Postoperative Pain After Root Canal Treatment Using Different Root Canal Sealers

Postoperative pain following root canal treatment remains one of the most importantfactors affecting patient comfort and perceived treatment success in endodontics. Theoccurrence and intensity of postoperative pain may be influenced by several factors,including instrumentation techniques, irrigation protocols, extrusion of debris orfilling materials into periapical tissues, and the physicochemical properties of rootcanal sealers. Bioceramic sealers have gained increasing popularity because of theirbioactivity, biocompatibility, antibacterial properties, and potential to enhanceperiapical healing. However, limited clinical evidence is available regarding theirinfluence on postoperative pain when compared with conventional epoxy resin‐basedsealers.This prospective randomized clinical trial is designed to evaluate and comparepostoperative pain levels after root canal treatment performed using three different rootcanal sealers: AH Plus, ProRoot Bio Sealer, and BC Sealer ion+. The study will includeadult patients diagnosed with asymptomatic irreversible pulpitis in mandibular first orsecond molars requiring primary root canal treatment. All clinical procedures will beperformed in a standardized manner by a single experienced clinician to minimizeoperator‐related variability.Root canal preparation will be completed using the ProTaper Universal rotaryinstrumentation system under standardized irrigation and disinfection protocols. Canalirrigation will include sodium hypochlorite, EDTA, chlorhexidine, and sonic activationprocedures. Obturation will be carried out using a modified single‐cone technique withgutta‐percha cones corresponding to the final preparation size and the allocated rootcanal sealer. Randomization will be performed using computer‐generated allocation, andallocation concealment will be ensured with sealed opaque envelopes. The study willfollow a single‐blind design in which participants and outcome assessors remain unawareof group assignment.AH Plus is an epoxy resin‐based sealer widely used because of its dimensional stability,sealing ability, and long‐term clinical performance. ProRoot Bio Sealer is a calciumsilicate‐based bioceramic sealer with enhanced bioactive cement content and a flexibledelivery system designed to improve handling and material placement. BC Sealer ion+ is anAkermanite‐based premixed bioceramic sealer capable of releasing both calcium andmagnesium ions, which may contribute to improved tissue healing, stem celldifferentiation, and prolonged bioactivity. Structural differences between conventionalcalcium silicate materials and Akermanite‐based formulations may influence ion releasekinetics and tissue responses, potentially affecting postoperative symptoms.Postoperative pain intensity will be recorded using the Numeric Rating Scale (NRS) atpredetermined postoperative intervals. Analgesic intake and flare‐up incidence will alsobe monitored throughout the follow‐up period. Statistical analysis will be performedusing appropriate parametric or non‐parametric tests according to data distribution, withstatistical significance established at P < 0.05. The findings of this study maycontribute to a better understanding of the clinical performance of contemporarybioceramic sealers and their potential influence on postoperative pain management inendodontic treatment.