Microscope Center, Department of Conservative Dentistry and Oral Science Research Center, College of Dentistry, Yonsei University, Seoul, Korea.
Department of Conservative Dentistry, National Health Insurance Service Ilsan Hospital, Goyang, Gyeonggi-do, Korea.
J Endod. 2022 Feb;48(2):144-151. doi: 10.1016/j.joen.2021.11.011. Epub 2021 Nov 29.
This randomized controlled clinical trial compared the clinical efficacy and outcome of a sealer-based obturation technique (SBO) with calcium silicate sealers and a continuous wave of condensation technique (CWC) with a resin-based sealer.
Root canals were prepared using rotary instruments and 2.5% sodium hypochlorite. At the next visit, patients were enrolled and randomly assigned into 2 groups on the basis of the obturation protocol: CWC with AH Plus sealer and SBO with Endoseal TCS. Patients were assessed for the level of postoperative pain using a numeric rating scale. The quality of root canal obturation was evaluated in terms of the sealer extrusion, root-filling voids, and level of root filling. The participants were recalled after at least 6 months. Healing of the teeth was determined as a decrease in Periapical Index score and resolution of symptoms. The results were statistically compared by using the χ test or Fisher exact test, followed by multivariate analysis with logistic regression.
A total of 74 teeth were included in the analysis (79% recalls), and the mean follow-up period was 17 months (6-29 months). Two groups expressed identical distribution of postoperative pain (P = .973) and similar quality of root canal obturation. The total success rates were 93.2% (CWC 92.3%, SBO 94.3%) by loose criteria and 60.8% (CWC 51.3%, SBO 71.4%) by strict criteria, with no significant differences between the 2 groups. The success rate by loose criteria in teeth with sealer extrusion was significantly lower than those in teeth without sealer extrusion (P = .049).
SBO using an Endoseal TCS could be a possible alternative to CWC using AH Plus. Sealer extrusion and postoperative pain were found to negatively impact prognosis of the endodontic treatment.
本随机对照临床试验比较了基于糊剂的根管封闭技术（SBO）与硅酸钙封闭剂和连续波冷凝技术（CWC）与树脂基封闭剂的临床疗效和结果。
使用旋转器械和 2.5%次氯酸钠对根管进行预备。在下一次就诊时，根据封闭方案将患者纳入并随机分为 2 组：CWC 用 AH Plus 封闭剂和 SBO 用 Endoseal TCS。使用数字评分量表评估患者术后疼痛程度。根据封闭剂挤出、根管充填空隙和根充水平评估根管充填质量。至少 6 个月后召回患者。通过根尖指数评分降低和症状缓解来确定牙齿愈合情况。使用 χ 检验或 Fisher 确切检验对结果进行统计学比较，然后使用逻辑回归进行多变量分析。
共有 74 颗牙齿纳入分析（79%召回），平均随访时间为 17 个月（6-29 个月）。两组术后疼痛分布相同（P=0.973），根管充填质量相似。按宽松标准总成功率为 93.2%（CWC 92.3%，SBO 94.3%），按严格标准为 60.8%（CWC 51.3%，SBO 71.4%），两组无显著差异。有封闭剂挤出的牙齿按宽松标准的成功率明显低于无封闭剂挤出的牙齿（P=0.049）。
使用 Endoseal TCS 的 SBO 可能是 CWC 用 AH Plus 的替代方法。封闭剂挤出和术后疼痛被发现对根管治疗的预后有负面影响。
