Outcomes of endodontic microsurgery with retrofilling of calcium silicate cements with or without calcium chloride accelerator: A randomized controlled clinical trial

Abstract

Introduction: Calcium silicate-based cement (CSC) with calcium chloride (CaCl 2) accelerator sets faster than the cement without accelerator. For endodontic microsurgery, CSC with the accelerator tends to be less soluble in tissue fluid that may improve clinical outcome. This study aimed to evaluate the outcome of endodontic microsurgery by retrofilling with CSC containing accelerator (Bio-MA) compared to the original CSC (ProRoot ® mineral trioxide aggregate [MTA]). Materials and Methods: Forty-eight teeth required surgical root canal retreatment was included according to the eligible criteria. Endodontic microsurgery with standardized protocol was performed under the dental operating microscope. Bio-MA or ProRoot ® MTA was randomly selected for retrofilling. At recall visit, treatment outcomes were evaluated as 'healed,' 'healing' or 'diseased,' based on clinical and radiographic assessments. The Chi-square test and Fisher's exact test were used in the statistical analysis of the outcome. Results: Seven teeth were excluded because of vertical root fracture detected in surgery (n = 5) and inadequate retrofilling depth (n = 2). Two cases were lost to follow-up. For thirty-nine teeth with 14.9 ± 5.2 months recall, 'healed' rates were 85% in Bio-MA and 84.2% in ProRoot ® MTA, and 'healing' rates was 15% in Bio-MA and 15.8% in ProRoot ® MTA. None of 'disease' was observed. No significant difference in the clinical outcome was observed between groups of Bio-MA and ProRoot ® MTA (P = 1.00). Conclusions: The endodontic microsurgery outcome of Bio-MA containing CaCl 2 accelerator was similar to that of ProRoot ® MTA without accelerator.