Comparison of the Effects of a Bioceramic and Conventional Resin-Based Sealers on Postoperative Pain after Nonsurgical Root Canal Treatment: A Randomized Controlled Clinical Study

Kiche Shim, Young-Eun Jang, Yemi Kim, Kiche Shim, Young-Eun Jang, Yemi Kim

Abstract

Background: This clinical trial aimed to compare the effects of bioceramic sealer and resin-based sealer on the incidence and intensity of postoperative pain.

Methods: Patients with anterior teeth or premolars requiring root canal treatment were assigned to group 1 (n = 51). Those with molars requiring treatment were assigned to group 2 (n = 57). In groups 1En and 2En, root canals were obturated with Endoseal MTA using the single-cone technique. In groups 1AH and 2AH, the sealer used was AH Plus with the continuous wave technique. On the day of canal filling, each patient was instructed to indicate their pain intensity over the 7 day postoperative period, at rest and, while biting, using a visual analog scale.

Results: There was no significant difference in the incidence or intensity of postoperative pain between the Endoseal MTA and AH Plus groups during the 7 day postoperative period (p > 0.05). Less time was needed to seal the root canals with Endoseal MTA, especially in group 2 (p < 0.05).

Conclusions: Endoseal MTA and AH Plus had similar effects on the incidence and intensity of postoperative pain. The obturation time was shorter when using Endoseal MTA compared to AH Plus.

Keywords: bioceramic sealer; postoperative pain; resin-based sealer; root canal sealer.

Conflict of interest statement

The authors declare no conflict of interest. The funders had no role in the design of the study; in the collection, analyses, or interpretation of data; in the writing of the manuscript, or in the decision to publish the results.

Figures

Figure 1
Figure 1
(A) Flow chart of patient selection in group 1. (B) Flowchart of patient selection in group 2.
Figure 2
Figure 2
(A) Intensity of postoperative pain at rest over a 7 day period. The values are estimated means. The bar represents the 95% confidence interval. Repeated-measures ANOVA was used for the analysis. (B) Intensity of pain while biting over the 7 day postoperative period. The values are estimated means. The bar represents the 95% confidence interval. Repeated-measures ANOVA was used for the analysis.

References

    1. Wong M., Lytle W.R. A comparison of anxiety levels associated with root canal therapy and oral surgery treatment. J. Endod. 1991;17:461–465. doi: 10.1016/S0099-2399(07)80138-5.
    1. Sathorn C., Parashos P., Messer H. The prevalence of postoperative pain and flare-up in single-and multiple-visit endodontic treatment: A systematic review. Int. Endod. J. 2008;41:91–99. doi: 10.1111/j.1365-2591.2007.01316.x.
    1. Arslan H., Güven Y., Karataş E., Doğanay E. Effect of the simultaneous working length control during root canal preparation on postoperative pain. J. Endod. 2017;43:1422–1427. doi: 10.1016/j.joen.2017.04.028.
    1. Patil A.A., Joshi S.B., Bhagwat S., Patil S.A. Incidence of postoperative pain after single visit and two visit root canal therapy: A randomized controlled trial. J. Clin. Diagn. Res. 2016;10:ZC09–ZC12. doi: 10.7860/JCDR/2016/16465.7724.
    1. Polycarpou N., Ng Y.L., Canavan D., Moles D., Gulabivala K. Prevalence of persistent pain after endodontic treatment and factors affecting its occurrence in cases with complete radiographic healing. Int. Endod. J. 2005;38:169–178. doi: 10.1111/j.1365-2591.2004.00923.x.
    1. Seymour R.A. The use of pain scales in assessing the efficacy of analgesics in post-operative dental pain. Eur. J. Clin. Pharm. 1982;23:441–444. doi: 10.1007/BF00605995.
    1. Comparin D., Moreira E.J.L., Souza E.M., De-Deus G., Arias A., Silva E.J.N.L. Postoperative pain after endodontic retreatment using rotary or reciprocating instruments: A randomized clinical trial. J. Endod. 2017;43:1084–1088. doi: 10.1016/j.joen.2017.02.010.
    1. Graunaite I., Skucaite N., Lodiene G., Agentiene I., Machiulskiene V. Effect of resin-based and bioceramic root canal sealers on postoperative pain: A split-mouth randomized controlled trial. J. Endod. 2018;44:689–693. doi: 10.1016/j.joen.2018.02.010.
    1. Thakur S., Emil J., Paulaian B. Evaluation of mineral trioxide aggregate as root canal sealer: A clinical study. J. Conserv. Dent. 2013;16:494–498.
    1. Savannah G. Bioceramic technology–The game changer in endodontics. Endod. Pract. 2009;13:13–17.
    1. Hwang J.H., Chung J., Na H.S., Park E., Kwak S., Kim H.C. Comparison of bacterial leakage resistance of various root canal filling materials and methods: Confocal laser-scanning microscope study. Scanning. 2015;37:422–428. doi: 10.1002/sca.21231.
    1. Jung S., Libricht V., Sielker S., Hanisch M.R., Schäfer E., Dammaschke T. Evaluation of the biocompatibility of root canal sealers on human periodontal ligament cells ex vivo. Odontology. 2019;107:54–63. doi: 10.1007/s10266-018-0380-3.
    1. Lim E.-S., Park Y.-B., Kwon Y.-S., Shon W.-J., Lee K.-W., Min K.-S. Physical properties and biocompatibility of an injectable calcium-silicate-based root canal sealer: In vitro and in vivo study. BMC Oral Health. 2015;15:129. doi: 10.1186/s12903-015-0112-9.
    1. Oh S., Cho S.-I., Perinpanayagam H., You J., Hong S.-H., Yoo Y.-J., Chang S.W., Shon W.-J., Yoo J.-S., Baek S.-H. Novel calcium zirconate silicate cement biomineralize and seal root canals. Materials. 2018;11:588. doi: 10.3390/ma11040588.
    1. Güven E., Taşlı P., Yalvac M., Sofiev N., Kayahan M., Sahin F. In vitro comparison of induction capacity and biomineralization ability of mineral trioxide aggregate and a bioceramic root canal sealer. Int. Endod. J. 2013;46:1173–1182. doi: 10.1111/iej.12115.
    1. de Miranda Candeiro G.T., Correia F.C., Duarte M.A.H., Ribeiro-Siqueira D.C., Gavini G. Evaluation of radiopacity, pH, release of calcium ions, and flow of a bioceramic root canal sealer. J. Endod. 2012;38:842–845. doi: 10.1016/j.joen.2012.02.029.
    1. Lee J.K., Kwak S.W., Ha J.-H., Lee W., Kim H.-C. Physicochemical properties of epoxy resin-based and bioceramic-based root canal sealers. Bioinorganic Chem. Appl. 2017;2017:1–8. doi: 10.1155/2017/2582849.
    1. Vouzara T., Dimosiari G., Koulaouzidou E.A., Economides N. Cytotoxicity of a new calcium silicate endodontic sealer. J. Endod. 2018;44:849–852. doi: 10.1016/j.joen.2018.01.015.
    1. Loushine B.A., Bryan T.E., Looney S.W., Gillen B.M., Loushine R.J., Weller R.N., Pashley D.H., Tay F.R. Setting properties and cytotoxicity evaluation of a premixed bioceramic root canal sealer. J. Endod. 2011;37:673–677. doi: 10.1016/j.joen.2011.01.003.
    1. Almeida L.H.S., Moraes R.R., Morgental R.D., Pappen F.G. Are premixed calcium silicate–based endodontic sealers comparable to conventional materials? A systematic review of in vitro studies. J. Endod. 2017;43:527–535. doi: 10.1016/j.joen.2016.11.019.
    1. Ates A.A., Dumani A., Yoldas O., Unal I. Post-obturation pain following the use of carrier-based system with AH Plus or iRoot SP sealers: A randomized controlled clinical trial. Clin. Oral Investig. 2019;23:3053–3061. doi: 10.1007/s00784-018-2721-6.
    1. Paz A. Evaluation of Postoperative Pain after Using Bioceramic Materials as Endodontic Sealers. EC Dent. Sci. 2018;17:1739–1748.
    1. Sadaf D., Ahmad M.Z. Factors associated with postoperative pain in endodontic therapy. Int. J. Biomed. Sci. 2014;10:243–247.
    1. Alí A., Olivieri J.G., Duran-Sindreu F., Abella F., Roig M., García-Font M. Influence of preoperative pain intensity on postoperative pain after root canal treatment: A prospective clinical study. J. Dent. 2016;45:39–42. doi: 10.1016/j.jdent.2015.12.002.
    1. Segura-Egea J.J., Cisneros-Cabello R., Llamas-Carreras J.M., Velasco-Ortega E. Pain associated with root canal treatment. Int. Endod. J. 2009;42:614–620. doi: 10.1111/j.1365-2591.2009.01562.x.
    1. Taşdemir T., Er K., Yildirim T., Buruk K., Çelik D., Cora S., Tahan E., Tuncel B., Serper A. Comparison of the sealing ability of three filling techniques in canals shaped with two different rotary systems: A bacterial leakage study. Oral Surg. Oral Med. Oral Pathol. Oral Radiol. Endodontol. 2009;108:e129–e134. doi: 10.1016/j.tripleo.2009.05.007.
    1. Pereira A.C., Nishiyama C.K., de Castro Pinto L. Single-cone obturation technique: A literature review. RSBO Rev. Sul-Bras. Odontol. 2012;9:442–447.
    1. Tasdemir T., Yesilyurt C., Ceyhanli K.T., Celik D., Er K. Evaluation of apical filling after root canal filling by 2 different techniques. J. Can. Dent. Assoc. 2009;75:201a–201d.
    1. El Sayed M.A.A.M., Taleb A.A.A., Balbahaith M.S.M. Sealing ability of three single-cone obturation systems: An in-vitro glucose leakage study. J. Conserv. Dent. 2013;16:489–493. doi: 10.4103/0972-0707.120936.
    1. Hörsted-Bindslev P., Andersen M.A., Jensen M.F., Nilsson J.H., Wenzel A. Quality of molar root canal fillings performed with the lateral compaction and the single-cone technique. J. Endod. 2007;33:468–471. doi: 10.1016/j.joen.2006.12.016.
    1. Guess G.M., Edwards K.R., Yang M.-L., Iqbal M.K., Kim S. Analysis of continuous-wave obturation using a single-cone and hybrid technique. J. Endod. 2003;29:509–512. doi: 10.1097/00004770-200308000-00005.
    1. Iglecias E.F., Freire L.G., de Miranda Candeiro G.T., dos Santos M., Antoniazzi J.H., Gavini G. Presence of voids after continuous wave of condensation and single-cone obturation in mandibular molars: A micro-computed tomography analysis. J. Endod. 2017;43:638–642. doi: 10.1016/j.joen.2016.11.027.

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