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Comparative analysis of postoperative pain following bioceramic sealer application with three obturation methods: A randomized controlled trial

Dent Med Probl. 2026 Mar-Apr;63(2):273-283. doi: 10.17219/dmp/208898.

ABSTRACT

BACKGROUND: One of the most important aspects of root canal therapy is pain control after treatment. Postoperative pain is an unwanted but common sensation following endodontic procedures. Recently, bioceramic sealers have gained attention in endodontics; however, clinical evidence supporting their effectiveness in pain reduction is still limited.

OBJECTIVES: This randomized controlled trial aimed to evaluate the efficacy of 3 obturation techniques using a bioceramic sealer (Cerafill RCS®) on postoperative pain in patients with asymptomatic irreversible pulpitis.

MATERIAL AND METHODS: Ninety-three patients diagnosed with asymptomatic irreversible pulpitis were randomly allocated to one of three groups according to the obturation technique: cold lateral compaction; single cone obturation; or a hot modified technique. The severity of pain was assessed using a visual analogue scale (VAS) at 6, 12, 24, and 48 h after treatment. The study utilized Kruskal-Wallis and Mann-Whitney U tests to analyze pain scores across groups. Linear regression analysis was performed to identify predictors of postoperative pain.

RESULTS: The sealer-based and hot modified techniques were associated with significantly lower postoperative pain levels compared to cold lateral compaction at all measured time points (p < 0.05). The regression analysis confirmed the obturation technique as a significant predictor of postoperative pain. The hot modified method, in particular, provided the most consistent pain relief, underscoring the potential of advanced obturation methods in enhancing patient recovery and comfort.

CONCLUSIONS: The sealer-based and hot modified methods significantly reduced postoperative pain compared to traditional techniques. These findings support the clinical adoption of innovative bioceramic sealer techniques to optimize pain management and patient satisfaction.

PMID:41925384 | DOI:10.17219/dmp/208898