BIOCERAMIC SEALANTS AND POSTOPERATIVE ENDODONTIC PAIN

Abstract: Introduction: Post-endodontic symptomatology is characterized by acute, localized pain associated with inflammatory processes of the periapical tissues, which can occur independently of the diagnosis that causes the pathology. Bioceramic endodontic sealants exhibit great fluidity and often extend beyond the foramen into periradicular tissues. Their excellent biocompatibility and bioactivity with the apical microenvironment promote tissue regeneration without compromising the prognosis. Objectives: To evaluate the presence or absence of over-obturation using bioceramic sealants and to compare postoperative pain at 24 and 48 hours. Materials and Methods: A prospective study was conducted. A total of 540 patients over 18 years of age underwent treatment on 604 root canals, including teeth with pulp or periodontal symptomatology and closed apices. All canals were filled with bioceramic sealants. At the end, patients recorded their perception of postoperative pain at 24 and 48 hours in three contexts: spontaneous pain, interocclusal contact, and palpation of the tooth, using a visual analog scale numbered from 0 to 10 (0=no pain; 10=maximum pain) according to Dugashvili et al. 2017. Categorical variables were described using absolute frequencies and percentages. Data were analyzed using Mann-Whitney U-tests or Wilcoxon Signed-Ranks tests, as appropriate (p<0.05). Results: Spontaneous pain was recorded as follows: at 24 hours = 0; 1.1±1.8; at 48 hours = 0; 0.5±1.2. Pain during interocclusal contact was recorded as follows: at 24 hours = 0; 1.2±1.9, and at 48 hours = 0; 0.5±1.2. There were no significant differences between cases with and without over-obturation. As for pain on palpation, it was recorded as follows: at 24 hours = 0; 1.1±1.9, and at 48 hours = 0; 0.5±1.3. Pain was significantly higher in the presence of over-obturation (U=24828; p<0.05). If we consider all three variables studied at 48 hours both at a global level and in the presence or absence of over-obturation, there was a statistically significant decrease in pain (p<0.05). Conclusion: Over-obturation with bioceramic sealants may be associated with an increase in postoperative pain compared to cases without over-obturation. Further studies are needed to describe the interaction of the bioceramic sealant with periapical tissues.