Postoperative Pain of Single-visit Endodontic Treatment with Gutta-percha Versus MTA Filling: a Randomized Superiority Trial

Overview

Journal BMC Oral Health

Publisher Biomed Central

Specialty Dentistry

Date 2023 Dec 20

PMID 38114967

Authors

Masoud Khabiri

Sahel Kamgar

Pedram Iranmanesh

Abbasali Khademi

Mahmoud Torabinejad

Affiliations

Soon will be listed here.

Abstract

Background: Postoperative pain has remained a challenge for clinicians. This randomized superiority trial compared the levels of postoperative pain following the use of gutta-percha (GP) and sealer or mineral trioxide aggregate (MTA) as root canal filling materials in teeth with asymptomatic apical periodontitis.

Methods: A total of 119 patients were initially evaluated in this two-arm, parallel-group, single-blind, superiority randomized trial. The inclusion criteria were participants aged 18-65 years with single-canal premolars diagnosed with asymptomatic apical periodontitis. The participants were finally divided into two groups using the permuted block randomization method. In the GP group (N = 46), the cleaned and shaped root canals were filled with gutta-percha and AH Plus sealer, while in the MTA group (N = 48), the cleaned and shaped root canals were filled with an MTA apical filling and a coronal gutta-percha and sealer. Patient pain level was measured 6, 12, 24, 48, and 72 h postoperatively using a 10-point visual analog scale (VAS). The data were analyzed by the chi-square, independent t, Friedman, and Mann-Whitney U tests.

Results: The mean of VAS scores decreased significantly over time in both groups (P < 0.001). The mean VAS scores were significantly lower in the MTA filling group than in the other group (P < 0.05). Female patients reported higher VAS scores at 6- and 12-hour periods in both groups (P < 0.05).

Conclusion: MTA as a root canal filling material might be a valuable option for clinicians due to its low postoperative pain.

Trial Registration: The trial protocol was registered at the Registry of Clinical Trials (IRCT20191104045331N1).

Citing Articles

Low-level laser treatment's ability to reduce dry socket pain.

Minervini G, Franco R, Martelli M, Hafedh S, Marrapodi M, Di Blasio M Acta Odontol Scand. 2024; 83:631-641.

PMID: 39530606 PMC: 11633036. DOI: 10.2340/aos.v83.42261.

References

Xavier M, Costa A, Caramelo F, Palma P, Ramos J . Evaluation of the Interfaces between Restorative and Regenerative Biomaterials Used in Vital Pulp Therapy. Materials (Basel). 2021; 14(17). PMC: 8434275. DOI: 10.3390/ma14175055. View

Kaur A, Shah N, Logani A, Mishra N . Biotoxicity of commonly used root canal sealers: A meta-analysis. J Conserv Dent. 2015; 18(2):83-8. PMC: 4379664. DOI: 10.4103/0972-0707.153054. View

Staffoli S, Plotino G, Nunez Torrijos B, Grande N, Bossu M, Gambarini G . Regenerative Endodontic Procedures Using Contemporary Endodontic Materials. Materials (Basel). 2019; 12(6). PMC: 6471897. DOI: 10.3390/ma12060908. View

Paul M, Mazumdar D, Vyavahare N, Baranwal A . Healing of the periapical lesion in posterior teeth with mineral trioxide aggregate using orthograde technique - Two case reports. Contemp Clin Dent. 2012; 3(Suppl 2):S264-8. PMC: 3514935. DOI: 10.4103/0976-237X.101111. View

Nagendrababu V, Gutmann J . Factors associated with postobturation pain following single-visit nonsurgical root canal treatment:  A systematic review. Quintessence Int. 2016; 48(3):193-208. DOI: 10.3290/j.qi.a36894. View

Mehrvarzfar P, Abbott P, Saghiri M, Delvarani A, Asgar K, Lotfi M . Effects of three oral analgesics on postoperative pain following root canal preparation: a controlled clinical trial. Int Endod J. 2011; 45(1):76-82. DOI: 10.1111/j.1365-2591.2011.01950.x. View

Zhang W, Peng B . Tissue reactions after subcutaneous and intraosseous implantation of iRoot SP, MTA and AH Plus. Dent Mater J. 2015; 34(6):774-80. DOI: 10.4012/dmj.2014-271. View

Ruparel N, Teixeira F, Ferraz C, Diogenes A . Direct effect of intracanal medicaments on survival of stem cells of the apical papilla. J Endod. 2012; 38(10):1372-5. DOI: 10.1016/j.joen.2012.06.018. View

Nagendrababu V, Pulikkotil S, Jinatongthai P, Veettil S, Teerawattanapong N, Gutmann J . Efficacy and Safety of Oral Premedication on Pain after Nonsurgical Root Canal Treatment: A Systematic Review and Network Meta-analysis of Randomized Controlled Trials. J Endod. 2019; 45(4):364-371. DOI: 10.1016/j.joen.2018.10.016. View

10.

Thakur S, Emil J, Paulaian B . Evaluation of mineral trioxide aggregate as root canal sealer: A clinical study. J Conserv Dent. 2013; 16(6):494-8. PMC: 3842714. DOI: 10.4103/0972-0707.120944. View

11.

Palma P, Marques J, Antunes M, Falacho R, Sequeira D, Roseiro L . Effect of restorative timing on shear bond strength of composite resin/calcium silicate-based cements adhesive interfaces. Clin Oral Investig. 2020; 25(5):3131-3139. DOI: 10.1007/s00784-020-03640-7. View

12.

Prati C, Gandolfi M . Calcium silicate bioactive cements: Biological perspectives and clinical applications. Dent Mater. 2015; 31(4):351-70. DOI: 10.1016/j.dental.2015.01.004. View

13.

Guven Y, Tuna E, Dincol M, Aktoren O . X-ray diffraction analysis of MTA-Plus, MTA-Angelus and DiaRoot BioAggregate. Eur J Dent. 2014; 8(2):211-215. PMC: 4054052. DOI: 10.4103/2278-344X.130603. View

14.

Reyes-Carmona J, Santos A, Figueiredo C, Felippe M, Felippe W, Cordeiro M . In vivo host interactions with mineral trioxide aggregate and calcium hydroxide: inflammatory molecular signaling assessment. J Endod. 2011; 37(9):1225-35. DOI: 10.1016/j.joen.2011.05.031. View

15.

Terauchi Y, Torabinejad M, Wong K, Bogen G . The Effect of Mineral Trioxide Aggregate Obturation Levels on the Outcome of Endodontic Retreatment: An Observational Study. J Endod. 2023; 49(6):664-674. DOI: 10.1016/j.joen.2023.04.004. View

16.

EHRMANN E, Messer H, Adams G . The relationship of intracanal medicaments to postoperative pain in endodontics. Int Endod J. 2003; 36(12):868-75. DOI: 10.1111/j.1365-2591.2003.00735.x. View

17.

Abbasipour F, Bakhtiar H, Vatanpour M, Khalilkhani H, Torabzadeh H, Janahmadi M . A comparative study on anti-hyperalgesia effect of MTA and Ketoprofen in inflammatory pain. Iran Endod J. 2013; 4(3):81-6. PMC: 3758864. View

18.

Dawood A, Parashos P, Wong R, Reynolds E, Manton D . Calcium silicate-based cements: composition, properties, and clinical applications. J Investig Clin Dent. 2015; 8(2). DOI: 10.1111/jicd.12195. View

19.

Abbasipour F, Akheshteh V, Rastqar A, Khalilkhani H, Asgary S, Janahmadi M . Comparing the effects of mineral trioxide aggregate and calcium enriched mixture on neuronal cells using an electrophysiological approach. Iran Endod J. 2012; 7(2):79-87. PMC: 3467133. View

20.

Jespersen J, Hellstein J, Williamson A, Johnson W, Qian F . Evaluation of dental pulp sensibility tests in a clinical setting. J Endod. 2014; 40(3):351-4. DOI: 10.1016/j.joen.2013.11.009. View