Impact of iRoot SP on Periodontal Clinical Parameters and Chewing Function in Patients With Chronic Apical...

Chronic apical periodontitis (CAP) remains among the most challenging endodontic conditions due to persistent infection and inflammatory destruction in the periapical region. In contemporary endodontic terminology (AAE 2015), CAP typically corresponds to apical periodontitis with radiographic apical radiolucency, which may present with or without symptoms.

This study evaluates the effect of a novel bioceramic sealer, iRoot SP, on periodontal clinical parameters and masticatory function in patients with chronic apical periodontitis (CAP) compared with the traditional AH-Plus sealer.

In a single-center randomised controlled trial, 108 patients with single-tooth CAP were randomly allocated in a 1:1 ratio to the iRoot SP group or the AH-Plus group. Standardised root canal treatments were performed according to a strict protocol. Primary outcome measures included immediate obturation quality, clinical efficacy at one week, postoperative pain, periodontal parameters (probing depth, sulcular bleeding, gingival and plaque indices), and masticatory efficiency assessed preoperatively and at follow-up intervals of one week, three months, and six months.

The iRoot SP group achieved a significantly higher adequate filling rate (96.3% vs. 85.2%, p < 0.05) and overall clinical effectiveness (98.2% vs. 83.3%, p < 0.01). Moreover, postoperative pain was markedly lower (3.7% vs. 18.5%, p < 0.05). Superior improvements in periodontal metrics and masticatory function were consistently observed at all follow-up points (all p < 0.001).

The innovative iRoot SP sealer enhances root canal obturation quality and clinical outcomes while reducing postoperative discomfort and promoting periodontal and functional recovery in CAP. These results underscore its potential as a superior alternative in endodontic therapy.