Clinical Outcome of Non-Surgical Root Canal Treatment Using a Single-cone Technique with Endosequence

By Chybowski E, Glickman G, Patel Y, Fleury A, Solomon E, He J

Date: 01/2019
Journal: JOE

Purpose: to evaluate the success rate of nonsurgical root canal therapy using BC and a single-cone technique within a private practice setting.


•N = 307

•Only single cone treated teeth included

•Treatment protocol described

•Patients treated in a private clinic were searched between 2009 – 2015 •Requested to return for 6 or 12 month recall

•Dates arranged chronologically, selection criteria specified

•Radiographic examination evaluated by 2 calibrated examiners

•Sample divided based on outcome category:

1.Healed: Functional, asymptomatic teeth with no or minimal radio- graphic periradicular (apical) pathosis (radiolucency)

2.Non-healed: Nonfunctional, symptomatic teeth with or without radiographic periradicular (apical) pathosis (radiolucency) or asymptomatic teeth with unchanged, new, or enlarged radiographic periradicular (apical) pathosis (radiolucency)

3.Healing Teeth that are asymptomatic and functional with a decreased size of radiographic periradicular (apical) pathosis (radiolucency)

Outcome Assessment:

•Healed and healing = success; non-healed = failure

•Patient factors, tooth-related factors and treatment factors were evaluated to identify possible prognostic factors (Table. 1)


•Overall success rate = 90.9% (83.1% healed)

•Initial RCT success 90.6% VS 91.7% for retreatment

•Significant difference in relation to size of PAL (rather than it’s presence) and patients’ ages (Table. 2)

•Major reasons for failure observed were cracks and VRFs

A potential benefit of BC and single-cone obturation is the ability to maintain a more conservative preparation design during instrumentation without any aggressive taper.

Size of lesion: This difference could be contributed to the lower availability of osteoblast progenitors present in larger lesions and the higher likelihood of such lesions being a cyst

This was the first study to report on the clinical success of root canal treatment using BC and a single-cone technique.

In conclusion:

within the limitations of this study:

•BC sealer using a single-cone technique can achieve a success rate of 90.9%. •Lesion size was determined to be a prognostic factor, with lesions <5 mm in diameter having a higher success rate.

•Sealer extrusion did not appear to affect the outcome of treatment.