Clinical efficacy of a sealer-based obturation using calcium silicate sealers: A randomized clinical trial.
INTRODUCTION
This randomized controlled clinical trial compared the clinical efficacy and outcome of a sealer-based obturation technique (SBO) with calcium silicate sealers and a continuous wave of condensation technique (CWC) with a resin-based sealer.


METHODS
Root canals were prepared using rotary instruments and 2.5% sodium hypochlorite. At the next visit, patients were enrolled and randomly assigned into two groups, based on the obturation protocol: CWC with AH Plus sealer (Dentsply DeTrey GmbH, Konstanz, Germany) and SBO with Endoseal TCS (Maruchi, Wonju, Korea). Patients were assessed for the level of postoperative pain using a numerical rating scale. The quality of root canal obturation was evaluated in terms of the sealer extrusion, root filling voids, and level of root filling. The participants were recalled after at least 6 months. Healing of the teeth was determined as a decrease in PAI score and resolution of symptoms. The results were statistically compared using the chi-square test or Fisher's exact test, followed by multivariate analysis with logistic regression.


RESULTS
A total of 74 teeth were included in the analysis (79% recalls) and the mean follow-up period was 17 months (6-29 months). Two groups expressed identical distribution of postoperative pain (P = 0.973) and similar quality of root canal obturation. The total success rates were 93.2% (CWC 92.3%, SBO 94.3%) by loose criteria and 60.8% (CWC 51.3%, SBO 71.4%) by strict criteria, with no significant differences between the two groups. The success rate by loose criteria in teeth with sealer extrusion was significantly lower than those in teeth without sealer extrusion (P = 0.049).


CONCLUSION
SBO using an endoseal TCS could be a possible alternative to CWC using AH Plus. Sealer extrusion and postoperative pain were found to negatively impact prognosis of the endodontic treatment.
['Kim|Ji-Hyung|JH|', 'Cho|Sin-Yeon|SY|', 'Choi|Yoonwoo|Y|', 'Kim|Do-Hyun|DH|', 'Shin|Su-Jung|SJ|', 'Jung|Il-Young|IY|']
sealer-based obturation outcome postoperative pain root canal treatment warm vertical condensation