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Outcomes and Associated Prognostic Factors for Orthograde Canal Obturation Using Ortho MTA III: A Randomised Prospective Clinical Trial.

Hyo-Jung Lee·Yeon-Jee Yoo·Hiran Perinpanayagam·Yoon Seon Lee·Tae-Hyeon Kim·Soojin Heo·Xiantao Chen·Kee-Yeon Kum
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Abstract

AIM: To prospectively compare treatment outcomes for orthograde canal obturation using Ortho MTA III (OMTA) with the continuous wave of compaction (CWC) using gutta-percha (GP) and AH Plus sealer, and to identify associated predictive factors. METHODOLOGY: Informed consent was obtained (110 patients), and single- or two-rooted permanent teeth (n&#x2009;=&#x2009;120) diagnosed with pulp necrosis (or previously treated) and asymptomatic apical periodontitis or chronic apical abscess (periapical index, PAI&#x2009;&#x2265;&#x2009;3) were randomly assigned to two groups (n&#x2009;=&#x2009;60/group). The canals were prepared to a minimal apical size #40 (ISO) based on their initial file size, disinfected and obturated by either CWC or OMTA using an enhanced disinfection protocol (GP disinfected, new gloves after each intraoperative radiograph and before starting obturation). Clinical and periapical radiographic examinations were conducted by two calibrated, independent endodontists during follow-up periods of at least 12&#x2009;months. Success rates and associated predictive factors (tooth-, operator- and patient-related) were analysed statistically using binary and multiple logistic regression (p&#x2009;<&#x2009;0.05). RESULTS: The median recall period was 30&#x2009;months (14-48&#x2009;months), and 104 teeth were finally analysed (recall rate: 86.67%). No significant differences in success rate were observed between the groups (p&#x2009;>&#x2009;0.05) under both loose (OMTA: 88.24%, CWC: 83.02%) and strict criteria (OMTA: 64.71%, CWC: 58.49%). Multivariate analysis revealed that age (OR&#x2009;=&#x2009;5.735, 95% CI: 1.286-25.577, p&#x2009;=&#x2009;0.022), periapical lesion size (OR&#x2009;=&#x2009;6.596, 95% CI: 1.397-31.138, p&#x2009;=&#x2009;0.017) and PAI score (OR&#x2009;=&#x2009;2.081, 95% CI: 1.047-4.136, p&#x2009;=&#x2009;0.036) were significant predictors of treatment failure. CONCLUSIONS: Orthograde obturation of infected canals with Ortho MTA III demonstrated comparable success and treatment outcomes to those filled with GP and sealer by CWC, supporting its potential as a clinically viable alternative for the obturation of infected root canals. TRIAL REGISTRATION: cris.nih.go.kr registration number: KCT00099939.

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HumansSilicatesProspective StudiesDrug CombinationsRoot Canal Filling MaterialsOxidesRoot Canal ObturationAluminum CompoundsCalcium CompoundsPeriapical PeriodontitisTreatment OutcomeFemalePrognosisAdultGutta-PerchaMiddle AgedPeriapical AbscessEpoxy ResinsDental Pulp NecrosisOrtho MTA IIIorthograde canal obturationoutcomeprognostic factorprospective studysuccess rateJournal ArticleRandomized Controlled TrialComparative Study

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Hyo-Jung Lee, Yeon-Jee Yoo, Hiran Perinpanayagam, Yoon Seon Lee, Tae-Hyeon Kim, Soojin Heo, Xiantao Chen, Kee-Yeon Kum. 2026-08-13. Outcomes and Associated Prognostic Factors for Orthograde Canal Obturation Using Ortho MTA III: A Randomised Prospective Clinical Trial.. https://doi.org/10.1111/iej.70248

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Journal Article; Randomized Controlled Trial; Comparative Study resourceAdult subjectComparative Study subjectDrug Combinations subjectFemale subjectHumans subjectJournal Article subjectMiddle Aged subjectRandomized controlled trials study

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