## 4 Discussion
[PERSON] et al. found that Retroplast's hydrophobic properties help maintain a dry environment, which enhances healing after surgery [92]. Although newer materials such as MTA and bioceramics have gained prominence due to their bioactivity and regenerative potential, Retroplast remains a viable alternative, given its established clinical success. Retroplast can achieve comparable outcomes to MTA in terms of sealing and healing, though its mechanical properties and resin-based composition may limit its bioactivity compared to more modern hydraulic materials [95]. While clinical evidence supports its use, further studies are necessary to fully evaluate its long-term performance and durability. Its composition also suggests potential for improved handling properties, which may enhance clinical outcomes [93]. Bioceramic materials, particularly calcium silicate-based formulations like EndoSequence(r), are increasingly popular in endodontics due to their excellent sealing properties, biocompatibility, and ability to promote tissue regeneration. These materials are known for forming hydroxyapatite upon exposure to moisture, enhancing integration with surrounding tissues [96; 97]. EndoSequence(r) (Brasseler, Savannah, GA, USA) is a calcium silicate-based bioceramic designed for root-end fillings, similar to materials like MTA and Biodentine(r). Unlike traditional MTA, EndoSequence(r) incorporates calcium phosphate, making it a bioceramic known for its biocompatibility, bioactivity, and non-toxic characteristics. The combination of calcium silicate and calcium phosphate confers significant dimensional stability, and, being bio-inert, the material does not degrade over time or provoke adverse reactions [98]. A key advantage of EndoSequence(r) is its nanoparticle composition, which facilitates deeper penetration into dentinal tubules, improving the mechanical seal. This penetration is enhanced by moisture within the tubules, which accelerates the setting reaction. This moisture-activated reactivity makes EndoSequence(r) highly suitable for retrograde filling procedures, where moisture is common in the surgical field. The high alkaline pH generated by the material creates an antimicrobial environment conducive to healing and tissue regeneration. Furthermore, the bioceramic nature promotes hydroxyapatite formation, enhancing integration with surrounding tissues and creating a robust seal at the root apex [98; 99]. A comparative study evaluating the penetration of various calcium silicate cements into dentinal tubules found that Biodentine(r) exhibited the greatest penetration (1.57 mm), while EndoSequence(r) demonstrated superior handling characteristics and consistent penetration (1.56 mm). ProRoot MTA showed lower penetration values (1.25 mm) but was noted to be more technique sensitive [100]. EndoSequence(r) also exhibits excellent radiopacity, aiding clinicians in visualization during radiographic assessment [101]. Numerous studies have highlighted the regenerative potential of bioceramic materials like EndoSequence(r), demonstrating their ability to stimulate hydroxyapatite crystal formation upon moisture exposure. This fosters a chemical bond with dentin, which not only enhances sealing ability, but also promotes remineralization of surrounding hard tissues--an essential process for healing in root-end surgeries [102; 103]. Clinical outcomes with calcium silicate-based cements such as EndoSequence(r), Biodentine(r), and ProRoot MTA have consistently demonstrated favorable results in terms of apical sealing, biocompatibility, and tissue healing. Their ability to form a bioactive interface with dentin has made them the materials of choice in root-end surgeries, where a tight seal and biological integration are critical for long-term success [104]. Additionally, EndoSequence(r) has been reported to generate a highly alkaline environment during early setting stages, which provides antimicrobial effects and stimulates new hard tissue and cement formation, thereby supporting faster healing and improved patient outcomes [101].