(PR95) Comparison of the Incidence, Intensity, and Duration of Post-Operative Pain After Hydraulic Filling with Calcium Silicate-Based Bioceramic Sealers and Warm Vertical Compaction with Resin-Based Sealers: A Randomized Clinical Trial

Objectives: To compare postoperative pain (PP) after hydraulic filling with calcium silicate-based bioceramic sealers (HF) and warm vertical compaction with resin-based sealers (WVC). Methodology: Informed consent was obtained from 618 patients requiring a primary root canal treatment in a vital or necrotic tooth (n=206 each) or non-surgical retreatment (n=206). A single operator blindly performed all procedures using the same cleaning and shaping protocol. Just before root canal obturation, the operator was informed if the patient had been randomly allocated to HF or WVC group. Participants recorded the presence, duration and level of PP and analgesic medication intake. A logistic regression was used to compare the incidence of PP and the need of painkillers between groups. Odds ratio (OR) and their 95% CI were estimated. Differences in general pain intensity between groups were analyzed using the ordinal chi-squared test. Postoperative pain after 6, 24 and 72 hours (recorded in a VAS scale), alongside the number of analgesic medication intake between the two groups, was assessed with a Mann-Whitney U test.

Results: Data was obtained from 595 patients. Patients in WCV presented a significant higher incidence of PP than in HF group after primary root canal treatment in vital (OR= 2.4, 95% CI 1.2-5), necrotic teeth (OR= 3.4, 95% CI 1.6-7.3), and after non-surgical retreatment (OR= 4, 95% CI 1.8-8.7), as well as higher intensity, duration and need for medication intake (p < 0.05).

Conclusions: Hydraulic filling with calcium silicate-based sealers was associated with less PP than warm vertical compaction with resin-based sealers.