The Effects of Calcium Silicate- and Calcium Hydroxide-based Root Canal Sealers on Postoperative Pain: A Randomized Clinical Trial

J Endod. 2023 Dec;49(12):1588-1594. doi: 10.1016/j.joen.2023.08.023. Epub 2023 Sep 7.

Abstract

Introduction: This study aimed to compare the postoperative pain level changes resulting from using calcium silicate- (EndoSeal MTA) and calcium hydroxide-based (Sealapex) root canal sealers in mandibular first and second molar teeth with symptomatic apical periodontitis.

Methods: A total of 60 patients with symptomatic apical periodontitis in their lower molar teeth were randomly allocated into 2 groups according to sealer type (n = 30). Demographic data, including gender, age, and smoking habit, and preoperative pain measures were recorded. Root canal treatments were performed in a single visit. Postoperative pain measurements and analgesic intake were measured at 6, 12, 24, and 48 hours and after 3, 5, and 7 days using the visual analog scale. The data were statistically analyzed using a chi-squared test (to compare gender, age, smoking habit, analgesic intake, and sealer extrusion), the Mann-Whitney U test (to compare pain levels), Friedman tests (for the evaluations of the reduction in pain levels over time), and Spearman's correlation test (to analyze the relationships of age, gender, smoking habit factors with postoperative pain) (P = .05).

Results: The statistical analysis showed no significant differences between the groups in postoperative pain and analgesic intake at any of the time intervals evaluated (P > .05).

Conclusions: Patients treated with calcium silicate- and calcium hydroxide-based root canal sealers experienced similar postoperative pain and no statistically significant differences were observed in analgesic intake.

Keywords: EndoSeal MTA; Sealapex; calcium hydroxide–based sealer; calcium silicate–based sealer; postoperative pain.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Analgesics
  • Calcium Compounds / pharmacology
  • Calcium Compounds / therapeutic use
  • Calcium Hydroxide / pharmacology
  • Calcium Hydroxide / therapeutic use
  • Dental Pulp Cavity
  • Epoxy Resins
  • Humans
  • Pain, Postoperative
  • Periapical Periodontitis*
  • Root Canal Filling Materials* / pharmacology
  • Root Canal Filling Materials* / therapeutic use
  • Silicates / pharmacology
  • Silicates / therapeutic use

Substances

  • calcium silicate
  • Calcium Hydroxide
  • Root Canal Filling Materials
  • Epoxy Resins
  • Calcium Compounds
  • Silicates
  • Analgesics