What question did this study set out to answer?

This research aims to compare different sealer types and obturation techniques for efficacy in treating apical periodontitis.

May 3, 2026

Endodontic treatment outcomes in apical periodontitis cases by the lateral condensation versus warm vertical compaction techniques: a one-year follow-up study.

Key Points

This research aims to compare different sealer types and obturation techniques for efficacy in treating apical periodontitis.
168 patients with single-rooted teeth were randomized into four groups: AHP-CLC, AHP-WVC, AHPbcs-CLC, and AHPbcs-WVC.
Clinical and radiological evaluations were performed preoperatively and at 1-year follow-up, focusing on PAI scores and treatment success.
Post-obturation pain was recorded at multiple time points up to one week after treatment.
At 1-year follow-up, the AHPbcs-WVC group had a significantly higher periapical healing score than the AHP-CLC group (p < 0.05).
Postoperative pain was most frequent in the AHPbcs-WVC group (60%) at 6 hours.
Overall success rates showed relative differences without statistical significance (p = 0.175).

Abstract

OBJECTIVE: To compare the effects of different sealers (epoxy resin-based AH Plus AHP and calcium silicate-based AH Plus Bioceramic Sealer AHPbcs) and obturation techniques (cold lateral condensation CLC and warm vertical compaction WVC) on radiological healing, sealer extrusion rates, pain, and postoperative treatment success in the treatment of teeth with periapical lesions. MATERIALS AND METHODS: 168 patients having single-rooted teeth with apical periodontitis were randomized into four groups: AHP-CLC, AHP-WVC, AHPbcs-CLC, and AHPbcs-WVC. Clinical and radiological evaluations (PAI score, periapical lesion size, periapical healing, sealer extrusion, and treatment success) were performed preoperatively and again at the end of a 1-year follow-up. Post-obturation pain levels and analgesic use were recorded at 6, 24, 72 h, and up to 1-week post-treatment. RESULTS: At the 1-year follow-up, the periapical healing score in the AHPbcs-WVC group was statistically significantly higher compared to that of the AHP-CLC group (p < 0.05). Postoperative pain, albeit relatively, was observed most frequently in the AHPbcs-WVC group (60%) at 6 h. Although the success rates showed relative differences between the groups, they were not statistically significant (p = 0.175). CONCLUSIONS: Although no significant difference was observed in overall success rates between the groups, the AHPbcs-WVC combination showed more favorable results in terms of periapical healing and lesion size reduction. Sealer extrusion was significantly associated with both sealer type and obturation technique and occurred more frequently with AHPbcs-WVC. CLINICAL RELEVANCE: AHPbcs even with an increased risk of extrusion when used with the WVC technique, offer better potential for periapical healing and treatment success. However, patients must be supported by pain management. These results emphasize that the choice of material and technique affects both the long-term success and patient comfort regarding pain in endodontic treatment. TRIAL REGISTRATION: ClinicalTrials.gov ID NCT07106307, retrospectively registered on 07/12/2025, https://clinicaltrials.gov/study/NCT07106307.

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