BEHAVIORAL FACTORS AND CLINICAL DECISION-MAKING IN THE USE OF BIOCERAMIC SEALERS FOR ROOT CANAL TREATMENT

Abstract

Moamen Abdelfadil Ismail*, Abdulrahman Hadi Alsalem, Mahmoud Jubran Jaber Almalki, Mazen Hussain S Alshahrani, Mohammed Raja Aloufi and Bassam Saud Alshaya

Background: Root canal treatment success relies heavily on effective obturation to seal the root canal system. Conventional resin-based sealers, such as AH Plus, have been widely used, but bioceramic sealers have emerged as a promising alternative due to their superior bioactivity, biocompatibility, and sealing properties. Despite their advantages, comparative clinical studies on their effectiveness remain limited. This study aimed to evaluate the efficacy of bioceramic sealers in enhancing root canal treatment outcomes compared to resinbased sealers.

Methods: A randomized controlled trial was conducted with 100 patients requiring primary endodontic treatment, randomly assigned to two groups: the experimental group (n=50) used a bioceramic sealer with the single-cone obturation (SCO) technique, while the control group (n=50) used AH Plus sealer with warm vertical compaction (WVC). Patients were followed for 12 months, with clinical and radiographic outcomes assessed at 3, 6, and 12 months. Primary outcomes included clinical success (absence of symptoms) and radiographic healing (reduction of periapical radiolucency). Secondary outcomes measured postoperative pain (VAS scores) and apical sealing ability (micro leakage). Statistical analyses included chi-square tests, t-tests, and Kaplan-Meier survival analysis.

Results: The bioceramic group demonstrated significantly higher clinical success rates at 12 months (95.8% vs. 76.6%, p=0.01) and superior radiographic healing (77.1% complete healing vs. 55.3%, p=0.02). Postoperative pain was significantly lower in the bioceramic group at all time points (p<0.008). Additionally, the bioceramic sealer showed better apical sealing, with 85.4% of cases exhibiting no micro leakage compared to 61.7% in the resin-based group (p=0.01).

Conclusion: Bioceramic sealers significantly improve root canal treatment outcomes, offering enhanced clinical success, periapical healing, and reduced postoperative pain compared to conventional resin-based sealers. Their superior sealing ability and biocompatibility make them a valuable alternative in modern endodontics. Further long-term studies are recommended to validate these findings and optimize their clinical application. Keywords: Bioceramic sealer, Root canal treatment, AH Plus, Apical sealing, Postoperative pain, Endodontic success.