Postoperative Pain in Cold and Warm Endo-techniques Using Bioceramic Sealer

Objectives: Several factors are related to the perception of postoperative pain that makes clinical studies on pain intensity even more difficult. Although mild discomfort is usually expected after endodontic treatment, the incidence of postoperative pain is estimated in range of 3%-58%. Both the type of the sealer applied and the mode of compaction (cold or warm) of gutta-percha may provoke post-endo pain.
The aim of this study was to evaluate and compare the intensity of postoperative pain after cold and warm root canal obturation applying bioceramic sealer.

Methods: This study was conducted on 30 premolars in 30 patients (38,5 mean age), randomly assigned in two experimental groups applying the same cleaning and shaping procedures , and a bioceramic sealer, but different root canal filling technique using standardized gutta-percha cones (cold technique group) and ThermaFil obturators (warm technique group). The level of postoperative pain was measured by a visual analogue scale (VAS) in 24, 48 and 72 hours. The collected data were grouped into 4 categories (no pain, mild pain, moderate pain and severe pain) and analyzed statisticaly by ANOVA (p<0.05).

Results: In cold and warm experimental groups no pain was reported in 6% and 0% of cases, mild pain was measured in 44% and 47%, moderate pain was observed in 31% and 33% and severe pain was reported in 19% and 20% of evaluations respectively. Statistically significant difference in postoperative pain was found between variables on 24 and 48 hour, as well as between 24 and 72 hour in both experimental groups (p<0.05).

Conclusions: In this study more intensive postoperative pain was reported after warm gutta-percha obturation, as expected, due to the rise of temperature. However, the majority of evaluated patients experienced mild and moderate pain.