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.
OBJECTIVE
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.


METHODS
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%).
Christiansen
R
R
Department of Oral Radiology, School of Dentistry, Faculty of Health Sciences, University of Aarhus, Aarhus C, Denmark. RChristiansen@odont.au.dk
Kirkevang
L-L
LL
Hørsted-Bindslev
P
P
Wenzel
A
A
D000328:Adult; D000368:Aged; D017607:Aluminum Compounds / Q000627:therapeutic use*; D016301:Alveolar Bone Loss / Q000150:complications; D001047:Apicoectomy / Q000379:methods*; D017610:Calcium Compounds / Q000627:therapeutic use*; D003731:Dental Caries / Q000150:complications; D003751:Dental Fistula / Q000150:complications; D003793:Dental Restoration, Permanent; D004338:Drug Combinations; D005260:Female; D005500:Follow-Up Studies; D005884:Gingival Hemorrhage / Q000150:complications; D006171:Gutta-Percha / Q000627:therapeutic use*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010087:Oxides / Q000627:therapeutic use*; D010483:Periapical Diseases / Q000601:surgery; D010514:Periodontal Pocket / Q000150:complications; D011176:Post and Core Technique; D019252:Radiography, Dental, Digital; D019233:Retreatment; D012184:Retrograde Obturation / Q000379:methods*; D012387:Root Canal Filling Materials / Q000627:therapeutic use*; D017640:Silicates / Q000627:therapeutic use*; D016037:Single-Blind Method; D014086:Tooth Mobility / Q000150:complications; D014098:Toothache / Q000150:complications; D014945:Wound Healing / Q000502:physiology
D017607:Aluminum Compounds; D017610:Calcium Compounds; D004338:Drug Combinations; D010087:Oxides; D012387:Root Canal Filling Materials; D017640:Silicates; C086631:mineral trioxide aggregate; D006171:Gutta-Percha