From lesion to resolution: A cone-beam computed tomography-based retrospective comparison of bioactive materials in nonsurgical root canal therapy

Abstract Aim: To evaluate periapical healing following nonsurgical root canal treatment of large periapical lesions using three bioactive materials, assessed using cone-beam computed tomography (CBCT) at 6 months and 1 year. Materials and Methods: A total of 40 teeth were taken for this retrospective study with single or multirooted teeth and periapical pathology of 4–8 mm in diameter, present with preoperative and follow-up CBCT scans available. All the cases considered underwent endodontic treatment using one of three bioactive materials (mineral trioxide aggregate, Biodentine, and bioceramics). Assessment of healing was done based on radiographic CBCT scans and CBCT–periapical index (PAI) criteria. The teeth were divided into healing, healed, or diseased based on the changes in the CBCT-PAI score after 6 months and 1 year. All the data were recorded in a tabular form and sent for statistical analysis using Chi-square test, t-test, and Friedman’s test. Results: While there was a statistically significant difference in individual teeth after 6 months ( P = 0.01) and 1 year ( P = 0.004), with maxillary incisors showing the highest percentage of healing after 1 year (29.6%), no significant difference was seen between the use of the three bioactive materials after 6 months ( P = 0.97) or 1 year ( P = 0.78), respectively. There was no statistically significant difference in age-wise ( P = 0.27; 0.82) or gender-wise ( P = 0.82; 0.39) distribution. Conclusion: Among all the teeth assessed, single-rooted maxillary teeth showed the highest amount of healing. All three bioactive materials showed a favorable outcome for the treatment regardless of the material used. In addition, healing outcomes were not significantly influenced by patient age or gender.