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

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.

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.

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).

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