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Clinical Outcome of Nonsurgical Root Canal Treatment Using a Matched Single-Cone Obturation Technique with a Calcium Hydroxide–based Sealer: A Retrospective Analysis

Published:September 30, 2022DOI:https://doi.org/10.1016/j.joen.2022.09.006

      Abstract

      Introduction

      The aim of this retrospective study was to estimate the outcome of nonsurgical root canal treatment using matched single-cones with a calcium hydroxide–based sealer and to identify the various prognostic factors influencing the outcome.

      Methods

      This was a retrospective study that enrolled 272 patients who underwent routine endodontic therapy and were obturated with matched single-cones and Sealapex as sealer. This study involved 223 patients with 261 teeth meeting the selection criteria and recalled between 24 and 84 months. The outcome was categorized as success (healed/healing clinically and radiographically) or failure (not healed clinically and/or radiographically). Two calibrated examiners assessed the treatment outcomes. A binomial logistic regression model was performed to identify the effect of various prognostic factors. The χ2 test was used to find the association between sealer extrusion and the initial periapical index scores.

      Results

      The overall success rate was found to be 89.7% for a mean recall period of 39.18 (±11.05) months. An increase in age was associated with increased odds of success, whereas the success rates were reduced by an increase in the number of roots and negative pulp sensibility status. Initial periapical index scores, presence of preoperative sinus tract, number of visits, and sealer extrusion did not affect the outcome significantly (P > .05).

      Conclusion

      Within the limitations of this study, it was found that teeth obturated with matched single-cone and Sealapex achieved substantial success rates. Sealer extrusion did not have any significant effect on the treatment outcome.

      Key Words

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      References

      1. Canal Preparation and Obturation Clinical Newsletter - AAE [Internet]. American Association of Endodontists.
        (Available at) (Accessed March 11, 2022)
        • Ozawa T.
        • Taha N.
        • Messer H.H.
        A comparison of techniques for obturating oval-shaped root canals.
        Dent Mater J. 2009; 28: 290-294
        • Pereira A.C.
        • Nishiyama C.K.
        • Pinto L. de C.
        Single-cone obturation technique: a literature review.
        . 2012; 9: 442-447
        • Germain S.
        • Meetu K.
        • Issam K.
        • et al.
        Impact of the root canal taper on the apical adaptability of sealers used in a single-cone technique: a micro-computed tomography study.
        J Contemp Dent Pract. 2018; 19: 808-815
        • Moinzadeh A.T.
        • Zerbst W.
        • Boutsioukis C.
        • et al.
        Porosity distribution in root canals filled with gutta percha and calcium silicate cement.
        Dent Mater Off Publ Acad Dent Mater. 2015; 31: 1100-1108
        • Li G.H.
        • Niu L.N.
        • Zhang W.
        • et al.
        Ability of new obturation materials to improve the seal of the root canal system: a review.
        Acta Biomater. 2014; 10: 1050-1063
        • Huang Y.
        • Orhan K.
        • Celikten B.
        • et al.
        Evaluation of the sealing ability of different root canal sealers: a combined SEM and micro-CT study.
        J Appl Oral Sci Rev FOB. 2018; 26: e20160584
        • Yilmaz Z.
        • Deniz D.
        • Ozcelik B.
        • et al.
        Sealing efficiency of BeeFill 2in1 and System B/Obtura II versus single-cone and cold lateral compaction techniques.
        Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2009; 108: e51-e55
        • Cañadas P.S.
        • Berástegui E.
        • Gaton-Hernández P.
        • et al.
        Physicochemical properties and interfacial adaptation of root canal sealers.
        Braz Dent J. 2014; 25: 435-441
        • Ordinola-Zapata R.
        • Bramante C.M.
        • Graeff M.S.Z.
        • et al.
        Depth and percentage of penetration of endodontic sealers into dentinal tubules after root canal obturation using a lateral compaction technique: a confocal laser scanning microscopy study.
        Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2009; 108: 450-457
        • Monticelli F.
        • Sword J.
        • Martin R.L.
        • et al.
        Sealing properties of two contemporary single-cone obturation systems.
        Int Endod J. 2007; 40: 374-385
        • Chybowski E.A.
        • Glickman G.N.
        • Patel Y.
        • et al.
        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
        • de Figueiredo F.E.D.
        • Lima L.F.
        • Oliveira L.S.
        • et al.
        Effectiveness of a reciprocating single file, single cone endodontic treatment approach: a randomized controlled pragmatic clinical trial.
        Clin Oral Investig. 2020; 24: 2247-2257
        • de-Figueiredo F.E.D.
        • Lima L.F.
        • Lima G.S.
        • et al.
        Apical periodontitis healing and postoperative pain following endodontic treatment with a reciprocating single-file, single-cone approach: a randomized controlled pragmatic clinical trial.
        PLoS One. 2020; 15: e022734
        • Sagsen B.
        • Er O.
        • Kahraman Y.
        • Orucoglu H.
        Evaluation of microleakage of roots filled with different techniques with a computerized fluid filtration technique.
        J Endod. 2006; 32: 1168-1170
        • Rezende G.C.
        • Massunari L.
        • Queiroz I.O. de A.
        • et al.
        Antimicrobial action of calcium hydroxide-based endodontic sealers after setting, against E. faecalis biofilm.
        Braz Oral Res. 2016; 30
        • Faria-Júnior N.B.
        • Tanomaru-Filho M.
        • Berbert F.L.C.V.
        • Guerreiro-Tanomaru J.M.
        Antibiofilm activity, pH and solubility of endodontic sealers.
        Int Endod J. 2013; 46: 755-762
        • Viapiana R.
        • Flumignan D.L.
        • Guerreiro-Tanomaru J.M.
        • et al.
        Physicochemical and mechanical properties of zirconium oxide and niobium oxide modified Portland cement-based experimental endodontic sealers.
        Int Endod J. 2014; 47: 437-448
        • Tanomaru-Filho M.
        • Cristine Prado M.
        • Torres F.F.E.
        • et al.
        Physicochemical properties and bioactive potential of a new epoxy resin-based root canal sealer.
        Braz Dent J. 2019; 30: 563-568
        • Caicedo R.
        • von Fraunhofer J.A.
        The properties of endodontic sealer cements.
        J Endod. 1988; 1: 527-534
        • Desai S.
        • Chandler N.
        Calcium hydroxide–based root canal sealers: a review.
        J Endod. 2009; 1: 475-480
        • Schäfer E.
        • Zandbiglari T.
        Solubility of root-canal sealers in water and artificial saliva: solubility of root-canal sealers.
        Int Endod J. 2003; 36: 660-669
        • Tagger M.
        • Tagger E.
        Periapical reactions to calcium hydroxide-containing sealers and AH 26® in monkeys.
        Dent Traumatol. 1989; 5: 139-146
        • Holland R.
        • de Souza V.
        Ability of a new calcium hydroxide root canal filling material to induce hard tissue formation.
        J Endod. 1985; 11: 535-543
        • Leonardo M.R.
        • Salgado A.A.
        • da Silva L.A.
        • Tanomaru Filho M.
        Apical and periapical repair of dogs’ teeth with periapical lesions after endodontic treatment with different root canal sealers.
        Pesqui Odontol Bras Braz Oral Res. 2003; 17: 69-74
        • Silva L.A.B.
        • Barnett F.
        • Pumarola-Suñé J.
        • et al.
        Sealapex Xpress and RealSeal XT feature tissue compatibility in vivo.
        J Endod. 2014; 40: 1424-1428
        • Waltimo T.M.T.
        • Boiesen J.
        • Eriksen H.M.
        • Ørstavik D.
        Clinical performance of 3 endodontic sealers.
        Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2001; 92: 89-92
        • Paredes-Vieyra J.
        • Enriquez F.J.J.
        Success rate of single- versus two-visit root canal treatment of teeth with apical periodontitis: a randomized controlled trial.
        J Endod. 2012; 38: 1164-1169
        • Von Elm E.
        • Altman D.G.
        • Egger M.
        • et al.
        The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement: guidelines for reporting observational studies.
        Bull World Health Organ. 2007; 85: 867-872
        • American Association of Endodontists
        AAE consensus conference recommended diagnostic terminology.
        J Endod. 2009; 35: 1634
        • 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
        • Poggio C.
        • Dagna A.
        • Ceci M.
        • et al.
        Solubility and pH of bioceramic root canal sealers: a comparative study.
        J Clin Exp Dent. 2017; 9: e1189-e1194
        • Ørstavik D.
        • Qvist V.
        • Stoltze K.
        A multivariate analysis of the outcome of endodontic treatment.
        Eur J Oral Sci. 2004; 112: 224-230
        • Hoskinson S.E.
        • Ng Y.L.
        • Hoskinson A.E.
        • et al.
        A retrospective comparison of outcome of root canal treatment using two different protocols.
        Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2002; 93: 705-715
        • Liang Y.H.
        • Li G.
        • Wesselink P.R.
        • Wu M.K.
        Endodontic outcome predictors identified with periapical radiographs and cone-beam computed tomography scans.
        J Endod. 2011; 37: 326-331
        • Laukkanen E.
        • Vehkalahti M.M.
        • Kotiranta A.K.
        Impact of type of tooth on outcome of non-surgical root canal treatment.
        Clin Oral Investig. 2019; 23: 4011-4018
        • Zmener O.
        • Pameijer C.H.
        Clinical and radiographical evaluation of a resin-based root canal sealer: a 5-year follow-up.
        J Endod. 2007; 33: 676-679
        • Stoll R.
        • Betke K.
        • Stachniss V.
        The influence of different factors on the survival of root canal fillings: a 10-year retrospective study.
        J Endod. 2005; 31: 783-790
        • Ordinola-Zapata R.
        • Noblett W.C.
        • Perez-Ron A.
        • et al.
        Present status and future directions of intracanal medicaments.
        Int Endod J. 2022; 55: 613-636
        • Nair P.
        On the causes of persistent apical periodontitis: a review.
        Int Endod J. 2006; 39: 249-281
        • Sundqvist G.
        Bacteriological studies of necrotic dental pulps (Doctoral dissertation, Umeå University).
        1976
        • 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: outcome of non-surgical root canal treatment.
        Int Endod J. 2011; 44: 610-625
        • Ng Y.L.
        • Mann V.
        • Gulabivala K.
        Tooth survival following non-surgical root canal treatment: a systematic review of the literature.
        Int Endod J. 2010; 43: 171-189
        • Ricucci D.
        • Rôças I.N.
        • Alves F.R.F.
        • et al.
        Apically extruded sealers: fate and influence on treatment outcome.
        J Endod. 2016; 42: 243-249
        • Kim J.H.
        • Cho S.Y.
        • Choi Y.
        • et al.
        Clinical efficacy of sealer-based obturation using calcium silicate sealers: a randomized clinical trial.
        J Endod. 2022; 48: 144-151
        • Kardon B.P.
        • Kuttler S.
        • Hardigan P.
        • Dorn S.O.
        An in vitro evaluation of the sealing ability of a new root-canal–obturation system.
        J Endod. 2003; 29: 658-661