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Assessment of pain and dissolution of apically extruded sealers and their effect on the periradicular tissues
Govind Shashirekha1, Amit Jena1, Satabdi Pattanaik2
1Department of Conservative Dentistry and Endodontics, Institute of Dental Sciences, Siksha 'O' Anusandhan Deemed to be University, Bhubaneswar, Odisha, India.
Aim:
This study aimed to evaluate the intensity of pain after unintentional extrusion of resin-based and calcium hydroxide (Ca[OH]2)-based endodontic sealers as well as their influence on the periradicular tissues.
Materials And Methods:
A total of 120 single-rooted teeth exhibiting extrusion of sealer in the postoperative radiographs were included in the study. According to the sealers used, the teeth were divided into four groups (n = 30): Group I - AH Plus®, Group II - Resino Seal, Group III - Sealapex™, and Group IV - Apexit® Plus. Postoperative pain was assessed at 0-6 h, 6-12 h, 12-24 h, and 24-48 h of obturation using Visual Analog Scale. Radiographs were taken at 3, 6, and ≥9 months to 1-year follow-up and compared with baseline radiographs to assess the dissolution of extruded sealers and healing of periradicular tissues.
Statistical Analysis:
ANOVA, Kruskal-Wallis, and Pearson's Chi-square test were used. Statistical significance level was set at P ≤ 0.05.
Results:
Postoperative pain intensity was higher in case of AH Plus® sealer followed by Sealapex™ up to 12 h of obturation and was statistically nonsignificant. Apexit® Plus at all time intervals showed statistically significant less pain intensity than AH Plus® and Sealapex™ but not from Resino Seal group. At 9-month follow-up, better healing of periradicular tissues was shown by AH Plus® (48.1%) followed by Apexit® Plus (44.4%) and Sealapex™ (41.2%) with statistically nonsignificant difference.
Conclusion:
In case of periapical extrusion, both resin-based and Ca(OH)2-based sealers caused postoperative pain. Both Ca(OH)2- and resin-based sealers did not influence the treatment outcome.
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