The applications of the plasma matrix in the treatments of dental pulp and periapical diseases / 口腔疾病防治

@#The plasma matrix is a kind of autologous blood conduct. It has been widely used in maxillofacial tissue regeneration, skin cosmetology and some other fields. Recently, to preserve the dental pulp as well as the teeth, pulp regeneration therapy and apical surgery have become increasingly important as well as the applications of bioactive materials. As a kind of autologous bioactive material, the plasma matrix has some natural advantages as it is easy to obtain and malleable. The plasma matrix can be used in the following cases: ①pulp revascularization of young permanent teeth with open apical foramina that cannot stimulate apical bleeding; ② apical barrier surgery with bone defects and large area perforation repair with bone defects or root sidewall repair surgery; ③ apical surgeries of teeth with large area of apical lesions, with or without periodontal diseases. The plasma matrix is a product derived from our blood, and there are no obvious contraindications for its use. Several systematic reviews have shown that the plasma matrix can effectively promote the regenerative repair of dental pulp in patients with periapical diseases. However, the applications of plasma matrix are different because its characteristics are affected by different preparation methods. In addition, there is still a lack of long-term clinical researches on the plasma matrix, and the histological evidences are difficult to obtain, so a large number of in vitro and in vivo experimental studies are still needed. This article will describe the applications of different kinds of plasma matrix for dental pulp regeneration and bone tissue regeneration in apical surgeries to provide references for clinicians in indication selection and prognosis evaluation.

Combined micro-apical surgery and vital pulp therapy in mandibular second molars with external root resorption caused by impacted teeth / 华西口腔医学杂志

OBJECTIVES@#This study aimed to establish a new treatment of the mandibular second molars with external root resorption caused by impacted teeth to preserve the affected teeth and their vital pulps.@*METHODS@#For mandibular second molars clinically diagnosed as external root resorption caused by impacted teeth, debridement and removal of the root at the resorption site via micro-apical surgery and direct capping of the pulp with bioactive material on the surface of the root amputation via vital pulp therapy were performed immediately after the impacted teeth were extracted.@*RESULTS@#The external root resorption of the affected tooth was ceased. It was asymptomatic with intact crown, normal pulp, periapical alveolar bone reconstruction, normal periodontal ligament, continuous bone sclerosis, and no periapical translucency in radiographic examination at the 1-year postoperative follow-up, thus showing good prognosis.@*CONCLUSIONS@#Simultaneous combination of micro-apical surgery and vital pulp therapy after extraction of impacted teeth could successfully preserve mandibular second molars with ERR caused by impacted teeth and their vital pulps.

Addition of MTA in a salicylate-based resin root canal sealer to retrograde root-end filling

Aim To evaluate the flow, pH and calcium release of white MTA (WMTA), salicylate-based resin root canal sealer (Sealapex; SEAL) and SEAL containing 10 (SE10) or 20% (SE20) (w/w) of MTA. Methodology Flow test was realized according to ISO 6876 specification. The sealers samples (n= 10) were placed in polyethylene tubes and immersed in deionized water. After 24 hours and 7, 14, and 28 days, the water pH was determined with a pH meter, and calcium release was assessed by atomic absorption spectrophotometry. Results SEAL and WMTA showed respectively the highest and lowest flow rate when compared with the other materials (P<0.05). SE20 showed the highest pH value only in 24h and 7 days periods (p<0.05). In 14- and 28-days periods, SEAL showed the lowest pH value (p<0.05), but there are no differences between other groups (p>0.05). In all periods, WMTA and SEAL respectively showed the highest and lowest calcium release (p<0.05). Conclusions SE20 proves to be an association with better flow and handling than WMTA, with satisfactory potential for alkalinization and calcium release.

Reimplante intencional: que procedimento é esse que pode salvar dentes? Dois relatos de caso em longo prazo / Intentional replantation: What kind of approach is this that can save teeth? Two long term case reports

Introdução: A manutenção da dentição natural é preferível na maioria dos casos. Muito embora hoje em dia se possa contar com os implantes dentários, em casos com prognóstico menos limitado a preservação dos dentes ainda é mais aconselhável que os implantes. A Endodontia, e todas as suas possibilidades terapêuticas existentes, intenta e faz o papel de especialidade que tem como princípio prevenir ou eliminar a periodontite apical, dando condições de reparo e saúde ao periodonto apical e tecido ósseo. Com o advento tecnológico dos últimos anos, os tratamentos de canal se tornaram muito mais previsíveis e isso se reflete no aumento dos índices de sucesso, tanto de tratamentos primários quanto de retratamentos. Contudo, existem casos que falham, mas esses casos não são o fim da linha para o dente. Entre as manobras existentes para se reintervir em dentes que tiveram um tratamento que fracassou, são possíveis a microcirurgia endodôntica apical ou o reimplante intencional. Método: A manobra de reimplante intencional consiste de várias etapas cirúrgicas que vão desde a extração do elemento dental até a reposição de volta ao seu alvéolo. Neste artigo foram descritos dois casos clínicos limítrofes que foram tratados por meio desse procedimento. Resultados: Os casos apresentaram resultados excelentes, como remissão das lesões apicais, reparo ósseo e permanência dos elementos em boca, com acompanhamento de longo prazo (2 e 11 anos). Conclusões: Com altos índices de sucesso já relatados na literatura, essa modalidade de tratamento precisa ser mais explorada e divulgada no Brasil, principalmente entre alunos de pós-graduação e especialistas em Endodontia, pois comprovadamente pode evitar a indicação desnecessária de implantes dentais (AU).

Introduction: The maintenance of natural dentition is preferable in most of cases. However, nowadays it is possible to use dental implants in cases where prognosis is very limited. Endodontics and all of its therapeutic modalities play an important role, which has, in principle, to prevent or eliminate apical periodontitis providing better conditions for wound healing of periapical and bone tissues. In the past few years, with technological advances, root canal treatment became more predictable and this can be seen reflected in the increase of success rates of primary treatment as well as non-surgical retreatment. Nevertheless, some cases can failure but, it is not the end for the tooth, once some therapeutic approaches are possible, like apical microsurgery or intentional replantation. Method: Intentional replantation is an approach in which some surgical steps are done, since the dental extraction until its repositioning back to the socket. In this article two bordering cases were described. Results: 2 and 11 years follow-up confirm the favorable results of this technique. Both cases with no apical lesion, bone healing and dental elements developing their natural functions. Conclusions: The high successful rates described in the literature give to this treatment approach an important face, and that should be more explored and disclosed in Brazil, specially between specialists and post-graduation students, once can avoid unnecessary dental implants (AU).

Gentamicin Loaded Bone Cement as Root End & Bone Defect Filling Material In Apical Resurgery Cases; A Clinical Study

Aim: Antibiotic loaded bone cement has been used extensively in orthopaedic surgery and in the treatment of osseous defects resulting from joint infection, osteomyelitis, osteitis. No endodontic investigation has used this type of material in the treatment of bony resorptive defects of the periapical lesions associated with failed endodontic therapy or periapical surgery. Therefore, this study was conducted with the use of gentamycin loaded bone cement, to assess healing ability of osseous defects in apical re-surgery cases after failed apical surgery. Methods: In all patients periapical lesions were surgically removed and gentamicin loaded bone cement was used as root end filling material and then carefully packed without pressure into the bony defect. Results: Long-term recall demonstrated clinical and radiographic healing and good tolerance of bone fill material by the periapical tissues. Conclusion: results from this study shows that gentamicin loaded bone cement is a biocompatible material and can be used effectively in apical resurgery cases for treating recalcitrant infectious osseous defects of periapical lesions associated with failed periapical surgery.

The applications of Nd：YAG laser and Er：YAG laser in endodontics / 口腔疾病防治

@#With the gradual maturity of laser technology, it has become widely considered a new method for disease treatment. Nd：YAG laser and Er：YAG laser are two representative solid-state lasers. These lasers are easy to use, comfortable and safe, and thus, they have recently become a research hotspot in dental treatment. Nd：YAG laser and Er：YAG laser have been used for the treatment of dentin hypersensitivity and dental caries, root canal therapy, pulp preservation and apical surgery. They are effective adjuvant methods for the treatment of dental pulp diseases and provide new avenues for clinical treatment. In this paper, the application of Nd：YAG laser and Er：YAG laser in the treatment of dental pulp disease is described to provide a reference for clinical treatment options.

Evaluación de Lesiones Periapicales en Pacientes Derivados a Cirugía Periapical Mediante Tomografía Computarizada de Haz Cónico / Evaluation of Periapical Lesions by Cone Beam Computed Tomography in Patients Referred for Apical Surgery

El uso de la tomografía computarizada de haz cónico (CBCT) en endodoncia ha ido en aumento, justificando su uso en casos más complejos, como cirugías periapicales. El objetivo fue evaluar las características imagenológicas encontradas en un grupo de pacientes derivados a cirugía periapical, mediante el uso de CBCT. Se realizó un estudio observacional descriptivo, en un grupo de pacientes, derivados a cirugía periapical, a los cuales se realizó un examen de CBCT, evaluación clínica y radiografía periapical. Un total de 18 pacientes fueron examinados (6 hombres y 12 mujeres), cuyas edades estaban entre los 19 y 64 años de edad. El diámetro mayor de las lesiones varió entre 6 mm a 16 mm. El uso de CBCT en cirugías periapicales entrega información más completa al cirujano, ya que permite mayor precisión al realizar el acceso quirúrgico y detecta un mayor número de lesiones periapicales que con la radiografía periapical, logrando en casos complejos un mejor diagnóstico y planificación del tratamiento.

The use of cone beam computed tomography (CBCT) in endodontics has increased, justifying its use in more complex cases, such as apical surgery. The aim was to evaluate the radiologic characteristics found in a group of patients referred to apical surgery, using CBCT. A descriptive study was conducted in a group of patients referred for apical surgery. In these patients, a clinical examination, a conventional radiographic evaluation and CBCT were performed. A total of 18 patients were examined (6 men and 12 women), ages were between 19 and 64 years old. The major diameter of the lesions ranged from 6 mm to 16 mm. The use of CBCT in apical surgery provides more complete information to the surgeon, allowing greater precision when performing surgical access and detects a greater number of periapical lesions than with conventional radiography. In complex cases is possible obtain better diagnosis and treatment planning.

Clinical effect of microscopic periapical surgery combined with MTA apical filling in treatment of chronic apical periodontitis / 口腔疾病防治

Objective @#To observe the clinical effect of microscopic periapical surgery combined with (mineral trioxide aggregate (MTA) apical filling in treatment of chronic apical periodontitis. @*Methods@#A total of 64 patients with 91 teeth of chronic apical periodontitis, which couldn't be treated with root canal treatment, were selected and randomly assigned into two groups. 32 patients with 43 teeth in the control group were treated with traditional surgery combined with amalgam filling. 32 patients with 48 teeth in the experimental group were treated with microsurgical apical surgery combined with MTA apical filling. Patients were followed for 12 months. The healing of periapical lesionwere assessed by clinical symptoms and X-ray examination every three months.@*Results @# In the experimental group, 27 cases cured, 17 cases improved, the success rate was 91.67% (44/48). In the control group, 19 cases cured, 12 cases improved, the success rate was 72.09% (31/43). The success rate in experimental group was significantly higher than the control group (χ2 = 5.997, P = 0.014). @*Conclusion@# Effect of microscopic periapical surgerycombined with MTA apical filling in treatment of chronic periapical periodontitis is satifactory.

The clinical evaluation of the effect of two different apical surgery timing / 实用口腔医学杂志

Objective:To observe the effect of two different apical surgery timing. Methods:68 patients with periapical lesion were divided into 2 groups. 30 patients( control group) were operated by apical surgery at least 1-2 months after root canal therapy( RCT) , while 38 patients(experimental group) were operated immediately after RCT. The patients were followed up 3, 6 and 12 months after apical surgery. Results:The curative effect analysed with the age, sex and tooth position showed no statistical difference between 2 groups(P>0. 05). Conclusion:Immediate and delayed apical surgery apical surger after RCT are similarly effective.

Proximity of the mandibular molar root apex from the buccal bone surface: a cone-beam computed tomographic study

OBJECTIVES: The purpose of this study was to evaluate the proximity of the mandibular molar apex to the buccal bone surface in order to provide anatomic information for apical surgery. MATERIALS AND METHODS: Cone-beam computed tomography (CBCT) images of 127 mandibular first molars and 153 mandibular second molars were analyzed from 160 patients' records. The distance was measured from the buccal bone surface to the root apex and the apical 3.0 mm on the cross-sectional view of CBCT. RESULTS: The second molar apex and apical 3 mm were located significantly deeper relative to the buccal bone surface compared with the first molar (p < 0.01). For the mandibular second molars, the distance from the buccal bone surface to the root apex was significantly shorter in patients over 70 years of age (p < 0.05). Furthermore, this distance was significantly shorter when the first molar was missing compared to nonmissing cases (p < 0.05). For the mandibular first molars, the distance to the distal root apex of one distal-rooted tooth was significantly greater than the distance to the disto-buccal root apex (p < 0.01). In mandibular second molar, the distance to the apex of C-shaped roots was significantly greater than the distance to the mesial root apex of non-C-shaped roots (p < 0.01). CONCLUSIONS: For apical surgery in mandibular molars, the distance from the buccal bone surface to the apex and apical 3 mm is significantly affected by the location, patient age, an adjacent missing anterior tooth, and root configuration.

Cutting efficiency of apical preparation using ultrasonic tips with microprojections: confocal laser scanning microscopy study

OBJECTIVES: The purpose of this study was to compare the cutting efficiency of a newly developed microprojection tip and a diamond-coated tip under two different engine powers. MATERIALS AND METHODS: The apical 3-mm of each root was resected, and root-end preparation was performed with upward and downward pressure using one of the ultrasonic tips, KIS-1D (Obtura Spartan) or JT-5B (B&L Biotech Ltd.). The ultrasonic engine was set to power-1 or -4. Forty teeth were randomly divided into four groups: K1 (KIS-1D / Power-1), J1 (JT-5B / Power-1), K4 (KIS-1D / Power-4), and J4 (JT-5B / Power-4). The total time required for root-end preparation was recorded. All teeth were resected and the apical parts were evaluated for the number and length of cracks using a confocal scanning micrscope. The size of the root-end cavity and the width of the remaining dentin were recorded. The data were statistically analyzed using two-way analysis of variance and a Mann-Whitney test. RESULTS: There was no significant difference in the time required between the instrument groups, but the power-4 groups showed reduced preparation time for both instrument groups (p < 0.05). The K4 and J4 groups with a power-4 showed a significantly higher crack formation and a longer crack irrespective of the instruments. There was no significant difference in the remaining dentin thickness or any of the parameters after preparation. CONCLUSIONS: Ultrasonic tips with microprojections would be an option to substitute for the conventional ultrasonic tips with a diamond coating with the same clinical efficiency.

Root Reconstructed with Mineral Trioxide Aggregate and Guided Tissue Regeneration in Apical Surgery: A 5-year Follow-up

Apical surgery should be considered as the last treatment option and employed when conventional endodontic treatment does not provide the expected result. In teeth undergoing apical surgery, the type of retrograde filling material is one of the factors interfering with the repair of periapical tissues. The material in intimate contact with the periapical tissues plays a fundamental role in the repair process. Several materials have been studied and indicated for use in apical surgery procedures, but the mineral trioxide aggregate (MTA) is still the most frequently used one. Guided tissue regeneration (GTR) techniques have been proposed as an adjunct to apical surgery to enhance bone healing. Here is reported a clinical case in which apical surgery was performed in conjunction with MTA-based root reconstruction of the maxillary right second incisor. After the apical surgery, a root-end cavity was prepared at the vestibular face of the involved tooth and filled with MTA. A bovine bone graft and a cortical collagen membrane were placed on the bone defect. After 5 years, clinical and radiographic assessments showed that the treatment was successful. It may be concluded that MTA presents favorable characteristics in adverse conditions and can be used in conjunction with GTR in cases involving root reconstruction.

A cirurgia apical deve ser considerada como a última opção de tratamento, e realizada quando o tratamento endodôntico convencional não proporciona o resultado esperado. Em dentes submetidos à cirurgia apical, o tipo de material retro-obturador é um dos fatores que interferem no reparo dos tecidos periapicais. O material em íntimo contato com os tecidos periapicais desempenha um papel fundamental no processo de reparo. Vários materiais têm sido estudados e indicados para o uso em procedimentos de cirurgias apicais, entretanto o agregado de trióxido mineral (MTA) ainda é o mais frequentemente utilizado. A regeneração tecidual guiada (GTR) tem sido proposta como um auxiliar na cirurgia apical para melhorar a formação óssea. Aqui é relatado um caso clínico em que a cirurgia apical foi realizada em conjunto com a reconstrução radicular do incisivo lateral superior esquerdo com MTA. Após a cirurgia apical, foi preparada uma retro-cavidade na parede vestibular e o dente envolvido foi obturado com MTA. Um enxerto de osso bovino e uma membrana de colágeno cortical foram colocados no defeito ósseo. Após 5 anos, avaliações clínica e radiográfica mostram que o tratamento foi bem sucedido. Pode-se concluir que o MTA apresenta características favoráveis em condições adversas e que pode ser usado em conjunto com GTR em casos envolvendo reconstrução radicular.

Sealing Ability of MTA Used as a Root End Filling Material: Effect of the Sonic and Ultrasonic Condensation

Despite the excellent properties of mineral trioxide aggregate (MTA), the condensation technique may have some influence in its sealing ability. The purpose of this study was to compare the sealing ability of sonic and ultrasonic setting of MTA. Thirty-four extracted human teeth had their canals prepared and filled with Sealapex sealer and gutta-percha using the active lateral condensation technique. The teeth were rendered waterproof and apicoectomy performed at 3 mm from the apex. Root-end cavities (3.0 mm deep and 1.4 mm diameter) were prepared with diamond ultrasonic tips. The root-end cavities were filled with Pro-Root MTA® with ultrasonic vibration, sonic vibration or no vibration. The positive control group did not receive any material while the negative control group was totally rendered waterproof. After material set, the specimens were immersed in Rodhamine B for 24 h, under vacuum in the first 15 min, then washed, dried and split longitudinally for evaluating the infiltration at the dentin/material interface. Data were analyzed using ANOVA and Tukey's tests at 5% significance level. Sonic vibration promoted the lowest infiltration values (p<0.05). It was concluded that sonic vibration could be considered an efficient aid to improve the sealing ability of MTA when used as root-end filling material.

Resumo O objetivo deste estudo foi avaliar in vitro, a influência da vibração sônica e ultrassônica no selamento marginal proporcionado pelo MTA. Trinta e quatro dentes humanos tiveram seus canais radiculares instrumentados e obturados com cimento Sealapex® pela técnica da condensação lateral ativa. Os dentes foram impermeabilizados e seccionados os 3 mm apicais. Retrocavidades (3 mm de profundidade e 1,4 mm de diâmetro) foram preparadas com pontas ultrassônicas diamantadas. As retrocavidades foram preenchidas com Pro-Root MTA® com auxílio da vibração ultrassônica, com auxílio da vibração sônica e sem vibração alguma. O grupo controle positivo não recebeu material retrobturador, enquanto que o negativo foi totalmente impermeabilizado. Após a presa do material, os espécimes foram mergulhados em Rodamina B por 15 min em vácuo, permanecendo nesta solução por mais 24 h. Em seguida, foram lavados, secados e clivados longitudinalmente para avaliação da infiltração do corante na interface dentina/material retrobturador. Os dados foram analisados utilizando a análise de variância e o teste de Tukey (p<0,05). Observou-se que apenas a vibração sônica foi diferente apresentando os menores índices de infiltração. Pode-se concluir que vibração sônica contribui com a melhora da capacidade de selamento marginal proporcionado pelo MTA quando empregado como material retrobturador. .

Persistent infection in root-filled tooth: an SEM morphological analysis after apical microsurgery

Introduction and Objective: Endodontic failure can be associated to well-conducted treatments due to microbial factors characterized by intra or extraradicular infections not eliminated during endodontic treatment. Case report: This report describes a case of persistent apical periodontitis of an asymptomatic maxillary lateral incisor endodontically retreated and subsequently subject to apical surgery. Conclusion: After SEM morphological analysis of the apical fragment, areas of cementum-dentin resorption that were probably responsible for the perpetuation of the disease process were observed.

The challenges of treating a fused tooth

This paper describes and discusses the multidisciplinary treatment involving a permanent maxillary lateral incisor fused to a supernumerary tooth, both presenting pulp necrosis and periapical lesion. A 15-year-old male patient sought treatment complaining of pain, swelling and mobility on the maxillary right lateral incisor. After clinical and radiographic examination, root canal preparation was performed according to the crown-down technique and a calcium hydroxide dressing was placed for 15 days. The patient returned and the definitive endodontic filling was done with thermomechanical compaction of gutta-percha and sealer. After 18 months, clinical and radiographic examinations were carried out and no pain or swelling was reported. Two years after endodontic treatment, the patient returned for periodontal and cosmetic treatments. Nine months later, a cone-beam computed tomography (CBCT) revealed that the previously detected periodontal defect and periapical lesion were persistent. Apical endodontic surgery was indicated. The supernumerary tooth was removed, the communicating distal surface was filled and the surgical site received bioactive glass and demineralized bovine organic bone. The pathological tissue was submitted to histopathological examination and the diagnosis was periapical cyst. One year after the apical endodontic surgery, CBCT showed bone formation at maxillary lateral incisor apical area. Two years after the surgery, the restoration was replaced due to aesthetic reasons and periapical radiograph showed success after 5 years of treatment. A correct diagnosis and establishment of an adequate treatment plan resulted in a successful management of the case.

Este caso descreve o tratamento multidisciplinar de um incisivo lateral superior permanente fusionado a um dente supranumerário, ambos apresentando necrose pulpar e lesão periapical. Paciente compareceu ao consultório se queixando de dor, edema e mobilidade do incisivo lateral superior. O preparo endodôntico foi realizado no sentido coroa-ápice e foi colocada pasta de hidróxido de cálcio como medicação intra-canal por 15 dias. A seguir, a obturação foi realizada pela termoplastificação da guta-percha. Após 18 meses, foram realizados exames clínicos e radiográficos indicando ausência de dor e edema. Dois anos após o tratamento endodôntico, o paciente retornou para o tratamento periodontal e estético. Nove meses depois, foi realizada tomografia computadorizada e observou-se presença de defeito periodontal e lesão periapical. Foi então indicada e planejada a cirurgia paraendodôntica. O dente supranumerário foi removido e a área de comunicação com o canal radicular do incisivo lateral foi preenchida; a loja cirúrgica foi preenchida com vidro bioativo e osso orgânico bovino desmineralizado. O tecido patológico da lesão periapical foi submetido à análise histopatológica sendo diagnosticado como cisto periapical. Um ano após a cirurgia parendodôntica, uma nova tomografia computadorizada mostrou neoformação óssea na região periapical do dente em questão. Doi anos após a cirurgia, a restauração foi trocada devido à motivos estéticos e uma radiografia periapical mostrou sucesso do tratamento (5 anos após o tratamento inicial). Um correto diagnóstico e plano de tratamento multidisciplinar é essencial para o sucesso do tratamento de dentes fusionados à dentes supranumerários.

Avaliação da radiopacidade de diferentes materiais utilizados como retrobturadores / Evaluation of radiopacity of different used as root-end filling materials

Objetivo: O presente estudo tem como objetivo avaliar a radiopacidade de três materiais utilizados como retrobturadores. Métodos: Foram avaliados a radiopacidade de três cimentos: Sealer 26, Cimento Portland e Fillapex associado com 50% de cimento Portland.Para a determinação da radiopacidade, foram confeccionados corpos de provas cilíndricos de 10 mm de diâmetro e 1 mm de altura com os cimentos em teste e cilindros de dentina de mesma espessura, de acordo com a norma ISO 6876:2001. Após a sensibilização e processamento das películas, as imagens foram digitalizadas e analisadas quanto a densidade radiográfica no programa Digora 1.51. O valor da radiopacidade foi determinado em densidade radiográfica que foi, também, convertida em milímetros de alumínio (mm Al). Resultados: Os resultados demonstraram que o Sealer 26 possui maior radiopacidade, seguido pelo Fillapex associado com 50% de Cimento Portland e o cimento Portland. Conclusão: Conclui-se que todos os materiais apresentaram radiopacidade maior que a dentina e as normas da ISO, com exceção do cimento Portland.

Aim: The present study aims to evaluate the radiopacity of three used as root-end filling materials. Methods: To evaluated the radiopacity of three cement: Sealer 26, Fillapex associated with 50% of Portland cement and Portland cement. For the determination of radiopacity, cylindrical specimens with 10 mm in diameter and 1mm in thickness were made with the cements under test and dentin cylinders of equal thickness, according to ISO 6876:2001. After the raising and processing of films, the images were digitized andanalyzed for the radiographic density in Digora 1.51. The value of radiopacity was determined in radiographic density that was also converted into millimetres of aluminium (mm Al). Results: The results showed that the Sealer 26 has greater radiopacity, followed by Fillapex associated with 50% of Portland cement and Portland cement. Conclusion: It is concluded that all materials presented radiopacity is greater than the dentin and the ISO standards, with the exception of Portland cement.