The healing process of periapical lesions: hydraulic vs traditional endodontic sealers

Objectives Aim of this prospective study was to assess the healing process of endodontically treated teeth with periapical lesions when hydraulic or traditional endodontic sealers were used. Methods Three hundred and fifty endodontic treatments were performed on 295 patients. The sample teeth were randomly divided into two groups according to the endodontic sealer was used (Group 1 Hydraulic Endodontic Sealer and Group 2 Zinc oxide-eugenol based sealer). All teeth were obturated with a warm gutta-percha technique. The healing process was documented at 1 and 2 years by intraoral X-ray using the Peri Apical Indexes. At last recall only 291 patients for 343 canal treatments were reevaluated with a recall rate of 98%. The statistical analysis evaluated the change of periapical size lesion in the time of both Groups, for each type of teeth, for each arch, the teeth with successful outcomes at T2, and the speed of the healing process between the two groups. Pearson chi-square test was used and the P value was set at <0.5. Results The rate of success was 97,6%; the healed teeth were 80,5%, the healing 17,2%, and not healed only 2,3%. The success rate was 98,8% for periapical lesions less than 5 mm and 96,4 % for periapical lesions bigger than 5 mm. When the teeth classified as successful were compared with not healed teeth, no significant difference was noted between the two Groups. However, 276 teeth were recorded as healed and 59 as healing and 8 others did not show any healing process and were classified as failure. Of these failures, four were recorded in Group 1 and four in Group 2. Significance The healing process of teeth treated with Hydraulic Endodontic Sealer was faster than that obturated with zinc phosphate sealer within the first year of clinical service but statistically significant difference. The size of the periapical lesion does influence the healing process time.