Zamparini Fausto, Spinelli Andrea, Cardinali Filippo, Ausiello Pietro, Gandolfi Maria Giovanna, Prati Carlo
Endodontic Clinical Section, Dental School, Department of Biomedical and Neuromotor Sciences, University of Bologna, 40125 Bologna, Italy.
Laboratory of Green Biomaterials and Oral Pathology, Dental School, Department of Biomedical and Neuromotor Sciences, University of Bologna, 40125 Bologna, Italy.
J Funct Biomater. 2023 Mar 18;14(3):164. doi: 10.3390/jfb14030164.
Recently several calcium silicate flowable sealers have been introduced as endodontic materials for the root canal. This clinical study tested the use of a new premixed calcium silicate bioceramic sealer in association with the Thermafil warm carrier-based technique (TF). Epoxy-resin-based sealer with the warm carrier-based technique was the control group.
Healthy consecutive patients (n = 85) requiring 94 root canal treatments were enrolled in this study and assigned to one filling group (Ceraseal-TF n = 47, AH Plus-TF n = 47) in accordance with operator training and best clinical practice. Periapical X-rays were taken preoperatively, after root canal filling and after 6, 12 and 24 months. Two evaluators blindly assessed the periapical index (PAI) and sealer extrusion in the groups (k = 0.90). Healing rate and survival rate were also evaluated. Chi-square tests was used to analyze significant differences between the groups. Multilevel analysis was performed to evaluate the factors associated with healing status.
A total of 89 root canal treatments in 82 patients were analyzed at the end-line (24 months). The total drop-out was 3.6% (3 patients; 5 teeth). A total of 91.1% of healed teeth (PAI 1-2) was observed in Ceraseal-TF, with 88.6% in AH Plus-TF. No significant difference was observed on healing outcome and survival among the two filling groups ( > 0.05). Apical extrusion of the sealers occurred in 17 cases (19.0%). Of these, 6 occurred in Ceraseal-TF (13.3%) and 11 in AH Plus-TF (25.0%). Three Ceraseal extrusions were radiographically undetectable after 24 months. All the AH Plus extrusions did not change during the evaluation time.
The combined use of the carrier-based technique and premixed CaSi-based bioceramic sealer showed clinical results comparable with carrier-based technique and epoxy-resin-based sealer. The radiographical disappearance of apically extruded Ceraseal is a possible event in the first 24 months.
最近，几种硅酸钙可流动封闭剂作为根管治疗的牙髓材料被引入。本临床研究测试了一种新型预混硅酸钙生物陶瓷封闭剂与基于热牙胶载体技术（TF）联合使用的效果。基于热牙胶载体技术的环氧树脂封闭剂作为对照组。
本研究纳入了85例连续的需要进行94次根管治疗的健康患者，并根据操作人员培训和最佳临床实践将其分配到一个充填组（Ceraseal-TF组，n = 47；AH Plus-TF组，n = 47）。在术前、根管充填后以及6个月、12个月和24个月时拍摄根尖X线片。两名评估人员对两组的根尖指数（PAI）和封闭剂挤出情况进行盲法评估（k = 0.90）。还评估了愈合率和生存率。采用卡方检验分析两组之间的显著差异。进行多水平分析以评估与愈合状态相关的因素。
在研究终点（24个月）时，共分析了82例患者的89次根管治疗。总失访率为3.6%（3例患者；5颗牙齿）。Ceraseal-TF组愈合牙齿（PAI 1 - 2）的比例为91.1%，AH Plus-TF组为88.6%。两组在愈合结果和生存率方面未观察到显著差异（P > 0.05）。封闭剂根尖挤出发生在17例（19.0%）。其中，Ceraseal-TF组有6例（13.3%），AH Plus-TF组有11例（25.0%）。24个月后，3例Ceraseal挤出在影像学上无法检测到。所有AH Plus挤出在评估期间均未改变。
基于载体技术与预混硅酸钙基生物陶瓷封闭剂联合使用的临床结果与基于载体技术和环氧树脂封闭剂相当。根尖挤出的Ceraseal在最初24个月内影像学上消失是可能发生的情况。
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