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This article gives an overview and a comparison of retrograde root-end filling materials used for apical surgery. The biological properties and healing modalities are addressed. Retrograde filling materials are intended to seal the root canal system, thereby preventing diffusion of fluid and bacteria between the root canal and the periapical tissues. It is equally important that the sealing ability remains stable over time, and that the material has good biocompatibility and allows healing to occur in the apical area. A wide variety of materials have been used over time. Dental amalgam has been commonly used. However, the use of amalgam has been prohibited in Norway. Zink oxide-eugenol containing materials such as IRM and Super-EBA are frequently used, and have a high success rate in follow-up studies. A relative new and promising material is Mineral Trioxide Aggregate (MTA). It has good sealing ability and it allows new cementum to be formed on its surface. It has also favourable hard tissue-inducing properties. Other materials in use are composite resin (Retroplast) and resin-modified glass ionomer cement. These materials are sensitive to humidity during application, but good results can be achieved with optimal handling. Independent of materials used, modern surgery principles with ultrasound and use of stereo microscope will improve the outcome of apical surgery. MTA seems to have the best biological properties of the materials used today, but clinically successful treatment can be obtained if the materials in contemporary use are handled properly. The manufacturer`s instructions for use, indications, and contraindications should be strictly adhered to.

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