Post-operative Pain and Clinical Outcome After Single-cone Obturation With a Calcium Silicate-based Versus Epoxy Resin Sealer

November 3, 2026 updated by: University Ghent

Post-operative Pain and Clinical Outcome After Single-cone Obturation With a Calcium Silicate-based Versus Epoxy Resin Sealer: a Randomized Clinical Trial

When the nerve inside a tooth becomes inflamed, it can cause severe pain and may eventually lead to the death of the nerve. In these cases, root canal treatment is necessary to remove the inflamed nerve or to treat or prevent infection associated with a dead nerve.

During root canal treatment, the root canals are carefully cleaned and then filled. This is usually done using a flexible, rubber-like material called gutta-percha, combined with a special dental cement known as a root canal sealer.

Different types of root canal sealers are available, including AH Plus and BioRoot Flow. The aim of this study is to compare these two sealers to determine whether there are differences in pain experienced after treatment and in treatment success, assessed during follow-up visits after 1 and 2 years.

Study Overview

Status

Not yet recruiting

Conditions

Intervention / Treatment

Study Type

Interventional

Enrollment (Estimated)

138

Phase

  • Not Applicable

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Contact

Study Locations

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

18 years and older (Adult, Older Adult)

Accepts Healthy Volunteers

No

Genders Eligible for Study

All

Description

Inclusion Criteria:

  • Written informed consent obtained
  • Age: ≥ 18 years
  • ASA I, II & III
  • Permanent single or multi-rooted mature tooth requiring root-canal treatment
  • Diagnosis: (a)symptomatic irreversible pulpitis or pulp necrosis, with or without apical periodontitis or initially treated

Exclusion Criteria:

  • Unlikely to be able to comply with the study procedures, as judged by the investigator
  • Immature permanent teeth
  • Teeth presenting with aberrant root canal anatomy (e.g., perforation, resorption or canal calcification)
  • Patients presenting with pain in another area and/or tooth of the oral cavity
  • Patient suffering from uncontrolled active periodontitis
  • Patients who took medication that could alter pain perception (e.g. analgesics) within at least 12 h before treatment
  • Known or suspected current malignancy
  • History of chemotherapy within 5 years prior to study or radiation in the head and neck region
  • History of other metabolic bone diseases
  • Endodontic retreatment (ortho-and retrograde), reversible pulpitis

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Primary Purpose: Treatment
  • Allocation: Randomized
  • Interventional Model: Parallel Assignment
  • Masking: Triple

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
Active Comparator: A calcium silicate-based sealer
Device: A calcium silicate-based sealer

Root canal obturation is performed using the single-cone technique, in which a gutta-percha cone is inserted into the root canal in combination with a calcium silicate-based sealer: BioRoot Flow
Experimental: An epoxy resin- based sealer
Device: An epoxy resin- based sealer

Root canal obturation is performed using the single-cone technique, in which a gutta-percha cone is inserted into the root canal in combination with an epoxy resin-based sealer: AH Plus Jet

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Post-operative pain
Time Frame: 6 hours, 24 hours, 48 hours, 72 hours and 7 days after treatment

The post-operative pain is scored with the Visual Analogue Scale (VAS). Patients are asked to fill out a pain diary 6 hours, 24 hours, 48 hours, 72 hours and 7 days after treatment with a pain score on the Visual Analogue Scale. They mark the level of pain on a scale from 0 to 10. Higher scores indicate greater pain intensity.
6 hours, 24 hours, 48 hours, 72 hours and 7 days after treatment
Treatment outcome
Time Frame: up to 2 years following treatment

The 1 and 2 year success rates are determined using a combination of radiographic and clinical outcome measures.

  • Clinical: The absence of pain, tenderness, swelling and a sinus tract)
  • Radiographic: The pre-operative and recall periapical radiographs are assessed qualitatively by means of the Periapical Index (PAI) and quantitatively by means of surface area measurements of the APs on periapical radiographs.

The two aforementioned outcomes will be combined to determine overall treatment success, which will be classified into three categories:

  • Strict success criteria (healed): Absence of clinical signs and/or radiographic evidence of complete resolution or the absence of a periapical radiolucency.
  • Loose success criteria (healing): Absence of clinical signs and a lower PAI-score/ smaller surface of the lesion compared to the pre-operative radiograph.
  • Failure (non-healing): Presence of clinical signs or unchanged/increased PAI-score (or surface of the lesion) at follow-up.
up to 2 years following treatment

Secondary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Quality of obturation
Time Frame: Immediately after treatment

The root canal obturation is evaluated on peri-apical radiograph on the presence of voids. First is stated if a void was present (Yes/No). If so, a distinction is made whether the void was smaller or bigger than 1 mm.
Immediately after treatment
Sealer extrusion
Time Frame: Immediately after treatment

The presence of sealer extrusion beyond the apical foramen is evaluated as a binary outcome (Yes/No).
Immediately after treatment

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

University Ghent

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Estimated)

November 1, 2026

Primary Completion (Estimated)

August 1, 2029

Study Completion (Estimated)

August 1, 2029

Study Registration Dates

First Submitted

October 20, 2026

First Submitted That Met QC Criteria

November 3, 2026

First Posted (Actual)

November 6, 2026

Study Record Updates

Last Update Posted (Actual)

November 6, 2026

Last Update Submitted That Met QC Criteria

November 3, 2026

Last Verified

October 1, 2026

More Information

Terms related to this study

Additional Relevant MeSH Terms

Other Study ID Numbers

  • ONZ-2026-0209

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

NO

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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