The Effects of Calcium Silicate- and Calcium Hydroxide-based Root Canal Sealers on Postoperative Pain: A Randomized Clinical Trial.

INTRODUCTION: This study aimed to compare the postoperative pain level changes resulting from using calcium silicate- (EndoSeal MTA) and calcium hydroxide-based (Sealapex) root canal sealers in mandibular first and second molar teeth with symptomatic apical periodontitis. METHODS: A total of 60 patients with symptomatic apical periodontitis in their lower molar teeth were randomly allocated into 2 groups according to sealer type (n = 30). Demographic data, including gender, age, and smoking habit, and preoperative pain measures were recorded. Root canal treatments were performed in a single visit. Postoperative pain measurements and analgesic intake were measured at 6, 12, 24, and 48 hours and after 3, 5, and 7 days using the visual analog scale. The data were statistically analyzed using a chi-squared test (to compare gender, age, smoking habit, analgesic intake, and sealer extrusion), the Mann-Whitney U test (to compare pain levels), Friedman tests (for the evaluations of the reduction in pain levels over time), and Spearman's correlation test (to analyze the relationships of age, gender, smoking habit factors with postoperative pain) (P = .05). RESULTS: The statistical analysis showed no significant differences between the groups in postoperative pain and analgesic intake at any of the time intervals evaluated (P > .05). CONCLUSIONS: Patients treated with calcium silicate- and calcium hydroxide-based root canal sealers experienced similar postoperative pain and no statistically significant differences were observed in analgesic intake.

The efficiency of different irrigation activation techniques in the removal of calcium silicate-based endodontic sealer from artificially created groove.

This study evaluated the removal of a calcium silicate-based sealer (EndoSeal MTA) with needle irrigation (NI), passive ultrasonic irrigation (PUI), XP-endo Finisher (XPF) and EDDY. A total of 56 human mandibular premolars were instrumented up to size 40.04 taper. The roots were separated longitudinally, and grooves were prepared with an ultrasonic tip at one-half of each root canal. The grooves were covered with EndoSeal MTA and re-attached roots were investigated based on the activation techniques applied. The results showed that significantly more material (p < 0.05) was removed in the EDDY group compared to the NI, PUI and XPF groups in the apical region. In the coronal region, no significant difference was observed between EDDY, XPF and PUI (p > 0.05), whereas all the latter were significantly more effective than NI (p < 0.05). These findings show that the removal of EndoSeal MTA can be more effective with EDDY compared to XPF, PUI and NI in the apical region.