Evaluation of Postoperative Pain in Response to Polydimethylsiloxane and Calcium Silicate-Based Endodontic Sealers Using the Visual Analog Scale (VAS)

Abstract

BACKGROUND The main purpose of obturation is to achieve a complete three-dimensional sealing of the pulp space to create a tight seal and prevent bacterial movement and its toxins to the periapical tissues. Different approaches and sealants have been developed due to the root canal system's intricacy for ensuring tight adherence. The root canal sealants need to establish a bond between the material and root dentine in order to prevent leakage. Even though the biocompatibility and sealing abilities of the materials are prioritized in modern endodontics, some sealers incorporate therapeutic or antibacterial drugs like corticosteroids or calcium hydroxide. An endodontic sealer's cytotoxicity and antibacterial capabilities must be perfectly balanced. Due to the limited evidence in endodontic literature regarding the relationship between postoperative pain and the sealers that are used in this study, we conducted the research to explore the same. AIM This study aimed to evaluate and compare pain in responses to polydimethylsiloxane and calcium silicate-based endodontic sealers (CS-BG). METHODOLOGY The participants were divided into two groups, Nanoseal (Nanoseal-S™; Prevest, DenPro, USA) and Bioceramic (CeraSeal™; Mera Biomed Co., Cheongju, Korea) with 20 patients in each group. After caries excavation and access opening, the biomechanical preparations were performed in each tooth. To avoid over-instrumentation, the working length was verified after each instrument use. The standard irrigation protocol was performed. Sealers were mixed according to the manufacturer's instructions followed by obturation. The patients were asked to take medicines only if they had pain. The pain was evaluated using the visual analog scale (VAS) postoperatively at 24 hours, 48 hours, and a week after the root canal obturation. RESULTS Pain perception using Nanoseal-S™ and CeraSeal™ materials were compared at 24 hrs, 72 hrs, and seven days. Nanoseal showed statistically significant repletion at 24 hrs and seven days. CONCLUSION The decreased irritation character of CS-BG for the periapical tissues explains the lesser percentage of pain during and pain immediately after root canal obturation observed in this investigation, which proves CS-BG is highly biocompatible with periapical tissue and further reduces patient anxiety during root canal obturation.