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Background <p>Postoperative pain is a common complication after endodontic treatment and may be influenced by obturation techniques and sealer properties. Calcium silicate-based sealers have gained attention for their bioactive properties; however, their clinical performance with respect to postoperative pain and healing outcomes remains uncertain. This randomized, double-blind clinical trial aimed to compare postoperative pain and healing outcomes following root canal obturation with a calcium silicate-based sealer (CSBS) versus an epoxy resin-based sealer (ERBS). </p> Methods <p>Seventy-two adult patients requiring endodontic treatment were randomly assigned to two groups based on the sealer used for obturation: Bio-C Sealer (CSBS) or AH Plus Jet (ERBS). Root canal preparation was performed using a reciprocating system, and obturation was carried out using the thermocompaction technique. Postoperative pain was assessed using a numerical rating scale (0–10) at 6, 12, 24, 48, and 72 hours after treatment. Rescue medication use was recorded. Radiographic healing was evaluated after 12 months using the Periapical Index (PAI).</p> Results <p>No significant differences were observed between groups in postoperative pain occurrence at any evaluated time point (p &gt; 0.05). The risk of postoperative pain was 4.5 times higher when extrusion of filling material occurred (RR = 4.55; 95% CI: 1.25–16.62). Younger participants showed a higher risk of postoperative pain within the first 24 hours (RR = 3.20; 95% CI: 1.33–7.74). Rescue medication use decreased over time, with no differences between groups. At the 12-month follow-up, 53 participants were evaluated, and similar healing outcomes were observed (Bio-C Sealer: 1.04 ± 0.21; AH Plus Jet: 1.04 ± 0.19; p &gt; 0.05).</p> Conclusions <p>Both sealers showed similar postoperative pain and healing outcomes. Filling material extrusion was the main factor associated with increased postoperative pain.</p> Trial registration <p>This study was registered with the Brazilian Clinical Trials Registry (ReBEC) (RBR-8s5cbfk) on 2022-03-08.</p>

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Effect of calcium silicate and epoxy resin-based sealers on postoperative pain: a randomized clinical trial

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年4月2日

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  • Jessica Waayen Caleffi de Oliveira,
  • Ingrid Luiza Mendonça Cunha,
  • Aida Renée Assayag Hanan,
  • André Augusto Franco Marques,
  • Fernando José Herkrath,
  • Emílio Carlos Sponchiado Júnior

摘要

Background

Postoperative pain is a common complication after endodontic treatment and may be influenced by obturation techniques and sealer properties. Calcium silicate-based sealers have gained attention for their bioactive properties; however, their clinical performance with respect to postoperative pain and healing outcomes remains uncertain. This randomized, double-blind clinical trial aimed to compare postoperative pain and healing outcomes following root canal obturation with a calcium silicate-based sealer (CSBS) versus an epoxy resin-based sealer (ERBS).

Methods

Seventy-two adult patients requiring endodontic treatment were randomly assigned to two groups based on the sealer used for obturation: Bio-C Sealer (CSBS) or AH Plus Jet (ERBS). Root canal preparation was performed using a reciprocating system, and obturation was carried out using the thermocompaction technique. Postoperative pain was assessed using a numerical rating scale (0–10) at 6, 12, 24, 48, and 72 hours after treatment. Rescue medication use was recorded. Radiographic healing was evaluated after 12 months using the Periapical Index (PAI).

Results

No significant differences were observed between groups in postoperative pain occurrence at any evaluated time point (p > 0.05). The risk of postoperative pain was 4.5 times higher when extrusion of filling material occurred (RR = 4.55; 95% CI: 1.25–16.62). Younger participants showed a higher risk of postoperative pain within the first 24 hours (RR = 3.20; 95% CI: 1.33–7.74). Rescue medication use decreased over time, with no differences between groups. At the 12-month follow-up, 53 participants were evaluated, and similar healing outcomes were observed (Bio-C Sealer: 1.04 ± 0.21; AH Plus Jet: 1.04 ± 0.19; p > 0.05).

Conclusions

Both sealers showed similar postoperative pain and healing outcomes. Filling material extrusion was the main factor associated with increased postoperative pain.

Trial registration

This study was registered with the Brazilian Clinical Trials Registry (ReBEC) (RBR-8s5cbfk) on 2022-03-08.