Comparative evaluation of postoperative pain and periapical healing after root canal treatment using three different base endodontic sealers - A randomized control clinical trial

Akshay Khandelwal, Jerry Jose, Kavalipurapu-Venkata Teja, Ajitha Palanivelu, Akshay Khandelwal, Jerry Jose, Kavalipurapu-Venkata Teja, Ajitha Palanivelu

Abstract

Background: The aim of the present study was to evaluate and compare the postoperative pain and periapical healing after root canal treatment using three different base endodontic sealers.

Material and methods: Primary root canal treatment was initiated in 63 patients diagnosed with necrotic pulp and apical periodontitis, cleaning and shaping was completed in two visit and different base endodontic sealers were used for obturation were selected based on the random allocation of the participants to the following groups; Tubli-Seal, AH Plus and BioRoot RCS. Postoperative pain was recorded by using 100 mm visual analog scale at 24 h, 48 h, 72 h and 7 d after obturation. Digital periapical radiographic evaluation was done to assess rate of periapical healing at baseline, 1, 3 and 6 months. Statistical analysis was done using Kruskal Wallis test and one-way ANOVA.

Results: The mean difference in the size of periapical lesions for Tubli-Seal (6.27, 13.41), AH Plus (3.86, 9.80) and BioRoot RCS (4.05, 10.22) at 3 months and 6 months respectively. The mean pain scores at 24 h for Tubli-Seal (17.94 ± 11.35), AH Plus (11.57 ± 11.18), BioRoot RCS (4.73 ± 7.72). At 48 h, Tubli-Seal (5.26 ± 9.04), AH Plus (1.57 ± 3.74) and BioRoot RCS (1.57 ± 3.74) respectively. The mean pain score at 72 h for Tubli-Seal was 2.63 ± 7.33 whereas none of the patients had reported pain in AH Plus and BioRoot RCS group. None of the patients had pain after 7 d of treatment.

Conclusions: BioRoot RCS showed less postoperative pain compared to AH Plus and Tubli-Seal and showed better periapical healing compared to AH Plus and Tubli-Seal at 3 and 6 months intervals respectively. Key words:BioRoot RCS, root canal obturation, root canal sealers, periapical periodontitis, Periapical healing, postoperative pain.

Conflict of interest statement

Conflicts of interest None declared.

Copyright: © 2022 Medicina Oral S.L.

Figures

Figure 1
Figure 1
CONSORT flowchart showing the design of the present study with overview of the different treatment protocols, loss of patients to follow up and periapical healing analysis.
Figure 2
Figure 2
The mean postoperative pain scores were evaluated at different time intervals (24 h, 48 h, 72 h, and 7 d) using the 100mm VAS Score. (Group 1 – Tubli-Seal, Group 2 – AH Plus, Group 3 – BioRoot RCS).

References

    1. Siqueira JF Jr, Rôças IN. Microbiology and treatment of acute apical abscesses. Clin Microbiol Rev. 2013;26:255–73.
    1. Zehnder M. Root Canal Irrigants. J Endod. 2006;32:389–98.
    1. Peters OA, Peters CI. Cleaning and Shaping of the Root Canal System. J Comp Pathol. 2012;146:283–7.
    1. Lee JK, Kwak SW, Ha JH, Lee W, Kim HC. Physicochemical Properties of Epoxy Resin-Based and Bioceramic-Based Root Canal Sealers. Bioinorg Chem Appl. 2017;2017:2582849.
    1. Dalopoulou A, Economides N, Evangelidis V. Extrusion of Root Canal Sealer in Periapical Tissues - Report of Two Cases with Different Treatment Management and Literature Review. Balkan Journal of Dental Medicine; 2017. pp. 12–8.
    1. Berbert FLCV, Leonardo MR, Silva LAB, Tanomaru Filho M, Bramante CM. Influence of root canal dressings and sealers on repair of apical periodontitis after endodontic treatment. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2002;93:184–9.
    1. AlRahabi MK. Predictors, prevention, and management of postoperative pain associated with nonsurgical root canal treatment: A systematic review. J Taibah Univ Med Sci. 2017;12:376–84.
    1. Zhang W, Peng B. Tissue reactions after subcutaneous and intraosseous implantation of iRoot SP, MTA and AH Plus. Dent Mater J. 2015;34:774–80.
    1. Paulaian B, Thakur S, Emil J. Evaluation of mineral trioxide aggregate as root canal sealer: A clinical study. J Conserv Dent. 2013;16:494–8.
    1. Lekic P, McCulloch CAG. Periodontal ligament cell populations: the central role of fibroblasts in creating a unique tissue. Anat Rec. 1996;245:327–41.
    1. Omoigui S. The biochemical origin of pain: the origin of all pain is inflammation and the inflammatory response. Part 2 of 3 - inflammatory profile of pain syndromes. Med Hypotheses. 2007;69:1169–78.
    1. Camargo CHR, Camargo SEA, Valera MC, Hiller KA, Schmalz G, Schweikl H. The induction of cytotoxicity, oxidative stress, and genotoxicity by root canal sealers in mammalian cells. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2009;108:952–60.
    1. Geurtsen W. Biocompatibility of root canal filling materials. Aust Endod J. 2001;27:12–21.
    1. Atmeh AR, Chong EZ, Richard G, Festy F, Watson TF. Dentin-cement interfacial interaction: calcium silicates and polyalkenoates. J Dent Res. 2012;91:454–9.
    1. Taraslia V, Anastasiadou E, Lignou C, Keratiotis G, Agrafioti A, Kontakiotis EG. Assessment of cell viability in four novel endodontic sealers. Eur J Dent. 2018;12:287–91.
    1. Dimitrova-Nakov S, Uzunoglu E, Ardila-Osorio H, Baudry A, Richard G, Kellermann O. In vitro bioactivity of BiorootTM RCS, via A4 mouse pulpal stem cells. Dent Mater. 2015;31:1290–7.
    1. Ng YL, Mann V, Gulabivala K. Outcome of secondary root canal treatment: a systematic review of the literatura. Int Endod J. 2008;41:1026–46.
    1. Orstavik D. Essential Endodontology: Prevention and Treatment of Apical Periodontitis. John Wiley & Sons; 2020. p. 408.
    1. Pak JG, White SN. Pain prevalence and severity before, during, and after root canal treatment: a systematic review. J Endod. 2011;37:429–38.
    1. Chu CH, Wong A, Zhang C. A systematic review of nonsurgical single-visit versus multiple-visit endodontic treatment. Clin Cosmet Investig Dent. 2014;6:45–56.
    1. Jung S, Sielker S, Hanisch MR, Libricht V, Schäfer E, Dammaschke T. Cytotoxic effects of four different root canal sealers on human osteoblasts. PLoS One. 2018;13:e0194467.
    1. Lodienė G, Kopperud HM, Ørstavik D, Bruzell EM. Detection of leachables and cytotoxicity after exposure to methacrylate- and epoxy-based root canal sealers in vitro. Eur J Oral Sci. 2013;121:488–96.
    1. Siboni F, Taddei P, Zamparini F, Prati C, Gandolfi MG. Properties of BioRoot RCS, a tricalcium silicate endodontic sealer modified with povidone and polycarboxylate. Int Endod J. 2017;50:e120–36.
    1. Camps J, Jeanneau C, El Ayachi I, Laurent P, About I. Bioactivity of a Calcium Silicate-based Endodontic Cement (BioRoot RCS): Interactions with Human Periodontal Ligament Cells In Vitro. J Endod. 2015;41:1469–73.
    1. Jeanneau C, Giraud T, Laurent P, About I. BioRoot RCS Extracts Modulate the Early Mechanisms of Periodontal Inflammation and Regeneration. J Endod. 2019;45:1016–1023.
    1. Akdeniz BG. Evaluation of periapical lesion healing by correction of gray values. J Endod. 2005;31:487.
    1. de Paula-Silva FWG, Wu MK, Leonardo MR, da Silva LAB, Wesselink PR. Accuracy of periapical radiography and cone-beam computed tomography scans in diagnosing apical periodontitis using histopathological findings as a gold standard. J Endod. 2009;35:1009–12.
    1. Kerosuo E, Orstavik D. Application of computerised image analysis to monitoring endodontic therapy: reproducibility and comparison with visual assessment. Dentomaxillofac Radiol. 1997;26:79–84.
    1. Huumonen S, Lenander-Lumikari M, Sigurdsson A, Ørstavik D. Healing of apical periodontitis after endodontic treatment: a comparison between a silicone-based and a zinc oxide-eugenol-based sealer. Int Endod J. 2003;36:296–301.
    1. Arias A, de la Macorra JC, Hidalgo JJ, Azabal M. Predictive models of pain following root canal treatment: a prospective clinical study. Int Endod J. 2013;46:784–93.

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