Change in serum biomarker levels in patients of apical periodontitis after root canal treatment using two different root canal sealers: A randomized controlled trial

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Aim: The aim of the study was to comparatively evaluate the difference in serum pro-inflammatory (soluble cluster of differentiation-14 [sCD14]) and anti-inflammatory (interleukin-10 [IL-10]) biomarkers levels when 2 different root canal sealers are used during root canal treatment (RCT) in systemically healthy patients with apical periodontitis. Methods: The study was a parallel double-blind randomized clinical trial; 54 carious mature permanent teeth with apical periodontitis were randomized using a block randomization technique to either Group 1 (Tubli-seal) ( n = 27) or Group 2 (BioRoot RCS) ( n = 27). Participants received root canal treatment (RCT) and were followed up at 15 days and 2 months. Venous blood samples were obtained, and serum pro-inflammatory, sCD14, and anti-inflammatory, IL-10 biomarkers were assessed by ELISA, and Periapical healing was evaluated by periapical index (PAI). Intragroup and intergroup analysis was done using the Friedman and Mann–Whitney U -test, respectively. Results: In Group 1, pro-inflammatory biomarker (sCD-14) demonstrated statistically significant results ( P = 0.008). Regarding anti-inflammatory biomarker (IL-10), neither of the groups displayed statistically significant changes ( P > 0.05). An analysis of the PAI scores revealed statistically significant improvements from preoperative to postoperative levels for both groups ( P = 0.00). Conclusion: RCT reduces serum pro-inflammatory biomarker levels and no significant changes in levels of anti-inflammatory biomarkers in patients of apical periodontitis.