Bioceramic, Resin-Based Sealers Show Similar Pain Outcomes After Single-Visit Root Canal: Study
Australia: Patients undergoing single-visit root canal treatment for teeth affected by apical periodontitis experienced similarly low levels of post-operative pain regardless of whether a calcium silicate-based (bioceramic) sealer or a resin-based sealer was used, a randomized controlled trial published in the Australian Endodontic Journal has shown.
Root canal obturation relies on sealing materials to prevent bacterial leakage and promote long-term treatment success. In recent years, bioceramic sealers have gained popularity because of their antimicrobial activity, high alkalinity, and ability to set in the presence of moisture. These materials are commonly paired with the single-cone obturation technique and are considered to offer improved sealing compared with conventional resin-based sealers. However, whether the choice of sealer influences post-treatment pain has remained uncertain.
To investigate this, researchers conducted a parallel-group randomized controlled trial involving adults older than 18 years who required non-surgical root canal treatment for mono-radicular or bi-radicular teeth diagnosed with pulp necrosis and apical periodontitis. A total of 101 teeth underwent endodontic treatment in a single visit before patients were randomly assigned to receive obturation with either a calcium silicate-based sealer or a resin-based sealer.
Pain intensity was assessed using a 100-mm Visual Analog Scale (VAS) before treatment and at 8, 24, and 48 hours after the procedure. Participants were advised to take ibuprofen 600 mg every eight hours only if required and were instructed to record both the dosage and frequency of medication use.
Of the enrolled participants, 89 completed the post-operative pain assessment and were included in the final analysis.
Key Findings:
- More than half of the participants (53.95%) reported pain before treatment.
- Pre-operative pain was more common in patients with bi-radicular teeth than in those with mono-radicular teeth.
- Baseline pain levels did not differ according to sex, dental arch, or the type of sealer used.
- Higher pre-operative pain was significantly associated with greater post-operative pain at 8, 24, and 48 hours.
- Teeth with symptomatic apical periodontitis had significantly higher pre-treatment pain than those with asymptomatic apical periodontitis.
- Post-operative pain at 8, 24, and 48 hours was comparable between the calcium silicate-based sealer and resin-based sealer groups.
- Overall, the incidence of post-operative pain following single-visit root canal treatment was low.
The authors concluded that in patients undergoing single-visit root canal treatment for apical periodontitis, the choice between a calcium silicate-based sealer and a resin-based sealer did not significantly affect postoperative pain. The findings suggest that both sealing materials provide comparable patient comfort during the early recovery period after endodontic treatment.
Reference: Australian Endodontic Journal. 2024;50:538-546. Study: Post-Operative Pain after Single-Visit Root Canal Treatment Using Resin-Based & Bioceramic Sealers.
Next Story