Comparative evaluation of post-operative pain & analgesic intake after root canal treatment using three bioceramic sealers- An In-vivo study

Abstract

To evaluate the occurrence and intensity of post-operative pain & number of analgesic tablets intake after single visit endodontic treatment using three different Bioceramic sealers.45 single rooted teeth diagnosed with asymptomatic irreversible pulpits requiring endodontic treatment were randomly assigned to three groups (n=15) according to sealer used during obturation. To avoid bias in post-operative pain perception, each sealer is evaluated in three different single rooted teeth of the same patient. The different groups are Group 1-MTA-Fillapex, Group –II Ceraseal RCS, Group-III BioRoot RCS. Single visit Endodontic treatment was performed and teeth were obturated using cold lateral compaction and different root canal sealers with no radiographic material extrusion beyond the apex. Severity of post obturation pain was assessed by Visual Analog Scale (VAS) with score ranging from 0 to 10 at 6hrs, 12hrs, 24hrs and 48hrs intervals. The need for analgesic (Tab. Aceclofenac 100 mg) intake was also recorded. Differences in incidence of postoperative pain were analyzed using the Kruskal Wallis test followed by Mann Whitneys Post Hoc to compare the mean VAS score & number of analgesics taken between three groups at different time intervals (p<0.05).MTA Fillapex shows statistically significant difference in mean VAS score (more pain) at 6hrs, 12hrs (p value < 0.001) & at 24hrs (p<0.005) than Ceraseal RCS and BioRoot RCS. There is statistically significant difference in the no. of analgesic intake for MTA Fillapex i.e., more tablets taken by the patient to relive pain (p<0.001) as compared to Ceraseal RCS and BioRoot RCS. The decrease in pain was statistically significant for each time intervals from 6hrs to 48hrs for all the three groups.The teeth of the patients where MTA Fillapex sealer was used as a sealer in the obturation showed significantly more pain at 6hrs & 12hrs and needed to take more analgesics than teeth obturated with other two sealers. This probably could be due to leaching out of resin constituents from MTA Fillapex.