One of the most crucial phases in root canal therapy is establishing a well-sealed root canal system. To date, no investigations have been conducted to assess the prevalence of apical sealer extrusion using periapical radiographs. This study was aimed to quantify the cases prevalence of apical sealer extrusion published in recent articles of endodontic literature. A total of 439 cases of completed non-surgical root canal treatments were obtained from 62 issues (September 2015 - November 2020) of the Journal of Endodontics and 9 issues (January - September 2020) of the International Endodontic Journal. Two observers independently reviewed each of the periapical radiographs for signs of sealer overfill. Cohen’s kappa coefficient for interobserver reliability was calculated at 98%. Of the 439 cases found in periapical imaging, an average of 142 exhibited apical extrusion of sealer. This corresponds to an average prevalence of 32.3% of published cases with sealer extrusion. It can be concluded that apical sealer extrusion is a relatively common finding in modern endodontic literature, and this may reflect the specialty’s clinical trends as a whole. While outcome studies about sealer extrusion may be conflicting, overfilled cases are routinely included in published articles in major endodontic journals.
