Aim: The aim of this retrospective cohort study was to assess the clinical and radiographic outcome after 5 ± 1 years of root canal treatments filled with Thermafil (TF) and to evaluate if the success rate is consistent with results reported by Literature with standard techniques. Methodology: A total of 213 endodontically treated teeth filled with TF and AH Plus were retrospectively examined. Following data were collected: initial pathology, primary treatment/retreatment and root filling length. Preoperative Periapical Index (PAI) was used as scoring system. At 5-years evaluation, teeth were judged healthy (PAI ≤ 2, no symptoms), endodontically-diseased (PAI ≥ 3 and/or symptoms, extraction or reintervention for endodontic reasons) or not-endodontically-diseased (root fracture, destructive caries, periodontal abscess). Outcome was blindly assessed by two examiners. Descriptive analysis and multivariate logistic regression were performed. Results: The total survival rate was 88%. Before the end-point, 20 teeth were extracted for not-endodontic reasons. Of the 193 analyzed teeth, 85% were considered healthy and proportions were significantly higher (Chi-square; p
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