Clinical Efficacy of Sealer-based Obturation Using Calcium Silicate Sealers: A Randomized Clinical Trial

Ji hyung Kim, Sin Yeon Cho, Yoonwoo Choi, Do hyun Kim, Su Jung Shin, Il Young Jung

Research output: Contribution to journalArticlepeer-review

5 Citations (Scopus)


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 2 groups on the basis of the obturation protocol: CWC with AH Plus sealer and SBO with Endoseal TCS. Patients were assessed for the level of postoperative pain using a numeric 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 Periapical Index score and resolution of symptoms. The results were statistically compared by using the χ2 test or Fisher 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 = .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 2 groups. The success rate by loose criteria in teeth with sealer extrusion was significantly lower than those in teeth without sealer extrusion (P = .049). Conclusions: 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.

Original languageEnglish
Pages (from-to)144-151
Number of pages8
JournalJournal of endodontics
Issue number2
Publication statusPublished - 2022 Feb

Bibliographical note

Funding Information:
Ji-hyung Kim and Sin-Yeon Cho contributed equally to this study. The authors thank Jung Hwa Hong, Department of Policy Affairs, National Health Insurance Service Ilsan Hospital, for statistical analysis. This research was supported by the Ministry of Trade, Industry & Energy (MOTIE), Korea Institute for Advancement of Technology (KIAT) through the Encouragement Program for The Industries of Economic Cooperation Region). The authors deny any conflicts of interest related to this study.

Funding Information:
This study did not fulfill the required sample size because of the limited time for patient recruitment. This study was funded by the government, and there was a limited time to use the fund. To reward the participants, a small amount of transportation expenses was applied for every visit. Unfortunately, because the time to use the fund was limited, we could not enroll as many participants as we calculated to ensure the proper power of the study.

Publisher Copyright:
© 2021 The Authors

All Science Journal Classification (ASJC) codes

  • Dentistry(all)


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