Effect of different sealers on post operative pain and peri apical healing in apical periodontitis cases: An in-vivo study

Apical periodontitis is characterized by localized inflammation of periapical tissues resulting from pulp disease, with potential causes including the progression of dental caries, trauma, or operative dental procedures.

Postoperative pain is a significant clinical outcome influenced by various treatment-related factors. These include maintaining the working length to the apical constriction, the duration and technique of endodontic treatment (whether completed in a single or multiple visits), and the type of endodontic sealer used for obturation.

Periapical healing involves the intricate interplay between osteoclasts and osteoblasts, resulting in the structural and functional replacement of bone. This process is influenced by both intrinsic and extrinsic mechanisms of the host. A local factor affecting the healing of periapical tissues is the root canal sealer, which can interfere with the process by leaching through the apical foramen and lateral canals.

The study will be done to evaluate and compare the effect of Bioceramic, Resin based and MTA based sealers on post operative pain and peri apical healing. The forthcoming clinical study will be carried out within the Department of Conservative Dentistry and Endodontics at I.T.S. Dental College, Hospital, and Research Centre in Greater Noida,Uttar Pradesh.  A total number of 30 patients will be selected from the O.P.D of Department of Conservative Dentistry and Endodontics according to inclusion and exclusion criteria. Inclusion criteria: single rooted tooth, Patient with asymptomatic/symptomatic apical periodontitis with periapical radiolucency more than 2mm, Age 18-60 years. Exclusion criteria: Multi rooted tooth, Re RCT cases,Patients on Immunosuppresive drugs/systemic diseases, Inability to reach full working length/ calcified canals, Tooth with draining sinus, Multi rooted tooth,Re RCT cases,Patients on Immunosuppresive drugs/systemic diseases, Inability to reach full working length/ calcified canals, Tooth with draining sinus. The selected patients will be further divided into 3 groups: Group 1: AH plus(Dentsply), Group 2: Bio C(Angelus), Group 3: MTA Plus(Prevest). After biomechanical preparation, the canals will be dried using sterile paper points according to corresponding taper and freshly mixed calcium hydroxide paste will be placed into the prepared canals using a lentulospiral. The patients will be recalled after a week and patients who will be asymptomatic exhibiting a VAS Score of 0, will be obturated. Assessment postoperative pain will be done at an interval of 24 hrs, 48 hrs, 72 hrs,7 days, at rest and while biting, using the VAS scale. The number of analgesic pills that had been taken by the patient at each follow-up period, and will be recorded on patient’s chart. Assessment of peri apical healing will be done at an interval of 1 month, 3 months and 6 months, with help of intra oral radiograph.