Root‐end filling materials: rationale and tissue response

The requirements of an ideal root‐end filling are reviewed, before the demise of amalgam is considered. The focus is on tissue response to newer alternative materials: zinc oxide–eugenol cements, Mineral Trioxide Aggregate, glass ionomer cements, composite resins, compomers, and Diaket. The conflicting findings of in vitro and in vivo studies are analysed, as well as whether a root‐end filling is necessary. The ‘apical seal’ is revisited with support for the concept of a ‘double seal’ that is physical and biological.