Effect of MTAD on outcome of primary root canal treatment: A randomized controlled trial

Aim: To compare the radiographic outcome of a root canal treatment with and without additional use MTAD solution after 24 months recall. Methodology: One hundred single-rooted teeth with periapical radiolucency of 100 patients were randomized into two groups using a randomized block design with block sizes of 10 patients each. Root canals were prepared with Reciproc Blue and irrigation was performed with 5 ml 2.5% NaOCl during instrumentation. Final irrigation protocol was performed using 5 ml 2.5% NaOCl (n= 50) or 5 ml MTAD (n=50). Then the root canals were irrigated with 5 ml of saline and obturated with gutta-percha and AH Plus sealer. Three patients were excluded due to pregnancy, systemic disease and use of medicament. The 97 patients were recalled and evaluated radiographically at 24 month according to PAI scores. Twenty five patients were lost during follow-up. Pre and posttreatment PAI scores were compared and teeth were considered 'healthy' (PAI ≤ 2) or 'diseased' (PAI ≥ 3). Whitney U test was used to compare the differences between the post-operative and follow-up images. Wilcoxon signed rank test was conducted to examine the changes in PAI score from base line to the follow-up evaluation. Results: Seventy two patients were reexamined 2 years after treatment. Overall, a statistically significant decrease in PAI score from the base line to the follow-up evaluation was seen in 65 of 72 teeth. Absence and reduction of the radiolucency together were observed in the MTAD group in 33 of 37 teeth (89.2 %) and 32 of 35 teeth (91.4 %) in the NaOCl group. There was no significant difference between the results of decrease in PAI score was seen in both groups (P = 0.551). Conclusion: Root canal treatments with and without MTAD irrigation contributed equally to periapical healing. Acknowledgements: This work was supported by Cukurova University Scientific Research Support Program project number TDH-2019-12197.