The effect of three different root canal filling materials on postoperative pain in teeth with irreversible pulpitis: a randomized clinical trial.

BACKGROUND

This randomized clinical trial aimed to compare postoperative pain (PP) and analgesic consumption following single-visit root canal treatment using two calcium silicate-based sealers (BioMTA + and Well-Root PT) and one epoxy resin-based sealer (Endoplus) in mature permanent mandibular molars diagnosed with asymptomatic irreversible pulpitis.

METHODS

Fifty-four patients were randomly allocated into three groups (n = 18) according to the obturation material used: Endoplus, BioMTA+, or Well-Root PT. All treatments were performed in a single visit under standardized clinical conditions. Root canals were prepared using FKG Race Evo rotary files and irrigated with NaOCl and EDTA, followed by passive ultrasonic activation. Postoperative pain was assessed using a visual analog scale (VAS) at 6, 12, 24, 48, and 72 h and at 1 week postoperatively. Analgesic intake was recorded. Data were analyzed using repeated measures ANOVA and chi-square tests, with the significance level set at p < 0.05.

RESULT: All groups exhibited a statistically significant reduction in postoperative pain over time (p < 0.001 for Endoplus and BioMTA+; p = 0.004 for Well-Root MTA). However, intergroup comparisons revealed no statistically significant differences in pain scores at any evaluation time point (p > 0.05). The highest pain levels were observed within the first 24 h, followed by a rapid decline thereafter. None of the patients required analgesic intake during the postoperative period. Demographic variables were comparable among the groups.

CONCLUSION

Within the limitations of this randomized clinical trial, no statistically significant differences were detected among BioMTA+, Well-Root PT, and Endoplus regarding early postoperative pain following single-visit root canal treatment in mandibular molars with asymptomatic irreversible pulpitis. The type of root canal sealer did not significantly influence postoperative pain outcomes.

TRIAL REGISTRATION: This study was registered at ClinicalTrials.gov (ID: NCT06795282, Record Dates: 22/12/2024).