Investigation of the effect of different root canal sealer on post operative pain after root canal treatment: A randomized clinical study

Purpose: The aim of this study is to evaluate the postoperative pain level after root canal treatment using different root canal sealers and to compare the effects of root canal sealer on pain. Anticipating pain due to root canal treatment and feeling pain after treatment is an important source of fear for patients. Dentists are also concerned about their patients' pain levels after root canal treatment. Post-treatment pain is expected, experienced, remembered and shared by patients. Therefore, the aim of our study is to determine the effects of different root canal sealers on the prevalence and severity of pain after root canal treatment and to estimate the prevalence and severity of post-treatment pain in patients who underwent root canal treatment. Materials and Methods: Our study was designed as a clinical study and was performed on the lower and upper premolar teeth of a total of 80 patients who applied to the Endodontics Department of Afyonkarahisar Health Sciences University Faculty of Dentistry Hospital, where root canal treatment was indicated. 80 patients were divided into 4 equal groups, and root canal treatment was applied to each group with V Taper Gold (Fanta Dental Material, Shanghai, China) files, with the help of VDW Gold endomotor, in clockwise 360° rotation mode at 2 nm torque and 300 rpm speed (continuous). Pain levels after the treatment using Sealapex, AH Plus, MTA Fillapex and Dia-Root Bioselar pastes were measured on a numbered pain scale (NRS) of 6-24-48-72. hours and were followed at 1 week. SPSS 26.0 package program was used for statistical analysis, and in comparing the groups for each time period in our study, the parametric tests 'Single Factor Variance Analysis (One-Way ANOVA)' and its equivalent in non-parametric tests 'Kruskal Wallis, Friedman' test were used. In the comparison analyses between the groups, the multiple comparison test 'Tukey' analysis was used. Pairwise comparisons between the measurements were analyzed with the 'LSD' test. Results: No statistically significant difference was found in all paste groups in terms of gender and postoperative pain (p>0.05). No statistically significant difference was found in terms of age and medication use distribution by paste groups (p>0.05). When the pain averages in the paste groups were compared, higher and significantly different pain averages were found in AH Plus paste at the 6th hour, 48th hour and 72nd hour time periods compared to the other paste groups (p<0.05). When each paste group was analyzed within themselves according to time periods, a statistically significant difference was found between the 6th hour and 24th hours in the Sealapex paste group (p<0.05). A statistically significant difference was found between all time periods in AH Plus paste (p<0.05). In patients using DiaRoot Biosealer paste, a statistically significant difference was found between the pain levels at the 6th hour and the 24th hours, 48th hours and 72nd hours after the procedure (p<0.05). When the pain levels in the MTA Fillapex paste group were compared among themselves, a statistically significant difference was found between the 6th hour and the 48th hour, the 72nd hour and the 1st week (p<0.05). When the pain levels at the 24th hour were compared with other time periods, a statistically significant difference was found with the 48th hour and 1st week pain averages (p<0.05). Conclusion: Pain after root canal treatment is one of the most important problems that reduce post-procedure comfort in patients. After the use of AH Plus paste and for the first 48 hours after treatment with other paste, we recommend that patients be further informed about the process and evaluated for analgesic medication.