Root canal sealers are essential for the success of endodontic treatment. Their physical
properties, biocompatibility, and interactions with peri-apical tissues directly affect
postoperative pain and healing. Endodontic sealers activate trigeminal nociceptors,
leading to the release of CGRP (calcitonin gene-related peptide), which causes pain and a
neurogenic inflammatory response. Resin-based sealers are widely used in endodontics due
to their superior physicochemical properties. However, they have limitations, including
the need for a completely dry canal due to their marked hydrophobicity and their initial
cytotoxic activity, which cannot be entirely controlled.
Bio-ceramic sealers represent a new generation of endodontic sealers that are favored by
many dental professionals due to their small particle size (less than 2 micrometers),
non-toxicity, high tissue compatibility, high hydrophilicity, and minimal dimensional
changes. Retrospective studies have shown varying outcomes related to postoperative pain
after root canal treatment using resin-based or bio-ceramic sealers.
Aim: This study aims to compare the occurrence and intensity of postoperative pain and
analgesic intake after root canal treatment using two different types of root canal
sealers.
Methods/Design: This study is a binary outcome randomized trial, following the
Consolidated Standards of Reporting Trials (CONSORT) guidelines for randomized trials of
non-pharmacologic treatment. The study sample will consist of adult patients with a
permanent single-rooted tooth diagnosed with asymptomatic apical periodontitis.
Participants will be randomly allocated to be treated in the Endodontic clinic of PHCC
Qatar with either resin-based sealers (control group) or bio-ceramic sealers
(experimental group) to compare postoperative pain after root canal treatment.
Patients will be observed for occurrence of pain or any other complications at 24 hours,
48 hours, and 7 days post-treatment. Postoperative pain will be assessed using a visual
analog scale (VAS) at 24 hours, 48 hours, and one week post-treatment.
Differences in the incidence of postoperative pain and the need for an analgesic will be
analyzed using the chi-square test. Differences in pain intensity after treatment will be
analyzed using the ordinal (linear) chi-square test.