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

Giulia Bardini, Laura Casula, Emanuele Ambu, Davide Musu, Montse Mercadè, Elisabetta Cotti, Giulia Bardini, Laura Casula, Emanuele Ambu, Davide Musu, Montse Mercadè, Elisabetta Cotti

Abstract

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 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.

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.

Trial registration: ClinicalTrials.gov Identifie: NCT04249206.

Keywords: Bioactive sealers; Endodontic outcome; Root canal obturation; Single cone.

Conflict of interest statement

The authors declare that they have no conflict of interest.

Figures

Fig. 1
Fig. 1
a PAI value distribution per treatment group at every follow-up—general samples. b Median values of PAI over time per treatment group—general samples
Fig. 2
Fig. 2
a PAI value distribution per treatment group at every follow-up—subsamples of teeth with AP. b Median values of PAI over time per treatment group—subsamples of teeth with AP
Fig. 3
Fig. 3
Representative case from the single-cone technique and BioRootTM RCS group, at month 0 (a) and 12 months follow-up (a1). Representative case from the warm vertical compaction of gutta-percha with zinc oxide-eugenol sealer group, at month 0 (b) and 12 months follow-up (b1)

References

    1. Nair PN. Apical periodontitis: a dynamic encounter between root canal infection and host response. Periodontol. 1997;2000(13):121–148. doi: 10.1111/j.1600-0757.1997.tb00098.x.
    1. Marton IJ, Kiss C. Overlapping protective and destructive regulatory pathways in apical periodontitis. J Endod. 2014;40:155–163. doi: 10.1016/j.joen.2013.10.036.
    1. Ng Y-L, Mann V, Gulabivala K. A prospective study of the factors affecting outcomes of nonsurgical root canal treatment: part 1: periapical health. Int Endod J. 2011;44:583–609. doi: 10.1111/j.1365-2591.2011.01872.x.
    1. Ng Y-L, Mann V, Gulabivala K. A prospective study of the factors affecting outcomes of non-surgical root canal treatment: part 2: tooth survival. Int Endod J. 2011;44:610–625. doi: 10.1111/j.1365-2591.2011.01873.x.
    1. Ng Y-L, Mann V, Rahbaran S, Lewsey J, Gulabivala K. Outcome of primary root canal treatment: systematic review of the literature - part 1. Effects of study characteristics on probability of success. Int Endod J. 2007;40:921–939. doi: 10.1111/j.1365-2591.2007.01322.x.
    1. Ng Y-L, Mann V, Rahbaran S, Lewsey J, Gulabivala K. Outcome of primary root canal treatment: systematic review of the literature -- part 2. Influence of clinical factors. Int Endod J. 2008;41:6–31. doi: 10.1111/j.1365-2591.2007.01323.x.
    1. Ng Y-L, Mann V, Gulabivala K. Outcome of secondary root canal treatment: a systematic review of the literature. Int Endod J. 2008;41:1026–1046. doi: 10.1111/j.1365-2591.2008.01484.x.
    1. (1994) Consensus report of the European Society of Endodontology on quality guidelines for endodontic treatment. Int Endod J 27:115–124. 10.1111/j.1365-2591.1994.tb00240.x
    1. (2006) Quality guidelines for endodontic treatment: consensus report of the European Society of Endodontology. Int Endod J 39:921–930. 10.1111/j.1365-2591.2006.01180.x
    1. Torabinejad M, Parirokh M, Dummer PMH. Mineral trioxide aggregate and other bioactive endodontic cements: an updated overview - part II: other clinical applications and complications. Int Endod J. 2018;51:284–317. doi: 10.1111/iej.12843.
    1. Parirokh M, Torabinejad M. Mineral trioxide aggregate: a comprehensive literature review--part I: chemical, physical, and antibacterial properties. J Endod. 2010;36:16–27. doi: 10.1016/j.joen.2009.09.006.
    1. Torabinejad M, Parirokh M. Mineral trioxide aggregate: a comprehensive literature review--part II: leakage and biocompatibility investigations. J Endod. 2010;36:190–202. doi: 10.1016/j.joen.2009.09.010.
    1. Gomes-Filho JE, Watanabe S, Lodi CS, Cintra LTA, Nery MJ, Filho JAO, Dezan E, Jr, Bernabé PFE. Rat tissue reaction to MTA FILLAPEX(R) Dent Traumatol. 2012;28:452–456. doi: 10.1111/j.1600-9657.2011.01096.x.
    1. Salles LP, Gomes-Cornelio AL, Guimaraes FC, et al. Mineral trioxide aggregate-based endodontic sealer stimulates hydroxyapatite nucleation in human osteoblast-like cell culture. J Endod. 2012;38:971–976. doi: 10.1016/j.joen.2012.02.018.
    1. Lee B-N, Lee K-N, Koh J-T, Min KS, Chang HS, Hwang IN, Hwang YC, Oh WM. Effects of 3 endodontic bioactive cements on osteogenic differentiation in mesenchymal stem cells. J Endod. 2014;40:1217–1222. doi: 10.1016/j.joen.2014.01.036.
    1. Zhou H, Du T, Shen Y, et al. In vitro cytotoxicity of calcium silicate-containing endodontic sealers. J Endod. 2015;41:56–61. doi: 10.1016/j.joen.2014.09.012.
    1. Zhang W, Li Z, Peng B. Effects of iRoot SP on mineralization-related genes expression in MG63 cells. J Endod. 2010;36:1978–1982. doi: 10.1016/j.joen.2010.08.038.
    1. Loushine BA, Bryan TE, Looney SW, Gillen BM, Loushine RJ, Weller RN, Pashley DH, Tay FR. Setting properties and cytotoxicity evaluation of a premixed bioceramic root canal sealer. J Endod. 2011;37:673–677. doi: 10.1016/j.joen.2011.01.003.
    1. Borges RP, Sousa-Neto MD, Versiani MA, Rached-Júnior FA, de-Deus G, Miranda CES, Pécora JD. Changes in the surface of four calcium silicate-containing endodontic materials and an epoxy resin-based sealer after a solubility test. Int Endod J. 2012;45:419–428. doi: 10.1111/j.1365-2591.2011.01992.x.
    1. Faria-Junior NB, Tanomaru-Filho M, Berbert FLCV, Guerreiro-Tanomaru JM. Antibiofilm activity, pH and solubility of endodontic sealers. Int Endod J. 2013;46:755–762. doi: 10.1111/iej.12055.
    1. Wang Z. Bioceramic materials in endodontics. Endod Top. 2015;32:3–30. doi: 10.1111/etp.12075.
    1. Assmann E, Bottcher DE, Hoppe CB, et al. Evaluation of bone tissue response to a sealer containing mineral trioxide aggregate. J Endod. 2015;41:62–66. doi: 10.1016/j.joen.2014.09.019.
    1. Zhang W, Li Z, Peng B. Ex vivo cytotoxicity of a new calcium silicate-based canal filling material. Int Endod J. 2010;43:769–774. doi: 10.1111/j.1365-2591.2010.01733.x.
    1. Zhang H, Shen Y, Ruse ND, Haapasalo M. Antibacterial activity of endodontic sealers by modified direct contact test against Enterococcus faecalis. J Endod. 2009;35:1051–1055. doi: 10.1016/j.joen.2009.04.022.
    1. Wang Z, Shen Y, Haapasalo M. Dentin extends the antibacterial effect of endodontic sealers against Enterococcus faecalis biofilms. J Endod. 2014;40:505–508. doi: 10.1016/j.joen.2013.10.042.
    1. Camps J, Jeanneau C, El Ayachi I, et al. Bioactivity of a calcium silicate-based endodontic cement (BioRoot RCS): interactions with human periodontal ligament cells in vitro. J Endod. 2015;41:1469–1473. doi: 10.1016/j.joen.2015.04.011.
    1. Camilleri J. Sealers and warm gutta-percha obturation techniques. J Endod. 2015;41:72–78. doi: 10.1016/j.joen.2014.06.007.
    1. Berman L, Hargreaves KM (2015) Cohen’s pathways of the pulp expert consult, 11th edn. Elsevier
    1. Buchanan LS. The continuous wave of condensation technique: a convergence of conceptual and procedural advances in obturation. Dent Today. 1994;13(80):82,84–82,85.
    1. Bose R, Nummikoski P, Hargreaves K. A retrospective evaluation of radiographic outcomes in immature teeth with necrotic root canal systems treated with regenerative endodontic procedures. J Endod. 2009;35:1343–1349. doi: 10.1016/j.joen.2009.06.021.
    1. Landis JR, Koch GG. The measurement of observer agreement for categorical data. Biometrics. 1977;33:159–174. doi: 10.2307/2529310.
    1. Orstavik D, Kerekes K, Eriksen HM. The periapical index: a scoring system for radiographic assessment of apical periodontitis. Endod Dent Traumatol. 1986;2:20–34. doi: 10.1111/j.1600-9657.1986.tb00119.x.
    1. Friedman S, Mor C. The success of endodontic therapy--healing and functionality. J Calif Dent Assoc. 2004;32:493–503.
    1. Castellucci A. Obturation of the radicular spaces. In: Rotstein I, Ingle IJ, editors. Ingle’s Endodontics 7. 7. Ltd: PHMPH USA; 2019. pp. 669–728.
    1. Friedman S, Abitbol S, Lawrence HP. Treatment outcome in endodontics: the Toronto study. Phase 1: initial treatment. J Endod. 2003;29:787–793. doi: 10.1097/00004770-200312000-00001.
    1. Farzaneh M, Abitbol S, Friedman S. Treatment outcome in endodontics: the Toronto study. Phases I and II: orthograde retreatment. J Endod. 2004;30:627–633. doi: 10.1097/01.DON.0000129958.12388.82.
    1. Gorni FGM, Gagliani MM. The outcome of endodontic retreatment: a 2-yr follow-up. J Endod. 2004;30:1–4. doi: 10.1097/00004770-200401000-00001.
    1. Chybowski EA, Glickman GN, Patel Y, Fleury A, Solomon E, He J. Clinical outcome of non-surgical root canal treatment using a single-cone technique with endosequence bioceramic sealer: a retrospective analysis. J Endod. 2018;44:941–945. doi: 10.1016/j.joen.2018.02.019.
    1. Ghoneim AG, Lutfy RA, Sabet NE, Fayyad DM. Resistance to fracture of roots obturated with novel canal-filling systems. J Endod. 2011;37:1590–1592. doi: 10.1016/j.joen.2011.08.008.

Source: PubMed

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