Three-year Clinical Outcome of Root Canal Treatment Using a Single-cone Technique and Ceraseal Premixed Bioceramic Sealer: A Prospective Cohort Study

Objective: To evaluate the outcome of teeth filled with a single cone technique and a premixed bioceramic sealer at 3 years of follow-up. Methods: Healthy patients were consecutively treated by a cohort of postgraduate operators. Root canal filling procedures were performed with NiTi rotary instrumentation, while non-surgical retreatments were performed using NiTi reciprocating instruments. Root canal filling procedures were performed using Ceraseal and the single cone technique. Post-endodontic restorations were performed after 15 days. Provisional and definitive crowns were positioned in case of non-sufficient coronal structure. Periapical radiographs were made before treatment, after filling, and at each follow-up visit (6, 12, 24 and 36 months). The periapical Index (PAI) was used to assess the presence of periapical lesions and their modifications over time. Success (absence of periapical radiolucency, PAI <3) and survival rates were evaluated. The presence of apical extrusion was also radiographically assessed. Linear regression analysis was used to investigate changes in mean PAI scores, and logistic regression analysis was used to investigate changes in the percentage of healed cases. All analyses were replicated using two distinct approaches: per protocol (PP) (treatments who completed the follow-up) and intention to treat (ITT) (all root canal treatments). A significance level of 5% was used for all statistical tests (α=0.05). Results: Fifty-eight endodontic treatments in 52 patients were performed (ITT). Thirty-eight endodontic treatments in 33 patients completed the 3 years of follow-up with a survival rate of 92.7%. The success rate was 85.4% (PP). Conclusion: The use of Ceraseal associated with the single cone technique was safe in maintaining endodontically affected teeth. (EEJ-2024-01-02).