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Healing of apical periodontitis after endodontic treatment: a comparison between a silicone-based and a zinc-oxide-eugenol based sealer
Of the 199 teeth, 156 could be followed for 12 months (Table 3). There was no difference in dropouts between the sealer groups (Table 3). Patients in RS group were slightly younger (Table 4). No differences in gender (Table 4) or tooth type (Table 5) between sealer groups were seen. At the outset or any other examination, there were no significant differences between sealer groups in any of the clinical or dental variables studied. Marginal bone level, density and length of filling or surplus did not differ between sealer groups (Table 6). The PAI values in the RS and GS groups at start were similar (Fig.1). It was a general observation that periapically extruded sealer was not absorbed by the tissues during the observation period.
Table 3. Number of teeth in different sealer groups.
Table 4. Sex and age of patients.
Table 5. Tooth types at start.
Table 6. Radiographic variables and frequency.
Figure 1. The effect of the sealer used on changes in periapical status (the boxes show the first and third quartiles with the median value in bold line. The whiskers show the minimum and maximum). Identical letters indicate no statistically significant differences (a=0.01).
Any subjective pain had been eliminated at the time of filling. Soft tissue and percussion status improved considerably between start and filling, and continued to improve at follow-ups. Figure 2 shows the percentage of cases at different time points showing healing of apical periodontitis. The healing was seen as a decrease in PAI scores at 12 weeks. This difference was statistically significant. Also a significant decrease was found between 12- and 52-week control. The overall â€˜successâ€™ rate at 12 months was 76%. â€˜Improvementâ€™ was 47 and 78% at 3 and12 months, respectively. Average PAI scores decreased from 3.43 at start to 2.21 at12 months for GS and from 3.40 to 2.26 for RS. In both sealer groups there was a statistical significant decrease of PAI scores after root-canal filling at 3 and 12 months examinations compared to time of filling (Fig.1). No significant difference between the groups at start or any of the follow ups was seen. Overfilled teeth in either group did not differ from others in respect of healing. There was no statistically significant difference in healing after treatment with RS compared to GS, expressed as either â€˜success rateâ€™or â€˜improvementâ€™ (Fig. 3).
Figure 2. Distribution of teeth in PAI scoring categories at various time points showing progression of healing of apical periodontitis.
Figure 3. Improvement'at 3 and 12 months and 'success' at 12 months in RS and GS groups (bars represent proportion; error bars represent confidence intervals for proportions).