Radiographic evaluation of periapical healing of permanent teeth with periapical lesions after extrusion of AH Plus sealer.  

By Sari S, Duruturk L. 

Purpose: To clinically and radiographically examine the effects of extrusion of AH Plus sealer on the healing of permanent teeth with apical periodontitis.


-N=87 root canals radiographically detected with apical periodontitis. (age range: 9-15 years).

-RCT: WL=RG apex-1mm, #35-#40 instrumentation, (2.5%) NaOCl, obturation with GP and AH plus sealer (lateral condensation)

-Posttreatment RGs indicated:

Sealer extrusion, 49 canals (Group 1) .

No sealer extrusion, 38 canals (Group 2).

– At the end of a 4-year follow-up period Periapical treatment was judged as: – complete healing (CH) – incomplete healing (IH)

-No healing (NH)

– Amounts of extraradicular sealer were recorded as:  “unchanged” “reduced” “almost absent” “absent”

Most highlighted Results:

•In cases with sealer extrusion: CH was detected in 83.6%

• In cases with no sealer extrusion: CH was detected in 89.5%

•A statistically significant difference between treatment groups was observed for CH at the 6-month follow-up  appointment only.

•There were no statistical differences for CH or NH between the groups in further follow-ups.

Clinical significance:

•extruded AH Plus does not prevent periapical healing, but can be a delaying factor for healing in children.