Three-year randomized clinical trial on the effectiveness of two integrated techniques for the treatment of maxillary central incisors with periapical pathosis

Aim To assess the effectiveness of two integrated shaping and filling techniques for the treatment of maxillary central incisors affected by chronic apical periodontitis. Methodology The trial enrolled 60 patients with a maxillary central incisors needing root canal treatment affected by chronic apical periodontitis with periapical radiolucency smaller than 5 mm in diameter. Block-randomization was undertaken to allocate the patients to two treatment groups with different canal shaping and filling protocols: group 1 (G1, n = 30), Revo-S/One Step Obturator; group 2 (G2, n = 30) GTX/GTX Obturator. An independent examiner evaluated the patients at baseline, after 6, 12, 24 and 36 months by performing percussion and palpation tests. At the same time points, standardized periapical radiographs were taken to score the radiographic healing according to a previously published scale. For this analysis, the level of agreement with regard to the scores assigned by two blind evaluators was tested by weighted kappa statistics. Comparability of baseline clinical data, as well as the differences between the two groups and among time points concerning clinical and radiographic data were evaluated with non-parametric tests (p < 0.05). Results All the patients were re-evaluated after 3 years. One patient per group complained of mild symptoms at the end of the observation period. Radiographic healing was progressive during the follow-up. The lesions were classified as totally healed, partially healed and not healed in 93.3%, 3.3% and 3.3% of cases in G1 and in 93.3%, 0% and 6.7% of cases in G2. The differences between groups were not significant (p > 0.05). Conclusions The two integrated endodontic systems were equally effective in achieving high three-year success rates in the treatment of maxillary central incisors with chronic apical periodontitis.