Background: Mature teeth with chronic apical abscesses characterized by intermittent discharge of pus through an\nassociated sinus tract. This communication between oral mucosa and periapical inflammation is challenging for the\nsealing ability of root canal obturation material. Therefore, the study aim was to compare the outcomes of\nendodontic treatment using mineral trioxide aggregate (MTA) cement to the conventional gutta-percha cone and\nroot canal sealer as an obturation material in mature teeth with chronic apical abscesses.\nMethods: Mature teeth with chronic apical abscesses referred to our clinic for root canal treatment between 2010\nand 2012 were treated in a single visit and distributed among treatment (T) and control (C) groups using a\npredetermined randomization block (TCTC). After chemo-mechanical preparation, teeth in group T received MTA\ncement mixed in a 0.26 water to powder ratio, and teeth group C received gutta-percha and root canal sealer\nusing the warm vertical technique. The treatment outcomes were defined as obturation length, periapical healing,\nresorption of extruded material, and survival rate at least 2.5 years after treatment. Three endodontists blinded to\nthe type of obturation material documented treatment outcomes. Statistical analysis at P < 0.05 was conducted to\nmeasure difference between the groups.\nResults: Thirty-six teeth were treated between 2010 and 2012, and 32 teeth were evaluated in 2015. Complete\nperiapical healing was observed in 87.5 % of MTA-treated teeth and 75.0 % of gutta-percha-treated teeth. Adequate\nobturation length was reported in 50.0 % of MTA-treated and 37.5 % of gutta-percha-treated teeth. Complete\nresorption of extruded material was evident in 83.3 % MTA-treated teeth and 100.0 % gutta-percha-treated teeth.\nThe survival rate of MTA-treated teeth was 100 % at 3, and 5 years, while the survival rate of gutta-percha-treated\nteeth was 83.3 % at 3, and 5 years. There was no significant difference between the groups in term of periapical\nhealing, survival rate, obturation length, or resorption of extruded material.\nConclusions: The outcomes of single-visit endodontic treatment of mature teeth with chronic apical abscesses\nusing MTA cement were better, but not statistically significant, compared to conventional treatme
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