Assessment of Extrusion and Postoperative Pain of a Bioceramic and Resin-Based Root Canal Sealer

Abstract

Objectives The objective of this study was to compare a bioceramic and a resin-based endodontic sealer with regard to extrusion and postoperative pain. Materials and Methods Sixty-four patients requiring endodontic treatment of single-rooted maxillary teeth with necrotic pulps were included in this study. The root canal treatments were performed in a single visit using a size 40.06 single-file reciprocating system under 2.5% NaOCl irrigation. After irrigation with 17% ethylenediaminetetraacetic acid (EDTA) and 2.5% NaOCl, the canals were dried and randomly divided into two different groups (n = 32) depending on the sealer used: resin-based group (RG) in which the canals were filled with the AH Plus, and the bioceramic group (BG) in which the canals were filled with the Sealer Plus BC. Ibuprofen (600 mg) was prescribed every 6 hours if the volunteers experienced pain. The patients registered their pain sensation in a visual analog scale (VAS) card, ranging from 0 to 10 at 24-hour, 48-hour, 72-hour, and 1-week intervals. Statistical analysis For statistical analysis, the level of significance was set at p < 0.05. Results Sealer extrusion occurred in nine patients of the RG and in 19 patients of the BG (p < 0.05). The average pain level at 24-hour and 48-hour intervals was, respectively, 1.46 ± 1.96 and 0.44 ± 0.86 for RG, and 1.21 ± 2.09 and 0.09 ± 0.38 for BG. There was no report of pain after 48 hours. The mean number of tablets taken for pain relief was 0.03 ± 0.17 for RG and 0.06 ± 0.24 for BG. No statistically significant difference was found with regard to pain level and intake of pain killer tablets (p > 0.05). Conclusions The BG sealer presented significantly more extrusion than the RG sealer. Sealer extrusion was not associated with pain. The average pain level and the mean number of tablets taken for pain relief were similar in both groups.

Calcium Silicate-Based Sealers Do Not Reduce the Risk and Intensity of Postoperative Pain after Root Canal Treatment when Compared with Epoxy Resin-Based Sealers: A Systematic Review and Meta-Analysis

“…In addition, four eligible studies also assessed the occurrence of pain 72 hours after the procedure. [31][32][33]35 There were no reports of pain in two studies 31,33 and there were no statistical differences between the sealers in the other two. 32,35 Pain Intensity Two studies assessed pain intensity at 6 and 12 hours after the procedure.…”

“…Thus, three studies were included in the quantitative analysis of risk and intensity of postoperative pain. [31][32][33] One study did not present extractable data 34 and it was excluded from the analysis; the corresponding author was contacted but the missing data was not provided. Moreover, we decided not to include Abbreviations: F, female; M, male; VAS, visual analogic scale.…”

Micro-computed tomographic evaluation of a new system for root canal filling using calcium silicate-based root canal sealers

“…This finding is in agreement with previous studies that compared the apically extruded debris proportionated with open-ended or side-vented needle tips and observed that open-ended needles were associated with significantly more extrusion [ 17 18 ]. Although the higher apical extrusion of ready-to-use calcium silicate-based sealers would not be related with pain [ 7 ], and could not have any significant effect on the treatment outcome [ 8 ], the sealer extrusion can lead to a neurogenic inflammation, which may underlie the flare-up occurrences [ 19 ]. Therefore, the use of SIS could be safer than the conventional system.…”

“…During the root canal obturation, an important issue is the sealer extrusion to the periradicular tissues or into the surrounding anatomical structures, which could cause postoperative pain [ 6 ]. Calcium silicate-based sealers have been associated with a significantly higher incidence of extrusion [ 7 8 ]. This fact could be associated with their application with an endodontic tip provided by the manufacturer [ 7 ].…”

“…Calcium silicate-based sealers have been associated with a significantly higher incidence of extrusion [ 7 8 ]. This fact could be associated with their application with an endodontic tip provided by the manufacturer [ 7 ]. Recently, a new Sealer Injection System (SIS) (Angelus) was developed to be used with ready to use premixed bioceramic sealers.…”