HEALING OF APICAL PERIODONTITIS AFTER UNINTENTIONAL EXTRUSION OF AH PLUS SEALER: A RETROSPECTIVE RADIOGRAPHIC ASSESSMENT

Aim of the study: to evaluate the healing of apical periodontitis, after unintentional extrusion of AH Plus sealer on root canal treatments and non-surgical retreatments. Materials and methods: sixty-four teeth with apical periodontitis (21 initial root canal treatment and 43 non-surgical retreatmen...

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Main Authors: Sinziana Adina Scarlatescu, Ioana Suciu, Ruxandra Bartok, Cristina Preoteasa, Irina Gheorghiu, Stefan Manea
Format: Article
Language:English
Published: Romanian Society of Oral Rehabilitation 2025-06-01
Series:Romanian Journal of Oral Rehabilitation
Online Access:https://rjor.ro/healing-of-apical-periodontitis-after-unintentional-extrusion-of-ah-plus-sealer-a-retrospective-radiographic-assessment/
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author Sinziana Adina Scarlatescu
Ioana Suciu
Ruxandra Bartok
Cristina Preoteasa
Irina Gheorghiu
Stefan Manea
author_facet Sinziana Adina Scarlatescu
Ioana Suciu
Ruxandra Bartok
Cristina Preoteasa
Irina Gheorghiu
Stefan Manea
author_sort Sinziana Adina Scarlatescu
collection DOAJ
description Aim of the study: to evaluate the healing of apical periodontitis, after unintentional extrusion of AH Plus sealer on root canal treatments and non-surgical retreatments. Materials and methods: sixty-four teeth with apical periodontitis (21 initial root canal treatment and 43 non-surgical retreatments) were treated by 2 endodontists. They were rotary prepared and filled using warm vertical condensation technique. All the teeth presented unintentional canal overfilling, recorded on postoperative radiograph. The patients were monitored clinically and radiographically at 1 and 2 years after the treatment. Two independent observers assessed the radiographs and determined the outcome according to PAI score pooled in a 3-category scale (1 or 2 - healed, 3 - uncertain, 4 or 5 - nonhealed). Mann-Whitney, Fischer's exact, and Wilcoxon tests were used for group comparisons. Results: Initial PAI score and tooth location in the maxillary arch were the factors that significantly afected the outcome. Initial PAI score was statistically significant lower in healed than in nonhealed or uncertain outcomes (p<0.001). Healing occurred more frequently in the maxillary teeth, compared to mandibular teeth (p=0.007; p<0.05). At 1 year recall, a healed outcome was observed in 78.12% teeth and mean PAI score decreased from 3.42 to 1.28 (p<0.001). At 2 year recall, the healed outcome increased to 81,25%. The majority of teeth presented a persistence of extruded AH Plus, both at 1 (89.07%) and 2 (89.59%) years recall. Conclusions: Treatment outcome in teeth with apical periodontitis was not related to the persistence or resorption of sealer extrusion. The best results were registred in maxillary teeth, especially in teeth with lower initial PAI score.
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publishDate 2025-06-01
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spelling doaj-art-23372638e4cb48348c081cc43922c3102025-08-20T03:36:42ZengRomanian Society of Oral RehabilitationRomanian Journal of Oral Rehabilitation2066-70002601-46612025-06-0117265966610.62610/RJOR.2025.2.17.60HEALING OF APICAL PERIODONTITIS AFTER UNINTENTIONAL EXTRUSION OF AH PLUS SEALER: A RETROSPECTIVE RADIOGRAPHIC ASSESSMENTSinziana Adina Scarlatescu0Ioana Suciu1Ruxandra Bartok2Cristina Preoteasa3Irina Gheorghiu4Stefan Manea5Carol Davila” University of Medicine and Pharmacy, Bucharest, Faculty of Dental Medicine, Department of EndodonticsCarol Davila” University of Medicine and Pharmacy, Bucharest, Faculty of Dental Medicine, Department of EndodonticsCarol Davila” University of Medicine and Pharmacy, Bucharest, Faculty of Dental Medicine, Department of Esthetic DentistryCarol Davila” University of Medicine and Pharmacy, Bucharest, Faculty of Dental Medicine, Department of Scientific Research Methodology-ErgonomicsCarol Davila” University of Medicine and Pharmacy, Bucharest, Faculty of Dental Medicine, Department of Restorative DentistryTitu Maiorescu” Faculty of Dental Medicine, Bucharest, Department of Disciplines of Specialty Dental MedicineAim of the study: to evaluate the healing of apical periodontitis, after unintentional extrusion of AH Plus sealer on root canal treatments and non-surgical retreatments. Materials and methods: sixty-four teeth with apical periodontitis (21 initial root canal treatment and 43 non-surgical retreatments) were treated by 2 endodontists. They were rotary prepared and filled using warm vertical condensation technique. All the teeth presented unintentional canal overfilling, recorded on postoperative radiograph. The patients were monitored clinically and radiographically at 1 and 2 years after the treatment. Two independent observers assessed the radiographs and determined the outcome according to PAI score pooled in a 3-category scale (1 or 2 - healed, 3 - uncertain, 4 or 5 - nonhealed). Mann-Whitney, Fischer's exact, and Wilcoxon tests were used for group comparisons. Results: Initial PAI score and tooth location in the maxillary arch were the factors that significantly afected the outcome. Initial PAI score was statistically significant lower in healed than in nonhealed or uncertain outcomes (p<0.001). Healing occurred more frequently in the maxillary teeth, compared to mandibular teeth (p=0.007; p<0.05). At 1 year recall, a healed outcome was observed in 78.12% teeth and mean PAI score decreased from 3.42 to 1.28 (p<0.001). At 2 year recall, the healed outcome increased to 81,25%. The majority of teeth presented a persistence of extruded AH Plus, both at 1 (89.07%) and 2 (89.59%) years recall. Conclusions: Treatment outcome in teeth with apical periodontitis was not related to the persistence or resorption of sealer extrusion. The best results were registred in maxillary teeth, especially in teeth with lower initial PAI score. https://rjor.ro/healing-of-apical-periodontitis-after-unintentional-extrusion-of-ah-plus-sealer-a-retrospective-radiographic-assessment/
spellingShingle Sinziana Adina Scarlatescu
Ioana Suciu
Ruxandra Bartok
Cristina Preoteasa
Irina Gheorghiu
Stefan Manea
HEALING OF APICAL PERIODONTITIS AFTER UNINTENTIONAL EXTRUSION OF AH PLUS SEALER: A RETROSPECTIVE RADIOGRAPHIC ASSESSMENT
Romanian Journal of Oral Rehabilitation
title HEALING OF APICAL PERIODONTITIS AFTER UNINTENTIONAL EXTRUSION OF AH PLUS SEALER: A RETROSPECTIVE RADIOGRAPHIC ASSESSMENT
title_full HEALING OF APICAL PERIODONTITIS AFTER UNINTENTIONAL EXTRUSION OF AH PLUS SEALER: A RETROSPECTIVE RADIOGRAPHIC ASSESSMENT
title_fullStr HEALING OF APICAL PERIODONTITIS AFTER UNINTENTIONAL EXTRUSION OF AH PLUS SEALER: A RETROSPECTIVE RADIOGRAPHIC ASSESSMENT
title_full_unstemmed HEALING OF APICAL PERIODONTITIS AFTER UNINTENTIONAL EXTRUSION OF AH PLUS SEALER: A RETROSPECTIVE RADIOGRAPHIC ASSESSMENT
title_short HEALING OF APICAL PERIODONTITIS AFTER UNINTENTIONAL EXTRUSION OF AH PLUS SEALER: A RETROSPECTIVE RADIOGRAPHIC ASSESSMENT
title_sort healing of apical periodontitis after unintentional extrusion of ah plus sealer a retrospective radiographic assessment
url https://rjor.ro/healing-of-apical-periodontitis-after-unintentional-extrusion-of-ah-plus-sealer-a-retrospective-radiographic-assessment/
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