Effect of Different Root Canal Sealers on Postoperative Pain

This randomized clinical trial aimed to evaluate postoperative pain following the use of bioceramic and epoxy resin-based root canal sealers in combination with the continuous wave of condensation technique (CWCT), addressing a clinically relevant gap in the literature. Seventy-two patients with single-rooted teeth diagnosed with asymptomatic irreversible pulpitis and presenting without preoperative pain were randomly assigned to three groups according to the root canal sealer used. The teeth were treated using AH Plus, TotalFill BC, or Bio-C Sealer. All endodontic procedures, including post-endodontic restorations, were completed in a single visit using the continuous wave of condensation technique (CWCT), following standardized preparation and irrigation protocols. Patients were provided with a Visual Analog Scale (VAS) form and were instructed to record their pain intensity on a scale from 0 to 10 at 6, 24, 48, and 72 hours, and 7 days after root canal treatment. Patients were recalled on day 7, and the completed VAS forms were collected. The null hypothesis was that the type of root canal sealer would have no statistically significant effect on postoperative pain levels. The alternative hypothesis was that, regardless of sealer type, the incidence and severity of postoperative pain would be significantly higher within the first 24 hours following treatment compared with the other assessment time points.

Inclusion Criteria: * Patients aged 18-65 years * Patients who agreed to participate in this study * Patients with single-rooted, single-canal maxillary or mandibular teeth diagnosed with asymptomatic irreversible pulpitis * Patients with asymptomatic teeth * Patients who have not used any analgesic, anti-inflammatory, or antibiotic drugs in the last 7 days * Patients with good oral hygiene * Patients with a sustained positive response to cold test and electric pulp test * Patients with healthy periapical tissues (to be confirmed by periapical radiography) Exclusion Criteria: * Patients who refused to participate in this study * Patients with medical problems (patients with immunosuppressive/systemic diseases, patients on medication) * Patients with negative responses to thermal and electrical pulp tests * Patients with advanced periodontal disease (probing depth \>4 mm) * Patients with preoperative percussion and palpation of the involved tooth * Open apex, presence of calcification, presence of resorption * Patients requiring endodontic treatment of more than one tooth * Patients with allergic sensitivity to materials and agents to be used during root canal treatment * Patients with allergic sensitivity to local anesthetics * Patients with systemic or allergic sensitivity to NSAIDs * Pregnant and lactating patients * Teeth that cannot be restored due to excessive material loss in the coronal structure