Eur Endod J. Ahead of Print: EEJ-75537 | DOI: 10.14744/eej.2024.75537

3-Year Clinical Outcome of Root Canal Treatment Using a Single-cone Technique and Ceraseal Premixed Bioceramic Sealer: A Prospective Cohort Study

Andrea Spinelli¹, Fausto Zamparini², Jacopo Lenzi⁴, Maria Giovanna Gandolfi³, Carlo Prati^1
1Clinical of Endodontic, Dental School, University of Bologna, Department of Biomedical and Neuromotor Sciences, Bologna, Italy
²Clinical of Endodontic, Dental School, University of Bologna, Department of Biomedical and Neuromotor Sciences, Bologna, Italy; Laboratory of Green Biomaterials and Oral Pathology, Dental School, University of Bologna, Department of Biomedical and Neuromotor Sciences, Bologna, Italy
³Laboratory of Green Biomaterials and Oral Pathology, Dental School, University of Bologna, Department of Biomedical and Neuromotor Sciences, Bologna, Italy
⁴Department of Biomedical and Neuromotor Sciences, Alma Mater Studiorum, University of Bologna, Bologna, Italy

Objective: To evaluate the outcome of teeth filled with single cone technique and a premixed bioceramic sealer at 3 years of follow-up.
Methods: Healthy patients were consecutively treated by a cohort of post graduated operators. Root canal filling procedures were performed with NiTi rotary instrumentation, while non-surgical retreatments were performed using NiTi reciprocating instruments. Root canal filling procedures were made using Ceraseal and cold single cone technique. Post-endodontic restorations were performed after 15 days. Provisional and definitive crowns were positioned in case of non-sufficient coronal structure. Periapical X-rays were performed before treatment, after filling and at each follow-up visits (6,12,24 and 36 months). Periapical Index (PAI) was used to assess the presence of periapical lesions and their modifications during time. Success (absence/resolution of periapical radiolucency, PAI< 3) and survival rates were evaluated. The presence of apical extrusion was also radiographically assessed. Linear regression analysis was used to investigate changes in mean PAI scores, and logistic regression analysis was used to investigate changes in the percentage of healed cases. All analyses were replicated using two distinct approaches: per protocol (PP) (treatments who completed the follow-up) and intention to treat (ITT) (all root canal treatments).
Results: A total of 58 endodontic treatments in 52 patients were performed (ITT). A total of 38 endodontic treatments in 33 patients completed the 3 years of follow up with a survival rate of 92.7%. Success rate was 85.4% (PP).
Conclusions: The use of Ceraseal associated with single cone technique was safe in maintaining endodontically affected teeth. (EEJ-2024-01-02)

Keywords: Apical extrusion, CaSi sealers, periapical healing, premixed bioceramic sealer, single cone technique

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