Comparative Evaluation of Bioceramic and Resin-Based Root Canal Sealers on Long-Term Endodontic Success: A Clinical and Radiographic Study

Bioceramic sealer, AH Plus, root canal obturation, endodontic success, periapical healing, postoperative pain, radiographic assessment.

SK Mahboob Rahaman¹*
Assistant Professor, Department of
Conservative Dentistry & Endodontics,
North Bengal Dental College & Hospital,
Darjeeling, West Bengal, India. Email:
[email protected]
Anuradha Mukherjee²
Professor & HOD, Department of
Conservative Dentistry & Endodontics,
North Bengal Dental College & Hospital,
Darjeeling, West Bengal, India. Email:
[email protected]
Prantika Mandal³
Dental Surgeon, Department of
Conservative Dentistry & Endodontics,
North Bengal Dental College & Hospital,
Darjeeling, West Bengal, India. Email:
[email protected]
Jyoti Kumari⁴
Senior Lecturer, Department of
Conservative Dentistry & Endodontics,
Dental College Azamgarh, Azamgarh,
Uttar Pradesh, India. Email:
[email protected]
Dibyasudha Jena⁵
Intern, BDS, Department of
Conservative Dentistry and Endodontics,
Kalinga Institute of Dental Sciences
KIIT
,
Deemed to be University, Bhubaneswar,
Odisha. Email:
[email protected]
Vinayak Singh⁶
Reader, Department of Conservative
Dentistry & Endodontics, KD Dental
College & Hospital, Mathura, Uttar
Pradesh, India. Email:
[email protected]
Ritik Kashwani7
Department of Oral Medicine and
Radiology, School of Dental Sciences,
Sharda University, Greater Noida, India
Email:[email protected]

Received-17-05-2026
Revised-23-06-2026
Accepted-27-06-2026

European Journal of Prosthodontics and Restorative Dentistry (2026) 34 (04s), 367-376

Comparative Evaluation of
Bioceramic and Resin-Based
Root Canal Sealers on LongTerm Endodontic Success: A
Clinical and Radiographic
Study

Background: Endodontic treatment success depends critically on the quality of root canal obturation. The sealer plays an indispensable role in achieving an impermeable three-dimensional seal. Bioceramic sealers, owing to their calcium silicate composition, bioactivity, and dimensional stability, have emerged as a contemporary alternative to conventional epoxy resin-based sealers such as AH Plus. However, long-term comparative clinical evidence remains limited. Objectives: This study aimed to compare the clinical and radiographic success rates of bioceramic sealer (EndoSequence BC Sealer) with epoxy resin-based sealer (AH Plus) over a 24-month follow-up period in patients undergoing primary root canal treatment. Materials and Methods: A prospective, randomised, single-blinded clinical trial was conducted on 120 patients requiring primary root canal treatment on single-rooted teeth. Patients were randomly allocated to Group I (bioceramic sealer; n=60) and Group II (epoxy resin sealer; n=60). Clinical parameters including periapical index (PAI) score, postoperative pain, and presence of periapical pathology were recorded at baseline, 6, 12, and 24 months. Radiographic assessment was performed using digital periapical radiographs analysed by two calibrated blinded examiners. Results: At 24 months, Group I demonstrated a clinical success rate of 93.3% compared to 88.3% in Group II (p=0.03). Mean postoperative pain scores were significantly lower in Group I at 48 hours (1.2 ± 0.8 vs. 2.1 ± 1.1; p<0.001). Radiographic healing of periapical lesions was observed in 90.0% of Group I compared to 81.7% of Group II (p=0.04). No statistically significant differences were found in sealer extrusion or retreatability indices. Conclusion: Bioceramic sealers exhibited superior long-term clinical and radiographic outcomes compared to epoxy resin-based sealers in primary root canal treatment, with significantly lower postoperative pain and higher rates of periapical healing. These findings support their preferential adoption in contemporary endodontic practice.

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