Objective To observe the reaction after 1 week and clinical efficacy after 2 years by using Vitapex paste filler treated elderly diabetes patients with sinus-type periapical periodontitis. Methods 225 teeth selected from 144 patients with elderly diabetes and sinus-type periapical periodontitis. When the preparation and sterilized root canal were finished, the teeth were divided into two groups: Group A of 72 patients with 116 teeth treated with Vitapex paste filler and gutta, group B of 72 patients with 109 teeth treated with Cortisomol paste filler and gutta. The reaction after 1 week and clinical efficacy after 2 years were observed. Results There weren’t significantly difference between two groups after 1 week（P＞0.05）; the effective difference between the two groups was significant after 2 years, the clinical efficacy of group A was obviously better than group B（P
