Clinical performance of 3 endodontic sealers

Calcium hydroxide is used in endodontics as an interappointment dressing. Its inclusion in salicylate resin or zinc oxide-eugenol-based sealers for filling root canals also may lead to a better treatment outcome. The purpose of the present study was to compare the clinical/radiographic treatment outcome of 3 sealers, 2 of which contain calcium hydroxide.

Two hundred and four teeth underwent a standardized endodontic treatment regimen and were assigned to 1 of 3 groups at the time of root filling: group PS, teeth filled with gutta-percha and Procosol sealer; group CR, teeth filled with gutta-percha and CRCS sealer; and group SA, teeth filled with gutta-percha and Sealapex sealer. The results of the treatment were assessed yearly for up to 4 years by clinical and radiologic (periapical index scores) controls. The ridit statistic (r) was used to compare PAI scores among the groups.

The overall treatment results were comparable with, but slightly poorer than, results previously obtained from patients seen at the Dental School at the University of Oslo. During the first year after filling, the mean ridit value decreased from .51 +/- .039 to .31 +/- .042 (Deltar = .20) in the SA group. Corresponding values went from .43 +/- .030 to .38 +/- .035 (Deltar = .05) in the PS group and from 37 +/- .045 to .34 +/- .050 (Deltar = .03) in the CR group. At the 2-year examination, teeth in group SA had slightly better periapical conditions (r =.22 +/-.045) than did teeth in group PA (r = .30 +/- .037) or in group CR (r = .30 +/- 052). The difference was statistically significant at P = .01. By years 3 and 4, no significant difference among the groups was detected.

The overall influence of the sealer on treatment outcome was small. Root fillings with salicylate resin containing Ca(OH)2 may support more rapid healing of apical periodontitis or operative trauma, but the results after 3 and 4 years were as good for zinc oxide-eugenol-based sealers with or without Ca(OH)2.