Non-Cochrane · intervention · PM41659194
Evidence synthesis of postoperative pain with bioceramic vs. epoxy resin sealers: umbrella review of randomized trials within existing systematic reviews.
Dahikar Mrunali, Mandwe Ashish, Banga Kulvinder Singh, et al. · Frontiers in dental medicine · 2025 · PubMed · doi:10.3389/fdmed.2025.1749298
Findings
Population Adults undergoing primary single-visit non-surgical root canal treatment
10 findings
| Bioceramic (calcium silicate-based) root canal sealer | Epoxy resin-based root canal sealer (e.g., AH Plus) | Postoperative pain intensity at 6 h 6 h · Clinical (dental practice or hospital) | SMD -0.12 [-0.38, 0.14] Low Studies not reported |
| Bioceramic (calcium silicate-based) root canal sealer | Epoxy resin-based root canal sealer (e.g., AH Plus) | Postoperative pain intensity at 24 h 24 h · Clinical (dental practice or hospital) | SMD -0.15 [-0.29, -0.01] Moderate Studies not reported |
| Bioceramic (calcium silicate-based) root canal sealer | Epoxy resin-based root canal sealer (e.g., AH Plus) | Postoperative pain intensity at 48 h 48 h · Clinical (dental practice or hospital) | SMD -0.29 [-0.42, -0.16] Moderate 4 studies |
| Bioceramic (calcium silicate-based) root canal sealer | Epoxy resin-based root canal sealer (e.g., AH Plus) | Postoperative pain intensity at 72 h or 7 days 72 h or 7 days · Clinical (dental practice or hospital) | SMD -0.03 [-0.16, 0.10] Moderate Studies not reported |
| Bioceramic (calcium silicate-based) root canal sealer | Epoxy resin-based root canal sealer (e.g., AH Plus) | Postoperative pain intensity at 48 h 48 h · Clinical (dental practice or hospital) | SMD -0.29 [-0.51, -0.08] Moderate Studies not reported |
| Bioceramic (calcium silicate-based) root canal sealer | Epoxy resin-based root canal sealer (e.g., AH Plus) | Postoperative pain intensity at 24 h 24 h · Clinical (dental practice or hospital) | SMD -0.15 [-0.28, -0.03] Moderate 5 studies |
| Bioceramic (calcium silicate-based) root canal sealer | Epoxy resin-based root canal sealer (e.g., AH Plus) | Analgesic consumption 24 h · Clinical (dental practice or hospital) | RR 0.91 [0.78, 1.06] Low Studies not reported |
| Bioceramic (calcium silicate-based) root canal sealer | Epoxy resin-based root canal sealer (e.g., AH Plus) | Analgesic use and flare-up incidence (combined) Clinical (dental practice or hospital) Unresolved: the two extractors disagree on this row. | RR 0.92 [0.76, 1.12] Low Studies not reported |
| Bioceramic (calcium silicate-based) root canal sealer | Epoxy resin-based root canal sealer (e.g., AH Plus) | Flare-up incidence Clinical (dental practice or hospital) | RR 0.97 [0.74, 1.26] Low Studies not reported |
| Bioceramic (calcium silicate-based) root canal sealer | Epoxy resin-based root canal sealer (e.g., AH Plus) | Analgesic use and flare-up incidence (combined) all reported time points (Figure 6) · Clinical (dental practice or hospital) | RR 0.93 [0.82, 1.04] Low 6 studies |
Included primary studies 10
Open in Studies| Study | Year | Also included by | Outcomes it informs here | Trial data |
|---|---|---|---|---|
| Graunaite 2018 Effect of Resin-based and Bioceramic Root Canal Sealers on Postoperative Pain: A Split-mouth Randomized Controlled Trial. PMID:29571915 | 2018 | 1 other review | Postoperative pain intensity at 24 h; Analgesic use and flare-up incidence (combined) | not extracted yet |
| Ates 2019 matched by author and year (probable) | NR | this review only | Postoperative pain intensity at 24 h; Postoperative pain intensity at 48 h; Analgesic use and flare-up incidence (combined) | not extracted yet |
| Eren 2022 Do resin-based root canal sealers cause more postoperative pain than other sealers? A systematic review of clinical studies and… PMID:35380208 | 2022 | this review only | not stated | not extracted yet |
| Fonseca 2019 Assessment of Extrusion and Postoperative Pain of a Bioceramic and Resin-Based Root Canal Sealer. PMID:31794999 | 2019 | this review only | Postoperative pain intensity at 24 h; Postoperative pain intensity at 48 h; Analgesic use and flare-up incidence (combined) | not extracted yet |
| Jamali 2021 Evaluation of the Effect of the Intensity and Occurrence of Postoperative Pain of Resin-Based and Bioceramic Root Canal Sealers: A… DOI:10.1590/pboci.2021.082 | 2021 | this review only | not stated | not extracted yet |
| Mekhdieva 2021 Postoperative Pain following Root Canal Filling with Bioceramic vs. Traditional Filling Techniques: A Systematic Review and Meta-Analysis… PMID:34640531 | 2021 | this review only | not stated | not extracted yet |
| Monteiro 2023 Effect of endodontic sealer on postoperative pain: a network meta-analysis. PMID:36875812 | 2023 | this review only | not stated | not extracted yet |
| Sowmya 2021 Postoperative Pain Associated With Resin And Bioceramic Based Sealers: A Systematic Review DOI:10.19070/2377-8075-21000739 | 2021 | this review only | not stated | not extracted yet |
| Sponchiado Junior 2021 Calcium Silicate-Based Sealers Do Not Reduce the Risk and Intensity of Postoperative Pain after Root Canal Treatment when Compared with… PMID:33759149 | 2021 | this review only | not stated | not extracted yet |
| Supare 2024 Effect of bioceramic-based and resin-based sealers on postoperative discomfort following root canal therapy: a systematic review and… PMID:39494306 | 2024 | this review only | not stated | not extracted yet |
Overlap with other reviews
Reviews that include the same primary studies are not independent evidence. Shared counts match studies by PMID, DOI or NCT, and otherwise by author and year (a probable match). Only the non-Cochrane dental reviews have study lists, so overlap with Cochrane reviews is not counted yet.
| Review | Shared studies | Jaccard |
|---|---|---|
| Efficacy of Bioceramic Cements Versus Conventional Cements in the Prognosis of Endodontic Treatments in Patients with Apical… (2026) | 1 | 0.03 |
Review question
| Element | Planned (methods) | Found (results) |
|---|---|---|
| Population | Patients undergoing primary, single-visit non-surgical root canal treatment of permanent teeth (adults per eligibility text; irrespective of age, sex or pulp status per Table 1) | Adults undergoing non-surgical root canal treatment (7 reviews; 63 unique RCTs) |
| Intervention | Root canal obturation with bioceramic (hydraulic calcium silicate-based) sealers | Bioceramic sealers (EndoSequence BC, iRoot SP, Endoseal MTA, TotalFill) |
| Comparison | Epoxy resin-based sealers (e.g., AH Plus) | Resin-based sealers (primarily AH Plus) |
| Outcomes | Postoperative pain intensity at 24 h and 48 h (primary); pain beyond 48 h, analgesic consumption, flare-up incidence (secondary) | Pain intensity 24 h (5 RCTs) and 48 h (4 RCTs); pain at 6 h and 72 h or 7 days; analgesic use; flare-up |
| Study designs | Systematic reviews and meta-analyses of RCTs, quasi-RCTs or controlled clinical trials | 7 systematic reviews (5 with meta-analysis, 1 narrative only) |
| Timing | 24 h, 48 h, beyond 48 h | 6 h, 24 h, 48 h, 72 h or 7 days |