Evaluation of post-operative pain in non-surgical root canal therapy: Comparison of sealer-based obturation with warm vertical compaction

Recent study results indicated that the sealer-based obturation (SBO) technique utilizing calcium silicate sealer (CSS) is correlated with similar post-operative pain levels and analgesic consumption as warm-vertical compaction (WVC) with resin-based sealer (RBS). Therefore, SBO with CSS may be a practical clinical alternative in the context of post-operative pain. The International Endodontic Journal has highlighted the results of this study.

This study included 195 patients who were referred for non-surgical root canal treatment (NSRCT) and fulfilled the essential inclusion criteria. Before the treatment, periapical radiographs and CBCT scans were conducted, and pain was assessed using a numerical rating scale (NRS). After completing the canal instrumentation, participants were randomly assigned to either Group SBO, which received SBO with CSS, or Group WVC, which utilized warm-vertical compaction with RBS. Post-operative pain levels and analgesic use were recorded at one, three, and seven days following the endodontic procedure. The differences in pain scores among the groups were assessed using the Mann-Whitney U and Friedman tests, while a generalized estimating equation was applied to evaluate correlations at different time points within each treatment group.

In the final analysis, 194 participants and 211 teeth were included, producing a response rate of 99.5%. There were no significant differences in post-operative pain or the use of analgesics between the two groups at any time point (p value > .05). On the other hand, pre-operative pain, age, apical diagnosis, and post-operative analgesic intake were significantly linked to post-operative pain (p value < .05).

The above findings indicated that the sealer-based obturation technique utilizing CSS is linked to post-operative pain and analgesic use that are comparable to warm-vertical compaction WVC with RBS. Therefore, SBO with CSS could be a practical alternative for managing pain after surgery.