A 12-month follow-up of primary and secondary root canal treatment in teeth obturated with a hydraulic sealer

Objectives This 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 methods Sixty-nine patients were randomly divided into two groups that were treated using the single-cone technique with BioRoot(TM)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,ttests for the equality of means, and non-parametric K-sample tests for the equality of medians were applied when appropriate. Results The 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. Conclusion At 12 months, both techniques showed reliable results. Further studies and longer follow-ups are needed. Clinical relevance This 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.

Automated summary

Both the bioactive sealer and the traditional gutta-percha, zinc oxide-eugenol sealer showed reliable results in non-surgical root canal treatments at 12-month follow-up. The bioactive sealer group exhibited a slightly higher success rate, although not statistically significant. More studies with longer follow-ups are needed to further evaluate the efficacy of these treatment techniques.