1
|
Gharechahi M, Hoseinzadeh M, Moradi S, Mehrjouei M. Evaluation of various obturation techniques with bioceramic sealers in 3D-printed C-shaped canals. BMC Oral Health 2024; 24:554. [PMID: 38735924 PMCID: PMC11089720 DOI: 10.1186/s12903-024-04334-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2023] [Accepted: 05/06/2024] [Indexed: 05/14/2024] Open
Abstract
This in vitro study compared various obturation techniques with bioceramic sealers for filling C-shaped 3D-printed replicas. A mandibular molar with a C-shaped root canal with a C1 configuration was obtained. After instrumenting with M3 Pro Gold files (United Dental, Shanghai, China) up to size #30/0.04, a CBCT scan of the tooth was taken. Sixty 3D-printed replicas of the tooth were created. The samples were obturated with EndoSeal TCS sealer (E. TCS; Maruchi, Wonju, Korea) or EndoSeal MTA (E. MTA; Maruchi, Wonju, Korea) (n = 30). The samples in each group were obturated with the following techniques (n = 10): (1) single-cone technique (SC), (2) SC with ultrasonic activation (UA), and (3) cold hydraulic compaction (CHC). Following incubation, the replicas' apical, middle, and coronal thirds were inspected under a digital microscope, and the proportion of filling material and void were calculated. Also, the obturation time and sealer extrusion were recorded. Data were analyzed using ANOVA, LSD post-hoc, and the chi-square tests (α = 0.05). The results indicated that in the apical third, E. TCS-SC, E. TCS-UA, and E. MTA-UA had the lowest void percentage among groups (p < 0.05). In the middle thirds, samples obturated with E. TCS-UA showed a significantly lower void percentage among all groups (p < 0.05). However, in the coronal third, E. TCS-CHC showed the least void percentage (p < 0.05), followed by E. TCS-UA and E. MTA-CHC. The E. TCS-SC and E. TCS-UA were the least time-consuming methods (p < 0.05). Sealer extrusion significantly differed among the groups, with E. MTA-UA and E. TCS-UA showing higher incidence (p = 0.019). It was concluded that E. TCS-UA was the most convenient obturation technique. However, care must be taken when obturating the canals with high flow and ultrasonic activation near the vital anatomical landmarks.
Collapse
Affiliation(s)
- Maryam Gharechahi
- Department of Endodontics, Faculty of Dentistry, Dental Materials Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Melika Hoseinzadeh
- Dentist, Research Assistant, Dental Research Center, Mashhad Dental School, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Saeed Moradi
- Department of Endodontics, Faculty of Dentistry, Dental Materials Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Mina Mehrjouei
- Department of Endodontics, School of Dentistry, Iran University of Medical Sciences, Tehran, Iran.
| |
Collapse
|
2
|
Zamparini F, Lenzi J, Duncan HF, Spinelli A, Gandolfi MG, Prati C. The efficacy of premixed bioceramic sealers versus standard sealers on root canal treatment outcome, extrusion rate and post-obturation pain: A systematic review and meta-analysis. Int Endod J 2024. [PMID: 38606520 DOI: 10.1111/iej.14069] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2023] [Revised: 03/03/2024] [Accepted: 03/25/2024] [Indexed: 04/13/2024]
Abstract
BACKGROUND Limited evidence is available regarding the superior clinical properties of bioceramic sealers comparted with traditional standard sealers. OBJECTIVES This review aimed to answer the following research questions: 'In healthy patients requiring a root canal treatment (P), what is the efficacy of premixed bioceramic sealers (I) compared with traditional root canal epoxy resin-based sealers (C) in terms of survival, success rates (PICO1) sealer extrusion and resorption (PICO2) post-obturation pain (PICO3) (O)?' METHODS Authors independently searched three electronic databases: PubMed (including MEDLINE), Web of Science, Embase and Scopus up to 31 October 2023. This was accompanied by both grey literature and manual search. Detailed selection criteria were applied, namely mature permanent teeth requiring root canal treatment, premixed bioceramic sealer with gutta-percha as an intervention group, a standard filling technique as control group and full-text available in English. A random-effect meta-analysis was used to synthesize the body of evidence regarding the use of bioceramic sealers in root canal treatment and their impact on post-obturation pain. Effect sizes were represented as relative risks on a logarithmic scale for binary outcomes and as mean differences for continuous outcomes. RESULTS A total of 941 articles were identified. Fifteen Comparative clinical studies were finally included. Eleven were randomized clinical trials, and four were prospective clinical trials with control group. The follow-up of these studies was not greater than 2 years. No publication bias was observed in any study. No significant differences were observed between the two groups in terms of survival and success rates. A small non-significant lower risk of extrusion was observed for bioceramics. A small, non-significantly lower post-operative-pain within 24-h was observed when bioceramics were used. DISCUSSION The majority of current evidence shows inconsistencies in reporting and is of short-term duration. Robust prospective long-term trials are needed in this area to better support future recommendations. CONCLUSION This systematic review is the first to analyse several clinical outcomes using premixed sealers. Included studies differed in terms of clinical protocol and operator expertise, but reported a similar outcome when comparing bioceramic versus standard sealers. Tooth survival, treatment outcome, post-operative pain and periapical extrusion were similar and presented no significant differences between the two sealer types. REGISTRATION PROSPERO database (CRD42023449151).
Collapse
Affiliation(s)
- Fausto Zamparini
- Endodontic Clinical Section, Dental School, Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy
- Laboratory of Green Biomaterials and Oral Pathology, Dental School, Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy
| | - Jacopo Lenzi
- Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy
| | - Henry Fergus Duncan
- Division of Restorative Dentistry and Periodontology, Dublin Dental University Hospital, Trinity College Dublin, Dublin, Ireland
| | - Andrea Spinelli
- Endodontic Clinical Section, Dental School, Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy
| | - Maria Giovanna Gandolfi
- Laboratory of Green Biomaterials and Oral Pathology, Dental School, Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy
| | - Carlo Prati
- Endodontic Clinical Section, Dental School, Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy
| |
Collapse
|
3
|
de Almeida-Junior LA, de Campos Chaves Lamarque G, Herrera H, Arnez MFM, Lorencetti-Silva F, Silva RAB, Silva LAB, Paula-Silva FWG. Analysis of the cytotoxicity and bioactivity of CeraSeal, BioRoot™ and AH Plus ® sealers in pre-osteoblast lineage cells. BMC Oral Health 2024; 24:262. [PMID: 38389110 PMCID: PMC10882839 DOI: 10.1186/s12903-024-04021-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2023] [Accepted: 02/13/2024] [Indexed: 02/24/2024] Open
Abstract
BACKGROUND The objective of the present study was to evaluate in vitro the cytotoxicity and bioactivity of various endodontic sealers (CeraSeal, BioRoot™ and AH Plus®) in pre-osteoblast mouse cells (MC3T3 cells). METHODS MC3T3 cells (ATCC CRL-2594) were plated in 1 × 104 cells/well in 96-well plates in contact with endodontic sealers at concentrations of 1:10 and 1:100. Cell viability was evaluated by MTT assay after 24 and 48 h. In addition, sealer bioactivity was measured by RT-PCR for mediator of inflammation (Tnf, Ptgs2) and mineralization (Runx2, Msx1, Ssp1 and Dmp1) after 24 h and by Alizarin Red S Assay of mineralization after 28 days. Data were analyzed using one-way ANOVA followed by the Tukey's post-test at a significance level of 5%. RESULTS BioRoot™ presented 24-hour cytotoxicity (p < 0.05) at 1:10 concentration. In the period of 48 h, no endodontic cement was cytotoxic to the cells compared to the control (p > 0.05). TNF-α gene expression was induced by AH Plus® (p < 0.05), while Ptgs2 was induced by the CeraSeal and BioRoot™ (p < 0.05). The expression of Runx2 was stimulated by BioRoot™ and AH Plus® (p < 0.05). In contrast, the expression of Dmp-1 Dmp1 was higher for the CeraSeal and BioRoot™ (p < 0.05). Nonetheless, the sealers did not impact the formation of mineralization nodules (p > 0.05). CONCLUSION CeraSeal, BioRoot™ and AH Plus® sealers were not cytotoxic to MC3T3 cells within 48 h, but differentially induced the expression of genes related to inflammation and mineralization without impacting biomineralization by the cells.
Collapse
Affiliation(s)
- Luciano Aparecido de Almeida-Junior
- Department of Clinics and Surgery, School of Dentistry, Federal University of Alfenas, Alfenas, Minas Gerais, Brazil
- Department of Pediatric Dentistry, Ribeirão Preto School of Dentistry, University of São Paulo, Av. do Cafe s/n, Monte Alegre, Ribeirão Preto, São Paulo, CEP: 14040-904, Brazil
| | - Giuliana de Campos Chaves Lamarque
- Department of Pediatric Dentistry, Ribeirão Preto School of Dentistry, University of São Paulo, Av. do Cafe s/n, Monte Alegre, Ribeirão Preto, São Paulo, CEP: 14040-904, Brazil
| | - Henry Herrera
- Universidad Católica de El Salvador, San Salvador, El Salvador
| | - Maya Fernanda Manfrin Arnez
- Department of Pediatric Dentistry, Ribeirão Preto School of Dentistry, University of São Paulo, Av. do Cafe s/n, Monte Alegre, Ribeirão Preto, São Paulo, CEP: 14040-904, Brazil
| | | | - Raquel Assed Bezerra Silva
- Department of Pediatric Dentistry, Ribeirão Preto School of Dentistry, University of São Paulo, Av. do Cafe s/n, Monte Alegre, Ribeirão Preto, São Paulo, CEP: 14040-904, Brazil
| | - Léa Assed Bezerra Silva
- Department of Pediatric Dentistry, Ribeirão Preto School of Dentistry, University of São Paulo, Av. do Cafe s/n, Monte Alegre, Ribeirão Preto, São Paulo, CEP: 14040-904, Brazil
| | - Francisco Wanderley Garcia Paula-Silva
- Department of Pediatric Dentistry, Ribeirão Preto School of Dentistry, University of São Paulo, Av. do Cafe s/n, Monte Alegre, Ribeirão Preto, São Paulo, CEP: 14040-904, Brazil.
| |
Collapse
|
4
|
Seron MA, Nunes GP, Ferrisse TM, Strazzi-Sahyon HB, Victorino FR, Dos Santos PH, Gomes-Filho JE, Cintra LTA, Sivieri-Araujo G. Postoperative pain after root canal filling with bioceramic sealers: a systematic review and meta-analysis of randomized clinical trials. Odontology 2023; 111:793-812. [PMID: 37378833 DOI: 10.1007/s10266-023-00830-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2023] [Accepted: 06/19/2023] [Indexed: 06/29/2023]
Abstract
The aim of this systematic review and meta-analysis (SRM) was to assess postoperative pain (PP) after endodontic treatment with bioceramic root canal sealer compared to AH Plus® sealer. This SRM was carried out in accordance with the items on the PRISMA 2020 checklist and Cochrane guidelines and registered in PROSPERO (CRD42021259283). Only randomized clinical trials (RCTs) were included. Meta-analysis was conducted using R software, the standardized means difference (SMD) measure of effect was calculated for quantitative variables, and the odds ratio (OR) for binary variables. The Cochrane tool (RoB 2.0) was used to assess the risk of bias, and the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) approach was used to assess the quality of evidence. Qualitative and quantitative analysis included 18 and 17 studies, respectively. For quantitative variables, the bioceramic root canal sealer presented less occurrence of postoperative pain than the AH Plus® sealer in 24 h (SMD - 0.17 [- 0.34; - 0.01], p = 0.0340). For binary variables, there was no difference observed between the sealers evaluated, except for sealer extrusion where the bioceramic group had lower post-filling material extrusion (OR 0.52 [0.32; 0.84], p = 0.007). Regarding the risk of bias analysis, low risk was observed for most domains, except allocation that was considered unclear, while the certainty of evidence ranged from moderate to low. The results showed that bioceramics sealers reduced postoperative endodontic pain only after 24 h and showed less sealer extrusion compared to the AH Plus® sealer. However, more robust and standardized clinical trials are needed to confirm the results with less heterogeneity and higher quality of evidence.
Collapse
Affiliation(s)
- Marcelo Augusto Seron
- School of Dentistry, Araçatuba, Department of Preventive and Restorative Dentistry, Araçatuba School of Dentistry, São Paulo State University - UNESP, Rua José Bonifácio 1193, Araçatuba, SP, 1193, Brazil
| | - Gabriel Pereira Nunes
- School of Dentistry, Araçatuba, Department of Preventive and Restorative Dentistry, Araçatuba School of Dentistry, São Paulo State University - UNESP, Rua José Bonifácio 1193, Araçatuba, SP, 1193, Brazil.
| | - Tulio Morandin Ferrisse
- Oral Medicine, Department of Diagnosis and Surgery, Araraquara School of Dentistry, São Paulo State University - UNESP, Araraquara, SP, Brazil
| | - Henrico Badaoui Strazzi-Sahyon
- Department of Dental Materials and Prosthodontics, Araçatuba School of Dentistry, São Paulo State University - UNESP, Araçatuba, SP, Brazil
| | | | - Paulo Henrique Dos Santos
- Department of Dental Materials and Prosthodontics, Araçatuba School of Dentistry, São Paulo State University - UNESP, Araçatuba, SP, Brazil
| | - João Eduardo Gomes-Filho
- School of Dentistry, Araçatuba, Department of Preventive and Restorative Dentistry, Araçatuba School of Dentistry, São Paulo State University - UNESP, Rua José Bonifácio 1193, Araçatuba, SP, 1193, Brazil
| | - Luciano Tavares Angelo Cintra
- School of Dentistry, Araçatuba, Department of Preventive and Restorative Dentistry, Araçatuba School of Dentistry, São Paulo State University - UNESP, Rua José Bonifácio 1193, Araçatuba, SP, 1193, Brazil
| | - Gustavo Sivieri-Araujo
- School of Dentistry, Araçatuba, Department of Preventive and Restorative Dentistry, Araçatuba School of Dentistry, São Paulo State University - UNESP, Rua José Bonifácio 1193, Araçatuba, SP, 1193, Brazil
| |
Collapse
|
5
|
Hu J, Zhu Y, Deng S, Wang Z, He F. Outcome of root canal treatment using warm vertical compaction with bioceramic and resin-based sealers: A randomised clinical trial. AUST ENDOD J 2023; 49 Suppl 1:170-178. [PMID: 36378149 DOI: 10.1111/aej.12713] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2022] [Revised: 10/24/2022] [Accepted: 10/29/2022] [Indexed: 11/16/2022]
Abstract
This study aimed to compare the effect of a bioceramic sealer (iRoot SP) and a resin-based sealer (AH Plus) on the outcome of root canal treatment in a 2-year follow-up. Seventy-six teeth with irreversibly or necrotic pulp were recruited. After instrumentation and disinfection, the root canals were obturated using warm vertical compaction with iRoot SP (n = 43) or AH Plus (n = 33). Patients were followed up by clinical and radiographic examination at 6 12 and 24 months with recall rates of 84.2%, 65.8% and 48.7%, respectively. During each recall session, the success rates were 80%, 85.2% and 85% in the iRoot SP group and 82.8%, 91.3% and 88.2% in the AH Plus group. The success rates of the two groups did not differ significantly (p > 0.05). The bioceramic sealer resulted in a similar clinical performance and success rate to the resin-based sealer in endodontic treatment during a 2-year follow-up.
Collapse
Affiliation(s)
- Jinghao Hu
- Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Zhejiang Provincial Clinical Research Center for Oral Diseases, Key Laboratory of Oral Biomedical Research of Zhejiang Province, Cancer Center of Zhejiang University, Hangzhou, China
| | - Yunjie Zhu
- Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Zhejiang Provincial Clinical Research Center for Oral Diseases, Key Laboratory of Oral Biomedical Research of Zhejiang Province, Cancer Center of Zhejiang University, Hangzhou, China
| | - Shuli Deng
- Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Zhejiang Provincial Clinical Research Center for Oral Diseases, Key Laboratory of Oral Biomedical Research of Zhejiang Province, Cancer Center of Zhejiang University, Hangzhou, China
| | - Zeji Wang
- Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Zhejiang Provincial Clinical Research Center for Oral Diseases, Key Laboratory of Oral Biomedical Research of Zhejiang Province, Cancer Center of Zhejiang University, Hangzhou, China
| | - Fuming He
- Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Zhejiang Provincial Clinical Research Center for Oral Diseases, Key Laboratory of Oral Biomedical Research of Zhejiang Province, Cancer Center of Zhejiang University, Hangzhou, China
| |
Collapse
|
6
|
Mahajan D, Manocha D, Patel P, Saraiya MB, Chaniyara K. A Systematic Review on Comparison of Periapical Healing and Post-Operative Pain between Bioceramic and Epoxy Resin Based Sealers. JOURNAL OF PHARMACY AND BIOALLIED SCIENCES 2023; 15:S862-S866. [PMID: 37693967 PMCID: PMC10485546 DOI: 10.4103/jpbs.jpbs_145_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2023] [Revised: 03/10/2023] [Accepted: 03/11/2023] [Indexed: 09/12/2023] Open
Abstract
To compare the incidence of postoperative discomfort and periapical healing in endodontically treated teeth following the use of resin-based or bioceramic sealers. In vivo, clinical trials were included in the study. The selection criteria, data extraction, and analysis were performed to evaluate the quality and publication bias of the selected studies. The primary outcome measure was the comparison of postoperative discomfort between the two sealer types. Seven studies were included in the systematic review, with a modest level of evidence found in the quality assessment. There are no significant differences in the postoperative discomfort levels between resin-based and bioceramic sealers. However, the overall quality of the clinical trials was moderate, highlighting the need for further well-designed clinical trials with appropriate measures of randomization, allocation concealment, and blinding to establish a definitive conclusion on the incidence of Postoperative discomfort associated with the use of these sealers.
Collapse
Affiliation(s)
- Deepali Mahajan
- Associate Endodontist at Singh Dental Care, Amritsar, Punjab, India
| | - Devansh Manocha
- Associate Dentist at Smile Design Orthodontic Clinic, Vadodara, Gujarat, India
| | - Priyesha Patel
- Associate Dentist at Shreeji Dental Clinic, Vadodara, Gujarat, India
| | - Maulik B. Saraiya
- Department of Prosthodontics, Manubhai Patel Dental College, Vadodara, Gujarat, India
| | - Keral Chaniyara
- Department of Oral Surgery, Manubhai Patel Dental College, Vadodara, Gujarat, India
| |
Collapse
|
7
|
Stanley E, Strother KK, Kirkpatrick T, Jeong JW. Calcium Silicate-based Sealer Extrusion into the Mandibular Canal: Three Different Recovery Outcomes: A Report of Three Cases. J Endod 2023:S0099-2399(23)00216-9. [PMID: 37098401 DOI: 10.1016/j.joen.2023.04.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2023] [Revised: 04/12/2023] [Accepted: 04/17/2023] [Indexed: 04/27/2023]
Abstract
The use of calcium silicate-based sealers (CSS) is increasing in dentistry as result of their favorable properties. The inadvertent extrusion of these sealers into the mandibular canal (MC) can result in temporary or permanent neurosensory alterations. Three different recovery outcomes of CSS extrusion into the MC after endodontic treatment of mandibular molars, confirmed by cone beam computed tomography (CBCT) imaging, are described. In Case 1, CSS from the mesiolingual canal of #31 was extruded into the MC during obturation. The patient reported paresthesia. The symptoms of paresthesia were completely resolved by nine months. In Case 2, CSS from the mesial canals of #30 was extruded into the MC during obturation. "Plasma-like spreading pattern" of the extruded sealer was observed on the radiographs. The patient reported paresthesia and dysesthesia. In addition, the patient complained of hyperalgesia with heat and mechanical allodynia. The symptoms continued to persist during follow up. At 22 months, the patient still reported persistent paresthesia, hyperalgesia and mechanical allodynia, affecting the ability to eat. In Case 3, CSS from the distal canal of #31 was extruded into the MC during obturation. The patient did not report any paresthesia or dysesthesia. All three patients elected a follow up approach and monitoring rather than surgical intervention. These cases illustrate the need for the development of guidelines for the management of iatrogenic CSS extrusion into the MC because such an occurrence may not necessarily result in permanent, temporary or no neurosensory alterations.
Collapse
Affiliation(s)
- Eva Stanley
- Department of Endodontics, The University of Texas Health Science Center at Houston School of Dentistry
| | - Kortnie K Strother
- Department of Endodontics, The University of Texas Health Science Center at Houston School of Dentistry
| | - Timothy Kirkpatrick
- Department of Endodontics, The University of Texas Health Science Center at Houston School of Dentistry
| | - Ji Wook Jeong
- Department of Endodontics, The University of Texas Health Science Center at Houston School of Dentistry.
| |
Collapse
|
8
|
Coşar M, Kandemir Demirci G, Çalışkan MK. The effect of two different root canal sealers on treatment outcome and post-obturation pain in single-visit root canal treatment: A prospective randomized clinical trial. Int Endod J 2023; 56:318-330. [PMID: 36385378 DOI: 10.1111/iej.13870] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2022] [Revised: 11/14/2022] [Accepted: 11/15/2022] [Indexed: 11/18/2022]
Abstract
AIM This randomized clinical trial aimed to evaluate and compare the effect of mineral trioxide aggregate (MTA)-based bioceramic- and resin-based sealers on the incidence and intensity of post-obturation pain and treatment outcome in asymptomatic vital molar teeth in single-visit root canal treatment. METHODOLOGY One hundred asymptomatic mandibular molar teeth with vital pulp were randomly assigned into two groups according to the sealer used: MTA Fillapex or AH Plus sealer. WaveOne Gold instruments were used for root canal preparations. Root canals were obturated with WaveOne Gold gutta-percha cones corresponding in size and taper to the last instrument used. MTA Fillapex was used in the first group and AH Plus was used in the second group as the root canal sealer. The effects of age, gender, tooth types and the level of root canal filling on the treatment outcome were evaluated after 1 and 2 years. Postoperative pain at 6, 12, 24, 48, 72 h, 4, 5, 6, 7 and 30 days after root canal treatment was measured with the Numerical Rating Scale. Chi-square test was used for the treatment outcome and Mann-Whitney U, chi-Square and Spearman correlation analyses were used for postoperative pain. α = .05 was the level of significance. RESULTS Twelve patients did not complete the 2-year follow-up and the study finished with 88 patients. In the MTA Fillapex group 41 correct, one short, two extruded, and in the AH Plus group 40 correct, one short and three extruded root canal fillings were detected. No significant differences were observed between the first- and second-year treatment outcomes between the groups (p > .05).There was no association between age, gender, tooth number, root canal filling length and the treatment success in all evaluated teeth (p > .05). The differences between the groups in terms of postoperative pain incidence and intensity at all time-points were not significant (p > .05). There was no correlation between the age and postoperative pain (p > .05), but pain was statistically higher in women (p < .05). CONCLUSIONS Mineral trioxide aggregate Fillapex showed similar success rate and post-obturation pain incidence and intensity as AH Plus sealer and can be used as a root canal sealer in asymptomatic mandibular molars with irreversible pulpitis.
Collapse
Affiliation(s)
- Melis Coşar
- Department of Endodontology, School of Dentistry, Ege University, Izmir, Turkey
| | | | | |
Collapse
|
9
|
Monteiro CMC, Martins ACR, Reis A, de Geus JL. Effect of endodontic sealer on postoperative pain: a network meta-analysis. Restor Dent Endod 2023; 48:e5. [PMID: 36875812 PMCID: PMC9982236 DOI: 10.5395/rde.2023.48.e5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2022] [Revised: 10/10/2022] [Accepted: 10/24/2022] [Indexed: 01/11/2023] Open
Abstract
This systematic review and network meta-analysis aimed to answer the following focused research question: "Does the type of endodontic sealer affect the postoperative pain in patients who received endodontic treatment?" Different databases and grey literature were surveyed. Only one randomized controlled trial were included. The risk of bias in the studies was evaluated by using the Cochrane Collaboration's tool. A random-effects meta-analysis was conducted to compare the risk and intensity of postoperative pain. The quality of the body of evidence was assessed using the Grading of Recommendations Assessment, Development, and Evaluation approach. Out of 11,601 studies, 15 remained for qualitative analyses and 12 for meta-analysis. Seven studies were classified at high risk of bias, and 8 studies raised some concerns. No significant differences between the endodontic materials were observed in the direct comparisons, both in risk and in intensity of postoperative pain (pairwise comparisons with 2 studies: I2 = 0%; p > 0.05 and 8 studies: I2 = 23%; p > 0.05, respectively). The certainty of the evidence was graded as low or moderate. There was no difference in the risk and intensity of postoperative pain after filling with different endodontic sealers. Further systematic reviews should be conducted. Trial Registration PROSPERO Identifier: CRD42020215314.
Collapse
Affiliation(s)
| | | | - Alessandra Reis
- Department of Restorative Dentistry, State University of Ponta Grossa, Ponta Grossa, PR, Brazil
| | - Juliana Larocca de Geus
- Department of Endodontics, Paulo Picanço School of Dentistry, Fortaleza, CE, Brazil.,Department of Restorative Dentistry, State University of Ponta Grossa, Ponta Grossa, PR, Brazil
| |
Collapse
|
10
|
Elafifi-Ebeid H, Betancourt P, Parada-Avendaño I, Arnabat-Domínguez J. Post-endodontic pain evaluation after different intracanal laser assisted disinfection techniques. A Systematic Review. J Clin Exp Dent 2023; 15:e149-e159. [PMID: 36911155 PMCID: PMC9994658 DOI: 10.4317/jced.59941] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2022] [Accepted: 09/05/2022] [Indexed: 01/16/2023] Open
Abstract
Background Post-endodontic pain (PEP) management is an important factor to be considered in endodontic treatment. Several risk factors have been described that can attribute to its appearance. Laser-assisted disinfection has been described by many authors for its antimicrobial effect. Few studies described the relation between laser disinfection and its effect on PEP. The objective of this review is to describe the relation between different intracanal laser disinfection techniques and their effects on PEP. Material and Methods An electronic search strategy was performed in Pubmed, Embase, and Web of Science (WOS) databases without restrictions as to the date of publication. Eligibility criteria were randomized controlled clinical trials (RCT) that used one of the different intracanal laser disinfection techniques in their experimental groups evaluating PEP outcome were included. Risk of bias analysis was performed by the Cochrane risk of bias tool. Results The initial research identified 245 articles from which 221 were excluded and 21 studies were sought for retrieval and 12 articles met our inclusion criteria for the final qualitative analysis. The laser systems used were Nd:YAG, Er:YAG and, diode lasers including photodynamic therapy. Conclusions The diode lasers showed the most promising results in terms of PEP reduction while Er:YAG showed more short-term efficacy (6 hours postoperative interval). The variables could not be analyzed homogenously due to the differences in the study designs. More RCT are needed comparing different laser disinfection techniques with the same baseline endodontic pathology to establish a specific protocol for the best outcome. Key words:Root canal treatment, Post-endodontic pain, Intracanal laser disinfection, laser dentistry.
Collapse
Affiliation(s)
- Haitham Elafifi-Ebeid
- Faculty of Medicine and Health Sciences, University of Barcelona, 08907 Barcelona, Spain
| | - Pablo Betancourt
- Research Centre for Dental Sciences (CICO), Department of Integral Adult Dentistry, Universidad de La Frontera, Temuco 4810296, Chile
| | - Isabel Parada-Avendaño
- Analysis and Design in Clinical Investigation, University of Barcelona, 08017 Barcelona, SpainAnalysis and Design in Clinical Investigation, University of Barcelona, 08017 Barcelona, Spain
| | - Josep Arnabat-Domínguez
- Faculty of Medicine and Health Sciences, University of Barcelona, 08907 Barcelona, Spain.,Idibell Institute, 08908 Barcelona, Spain
| |
Collapse
|
11
|
Severity of Post-Operative Pain after Instrumentation of Root Canals by XP-Endo and SAF Full Sequences Compared to Manual Instrumentation: A Randomized Clinical Trial. J Clin Med 2022; 11:jcm11237251. [PMID: 36498825 PMCID: PMC9740715 DOI: 10.3390/jcm11237251] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2022] [Revised: 11/27/2022] [Accepted: 12/03/2022] [Indexed: 12/12/2022] Open
Abstract
This investigation aimed to examine the post-operative pain experienced following single-visit root canal treatment using the XP-endo shaper sequence (XPS), full-sequence self-adjusting file (SAF), and manual K-files (HKF). A randomized equivalence parallel design, double-blinded clinical study was conducted on 120 patients with symptomatic irreversible pulpitis, with or without clinical signs of apical periodontitis. Only teeth with fully formed roots and no periapical lesions were incorporated in the study. Patients were apportioned to one of three groups (n = 40) randomly: Group 1-XPS, Group 2-SAF, and Group 3-HKF. Pre- and post-instrumentation pain was rated utilizing Visual Analog Scale (VAS) with a spectrum of 0-100 mm. The descriptive statistics and one-way ANOVA with 95% confidence intervals were used for statistical analysis. The mean VAS scores before instrumentation were consistent in all three groups. At 6, 24, 48, and 72 h, patients with root canals instrumented by SAF had the lowest post-instrumentation mean VAS score, followed by XPS. For all time intervals, the patients in the HKF group had the highest VAS score. The full-sequence SAF instrumentation resulted in less post-operative pain than the XP-endo plus protocol, while manual instrumentation with K-files resulted in the highest post-operative pain.
Collapse
|
12
|
Koçer A, Dönmez Özkan H, Turk T. Postoperative pain intensity and incidence following single visit root canal treatment with different obturation techniques: a randomized clinical trial. PeerJ 2022; 10:e13756. [PMID: 35915749 PMCID: PMC9338753 DOI: 10.7717/peerj.13756] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2022] [Accepted: 06/28/2022] [Indexed: 01/17/2023] Open
Abstract
Background There are few studies in the literature about the effect of obturation techniques on postoperative pain. Besides, GuttaFlow2 was used for the first time in this study regarding postoperative pain. This study aimed to compare the postoperative pain levels and incidence following single-visit root canal treatment with different canal filling techniques; cold lateral compaction (CLC), thermoplasticised solid-core carrier (GuttaCore) based filling and cold free-flow compaction (GuttaFlow2) technique. Methods The patients (n = 93) having single-rooted teeth with a single canal diagnosed with asymptomatic irreversible pulpitis or single-rooted vital teeth with a single canal requiring endodontic treatment because of prosthetic reasons were enrolled in this study. Patients were randomized into three groups (n = 31) according to the obturation technique. A single operator performed all the treatments in a single visit. Data on obturation levels, postoperative pain and analgesic intake frequency were recorded at postoperative 6, 12 and 24 h and daily afterward until the 7th day. Postoperative pain was measured by visual analogue scale (VAS). The date were statistically analyzed with chi-squared tests (for the analyses of the categorical data), the nonparametric Kruskal-Wallis test (for the comparisons of VAS score) and with the Friedman test (for the assessments of the changes in VAS scores over time). Results The GuttaCore group recorded the higher pain levels, except first 12 h, on the other hand, the GuttaFlow2 group recorded the lower pain levels at all time periods. Significant differences occurred among the groups during the first 4 days (p < 0.05), except at 12 h (p = 0.054). The patients in the CLC and GuttaFlow2 groups did not need to use the prescribed analgesic; however, one patient in the GuttaCore group used it once. Conclusions Postoperative pain levels following root canal therapy were affected by the obturation technique especially first 4 days following obturation.
Collapse
Affiliation(s)
- Aliye Koçer
- Department of Endodontics, Aydın Adnan Menderes University, Efeler, Aydın, Türkiye
| | - Hicran Dönmez Özkan
- Department of Endodontics, Aydın Adnan Menderes University, Efeler, Aydın, Türkiye
| | - Tugba Turk
- Department of Endodontics, Ege University, Bornova, İzmir, Türkiye
| |
Collapse
|
13
|
Pilot Evaluation of Sealer-Based Root Canal Obturation Using Epoxy-Resin-Based and Calcium-Silicate-Based Sealers: A Randomized Clinical Trial. MATERIALS 2022; 15:ma15155146. [PMID: 35897577 PMCID: PMC9332451 DOI: 10.3390/ma15155146] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/04/2022] [Revised: 07/22/2022] [Accepted: 07/22/2022] [Indexed: 02/04/2023]
Abstract
The purpose of this randomized controlled clinical trial was to assess the short-term clinical effectiveness of sealer-based root canal obturation using calcium-silicate-based sealer (CSBS) and epoxy-resin-based sealer (ERBS). A total of eighty patients (eighty teeth) were enrolled and seventy-two patients (seventy-two teeth) were randomly assigned into four different sealer groups: AH Plus (AH, Dentsply Sirona), ADseal (AD, Meta Biomed), CeraSeal (CS, Meta Biomed), or EndoSeal TCS (ES, Maruchi). At the first visit, root canal treatment was performed using ProTaper. Next, the NiTi file system and passive ultrasonic irritation was applied with 2.5% NaOCl. At the second visit, the teeth were obturated with a sealer-based obturation technique using the assigned sealer. The quality of filling obturation was evaluated with postoperative radiographs in terms of the presence of voids and sealer extrusion. The patients were recalled at 1-week, 1-month, and 3-month intervals, and pain levels were measured using visual analog scales (VAS), and clinical examination performed with percussion and palpation. Radiographs were also taken. The results were statistically compared by using the χ2 test or Fisher exact test. Among the 80 teeth included, 72 teeth received allocated intervention and 71 teeth were included in the analysis (98.6% recall). There was no significant difference among the sealers in void and sealer extrusion (p > 0.05). Postoperative pain was not indicated prominently regardless of the type of sealer. For a 3-month follow-up period, all cases were maintained successfully except for one case from AD. According to the findings, there was no significant difference between CSBS and ERBS in terms of postoperative pain or the healing process, and the variation in filling quality appears to be linked to the properties of each product.
Collapse
|
14
|
Clinical and Radiographic Outcome of Non-Surgical Endodontic Treatment Using Calcium Silicate-Based Versus Resin-Based Sealers-A Systematic Review and Meta-Analysis of Clinical Studies. J Funct Biomater 2022; 13:jfb13020038. [PMID: 35466220 PMCID: PMC9036224 DOI: 10.3390/jfb13020038] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2022] [Revised: 04/02/2022] [Accepted: 04/06/2022] [Indexed: 12/10/2022] Open
Abstract
The aim of this paper is to systematically analyse the effect of calcium silicate-based sealers in comparison to resin-based sealers on clinical and radiographic outcomes of non-surgical endodontic treatment in permanent teeth. Methods: The study was conducted according to the guidelines of the Cochrane Handbook for Systematic Reviews of Interventions and Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA) statement. The literature search was performed using PubMed/MEDLINE, Cochrane Central Register of Controlled Trials, Web of Science, DOAJ and OpenGrey with no language restrictions. Two reviewers critically assessed the studies for eligibility. Grading of Recommendations, Assessment, Development and Evaluations (GRADE) was carried out to assess the evidence. Meta-analysis of the pooled data with subgroups was carried out using the RevMan software (p < 0.05). Results: Results from the included studies showed that there were no significant differences between the groups in the 24 h post-obturation pain levels (mean difference (MD), −0.19, 95% CI = −0.43−0.06, p = 0.14, I2 = 0%), but at 48 h (MD, −0.35, 95% CI = −0.64−0.05, p = 0.02, I2 = 0%), a significant difference was observed in favour of calcium silicate sealers. Furthermore, there were no significant differences between the two sealers due to risk of onset or intensity of postoperative pain, need for analgesic and extrusion of the sealer. The heterogeneity assessed using Q test between the included studies was 97% (I2). Conclusions: Within the limitations of this review, the paper shows that calcium silicate-based sealers exhibited optimal performance with similar results to resin-based sealers in terms of average level of post-obturation pain, risk of onset and pain intensity at 24 and 48 h. The observations from the included studies are informative in the clinical evaluation of calcium silicate-based sealers and provide evidence for the conduction of well-designed, controlled randomised clinical trials for a period of at least four years in the future.
Collapse
|
15
|
Yehia M, Mohamed M, Ibrahim L, Moukarab D. Effect of Different Treatment Regimen and Types of Endodontic Sealers on Pain and Periapical Radiographic Changes. Open Access Maced J Med Sci 2021. [DOI: 10.3889/oamjms.2021.7219] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
INTRODUCTION: The study aims as a pilot study to evaluate the effect of different treatment regimen and different types of endodontic sealers on pain and periapical radiographic changes was studied.
MATERIALS AND METHODS: Forty patients in need of an endodontic root canal treatment on anterior teeth were selected and divided into two groups (20 patients each), according to the endodontic treatment protocol (single or multiple visits). Then, each group was subdivided into two subgroups according to sealer used 10 each (AH Plus Jet resin sealer, Total Fill Bioceramic Sealer). To record pain intensity of the patients at different intervals: 1, 2, 3, 7 days, a visual analog scale was used. Furthermore, patients were recalled after 1, 3, 6, 9 months to evaluate periapical radiographic changes.
RESULTS: Showed that as regard pain assessment both tested endodontic sealers, as well as single or multiple visits have no statistically significant difference between pain values of patients during all the observation period from immediately post-operative, after 4, 12, 24, 48, 72 h as well as after 7 days (p > 0.05). As regard lamina dura thickness, results showed that with both tested endodontic sealers as well as single or multiple visits, there was no statistically significant difference between lamina dura thickness of patients after 1 month, 3, 6 as well as after 9 months.
CONCLUSIONS: Neither number of visits of endodontic treatment nor type of sealer used for obturation affects post-operative pain and thickness of lamina dura.
Collapse
|
16
|
Persic Bukmir R, Paljevic E, Vidas J, Glazar I, Pezelj-Ribaric S, Brekalo Prso I. Is Coronal Restoration a Predictor of Posttreatment Apical Periodontitis? Eur J Dent 2021; 16:386-395. [PMID: 34753188 PMCID: PMC9339940 DOI: 10.1055/s-0041-1735909] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Objectives
To investigate the posttreatment apical periodontitis (AP) in endodontically treated teeth through a multivariate approach and to analyze the relative importance of quality and type of coronal restoration as predictors of periapical disease.
Materials and Methods
The present study sample was drawn within 2-year period from the 1,072 consecutive patients older than 18 years, first time attending the Dental Clinic of the Clinical Hospital Center Rijeka, Croatia. A total of 1,350 endodontically treated teeth were included in the study. For each tooth, the periapical status, root filling quality, intracanal post, separated file presence, marginal bone loss, and quality and type of coronal restoration were recorded.
Statistical Analysis
Chi-square tests were used to analyze the variations in the periapical status, quality of root canal filling, and quality of coronal restoration in different tooth types. The effect of explanatory variables on periapical status was explored using univariate and multivariate logistic regression models. The outcome variable was set as the presence versus absence of AP in the tooth.
Results
Multivariate logistic regression analysis revealed statistically significant associations and increased risk for AP presence in molars (odds ratio [OR] = 2.15;
p
< 0.001), teeth positioned in mandible (OR = 1.49;
p
= 0.007), teeth with short length of root filling (OR = 4.08;
p
< 0.001), overfilled teeth (OR = 2.99;
p
= 0.001), and teeth with inadequate density of root filling (OR = 4.14;
p
< 0.001). Considering variables related to coronal restoration, neither coronal restoration type nor quality was found to be predictive for posttreatment AP. Merely, the presence of intracanal post significantly increased the odds of AP presence (OR = 1.57;
p
= 0.009).
Conclusion
The results of the present study did not indicate that type or quality of coronal restoration may be predictors of posttreatment AP. Periapical disease was significantly associated with molars, mandibular teeth, substandard quality of root fillings, and intracanal post presence.
Collapse
Affiliation(s)
- Romana Persic Bukmir
- Department of Endodontics and Restorative Dentistry, Faculty of Dental Medicine, University of Rijeka, Rijeka, Croatia
| | - Ema Paljevic
- Department of Endodontics and Restorative Dentistry, Faculty of Dental Medicine, University of Rijeka, Rijeka, Croatia
| | - Jelena Vidas
- Department of Endodontics and Restorative Dentistry, Faculty of Dental Medicine, University of Rijeka, Rijeka, Croatia
| | - Irena Glazar
- Department of Oral Medicine and Periodontology, Faculty of Dental Medicine, University of Rijeka, Rijeka, Croatia
| | - Sonja Pezelj-Ribaric
- Department of Oral Medicine and Periodontology, Faculty of Dental Medicine, University of Rijeka, Rijeka, Croatia.,Department of Dental Medicine, Faculty of Dental Medicine and Health, Josip Juraj Strossmayer University of Osijek, Osijek, Croatia
| | - Ivana Brekalo Prso
- Department of Endodontics and Restorative Dentistry, Faculty of Dental Medicine, University of Rijeka, Rijeka, Croatia.,Department of Dental Medicine, Faculty of Dental Medicine and Health, Josip Juraj Strossmayer University of Osijek, Osijek, Croatia
| |
Collapse
|
17
|
Mekhdieva E, Del Fabbro M, Alovisi M, Comba A, Scotti N, Tumedei M, Carossa M, Berutti E, Pasqualini D. Postoperative Pain following Root Canal Filling with Bioceramic vs. Traditional Filling Techniques: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. J Clin Med 2021; 10:4509. [PMID: 34640531 PMCID: PMC8509229 DOI: 10.3390/jcm10194509] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2021] [Revised: 09/26/2021] [Accepted: 09/27/2021] [Indexed: 12/31/2022] Open
Abstract
This meta-analysis aimed to evaluate postoperative pain (POP) following root canal filling (RCF) with gutta-percha/bioceramic sealer (BCS) vs. gutta-percha/traditional sealer (TS) techniques. Electronic databases were searched for randomized trials. Subgroup analyses were performed for analgesic intake, flare-ups, postoperative time (24/48 h), pulp status, and retreatment. The search yielded 682 records, and nine studies were selected. BCS was associated with significantly lower POP vs. TS at 24 h (P = 0.04) and 48 h (P = 0.0005). In addition, non-significant trends favoring BCS for analgesic intake at 24 h (P = 0.14), flare-ups (P = 0.24) and obturation techniques at 24 h (P = 0.41) and 48 h (P = 0.33), non-significant trends for lower POP with TS vs. BCS 24 h and 48 h in vital teeth (P = 0.50, P = 0.18, respectively), and for lower POP with BCS vs. TS in non-vital teeth at 24 h and 48 h (P = 0.16, P = 0.84, respectively). POP was numerically lower with TS vs. BCS at 24 h (P = 0.65) and 48 h after retreatment (P = 0.59). Moreover, POP did not vary between fillers when the treatment was over single (P = 0.28) or multiple visits (P = 0.50). BCS was associated with significantly lower short-term POP, and with a trend for lower analgesic intake and flare-up incidence, as compared to TS.
Collapse
Affiliation(s)
- Elina Mekhdieva
- Endodontics and Restorative Dentistry, CIR Dental School, Department of Surgical Sciences, University of Turin, 10126 Turin, Italy; (E.M.); (M.A.); (A.C.); (N.S.); (M.C.); (E.B.)
| | - Massimo Del Fabbro
- Department of Biomedical, Surgical and Dental Sciences, University of Milan, 20122 Milan, Italy; (M.D.F.); (M.T.)
- IRCCS Orthopedic Institute Galeazzi, 20161 Milan, Italy
| | - Mario Alovisi
- Endodontics and Restorative Dentistry, CIR Dental School, Department of Surgical Sciences, University of Turin, 10126 Turin, Italy; (E.M.); (M.A.); (A.C.); (N.S.); (M.C.); (E.B.)
| | - Allegra Comba
- Endodontics and Restorative Dentistry, CIR Dental School, Department of Surgical Sciences, University of Turin, 10126 Turin, Italy; (E.M.); (M.A.); (A.C.); (N.S.); (M.C.); (E.B.)
| | - Nicola Scotti
- Endodontics and Restorative Dentistry, CIR Dental School, Department of Surgical Sciences, University of Turin, 10126 Turin, Italy; (E.M.); (M.A.); (A.C.); (N.S.); (M.C.); (E.B.)
| | - Margherita Tumedei
- Department of Biomedical, Surgical and Dental Sciences, University of Milan, 20122 Milan, Italy; (M.D.F.); (M.T.)
- Department of Medical, Oral and Biotechnological Sciences, University “G. d′Annunzio” of Chieti-Pescara, 65122 Chieti, Italy
| | - Massimo Carossa
- Endodontics and Restorative Dentistry, CIR Dental School, Department of Surgical Sciences, University of Turin, 10126 Turin, Italy; (E.M.); (M.A.); (A.C.); (N.S.); (M.C.); (E.B.)
| | - Elio Berutti
- Endodontics and Restorative Dentistry, CIR Dental School, Department of Surgical Sciences, University of Turin, 10126 Turin, Italy; (E.M.); (M.A.); (A.C.); (N.S.); (M.C.); (E.B.)
| | - Damiano Pasqualini
- Endodontics and Restorative Dentistry, CIR Dental School, Department of Surgical Sciences, University of Turin, 10126 Turin, Italy; (E.M.); (M.A.); (A.C.); (N.S.); (M.C.); (E.B.)
| |
Collapse
|
18
|
Kandemir Demirci G, Miçooğulları Kurt S, Serefoglu B, Kaval ME, Çalışkan MK. The influence of different NiTi instrumentation techniques on postoperative pain after single-visit root canal treatment. AUST ENDOD J 2021; 47:559-568. [PMID: 34278665 DOI: 10.1111/aej.12547] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2021] [Revised: 05/27/2021] [Accepted: 07/04/2021] [Indexed: 11/30/2022]
Abstract
This study aimed to evaluate the effect of multi-file rotary (Protaper Universal) and reciprocating single-file (Reciproc Blue) root canal preparation techniques on the occurrence of postoperative pain in asymptomatic mandibular molar teeth with large periapical lesions in single-visit root canal treatment (RCT). A hundred and twenty teeth were randomly assigned to two groups: Protaper Universal (PTU) or Reciproc Blue (RB) instruments. Postoperative pain at 6, 12, 24, 48, 72 h and 7 days after obturation was measured. Mann-Whitney U-test was performed to compare the pain scores between the groups and to assess the relation of pain with patients' age and gender. Spearman's rank correlation was utilized to correlate the pain intensity and analgesic intake at different time points. There was no significant difference between the instrumentation techniques regarding postoperative pain at any time points evaluated (P > 0.05). There was a correlation between analgesic intake and intensity of pain (P < 0.05). No statistically significant difference was found among the groups assessed in the study in terms of analgesic intake (P > 0.05).
Collapse
Affiliation(s)
| | | | - Burcu Serefoglu
- Department of Endodontology, School of Dentistry, Ege University, Izmir, Turkey
| | - Mehmet E Kaval
- Department of Endodontology, School of Dentistry, Ege University, Izmir, Turkey
| | - Mehmet K Çalışkan
- Department of Endodontology, School of Dentistry, Ege University, Izmir, Turkey
| |
Collapse
|
19
|
de Freitas Portela FSM, De Martin AS, Pelegrine RA, Gutmann JL, Kato AS, Bueno CEDS. Effect of Foraminal Enlargement on Postoperative Pain in Necrotic Single-Rooted Teeth: A Randomized Clinical Trial. J Endod 2021; 47:1046-1051. [DOI: 10.1016/j.joen.2021.04.008] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2021] [Revised: 04/06/2021] [Accepted: 04/07/2021] [Indexed: 10/21/2022]
|
20
|
Sponchiado Junior EC, Vieira WDA, Normando AGC, Pereira JV, Ferraz CCR, Almeida JFA, Marciano MA, Gomes BP, de-Jesus-Soares A. Calcium Silicate-Based Sealers Do Not Reduce the Risk and Intensity of Postoperative Pain after Root Canal Treatment when Compared with Epoxy Resin-Based Sealers: A Systematic Review and Meta-Analysis. Eur J Dent 2021; 15:347-359. [PMID: 33759149 PMCID: PMC8184314 DOI: 10.1055/s-0041-1724157] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
This review aims to evaluate whether root canal obturation with calcium silicate-based (CSB) sealers reduces the risk and intensity of endodontic postoperative pain when compared to epoxy resin-based (ERB) sealers. The review was registered at PROSPERO (CRD42020169255). Two independent reviewers conducted an electronic search in PubMed, Scopus, EMBASE, Web of Science, Cochrane Library and LILACS until November 2020 and included only randomized clinical trials with adult health participants undergoing root canal treatment. After selection, the JBI Critical Appraisal tool was used to assess the risk of bias. A fixed-effect meta-analysis was performed to summarize the results of pain risk and pain intensity at time intervals of 24 and 48 hours. Finally, the certainty of evidence was assessed using the GRADE approach. The search resulted in 1,206 records, of which five studies (n = 421 patients) met the eligibility criteria and presented moderate to low risk of bias. There was no significant difference between groups in the risk of pain in the first 24 hours (relative risk or RR = 0.83, 95% confidence interval or CI: 0.60, 1.16, I 2 =) or 48 hours (RR = 0.56, 95% CI: 0.26, 1.21, I 2 =). Silicate-based sealers led to lower pain intensity only at 48 hours (mean and standard deviation = 0.37, 95% CI: 0.69, 0.05). All analyses revealed low heterogeneity (I 2 < 25%). The evidence presented moderate level of certainty. Currently available evidence has shown that there is no difference between CSB and ERB sealers in the risk or intensity of postoperative pain.
Collapse
Affiliation(s)
- Emílio Carlos Sponchiado Junior
- Department of Restorative Dentistry, Division of Endodontics, Piracicaba Dental School, State University of Campinas, Piracicaba, São Paulo, Brazil
- Division of Endodontics, Dental School, Federal University of Amazonas, Manaus, Amazonas, Brazil
| | - Walbert de Andrade Vieira
- Department of Restorative Dentistry, Division of Endodontics, Piracicaba Dental School, State University of Campinas, Piracicaba, São Paulo, Brazil
| | - Ana Gabriela Costa Normando
- Department of Restorative Dentistry, Division of Endodontics, Piracicaba Dental School, State University of Campinas, Piracicaba, São Paulo, Brazil
| | - Juliana Vianna Pereira
- Department of Restorative Dentistry, Division of Endodontics, Piracicaba Dental School, State University of Campinas, Piracicaba, São Paulo, Brazil
- Division of Endodontics, Dental School, Federal University of Amazonas, Manaus, Amazonas, Brazil
| | - Caio Cezar Randi Ferraz
- Department of Restorative Dentistry, Division of Endodontics, Piracicaba Dental School, State University of Campinas, Piracicaba, São Paulo, Brazil
| | - José Flávio A. Almeida
- Department of Restorative Dentistry, Division of Endodontics, Piracicaba Dental School, State University of Campinas, Piracicaba, São Paulo, Brazil
| | - Marina Angélica Marciano
- Department of Restorative Dentistry, Division of Endodontics, Piracicaba Dental School, State University of Campinas, Piracicaba, São Paulo, Brazil
| | - Brenda P.F.A. Gomes
- Department of Restorative Dentistry, Division of Endodontics, Piracicaba Dental School, State University of Campinas, Piracicaba, São Paulo, Brazil
| | - Adriana de-Jesus-Soares
- Department of Restorative Dentistry, Division of Endodontics, Piracicaba Dental School, State University of Campinas, Piracicaba, São Paulo, Brazil
| |
Collapse
|
21
|
Drumond JPS, Maeda W, Nascimento WM, Campos DDL, Prado MC, de-Jesus-Soares A, Frozoni M. Comparison of Postobturation Pain Experience after Apical Extrusion of Calcium Silicate– and Resin–Based Root Canal Sealers. J Endod 2021; 47:1278-1284. [DOI: 10.1016/j.joen.2021.05.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2021] [Revised: 04/30/2021] [Accepted: 05/21/2021] [Indexed: 12/16/2022]
|
22
|
Jamali S, Darvish M, Nasrabadi N, Jafarizadeh S. Evaluation of the Effect of the Intensity and Occurrence of Postoperative Pain of Resin-Based and Bioceramic Root Canal Sealers: A Systematic Review and Meta-Analysis of Randomized Controlled Trial Studies. PESQUISA BRASILEIRA EM ODONTOPEDIATRIA E CLÍNICA INTEGRADA 2021. [DOI: 10.1590/pboci.2021.082] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
|
23
|
Ferreira NDS, Gollo EKF, Boscato N, Arias A, Silva EJNLD. Postoperative pain after root canal filling with different endodontic sealers: a randomized clinical trial. Braz Oral Res 2020; 34:e069. [PMID: 32696911 DOI: 10.1590/1807-3107bor-2020.vol34.0069] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2019] [Accepted: 04/20/2020] [Indexed: 11/22/2022] Open
Abstract
The aim of this randomized clinical trial was to compare the occurrence and intensity of postoperative pain and analgesic intake after root canal treatment, using different root canal sealers. Sixty single-rooted teeth diagnosed with asymptomatic necrosis and apical periodontitis were randomly assigned to 3 experimental groups (n=20), according to the root canal sealer: AH Plus, Endofill or MTA Fillapex. Endodontic treatment was performed in two sessions, and calcium hydroxide was used as the intracanal dressing. Patients were instructed to record pain intensity as none, slight, moderate and severe. Scores from 1 to 4 were attributed to each level of pain after 24 h, 48 h and 7 days. The need for analgesic intake was also recorded. Differences in the incidence of postoperative pain and the need for an analgesic were analyzed using the chi-square test. Differences in pain intensity after treatment were analyzed using the ordinal (linear) chi-square test. No significant differences were detected among the groups in terms of either incidence or intensity of postoperative pain, or need for analgesic intake, at any timepoint (p>0.05). No pain was reported after 7 days. AH Plus, Endofill and MTA Fillapex used for filling root canals resulted in the same rate of postoperative pain and need for analgesic medication.
Collapse
Affiliation(s)
- Nadia de Souza Ferreira
- Department of Semiology and Clinics, School of Dentistry, Universidade Federal de Pelotas, Pelotas, RS, Brazil
| | | | - Noeli Boscato
- Department of Restorative Dentsitry, School of Dentistry, Universidade Federal de Pelotas, Pelotas, RS, Brazil
| | - Ana Arias
- Conservative Dentistry Department, School of Dentistry, Universidad Complutense de Madrid, Madrid, Spain
| | | |
Collapse
|
24
|
Tanomaru-Filho M, Torres FFE, Pinto JC, Santos-Junior AO, Tavares KIMC, Guerreiro-Tanomaru JM. Micro-computed tomographic evaluation of a new system for root canal filling using calcium silicate-based root canal sealers. Restor Dent Endod 2020; 45:e34. [PMID: 32839715 PMCID: PMC7431941 DOI: 10.5395/rde.2020.45.e34] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2020] [Revised: 03/29/2020] [Accepted: 04/13/2020] [Indexed: 12/20/2022] Open
Abstract
Objectives This study evaluated by using micro-computed tomography (micro-CT) the filling ability and sealer apical extrusion promoted by a new Sealer Injection System (SIS; Angelus) with side openings needle, in comparison with the conventional injection system, associated with a new ready-to-use calcium silicate-based sealer (Bio-C Sealer). Materials and Methods Acrylic resin models containing a main curved artificial canal and 3 simulated lateral canals in apical, middle and cervical thirds were used. The main root canals were prepared using a rotary system up to size 35.05. The canals were filled with Bio-C sealer by using a single cone technique and the conventional delivery system or SIS. Samples were scanned in micro-CT. The percentage of voids throughout the entire extension of the main root canal and in each third of the lateral canals, besides the apical extrusion of the sealer was calculated. Data were submitted to t-test (p < 0.05). Results There was no difference between both systems in the main root canals filling. Although the volume percentage of voids was similar in the apical and middle thirds of lateral canals, SIS had the greatest filling ability of the cervical third lateral canal. Moreover, the conventional system showed the highest apical extrusion of the sealer. Conclusions The conventional and SIS obturation systems had an appropriate filling ability of the main root canal. SIS had the best filling of the cervical third of the lateral canals, besides lower sealer apical extrusion, suggesting its clinical indication.
Collapse
Affiliation(s)
- Mario Tanomaru-Filho
- Department of Restorative Dentistry, São Paulo State University (UNESP), School of Dentistry, Araraquara, SP, Brazil
| | | | - Jader Camilo Pinto
- Department of Restorative Dentistry, São Paulo State University (UNESP), School of Dentistry, Araraquara, SP, Brazil
| | - Airton Oliveira Santos-Junior
- Department of Restorative Dentistry, São Paulo State University (UNESP), School of Dentistry, Araraquara, SP, Brazil
| | | | | |
Collapse
|