Root Canal Filling Materials and Postoperative Pain Management

A recent randomized trial published in the BMC Oral Health unveiled promising results regarding root canal filling materials in the management of postoperative pain. The study was conducted on 119 patients by comparing the postoperative pain levels between two commonly used materials—gutta-percha (GP) and sealer versus mineral trioxide aggregate (MTA). Researchers found that Mineral Trioxide Aggregate as root canal filling material tied to less postoperative pain compared to gutta-percha (GP) and sealer.

Postoperative pain has been a challenge for clinicians, which prompts a rigorous exploration of effective interventions. This trial focused on patients aged 18-65 years with single-canal premolars diagnosed with asymptomatic apical periodontitis to address a critical gap in pain management techniques.

This two-arm, parallel-group, single-blind trial employed permuted block randomization to group participants into two cohorts:

• In the GP group (N = 46), root canals were filled with gutta-percha and AH Plus sealer.
• In the MTA group (N = 48), MTA was used for apical filling and a combination of gutta-percha and sealer coronally.

Pain levels were assessed at specific intervals (6, 12, 24, 48, and 72 hours postoperatively) using a 10-point visual analog scale (VAS).

Over time, this study revealed a significant decrease in mean VAS scores in both groups (P < 0.001). However, the MTA group exhibited notably lower VAS scores compared to the GP group, signifying a superior pain management profile (P < 0.05). An intriguing finding emerged regarding gender differences, with female patients reporting higher VAS scores at specific intervals (6- and 12-hour periods) in both groups (P < 0.05).

The study suggests that MTA as a root canal filling material holds significant outcomes for clinicians in reducing postoperative pain. The superior pain management observed in the MTA group positions it as a valuable option by potentially transforming the landscape of root canal procedures.

Reference

Khabiri, M., Kamgar, S., Iranmanesh, P., Khademi, A., & Torabinejad, M. (2023). Postoperative pain of single-visit endodontic treatment with gutta-percha versus MTA filling: a randomized superiority trial. In BMC Oral Health (Vol. 23, Issue 1). Springer Science and Business Media LLC. https://doi.org/10.1186/s12903-023-03372-6