(PR08) Assessment of Bioceramic Sealer Extrusion on the Healing of Periapical Tissues After Non-Surgical Root Canal Treatment and Retreatment Using CBCT Analysis

Abstract: This study aimed to evaluate the impact of bioceramic sealer (BCS) extrusion on the outcome of root canal treatment (RCT) and retreatment (RT) and to investigate the volumetric change and displacement of extruded BCS following treatment. Among teeth treated by RCT and RT from July 2020 to March 2021 at the postgraduate Endodontic clinic, University of Pennsylvania School of Dental Medicine, cases with BCS (EndoSequence® BC sealer) extrusion on the postoperative periapical radiograph (PA) were identified. CBCT scans were taken verifying the location and volume of extruded sealer. At the 6-month follow-up, clinical and radiographic exam were performed. Two experienced endodontists evaluated PA and CBCT images. Periapical lesion on each root was classified as “healed”, “healing”, or “non-healed”. The size and location of extruded sealer were classified as “no change”, “decreased”, or “increased”; and “displaced” or “non-displaced”. In total, eleven roots of nine teeth were included. CBCT analysis demonstrated 1 “healed” root (9.09%), 10 “healing” roots (90.9%), and 0 “non-healed” roots. Periapical radiograph analysis revealed 3 “healed” roots (33.3%), 5 “healing” roots (55.6%), and 1 “non-healed” root (11.1%). Overall, healing observed on CBCT was superior to radiographic healing. Extruded sealer was found to be displaced in 4 of 5 roots (80%) and appeared to have remained the same size in 4 of 5 roots (80%). In conclusion, BCS extrusion in collected samples did not negatively affect the outcome of RCT or RT, nor does it appear to change in size; however, extruded BCS appears to displace within periapical tissues.