Radiographic healing after a root canal treatment performed in single-rooted teeth with and without ultrasonic activation of the irrigant: A randomized controlled trial

Introduction The aim of this study was to compare the outcome of a root canal treatment with and without additional ultrasonic activation of the irrigant. Methods Single-rooted teeth with radiographic evidence of periapical bone loss were randomly assigned to 2 treatment groups. In both groups syringe irrigation was performed, and in one group the irrigant was also activated by ultrasound. Ten to 19 months after treatment, the teeth were examined by using periapical radiography (PA) and cone-beam computed tomography (CBCT). Area and volume of the periapical lesions were measured, and the outcome was presented in 4 categories: absence, reduction or enlargement of the radiolucency, or uncertain. Lesions were classified as reduced or enlarged when the change in size of the radiolucency was 20% or more. Results The recall rate was 82%, and 84 teeth were analyzed. CBCT detected significantly more post-treatment lesions than PA (P =.038), but the percentages of absence and reduction of the radiolucency together revealed by CBCT and PA were similar (P =.383). The CBCT results showed that absence of the radiolucency was observed in 16 of 84 teeth (19%) and reduction of the radiolucency in 61 of 84 teeth (72.6%), but there was no significant difference between the results of the 2 groups (P =.470). Absence and reduction of the radiolucency together were observed in the ultrasonic group in 39 of 41 teeth (95.1%) and in the syringe group in 38 of 43 teeth (88.4%). Conclusions Root canal treatments with and without additional ultrasonic activation of the irrigant contributed equally to periapical healing.