Comparative evaluation of postoperative pain and healing following root canal obturation with calcium silicate and bioactive glass-based sealers to epoxy resin-based sealers: A systematic review and meta-analysis

Abstract

Aim: To compare the postoperative pain and healing following obturation with calcium silicate and bioactive glass-based sealers to epoxy resin sealers. Materials and Methods: A systematic search (2018-2024) was conducted using PubMed, Cochrane, and Google Scholar, following the Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines (PRISMA). Risk of bias (RoB) was assessed using Cochrane RoB 2 tool and quality was evaluated using GRADE. Twenty-three studies were included for qualitative analysis and 11 for quantitative analysis, including meta-analysis for bioactive glass and epoxy resin-based sealers. Results: Meta-analysis revealed no significant difference in pain occurrence between groups at 24 h, 48 h, and 7 days. Similarly, for bioactive glass sealer, no significant difference in pain occurrence was observed at 24 h, 48 h, and 7 days. Conclusion: Calcium-silicate-based sealers showed comparable and satisfactory results to epoxy resin sealers regarding postoperative pain incidence and intensity. In addition, they facilitated improved healing of periapical tissues. Notably, bioactive glass-based sealer also demonstrated exceptional properties, offering enhanced benefits.