An analysis of endodontic treatment with three nickel-titanium rotary root canal preparation techniques

Aim To investigate clinical results of root canal treatment performed with the aid of nickel-titanium (NiTi) rotary instruments. Summary A total of 179 patients underwent root canal treatment with either (A) Lightspeed, or (B) ProFile .04 or (C) ProFile .04 and .06 or GT rotary instruments to create tapered preparations. In groups A and B, laterally condensed gutta-percha and AH Plus were used. Canals in group C were obturated with System B, Obtura II and Roth's 801 sealer. Initial and recall radiographs were assessed using the periapical index (PAI). Outcomes were analysed using chi-square tests, event-time analyses and logistic regression models. Two hundred and thirty-three teeth were radiographically assessed after a mean interval of 25.4+/-11.8 months. Favourable outcome of treatment, defined as PAI86.7%. Logistic regression analysis and univariate analyses indicated that teeth with preoperative PAI scores >2 and retreated teeth had a significantly lower chance of healing compared with periapically healthy teeth and primary treatments, respectively. Preparation technique, length of fill and the type of sealer did not significantly affect healing rates. Key learning points Root canal treatment with NiTi root canal instrumentation systems renders favourable outcomes in more than 86% of the cases. Outcome is significantly affected by preoperative diagnoses but not by the specific choice of instrumentation system

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, 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: NCT0424920