Calcium Silicate and Epoxy Sealer in Endodontic Treatment: A Randomized Controlled Trial Short title: Calcium Silicate and Epoxy Resin Sealers

Abstract Background The selection of an appropriate sealer is critical for the success of endodontic treatments. Although calcium silicate-based sealers (CSS) and epoxy resin-based sealers (ERS) have exhibited promise in short-term studies, a comprehensive understanding of their long-term clinical effectiveness in single-visit root canal treatment remains essential. Objectives This study aimed to compare and evaluate the long-term clinical effectiveness of a calcium silicate-based sealer and an epoxy resin-based sealer in the context of single-visit root canal treatment. Materials and methods A prospective, longitudinal clinical trial was conducted involving 42 teeth diagnosed with irreversible pulpitis conditions. The teeth were randomly assigned to two groups based on the obturation sealer used: calcium silicate-based sealer (CSS) and epoxy resin-based sealer (ERS). Postoperative parameters, including pain, swelling, fistula, and sensitivity under biting pressure, were assessed at regular intervals for up to 36 months following the single-visit endodontic treatment. Treatment outcomes were determined based on established criteria, categorizing cases as success, failure, or uncertain. Statistical analysis employed the Chi-squared test, t-test, Mann-Whitney U-test, and Wilcoxon signed-rank test (p < 0.05). Results Preliminary results indicate comparable incidences of postoperative complications between the two groups over the long-term follow-up period. Conclusion This study suggests that both calcium silicate-based and epoxy resin-based sealers demonstrate similar long-term clinical effectiveness in single-visit root canal treatments. These findings offer valuable insights for practitioners aiming to achieve sustained treatment success through sealer selection. Clinical relevance: We can use two types of cement Calcium silicate-based and epoxy resin-based sealersinterchangeably in root canal treatment. ClinicalTrials registration number: NCT05904184