Effect of Continuous Wave of Condensation on Postoperative Pain Using Bioceramic Versus Resin Sealers: a Randomized Clinical Trial

A total of 72 participants who presented to the Department of Endodontics, Faculty of Dentistry, Dicle University, with the need for root canal treatment and met the predefined inclusion and exclusion criteria were included in this study. Root canal treatment was performed on single-rooted, single-canaled teeth. Prior to treatment, all participants were informed about the study and provided written informed consent. Following the administration of local anesthesia (2% lidocaine with 1:80,000 epinephrine), the tooth was isolated using a rubber dam, caries and existing restorations were removed with high-speed diamond burs under water cooling, and an access cavity was prepared. Pulp vitality was confirmed by observing bleeding from the canal orifice.

Working length was determined using a #15 K-file in conjunction with the integrated apex locator of the EndoRadar Pro motor and was radiographically confirmed at 0.5 mm short of the radiographic apex. Root canals were prepared using the T-Endo MUST (Dentac, Istanbul, Türkiye) reciprocating file system driven by the EndoRadar Pro motor. According to the initial apical diameter, canals were enlarged to sizes m25 (25/0.06), m40 (40/0.04), or m50 (50/0.04). A new file was used for each patient. Irrigation was performed using a 30-gauge side-vented closed-end irrigation needle positioned 2 mm short of the working length. During instrumentation, 2 mL of 2.5% sodium hypochlorite (NaOCl) was used after each file change, resulting in a total volume of approximately 20 mL per tooth. The final irrigation protocol consisted of 5 mL of 17% EDTA, 5 mL of 2.5% NaOCl, and 10 mL of distilled water. During final irrigation, both EDTA and NaOCl were activated using a sonic irrigation device with a polymer tip tip (Scope; Gtech Dizayn Dental, Yozgat, Türkiye) for a total of 1 minute, delivered in three 20-second activation cycles. The canals were subsequently dried with paper points. Patients were then randomly allocated into three groups according to the root canal sealer used (n = 24).

Group 1: AH Plus (Dentsply DeTrey, Konstanz, Germany); Group 2: TotalFill BC Sealer (FKG Dentaire SA, La Chaux-de-Fonds, Switzerland); Group 3: Bio-C Sealer (Angelus, Londrina, Paraná, Brazil).

AH Plus was mixed according to the manufacturer's instructions and applied to the canal walls using the master gutta-percha cone. TotalFill BC Sealer and Bio-C Sealer were applied in their premixed forms by injection into the coronal third of the canal. Subsequently, all canals were obturated using the continuous wave of condensation technique (CWCT). All treatments, including post-endodontic restorations, were completed during the same visit. Patients were provided with a Visual Analog Scale (VAS) form and were instructed to record their pain intensity on a scale ranging from 0 to 10 at 6, 24, 48, and 72 hours, and 7 days after treatment. Analgesic intake was also recorded on the VAS form. Patients were recalled on the seventh day, and the completed VAS forms were collected. All data were entered into an Excel spreadsheet and analyzed.

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