Clinical outcomes of a novel flowable calcium silicate cement in equine endodontic treatment

Orthograde endodontic treatment of equine cheek teeth is performed infrequently with variable success rates of obturation with calcium hydroxide paste (CHP). A novel flowable calcium silicate cement (eCSC) formulated for use as an obturation material in equine teeth has demonstrated acceptable canal filling volumes and evidence of dentinal tubule penetration. However, clinical outcomes of eCSC-obturated equine teeth have not been reported.

To report the clinical outcomes of orthograde endodontic treatment using eCSC.

Retrospective case series.

Horses that underwent orthograde endodontic treatment using eCSC at a single referral centre between October 2020 and March 2026 and had ≥12 months follow-up were included in the study.

Seven horses, with endodontic treatments on six cheek teeth and one incisor were included. The success rate of eCSC was 6 of 7 cases, with up to 5.5 years of follow-up. One eCSC case demonstrated healing of a draining tract to the paranasal sinus on CT and histologically showed no evidence of periapical infection or inflammation 16 months after treatment. The singular failed eCSC-treated tooth demonstrated incomplete cleaning and obturation of one pulp canal on histological examination.

Small case numbers, heterogeneous follow-up, and a single operator limit the generalisability of these findings.

Orthograde endodontic treatment of equine teeth using eCSC can result in long-term clinical success. CT and histopathological findings available for one case support biological healing in successfully treated eCSC cases. A prospective, multi-centre study with standardised follow-up is warranted to establish the predictability and indications of eCSC as an obturation material for equine endodontics.