The Outcome of Nonsurgical Root Canal Treatment Using Sealer-based Obturation versus Warm Vertical Compaction: A Randomized Controlled Trial.

INTRODUCTION

Calcium silicate sealer (CSS) based obturation (SBO) has gained wide popularity for its relative simplicity and material biocompatibility. Limited information exists how its treatment outcome compares to warm-vertical compaction (WVC). The primary aim of this randomized controlled clinical trial was to compare the outcome of nonsurgical root canal treatment using SBO with CSS versus WVC with a resin-based sealer. The secondary aim was to assess differences in the obturation time between SBO and WVC.

METHODS

A total of 195 participants with 212 teeth took part in this study and randomly allocated to either SBO or WVC after completion of the bio-mechanical instrumentation. The time required to complete the obturation was recorded. Participants were followed-up after a minimum of 12 months for clinical and radiographic assessment using periapical radiographs with the periapical index (PAI) and cone-beam computed tomography (CBCT) scans using the CBCT-PAI. Statistical evaluation involved descriptive analysis and binary logistic regression.

RESULTS

One hundred eighty-one teeth in 167 participants were followed-up (85.4%) after 12-22 months (mean 12.9 months). Using strict criteria, success rates were 76.6% for SBO and 80.5% for WVC based on PAI, and 71.3% for SBO and 65.5% for WVC using CBCT-PAI. The overall success was 78.5% assessed using PA radiographs and 68.5% using CBCT with no significant differences in outcomes. SBO required significantly less time (85.4 ± 44.0s) to complete the root filling compared to WVC (159.7 ± 71.0s) (P < .001).

CONCLUSIONS

Given comparable clinical outcomes to WVC yet demonstrating faster obturation time, SBO with CSS may be a suitable clinical alternative.