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Immediate and short-term clinical outcomes of iRoot SP in root canal retreatment: a retrospective study
1Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Hangzhou, 310000, Zhejiang Province, China.
Objective:
To assess the immediate and short-term clinical efficacy of iRoot SP sealer with warm gutta-percha filling in root canal retreatment and analyze influencing factors.
Materials And Methods:
This retrospective study included patients undergoing root canal retreatment at the Department of Endodontics, Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, between September 2021 and October 2022. Procedures were performed by two experienced endodontists. Clinical and radiographic data were analyzed to identify failure causes of primary treatment, evaluate immediate outcomes in 542 retreated canals, and determine factors influencing immediate (n = 230 teeth) and follow-up (n = 145 teeth) outcomes. Chi-square tests were used (α = 0.05), and 95% confidence intervals were calculated for success rates.
Results:
Primary failures: sparse filling (43.5%) and underfilling (36.7%). Immediate adequate filling: 87.3%. Tooth type significantly affected treatment, filling, and extrusion rates (P < 0.05). Premolars had the highest filling and extrusion. Inter-operator differences existed for procedural parameters (P < 0.05) but not success. Overall follow-up success was 89.0% (loose criteria) and 58.6% (strict criteria). Descriptively, molars showed a high loose-criteria success (91.2%) but a low strict-criteria success (50.0%); these differences were not statistically significant. Preoperative radiolucency increased extrusion (29.7% vs. 14.6%) and reduced success under both criteria (loose: 86.2% vs. 100.0%; strict: 50.0% vs. 93.1%; all P < 0.05). 95% confidence intervals are reported in the full text.
Conclusions:
iRoot SP achieved 89.0% (loose criteria) and 58.6% (strict criteria) short-term success. Under loose criteria, molars achieved 91.2% success. Preoperative periapical radiolucency doubled sealer extrusion and reduced success under both criteria.
Clinical Relevance:
iRoot SP achieved 89.0% success (loose criteria) and 58.6% (strict criteria) in short-term root canal retreatment. Molar retreatment should not be avoided due to complexity. Preoperative periapical radiolucency doubles sealer extrusion and predicts poorer outcomes, warranting modified placement technique and extended follow-up for lesions > 5 mm.
