Treatment outcomes of root perforations repaired by calcium silicate-based cements with or without an accelerator: A randomized controlled trial

ABSTRACT Aim: To compare the clinical outcomes of root perforations repaired using two calcium silicate-based cements (CSC) with or without accelerator in a randomized controlled trial. Methods: The study was designed as a noninferiority, double-blind, randomized controlled trial. Forty-six teeth with root perforations were recruited following the inclusion and exclusion criteria. Teeth were randomly allocated and treated according to the root-repair material into CSC with accelerator (Bio-MA) and CSC without accelerator (ProRoot ® MTA) groups. Treatment outcomes of the perforation site and periradicular area were evaluated from clinical and radiographic examination as healed, healing, or disease, where healed and healing were combined and defined as success. Chi-square, Fisher’s exact, and noninferiority analyses were used to analyze the outcomes. Results: The recall rate was 100% with a median period of 23.5 months. At the perforation site, healed and healing were 90.5% (19/21) and 9.5% (2/21) in the Bio-MA group and 95.7% (22/23) and 4.3% (1/23) in the ProRoot ® MTA group; no disease was found in either group. At the periradicular area, the Bio-MA group had 85.7% (18/21) healed and 14.3% (3/21) healing while ProRoot ® MTA group had 82.6% (19/23) healed, 13.0% (3/23) healing, and 4.4% (1/23) disease. No significant difference in treatment outcome, either at the perforation site or periradicular area, was found between the groups ( P > 0.05). Bio-MA tended to be noninferior in root-perforation repair compared with ProRoot ® MTA. Conclusion: Treatment outcomes of root perforation repair using CSC with or without accelerator demonstrated similarly high success rates ( P > 0.05).