Abstract: Objective To compare and evaluate clinical efficacy of calcium silicate based bio-ceramic materials iRoot BP Plus and MTA as root-end filling materials and to determine prognostic factors affecting the outcome of endodontic microsurgery (EMS). Methods A clinical database was searched for EMS cases from 2016 to 2018. The nearest neighbor matching method was used to match age, gender, lesion location, root canal treatment type and whether the lesion complicated with periodontal desease of patients undergoing EMS using iRoot BP Plus or MTA as root-end filling materials with 1∶1 propensity score. Multifactor binary Logistics regression analysis was used to evaluate interfering factors of EMS and the forest plot was drawn. Results A total of 179 teeth were included. The absolute normalized differences of all co-variables were <0.1. One-year success rate of microapical surgery was 91.2% in iRoot BP Plus group and 89.7% in MTA group (P=0.771). Multivariate binary Logistic regression analysis after PSM showed that age, lesion location and whether the lesion complicated with periodontal desease had statistically significant effects on clinical efficacy and prognosis of microscopic apical surgery. Conclusion Microapical surgery has good clinical efficacy, and there is no significant difference in the success rate of microapical surgery with MTA or iRoot BP Plus as backfilling materials. Age, lesion location and whether the lesion complicated with periodontal desease are significant factors influencing the clinical effect of microapical surgery.

Key words: calcium silicate cement, propensity score matching, root-end filling, endodontic microsurgery