REGENERATION OF PERIAPICAL TISSUES AFTER ENDODONTIC TREATMENT WITH BIOCERAMIC SEALERS

Abstract

Introduction. The relevance of this study lies in the need to enhance the effectiveness of endodontic treatment and ensure the long-term preservation of tooth functionality, which is often complicated by infectious and inflammatory processes in the periapical region. Conventional sealers provide mechanical obturation but lack properties that stimulate biological repair, reducing treatment predictability and increasing the risk of relapse. In this context, bioceramic materials are regarded as a promising solution due to their bioactivity, osteoinductive characteristics, and high sealing capacity. Objective. The aim of this study is to provide a scientific rationale for the role of bioceramic sealers in the regeneration of periapical tissues following endodontic treatment, considering their physicochemical properties, clinical effectiveness, and limitations in practical application. Materials and Methods. The methodology is based on a systematic analysis of recent publications, comparative synthesis of in vitro and in vivo findings, and clinical observations. Evidence-based medicine principles were applied to evaluate the effectiveness of bioceramic materials compared with traditional sealers, while structural analysis was used to assess their impact on the biological mechanisms of regeneration. Results. Bioceramic sealers were found to provide reliable sealing of root canals, reduce the risk of microleakage, and create favorable conditions for mineralization and the formation of new bone tissue through the release of calcium ions. Faster positive radiographic healing dynamics and a lower rate of postoperative complications were observed compared with traditional materials. After one year, the rate of periapical structure recovery exceeded 85 percent, confirming the clinical relevance of bioceramic use. Conclusions. The broad integration of bioceramic sealers into clinical practice is limited by high cost, the lack of long-term multicenter studies, and insufficient protocol standardization. At the same time, their application enhances the effectiveness of endodontic therapy and contributes to long-term treatment stability. Future Perspectives. Further research should focus on conducting multicenter clinical trials, analyzing molecular mechanisms of osteoinduction in greater depth, and developing cost-effective modifications of bioceramic materials. Achieving these objectives will support the establishment of bioceramics as nextgeneration materials capable of transforming endodontic therapy standards.