A randomized controlled trial comparing novel and traditional apical barrier techniques in endodontic procedures

Area of Science:

• Endodontics
• Dental Materials Science
• Biomedical Engineering

Background:

• Large root canals and incompletely developed apical foramina present challenges in root canal therapy.
• Traditional apical barrier techniques (T-ABT) often lack precision in material volume and plugger design.
• A novel apical barrier technique (N-ABT) utilizing 3D printing technology was developed to address these limitations.

Purpose of the Study:

• To compare the clinical efficacy of a novel apical barrier technique (N-ABT) with a traditional apical barrier technique (T-ABT).
• To evaluate differences in filling quality, efficiency, and clinical outcomes between the two techniques.

Main Methods:

• A randomized controlled clinical trial involving 47 patients (50 teeth) with large root canals and immature apices.
• Teeth were randomized to N-ABT (3D-printed personalized pluggers and volume control) or T-ABT (standard plugger, no volume control).
• Follow-up was conducted for 24 months, assessing clinical success, healing rates, filling efficiency, and overfilling incidence.

Main Results:

• No significant adverse events were reported in either group over 24 months.
• N-ABT significantly reduced obturation attempts (1.41±0.50 to 1) and filling time (99.31±25.08s to 38.78±15.56s).
• N-ABT significantly increased the no-overfilling rate (8.7% to 40.9%) and showed a trend towards higher healing rates at 24 months (68.2% vs. 47.8%).

Conclusions:

• The novel apical barrier technique (N-ABT) demonstrates superior filling quality and efficiency compared to T-ABT.
• N-ABT reduces technical sensitivity and shows potential for automated filling procedures, enhancing clinical applicability.
• N-ABT offers improved clinical outcomes and procedural efficiency in managing complex root canal anatomy.