Department of Restorative Dentistry, Division of Endodontics, São Leopoldo Mandic Dental School, Campinas, São Paulo, Brazil.
Department of Restorative Dentistry, Endodontics Division, Piracicaba Dental School, State University of Campinas, Piracicaba, São Paulo, Brazil.
J Endod. 2021 Aug;47(8):1278-1284. doi: 10.1016/j.joen.2021.05.008. Epub 2021 May 29.
This study compared the intensity of postobturation pain after unintentional apical extrusion of calcium silicate-based root canal sealers (EndoSequence BC Sealer [Brasseler USA, Savannah, GA] and Bio-C Sealer [Angelus, Londrina, PR, Brazil]) with a resin-based sealer (AH Plus; Dentsply Sirona, York, PA).
A total of 330 patients referred for root canal treatment on molar teeth with asymptomatic irreversible pulpitis were recruited. Root canals were prepared using WaveOne Gold instruments (Dentsply Sirona) in a crown-down technique and irrigated with 2% chlorhexidine gel and saline solution. Next, patients were randomly distributed into 3 groups according to the root canal sealer used (n = 110): AH Plus, BC Sealer, and Bio-C Sealer. Root canal filling was then accomplished with a vertical compaction technique. Patients presenting with an unintentional extrusion of sealers (n = 13/group) were assessed for postobturation pain experience using a visual descriptor scale ranging from 0-10 at 6-, 12-, 24-, and 48-hour and 1-week intervals after treatment. Mixed analysis of variance repeated measures were used to assess the results (α = 0.05).
The extrusion rate was similar for all sealers (~12%). There was no significant difference in the postobturation pain results between the root canal sealers evaluated (P > .05). However, after the time interval of 12 hours, AH Plus (P = .04073) and Bio-C Sealer (P = .04327) demonstrated a significant reduction in pain, whereas BC Sealer did not show differences in pain intensity, even in the maximum period evaluated of 1 week (P > .05).
The occurrence of unintentional apical extrusion of calcium silicate-based root canal sealers presents similar postoperative pain results compared with resin-based sealers with low-intensity pain.
本研究比较了意外超充钙硅基根管封闭剂（EndoSequence BC 封闭剂[Brasseler USA，萨凡纳，GA]和 Bio-C 封闭剂[Angelus，隆德里纳，PR，巴西]）与树脂基封闭剂（AH Plus；登士柏西诺德，约克，PA）后根管治疗后的疼痛强度。
共招募了 330 名因不可逆性牙髓炎而接受磨牙根管治疗的患者。根管采用 WaveOne Gold 器械（登士柏西诺德）进行冠向下预备，并使用 2%洗必泰凝胶和生理盐水冲洗。然后，根据使用的根管封闭剂（n=110）将患者随机分为 3 组：AH Plus、BC 封闭剂和 Bio-C 封闭剂。然后采用垂直压实技术进行根管充填。在治疗后 6、12、24 和 48 小时以及 1 周时，对出现意外超充封闭剂的患者（每组 13 例）进行视觉描述量表评估，疼痛程度从 0 到 10 分。采用重复测量混合方差分析评估结果（α=0.05）。
所有封闭剂的超充率相似（约 12%）。评估的根管封闭剂之间的根管治疗后疼痛结果无显著差异（P>.05）。然而，在 12 小时的时间间隔后，AH Plus（P=0.04073）和 Bio-C 封闭剂（P=0.04327）的疼痛显著减轻，而 BC 封闭剂的疼痛强度在 1 周的最大评估时间内没有差异（P>.05）。
与低强度疼痛的树脂基封闭剂相比，意外超充钙硅基根管封闭剂的发生会导致类似的术后疼痛结果。
