Long-term Insight on “SealBio”: The Regeneration-based, Non-obturation  Treatment for Mature-teeth

Methods: Thirty-five teeth in 29 patients (age range 25-76 yrs; mean age 43 years, 18 men and 10 women) of pulp and periapical disease in mature permanent teeth were treated by the non-obturation, regeneration-based endodontic treatment protocol “SealBio.” The technique involves apical clearing, apical foramen widening and intentional over-instrumentation to induce bleeding at the apical foramen, which provide a scaffold, where stem cells can get seeded, differentiate and form a biological seal of the apical foramina. The cases were followed-up clinically and radiographically at regular interval of six-months for up to 5-years.

Results:   Follow-up of 5-years for 7 cases, 4-years for 8 cases, 3-years for 9 cases and 1½ - 2 years for 5 cases could be completed. None of the cases had post treatment flare-up. Except one case, all the cases showed very good healing, both on clinical evaluation and on radiographs. The case that had failed, retreatment was comparatively simple, as there was no obturating material in the canal and re-entry was easy. Three cases of very large periapical lesions showed excellent healing at one-year.  In three cases, post and core restoration was done.

Conclusion: Following conclusions were drawn from 5-years’ experience on “SealBio” technique.  

1. Leaving the canal un-obturated does not cause re-infection, if the healing process had initiated and the coronal seal was maintained.
2.  Re-treatment was simple to perform as the canals could be re-entered easily.   
3. The technique also permitted post and core restoration, where required, as no vital tissue was expected in the canal space, unlike in cases of revascularization.