Superiority of Warm Vertical Condensation in C-shaped root canals: improved periodontal health, enhanced fracture resistance, with reduced pain and secondary caries incidence.

OBJECTIVE

To compare the clinical efficacy between the methods of Cold Lateral Compaction (CLC) and Warm Vertical Condensation (WVC) in treating C-shaped root canals, focusing on periodontal health, fracture resistance, postoperative pain, and the incidence of secondary caries.

METHODS

This retrospective cohort study involved 229 patients treated with either CLC (n=106) or WVC (n=123) from January 2022 to December 2023. Baseline characteristics were comparable between the two groups. Clinical data on clinical efficacy, periodontal indices, fracture resistance, pain scores, and secondary caries incidence were collected and analyzed.

RESULTS

The WVC technique demonstrated superior clinical outcomes, with an effectiveness rate of 95.93% compared to 87.74% for CLC (P=0.022). Patients treated with WVC showed significantly greater improvements in periodontal indices, including reduced plaque and gingival indices, probing depth, and tooth mobility one month post-treatment (all P<0.05). Additionally, the WVC group exhibited enhanced fracture resistance, with shorter dye penetration lengths and higher compressive load capacity (P=0.004 and P=0.006, respectively). Postoperative pain was reduced in the WVC group, as indicated by lower Visual Analog Scale (VAS) scores (P=0.027). Furthermore, the incidence of secondary caries at 24 months was significantly lower in the WVC group (11.38% vs 23.58% for CLC, P=0.014). The WVC group also showed marked reductions in inflammatory markers postoperatively, including interleukin-6 (IL-6), tumor necrosis factor-α (TNF-α), interleukin-8 (IL-8), and C-reactive protein (CRP) (P<0.05).

CONCLUSION

The WVC technique is more effective than CLC for C-shaped root canals. It not only provides superior sealing capabilities but also improves periodontal health, increases fracture resistance, reduces postoperative pain, and lowers the incidence of secondary caries.