Influence of Obturation Technique on Postoperative Pain and Healing Outcomes

Abstract

Obturation is an important part of root canal treatment, which is concerned with securing a three-dimensional seal to avoid reinfection and facilitate periapical healing. The effect of obturation technique on the postoperative pain and the long-term healing effects have been a long-standing issue because depending on the technique used may influence not only the comfort of the patients in the short-term but also the outcome of the treatment in the long-term. Although cold lateral condensation is dependable and commonly applied, it can possibly relate with more voids and greater discomfort in the postoperative stage because of its mechanical forces. In vertical compaction, warm vertical compaction offers the best adaptation to canal walls, and has risks of overextension and possible periapical irritation. Obturation systems that are carried out with carriers are efficient and homogeneously filled, but prone to sealer extrusion. The single-cone method in which bioceramic sealers are used has been more recently considered due to its simplicity, bioactivity and good prognosis. It has been argued that apical extrusion of materials, preoperative status, and postoperative pain are significant predictors of postoperative pain, and obturation quality and biological compatibility of sealers are related to long-term healing. The balance between the technical efficiency, patient comfort, and biological properties of materials should, therefore, be maintained in clinical decision-making. The further developments of bioceramic systems and outcome assessment tools can optimize obturation strategies to give better patient-centered outcomes.