Postoperative Pain following Root Canal Filling with Bioceramic vs. Traditional Filling Techniques: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

Abstract

This meta-analysis aimed to evaluate postoperative pain (POP) following root canal filling (RCF) with gutta-percha/bioceramic sealer (BCS) vs. gutta-percha/traditional sealer (TS) techniques. Electronic databases were searched for randomized trials. Subgroup analyses were performed for analgesic intake, flare-ups, postoperative time (24/48 h), pulp status, and retreatment. The search yielded 682 records, and nine studies were selected. BCS was associated with significantly lower POP vs. TS at 24 h (P = 0.04) and 48 h (P = 0.0005). In addition, non-significant trends favoring BCS for analgesic intake at 24 h (P = 0.14), flare-ups (P = 0.24) and obturation techniques at 24 h (P = 0.41) and 48 h (P = 0.33), non-significant trends for lower POP with TS vs. BCS 24 h and 48 h in vital teeth (P = 0.50, P = 0.18, respectively), and for lower POP with BCS vs. TS in non-vital teeth at 24 h and 48 h (P = 0.16, P = 0.84, respectively). POP was numerically lower with TS vs. BCS at 24 h (P = 0.65) and 48 h after retreatment (P = 0.59). Moreover, POP did not vary between fillers when the treatment was over single (P = 0.28) or multiple visits (P = 0.50). BCS was associated with significantly lower short-term POP, and with a trend for lower analgesic intake and flare-up incidence, as compared to TS.

Micro-Computed Tomography Evaluation of Minimally Invasive Shaping Systems in Mandibular First Molars

“…This may relate to the different techniques adopted for the shaping of the apical third, whereby the use of a shorter sequence and a manual NiTi instrument #25 could have resulted in a more conservative approach in the PTNm group. This aspect could be related to different outcomes in terms of post-operative pain and quality of life, but it was not investigated due to the ex vivo study limits [ 40 , 41 ].…”

Clinical and Radiographic Outcome of Non-Surgical Endodontic Treatment Using Calcium Silicate-Based Versus Resin-Based Sealers—A Systematic Review and Meta-Analysis of Clinical Studies

“…Previously published systematic reviews and meta-analysis [ 29 , 30 , 31 ] evaluated the postoperative pain at different time intervals, with a maximum of only seven days. Junior et al [ 29 ] were unable to perform meta-analysis for sealer extrusion and doses of medications i.e., Ibuprofen.…”

“…Jamali et al [ 30 ] included articles published in English only, which could lead to selection and selective outcome reporting biases. In addition, Mekhdieva et al [ 31 ] failed to provide a clear description of the inclusion and exclusion criteria used for their study. This current systematic review is the first meta-analysis to assess the effect of CSBSs vs. RBSs on the clinical as well as radiographic outcomes when used for root canal treatment in permanent teeth.…”

“…Junior et al [ 29 ] and Jamali et al [ 30 ] published systematic reviews comparing the effect of CSBSs and RBS on clinical outcomes, which included five and four controlled randomised clinical trials, respectively. In addition, Mekhdieva et al [ 31 ] evaluated the postoperative pain following warm vertical compaction technique using bioceramic sealer in comparison to cold lateral condensation. However, these reviews conducted previously evaluated only the intensity of post-obturation pain and failed to include parameters such as radiographic healing and absence of clinical symptoms, i.e., sinus healing, reduction in inflammation and absence of tenderness to percussion.…”

A Comparative Study of Two Martensitic Alloy Systems in Endodontic Files Carried out by Unskilled Hands

“…The instrumentation phase of root canals is considered to be one of the most important steps in endodontics [32] because it facilitates the passage of irrigants along its entire length and geometrically configures the canal for a correct, three-dimensional obturation [33].…”