Effect of epoxy resin-based and bioceramic-based root canal sealers on postoperative pain: A randomized controlled clinical trial

Objective: The aim of this thesis was to evaluate the effect of three different root canal sealers—one epoxy resin-based (AH Plus) and two bioceramic-based (TotalFill BC and Bio-C)—on postoperative pain following single-visit root canal treatment of single-rooted, single-canal teeth diagnosed with asymptomatic irreversible pulpitis (AIP), irrespective of jaw, side, or patient sex. Materials and Methods: This study included 72 teeth (one tooth per patient) from 72 systemically healthy patients (22 males and 50 females) diagnosed with AIP. Single-rooted, single-canal teeth were enrolled regardless of arch (maxillary/mandibular), laterality, or sex. Patients were randomly allocated into three groups according to the sealer used (n = 24 per group): Group 1: AH Plus; Group 2: TotalFill BC; Group 3: Bio-C. Apical patency was verified with a size 10 K-file, and the working length was determined with an endomotor equipped with an integrated apex locator. After the root canal irrigation protocol, all teeth in the groups were obturated using the continuous wave obturation technique. Postoperative pain intensity was recorded using a visual analog scale (VAS, 0-10) at 6, 24, 48, and 72 hours, and on day 7 after treatment. The presence of pain was also recorded at each time point as a dichotomous variable (yes/no). The level of statistical significance was set at p<0.05. Results: Sex, jaw, region, age, and the type of root canal sealer did not have a statistically significant effect on the presence of pain (p>0.05). While no significant difference was found regarding the number of patients reporting pain between the 6th and 24th hours (p>0.05), the number of patients with postoperative pain at these time intervals was significantly higher compared to the other measurement times (p<0.05). Conclusion: The epoxy resin-based and bioceramic-based root canal sealers used in this study produced comparable results with respect to postoperative pain. In all groups, postoperative pain had completely resolved after the first 24 hours of follow-up.