Abstract
ObjectivesThis randomized, controlled, pilot study assessed the outcome of non-surgical primary/secondary root canal treatments either with a novel bioactive sealer and the single-cone technique or with gutta-percha, zinc oxide-eugenol sealer (ZOE), and warm vertical compaction.Materials and methodsSixty-nine patients were randomly divided into two groups that were treated using the single-cone technique with BioRootTM RCS (Septodont) (BIO group) or warm vertical compaction with gutta-percha and ZOE sealer (PCS group). Two subsamples (BIOAP and PCSAP) comprised the cases with apical periodontitis. Treatment was undertaken by four residents using a standardized instrumentation and disinfection protocol. The periapical index (PAI) was recorded, and clinical and radiographic follow-up performed at 1, 3, 6, and 12 months. Treatment success was assessed according to “periapical healing” and “tooth survival”. The test for the equality of proportions, t tests for the equality of means, and non-parametric K-sample tests for the equality of medians were applied when appropriate.ResultsThe survival rate was similar in the BIO and PCS (p = 0.4074) and the BIOAP and PCSAP groups (p = 0.9114). The success rate was higher in the BIO groups, but not statistically significant (p = 0.0735). In both BIOAP and PCSAP groups, a progressive decrease in the PAI was observed.ConclusionAt 12 months, both techniques showed reliable results. Further studies and longer follow-ups are needed.Clinical relevanceThis study documents the feasibility of using a bioactive sealer in conjunction with the single-cone technique to obturate the root canal and obtaining a predictable outcome.Trial registrationClinicalTrials.gov Identifie: NCT04249206
Highlights
Apical periodontitis (AP) is a chronic inflammatory disease caused by an endodontic infection and is characterized by hard tissue resorption and destruction of periapical tissues [1, 2]
Bioactive endodontic cements (Portland’s bioceramics) have been introduced to the market; they have been used as pulp capping agents, as filling materials to seal endodontic/periodontal joins or, more recently, as sealers to be used in conjunction with GP [10]
The teeth with AP from both groups were further divided into two subsamples: BIOAP = 28 teeth in 18 patients from the BIO group, and PCSAP = 24 teeth in 16 patients from the PCS group (Table 1)
Summary
Apical periodontitis (AP) is a chronic inflammatory disease caused by an endodontic infection and is characterized by hard tissue resorption and destruction of periapical tissues [1, 2]. Bioactive endodontic cements (Portland’s bioceramics) have been introduced to the market; they have been used as pulp capping agents, as filling materials to seal endodontic/periodontal joins or, more recently, as sealers to be used in conjunction with GP [10]. The precursor of these cements, mineral trioxide aggregate (MTA), which is a Portland-derived cement, exhibited excellent hydraulic properties There is a paucity of information in the specialized literature on the outcomes achieved with the new bioactive sealers used with the single-cone obturation technique in vivo; the latter (sealers and technique) are often advertised
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