Postoperative pain is a common complication after endodontic treatment and may be influenced by obturation techniques and sealer properties. Calcium silicate-based sealers have gained attention for their bioactive properties; however, their clinical performance with respect to postoperative pain and healing outcomes remains uncertain. This randomized, double-blind clinical trial aimed to compare postoperative pain and healing outcomes following root canal obturation with a calcium silicate-based sealer (CSBS) versus an epoxy resin-based sealer (ERBS). Seventy-two adult patients requiring endodontic treatment were randomly assigned to two groups based on the sealer used for obturation: Bio-C Sealer (CSBS) or AH Plus Jet (ERBS). Root canal preparation was performed using a reciprocating system, and obturation was carried out using the thermocompaction technique. Postoperative pain was assessed using a numerical rating scale (0–10) at 6, 12, 24, 48, and 72 hours after treatment. Rescue medication use was recorded. Radiographic healing was evaluated after 12 months using the Periapical Index (PAI). No significant differences were observed between groups in postoperative pain occurrence at any evaluated time point (p > 0.05). The risk of postoperative pain was 4.5 times higher when extrusion of filling material occurred (RR = 4.55; 95% CI: 1.25–16.62). Younger participants showed a higher risk of postoperative pain within the first 24 hours (RR = 3.20; 95% CI: 1.33–7.74). Rescue medication use decreased over time, with no differences between groups. At the 12-month follow-up, 53 participants were evaluated, and similar healing outcomes were observed (Bio-C Sealer: 1.04 ± 0.21; AH Plus Jet: 1.04 ± 0.19; p > 0.05). Both sealers showed similar postoperative pain and healing outcomes. Filling material extrusion was the main factor associated with increased postoperative pain. This study was registered with the Brazilian Clinical Trials Registry (ReBEC) (RBR-8s5cbfk) on 2022-03-08.
Oliveira et al. (Thu,) studied this question.