Randomized clinical trial of root-end resection followed by root-end filling with mineral trioxide aggregate or smoothing of the orthograde gutta-percha root filling--1-year follow-up.

R Christiansen, L-L Kirkevang, P Hørsted-Bindslev, A Wenzel

Journal: International endodontic journal 2009;42(2):105-14

PMID: 19134038

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Abstract

AIM

To compare healing after root-end resection with a root-end filling of mineral trioxide aggregate (MTA) or smoothing of the orthograde gutta-percha (GP) root filling.

METHODOLOGY

Forty-four patients (consisting of 52 teeth with periapical infection), average age of 54.6 years (range 30-77) participated in a randomized clinical trial (RCT) comparing the MTA and GP treatment methods. Radiographs produced 1-week and 12 months post-operatively were compared after blinding for treatment method, and healing was assessed as complete, incomplete, uncertain, or unsatisfactory.

RESULTS

Six teeth were not available for the 12-month follow-up: three teeth (GP) had been re-operated because of pain and two teeth (one GP, one MTA) had been extracted because of root fracture (these five teeth were classified as failures). One patient (GP) was not available for recall. In the GP group, seven teeth (28%) showed complete healing, six teeth (24%) incomplete healing, six teeth (24%) uncertain healing and two teeth (8%) unsatisfactory healing after 1 year. In the MTA group, 22 teeth (85%) showed complete healing, three teeth (12%) incomplete healing, and none were scored as uncertain or unsatisfactory healing after 1 year. The difference in healing between the GP and the MTA groups was significant (P < 0.001).

CONCLUSIONS

The results from this RCT emphasize the importance of placing a root-end filling after root-end resection. Teeth treated with MTA had significantly better healing (96%) than teeth treated by smoothing of the orthograde GP root filling only (52%).

Address: Department of Oral Radiology, School of Dentistry, Faculty of Health Sciences, University of Aarhus, Aarhus C, Denmark. [email protected]

DOI: 10.1111/j.1365-2591.2008.01474.x

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MeSH Terms: Adult, Aged, Aluminum Compounds, Alveolar Bone Loss, Apicoectomy, Calcium Compounds, Dental Caries, Dental Fistula, Dental Restoration, Permanent, Drug Combinations, Female, Follow-Up Studies, Gingival Hemorrhage, Gutta-Percha, Humans, Male, Middle Aged, Oxides, Periapical Diseases, Periodontal Pocket, Post and Core Technique, Radiography, Dental, Digital, Retreatment, Retrograde Obturation, Root Canal Filling Materials, Silicates, Single-Blind Method, Tooth Mobility, Toothache, Wound Healing