Comparative Evaluation of Bio-C Temp and Calcium Hydroxide as Intracanal Medicaments in Managing Postoperative Pain...

Objectives: This prospective observational study aimed to compare the efficacy of a novel bioceramic intracanal medicament (Bio-C Temp) with a conventional calcium hydroxide-based medicament (UltraCal XS) in reducing postoperative spontaneous pain and percussion sensitivity in patients with symptomatic irreversible pulpitis (SIP) with apical periodontitis (AP). Methods: Thirty-seven systemically healthy patients diagnosed with SIP with AP were included. The selected teeth were vital, single-rooted, single-canal maxillary or mandibular teeth presenting with prolonged moderate to severe pain in response to cold testing (Visual Analog Scale [VAS] ≥ 50 mm), moderate to severe percussion pain (VAS ≥ 50 mm), and a periapical index (PAI) score ≤ 2. Patients were randomly allocated to receive either Bio-C Temp (n = 19) or UltraCal XS (n = 18) as the intracanal medicament. Postoperative pain, percussion sensitivity, and analgesic consumption were recorded at 6, 12, and 24 h, and 3, 5, and 7 days. Data were analyzed using R statistical software (version 4.5.0). Statistical significance was set at p < 0.05. Results: Both groups demonstrated a significant reduction in postoperative pain and percussion sensitivity compared with preoperative levels (p < 0.05). By the end of the 7th day, the UltraCal XS group showed significantly lower spontaneous pain (p < 0.001) and percussion sensitivity (p < 0.001) than the Bio-C Temp group. Complete spontaneous pain relief was reported in 65% of the UltraCal XS group and 31% of the Bio-C Temp. However, no patient in either group achieved complete resolution of percussion sensitivity. Conclusions: UltraCal XS provided superior short-term postoperative pain relief and greater reduction in percussion sensitivity compared with the bioseramic medicament. Neither medicament fully resolved percussion sensitivity within 7 days.