used as retro grade filling material INTRODUCTION The purpose of the present study was to evaluate the clinical outcomes of endodontic microsurgery when super ethoxy-benzoic acid ( Super EBA ; Harry J. Bosworth , Skokie , IL ) and mineral trioxide aggregate ( MTA ) were used as root-end filling material s in a prospect i ve r and omized controlled study . METHODS Of the 388 teeth eligible for endodontic microsurgery , 128 teeth were excluded from the study , and 260 teeth were r and omly assigned to either the Super EBA group or the MTA group with equal numbers using the " minimization method . " Endodontic microsurgical procedures were performed according to the Yonsei protocol reported in a previous study and were carried out by a single operator . The patients were followed up at 3 , 6 , and 12 months . The primary outcome measure was the change in the apical bone density at 12 months , and the secondary outcome measures were the presence of clinical symptoms or abnormal findings at 12 months . RESULT 
    Output:
    