Clinical and Radiographic Outcomes of Root Canal Obturation with Hydraulic Condensation and Tricalcium Silicate Bioceramic Sealer: A 12-Month Observational Study on Periapical Healing

Successful endodontic treatment relies on effective shaping, disinfection and obturation. Calcium silicate sealers such as BioRoot™ RCS show promise due to their bioactivity and sealing properties, but more clinical evidence using standardized protocols is needed. This observational clinical study aimed to assess periapical healing at 6 and 12 months following single-visit root canal treatment using BioRoot™ RCS with hydraulic condensation in teeth with irreversible pulpitis or apical periodontitis. Sixty-six teeth were treated using a standardized protocol: ProTaper Gold instrumentation, sonic-activated irrigation, and hydraulic condensation with gutta-percha cone and BioRoot™ RCS. Periapical healing was evaluated using the periapical index (PAI) at baseline, 6 months, and 12 months. Clinical success was defined as functional, asymptomatic teeth and a PAI ≤ 2. Statistical analysis included repeated measures of ANOVA and McNemar's test. All 66 teeth remained asymptomatic and functional of 12 months, yielding a 100% survival rate. Clinical success was confirmed in 97% of cases. PAI scores decreased significantly over time (<i>p</i> < 0.001) in apical periodontitis cases. Single-visit endodontic treatment with BioRoot™ RCS and hydraulic condensation demonstrated excellent clinical and radiographic outcomes. This approach promotes resolution of apical periodontitis in non-vital cases and supports the preservation of periapical health in teeth initially diagnosed with irreversible pulpitis.