Outcomes and prognostic factors of endodontically treated teeth with unintentional root canal sealer extrusion: A retrospective cohort study.

OBJECTIVES: This study aimed to evaluate treatment outcomes and sealer dissolution in endodontically treated teeth with unintentional root canal sealer extrusion, and to identify prognostic factors influencing these outcomes. METHODS: A total of 155 teeth with unintentional root canal sealer extrusion in at least one root were identified from 7196 endodontically treated teeth between January 2015 and December 2023. Clinical and radiographic data were collected to assess treatment outcomes and sealer dissolution. Outcomes (per root) were classified as success or failure based on strict and loose criteria. Sealer dissolution was categorized as no, partial, or complete. Bivariate and multivariate multilevel logistic regression analyses were conducted to identify variables associated with treatment outcomes and sealer dissolution (p < 0.05). RESULTS: With an average follow-up period of 13 months, the success rates were 54.87 % based on strict criteria and 98.46 % based on loose criteria. Complete dissolution of the sealer was observed in 4.17 % of cases using epoxy resin-based sealers and 11.11 % of cases using calcium silicate-based sealers. Multilevel analysis revealed that the size of the periapical lesion significantly influenced treatment success when evaluated using strict criteria. CONCLUSION: Treatment outcomes and sealer dissolution in cases with unintentional sealer extrusion were not influenced by the type of extruded material. The size of the periapical lesion was the only significant predictor of treatment success based on strict criteria. CLINICAL SIGNIFICANCE: This study confirms the high success rate of endodontically treated teeth, even with unintentional sealer extrusion. However, a large periapical radiolucency significantly reduces success rates.