Journal of endodontics最新文献

{"title":"Cetrimide-Enhanced Calcium Hydroxide Paste: A Biocompatible and Bioactive Option for Regenerative Endodontics.","authors":"Júlia Eick Iglesias, Lucas Siqueira Pinheiro, Gabriela Cardoso Ferreira, Marla Cuppini, Fabrício Mezzomo Collares, Fabiana Soares Grecca","doi":"10.1016/j.joen.2025.07.016","DOIUrl":"https://doi.org/10.1016/j.joen.2025.07.016","url":null,"abstract":"<p><strong>Introduction: </strong>This study compared the cytotoxicity, bioactivity, and biocompatibility of calcium hydroxide paste (CHP) with or without 0.2% cetrimide in microspheres (CETm) or in pure form (CET).</p><p><strong>Methods: </strong>CETm or CET were added to CHP and evaluated for cytocompatibility (MTT assay) and bioactivity (Alizarin Red and alkaline phosphatase), using stem cells from the apical papilla. Biocompatibility was assessed by implanting polyethylene tubes containing the materials into rat subcutaneous tissue. One-way ANOVA followed by Tukey post-hoc was used to analyze the results of MTT, ALP and ALZ assays. Kruskal-Wallis with Dunn's post-hoc test was used for the biocompatibility test (p<.05).</p><p><strong>Results: </strong>All pastes exhibited cell viability above 100% and bioactivity in ALP and ALZ assays. No abscesses, eosinophils, neutrophils, or giant cells were observed. After 90 days, all materials induced fibrous condensation, and inflammation decreased from mild to insignificant.</p><p><strong>Conclusion: </strong>Adding CETm or CET to CHP may offer a potential intracanal medication for REPs, demonstrating favourable biological properties.</p>","PeriodicalId":15703,"journal":{"name":"Journal of endodontics","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144731587","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Bacterial viability in persistent apical inflammatory lesions: A systematic review.","authors":"D Nascimento, I C Guedes, L M Brand, L Bernardi, J M Vasconcelos, J A P Figueiredo, F Visioli, M L Lamers, L N Hashizume, P V Rados","doi":"10.1016/j.joen.2025.07.015","DOIUrl":"https://doi.org/10.1016/j.joen.2025.07.015","url":null,"abstract":"<p><strong>Introduction: </strong>Apical inflammatory lesions are a response to microbial infections. However, their persistence despite adequate clinical and radiographic conditions remains incompletely understood. This systematic review aimed to analyze the evidence regarding the presence of viable microorganisms in cases of persistent apical periodontitis.</p><p><strong>Methods: </strong>A search was conducted in MEDLINE/PubMed, EMBASE, Scopus, Web of Science, The Cochrane Library, the CAPES Bank of Theses and Dissertations, and grey Literature. Restrictive inclusion criteria were applied, limiting the selection to studies in which periapical tissue samples were obtained during apical surgery. The quality of the included studies was assessed using a Joanna Briggs Institute Checklist.</p><p><strong>Results: </strong>The search yielded 522 studies, and 4 were selected for full analysis. The main finding of this review indicated the presence of viable microorganisms in persistent apical periodontitis. One study demonstrated bacterial viability through cell culture, while three others used RNA-based methods. The studies employing RNA analysis showed methodological heterogeneity. It was also noted that infections associated with persistent apical periodontitis are characterized by a diversity of microorganisms.</p><p><strong>Conclusions: </strong>The evidence presented in this review suggests the presence of viable bacteria in persistent apical periodontitis. However, it remains unclear whether the persistence of the lesion is due to viable bacteria within the lesion itself, microorganisms located intra- and extraradicular surfaces, or a combination of both.</p>","PeriodicalId":15703,"journal":{"name":"Journal of endodontics","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144717999","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Factors Influencing Discrepancies between Presurgery Cone-beam Computed Tomography and Intraoperative Measurements in Apical Surgery.","authors":"Dan Henry Levy, Nirit Yavnai, Sarit Rozenfeld, Avi Levin, Myriam Assouline, Gabriel Batashvili, Joe Ben Itzhak, Amit Talmon, Michael Solomonov","doi":"10.1016/j.joen.2025.07.014","DOIUrl":"10.1016/j.joen.2025.07.014","url":null,"abstract":"<p><strong>Introduction: </strong>This study evaluated the accuracy of cone-beam computed tomography (CBCT) in apical surgery planning by comparing preoperative CBCT measurements with intraoperative findings and identifying factors associated with discrepancies.</p><p><strong>Methods: </strong>Ninety patients (107 teeth) scheduled for apical surgery underwent preoperative CBCT imaging using a Planmeca ProMax 3D Classic unit (90 kV, 10 mA, 100 μm voxel size, 5 × 5 cm field of view). Three calibrated examiners measured the apico-coronal and mesiodistal dimensions of buccal cortical bone perforations, as well as the apico-coronal length of the remaining buccal cortical plate (BCP) collar. CBCT measurements were compared to intraoperative measurements. Statistical analyses assessed associations between CBCT inaccuracies and variables including age, sex, lesion size, tooth type (anterior vs posterior), location (maxilla vs mandible), root canal status, and time interval between CBCT and surgery.</p><p><strong>Results: </strong>A total of 101 surgical sites were analyzed. CBCT demonstrated a sensitivity of 90.6% and a specificity of 93.9% for detecting cortical plate perforations. Paired statistical tests revealed that CBCT significantly underestimated the mesiodistal dimension of lesions (P = .011) and overestimated the BCP collar dimension (P = .005). Multivariate generalized linear model analysis indicated that larger lesion size, mandibular location, and the presence of a root filling were significantly associated with greater discrepancies.</p><p><strong>Conclusions: </strong>CBCT demonstrates inherent limitations in measurement accuracy for apical surgery planning. Discrepancies are influenced by lesion size, tooth location, and root canal status. Clinicians should account for these factors when interpreting CBCT data to minimize preoperative planning errors.</p>","PeriodicalId":15703,"journal":{"name":"Journal of endodontics","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144718000","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Fourth Dimension of Endodontic Treatment Outcomes: Patient- Reported Outcome Measures (PROMs) Following Root Canal Treatment by Dental Interns.","authors":"Huma Farid, Bushra Afridi, Sana Ahmed, Rana Muhammad Ahmed Khan","doi":"10.1016/j.joen.2025.07.013","DOIUrl":"https://doi.org/10.1016/j.joen.2025.07.013","url":null,"abstract":"<p><strong>Introduction: </strong>Patient-Reported Outcomes (PROs) captures the patient's direct perspective on treatment effectiveness. This study evaluated PROs after root canal treatment (RCT) performed by dental interns on quality of life using pre- and post-RCT Oral Health Impact Profile (OHIP) scores. It also examined associations between demographics, baseline pulpal/periapical diagnosis, and OHIP scores.</p><p><strong>Methods: </strong>A prospective study was conducted at the Operative Dentistry Department of a dental institution, (January-June 2023) with 317 patients requiring RCT and meeting inclusion criteria. The Wilcoxon Signed-Rank Test compared pre- and post-RCT OHIP scores. Differences in OHIP scores based on gender, arch, and tooth position were assessed with the Mann-Whitney U test. The Kruskal-Wallis test examined OHIP score variations by pulpal/periapical diagnosis and age, with Dunn's post hoc test for pairwise comparisons. Significance level was set at < 0.05.</p><p><strong>Results: </strong>The final sample comprised 266 participants. OHIP scores significantly reduced post-RCT indicating enhanced quality of life after RCT (p < 0.05). Males had higher pre- and post-RCT OHIP scores than females with statistical significance p < 0.05). Patients aged 51+ had the lowest pre-RCT OHIP scores (p < 0.05). Those with acute apical abscess and asymptomatic apical periodontitis had significantly higher pre-RCT OHIP scores (p ≤ 0.001), with acute apical abscess patients showing the greatest post-RCT improvement as depicted by reduction in OHIP scores (p < 0.05).</p><p><strong>Conclusion: </strong>From the patients' perspective, regardless of demographics or pulpal/periapical diagnosis, RCT significantly improved quality of life. Male participants had greater perceived discomfort before and after treatment as compare to female. Patients aged 51+ perceived a lower impact of pulpal or periapical disease both before and after RCT. Greater post-RCT improvement was observed in participants diagnosed with acute apical abscess.</p>","PeriodicalId":15703,"journal":{"name":"Journal of endodontics","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144718001","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Worldwide prevalence of Radix Molaris in Mandibular Second molar assessed by Cone Beam Computed Tomography: Systematic review and meta-analysis.","authors":"Afaf Al-Haddad, Nada Alarami, Abdullah F Alshammari, Ömer Hatipoğlu, Fatma Pertek Hatipoğlu, Ahmad A Madfa","doi":"10.1016/j.joen.2025.07.012","DOIUrl":"https://doi.org/10.1016/j.joen.2025.07.012","url":null,"abstract":"<p><strong>Objectives: </strong>This study aimed to investigate the worldwide prevalence of radix entomolaris (RE) and paramolaris (RP) in mandibular second molars via cone beam computed tomography.</p><p><strong>Methods: </strong>The electronic databases MEDLINE, Web of Science, Scopus and Embase were searched using related MeSH keywords. In vivo CBCT-based studies that evaluated the prevalence of RE and RP in mandibular second molars were retrieved and assessed. The included studies were quantitatively analysed via a meta-analysis to determine the pooled prevalence rates of RE and RP. Furthermore, the studies were qualitatively assessed using the Newcastle‒Ottawa quality assessment scale.</p><p><strong>Results: </strong>Twenty-six studies were eligible for this review, and a meta-analysis of 21,383 mandibular second molars was performed. All the studies involved were ranked as high quality with no evidence of publication bias. The global prevalence of RE was 0.72% (95% CI: 0.45% to 1.04%), and that of RP was 0.17% (95% CI: 0.004% to 0.36%). Sex and geographical location did not significantly influence RE or RP incidence.</p><p><strong>Conclusion: </strong>The prevalence of radix molaris is not infrequent. The incidence of RE is higher than that of RP, and neither sex nor country influences the incidence rate of either presentation.</p>","PeriodicalId":15703,"journal":{"name":"Journal of endodontics","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144674937","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of Cellular Senescence on the Immune-Inflammatory Response and Regenerative Capacity of Human Dental Pulp Cells.","authors":"Johnny Carvalho da Silva, Raquel Figuerêdo Ramos, Ana Angélica Soares Vieira da Silva, Maria Ester França de Melo, Mayara Alves de Oliveira, Larissa Barbosa de Sousa, Elizabete Cristina Iseke Bispo, Ingrid Gracielle Martins da Silva, Maurício Gonçalves da Costa Sousa, José Raimundo Corrêa, Felipe Saldanha-Araujo, Taia Maria Berto Rezende","doi":"10.1016/j.joen.2025.07.009","DOIUrl":"10.1016/j.joen.2025.07.009","url":null,"abstract":"<p><strong>Introduction: </strong>Cellular senescence is a state of irreversible cell cycle arrest that can compromise tissue homeostasis through the secretion of inflammatory mediators and disruption of the cellular microenvironment. In dental pulp, senescence may impair reparative functions and increase susceptibility to inflammation and degeneration. However, the specific effects of senescence on the immune behavior of pulp cells remain poorly understood. This study aimed to investigate how senescence influences the viability, morphology, migration, proliferation, and immune response of human dental pulp cells.</p><p><strong>Methods: </strong>Cellular senescence was induced with 500 μM doxorubicin and confirmed by β-galactosidase staining. To simulate immunoinflammatory conditions, cells were stimulated with lipopolysaccharide, either alone or in combination with interferon-gamma. Morphologic changes were analyzed by scanning electron microscopy, while cell viability and proliferation were assessed using the Trypan Blue exclusion assay. Migratory capacity was evaluated through the scratch wound healing assay. Gene expression of pro- and anti-inflammatory mediators was quantified by real-time polymerase chain reaction.</p><p><strong>Results: </strong>The results of this study indicate that cellular senescence impairs the dental pulp's essential functions, particularly its regenerative and repair capacity under inflammatory conditions. Senescent pulp cells exhibited reduced viability, proliferation, and migration, along with morphologic changes suggesting decreased tissue function. Inflammatory pathways were altered, showing increased proinflammatory cytokine expression and decreased regenerative cytokine expression.</p><p><strong>Conclusions: </strong>The findings suggest that senescence can directly impact the prognosis of conservative endodontic treatments, particularly in patients with pulp compromised by lesions. This emphasizes the need for therapeutic strategies to mitigate senescence effects and preserve pulp vitality.</p>","PeriodicalId":15703,"journal":{"name":"Journal of endodontics","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144667730","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effect of Root Perforation and Bone Defect on Stress Distribution and Displacement of Maxillary First Premolars: Biomechanical Decoupling Effect of MTA Restoration.","authors":"Ling Li, Hui Deng, Yu Zhao, Yihuai Pan, Jun Li","doi":"10.1016/j.joen.2025.07.011","DOIUrl":"10.1016/j.joen.2025.07.011","url":null,"abstract":"<p><strong>Introduction: </strong>This study used finite element analysis to investigate the effects of root perforation and secondary bone defects on the stress distribution and displacement in maxillary first premolars and to evaluate the efficacy of mineral trioxide aggregate (MTA) in root perforation repair.</p><p><strong>Methods: </strong>A three-dimensional model of a maxillary first premolar was constructed based on clinical cone-beam computed tomography data. Sixteen finite element models were established, including intact teeth, root-filled teeth, perforated teeth with or without repair (unR/R groups), and varying bone defect radii (0 ∼ 3 mm). Root perforation at the middle third and repaired by MTA was simulated. A vertical occlusal force of 300 N was applied via finite element analysis software (Cosmos Simulation) to analyze maximum principal stress (MPS) and displacement. Material parameters were defined as isotropic and linearly elastic based on literatures.</p><p><strong>Results: </strong>MTA repair of root perforation reduced the average maximum MPS in dentin by 73%. As bone defect radius increased, the unR group exhibited fluctuating increases in maximum MPS, while the R group maintained relatively stable maximum MPS levels. The dentin/enamel maximum MPS ratio in the R group recovered to 0.47. Maximum displacement in both groups positively correlated with bone defect size.</p><p><strong>Conclusion: </strong>MTA repair of root perforation restored physiological load distribution patterns in maxillary first premolars by reconstructing structural continuity, effectively decoupling bone defects from stress concentration. However, it could not fully counteract the increased displacement caused by periodontal support loss.</p>","PeriodicalId":15703,"journal":{"name":"Journal of endodontics","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144667728","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Endodontic Infections Requiring Hospitalization: Absolute Risk Estimations Based on Data From Two Swedish Populations.","authors":"Krister Sevä, Thomas Kvist, Fredrik Frisk, Fernando J Mota de Almeida","doi":"10.1016/j.joen.2025.07.008","DOIUrl":"10.1016/j.joen.2025.07.008","url":null,"abstract":"<p><strong>Introduction: </strong>Knowledge of the link between oral conditions and odontogenic infections requiring hospitalization is limited. This study examines the variables associated with hospitalization due to odontogenic infections and calculates the risk for hospitalization for specific endodontic conditions.</p><p><strong>Methods: </strong>Consecutive patients hospitalized over 9 years in a Swedish region for odontogenic infections were included. Patient records and previous dental treatments were reviewed. Descriptive statistics were used, and the population was compared with control data from government statistics, national health registries, and other Swedish studies. Absolute risks for hospitalization due to endodontic conditions were calculated.</p><p><strong>Results: </strong>The sample study included 97 patients (mean age 47.03, 52 males). Hospitalized individuals were more often smokers and had psychiatric diagnoses (P = .001). Most hospitalizations (80%) were due to odontogenic infections originating from the mandibular molar region, with nearly half (49.5%) linked to endodontic infections. The absolute risk for primary apical periodontitis (AP)was 74.3 hospitalizations per 100,000 individuals/year, whereas the absolute risk for secondary AP (ie, root-filled tooth and AP) was 0.7 per 100,000 individuals/year. The risk of hospitalization following root canal treatment was 30 per 100,000 treatments.</p><p><strong>Conclusions: </strong>Hospitalization due to odontogenic infections remains rare. However, the risk of hospitalization increases in patients with mandibular molar infections and who smoke, have specific diagnosed mental health disorders, or seek dental care only during acute situations.</p>","PeriodicalId":15703,"journal":{"name":"Journal of endodontics","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144667729","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prevalence of Palatal Grooves on Maxillary Anterior Teeth Using Cone-beam Computed Tomography: A Systematic Review and Meta-Analysis.","authors":"Oscar Lozano González, Marco Felipe Salas Orozco, Nuria Patiño Marín, Paul V Abbott, Marc Garcia-Font, Francesc Abella Sans","doi":"10.1016/j.joen.2025.07.002","DOIUrl":"10.1016/j.joen.2025.07.002","url":null,"abstract":"<p><strong>Background: </strong>The aim of this study was to systematically review the literature and perform a single-arm meta-analysis to estimate the prevalence of palato-gingival grooves (PGs) in maxillary anterior teeth using cone-beam computed tomography (CBCT).</p><p><strong>Methods: </strong>This study followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. A comprehensive literature search was conducted across multiple databases, including PubMed, Embase, Cochrane Library, Web of Science, and Scopus, to identify peer-reviewed studies and the gray literature reporting the prevalence of PGs in maxillary anterior teeth using CBCT. Studies were included if they provided data on the presence and characteristics of the palatal groove. The research protocol was previously registered in the International Prospective Register of Ongoing Systematic Reviews (PROSPERO; CRD42025633698). The Joanna Briggs Institute Critical Appraisal Checklist for Prevalence Studies was used to assess the methodological quality of the included studies. A single-arm meta-analysis was performed using a random-effects model to estimate the overall prevalence while accounting for variability across studies.</p><p><strong>Results: </strong>Eight studies met the inclusion criteria, evaluating 2212 subjects and 8900 maxillary anterior teeth. Sex distribution was 615 females (53.2%) and 541 males (46.8%), although not all studies reported sex data. The pooled prevalence of PGs was 1.5% (95% CI: 1.1%-2.1%), with substantial heterogeneity (I² = 71.19). PGs were most frequently observed in maxillary lateral incisors (16.92%), while central incisors had a lower prevalence (1.22%) and canines were rarely affected (0.14%). Gu's Type I PGs was the most observed classification in the included studies. Most PG cases were unilateral (85.3%), with only 14.7% being bilateral. The methodological quality of the included studies was moderate to high, with a final Joanna Briggs Institute score of 84.38%.</p><p><strong>Conclusion: </strong>According to the analyzed studies, the estimated prevalence of PGs detected through CBCT was 1.5%. It primarily affects lateral incisors and occurs more frequently as a unilateral condition.</p>","PeriodicalId":15703,"journal":{"name":"Journal of endodontics","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-07-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144626468","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Outcome of Nonsurgical Root Canal Treatment Using Sealer-based Obturation versus Warm Vertical Compaction: A Randomized Controlled Trial.","authors":"Fahad Alzoubi, Samhan Alajmi, Abdullah Alkandari, Saad Alqahtani, Amer Alanezi, Frank C Setzer","doi":"10.1016/j.joen.2025.07.003","DOIUrl":"10.1016/j.joen.2025.07.003","url":null,"abstract":"<p><strong>Introduction: </strong>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.</p><p><strong>Methods: </strong>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.</p><p><strong>Results: </strong>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).</p><p><strong>Conclusions: </strong>Given comparable clinical outcomes to WVC yet demonstrating faster obturation time, SBO with CSS may be a suitable clinical alternative.</p>","PeriodicalId":15703,"journal":{"name":"Journal of endodontics","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-07-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144626471","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}