{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,10]],"date-time":"2026-10-10T06:12:08Z","timestamp":1791612728532,"version":"4.3.4"},"reference-count":30,"publisher":"Springer Science and Business Media LLC","issue":"10","license":[{"start":{"date-parts":[[2025,9,11]],"date-time":"2025-09-11T00:00:00Z","timestamp":1757548800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2025,9,11]],"date-time":"2025-09-11T00:00:00Z","timestamp":1757548800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"name":"Kafr El Shiekh University"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Clin Oral Invest"],"abstract":"<jats:title>Abstract<\/jats:title>\n          <jats:sec>\n            <jats:title>Objectives<\/jats:title>\n            <jats:p>Postoperative pain remains a significant concern in endodontics. The main aim of this clinical trial was to assess the impact of various obturation technique and sealer types on post-obturation pain and sealer extrusion in single-visit nonsurgical root canal treatments.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Materials and methods<\/jats:title>\n            <jats:p>Study participants were recruited through consecutive sampling from patients referred to the Endodontic Department, Faculty of Dentistry, Institution University, diagnosed as asymptomatic irreversible pulpitis. The study was conducted on 150 cases that were equally and randomly allocated to each of the studied groups (30 for each group) as following; Group 1 - cold lateral compaction with CeraSeal (CLC-CS); Group 2 - continuous wave compaction with CeraSeal (CWC-CS); Group 3 - single cone technique with CeraSeal (SC-CS); Group 4 - Cold lateral compaction with AH Plus (CLC-AH); and Group 5 - continuous wave compaction with AH Plus (CWC-AH). All endodontic procedures were performed by a single experienced endodontist to standardize treatment protocols. The main outcomes were the post-obturation pain which was assessed using a visual analog scale (VAS) scale (0\u201310), and the incidence of sealer extrusion among the studied groups.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Results<\/jats:title>\n            <jats:p>At 6, 24, and 72\u00a0h the postobturation pain score did not differ significantly between all studied groups. After 12 and 48\u00a0h CWC-CS and CLC-CS showed the lowest significant postobturation pain score respectively, and CWC-AH had the most significant postobturation pain score. During the study, none of the patients needed an emergency visit, the pain score was ranged from (0:1.4). Within the same group, the pain intensity began to significantly decrease for gp1 (CLC-CS) after 24\u00a0h, for gp3, gp4, and gp5 (SC-CS, CLC-AH, and CWC-AH, respectively) after 12\u00a0h, and for gp2 (CWC-CS) after 6\u00a0h. After 72\u00a0h, the level of pain in each group was around 0. Regardless of the type of sealer used, no significant difference was found between the type of obturation technique and the postoperative pain intensity (<jats:italic>p<\/jats:italic>\u2009=\u20090.124), while regardless of the type of obturation technique used, there was a significant difference in postoperative pain intensity and sealer type (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001). The incidence of sealer extrusion did not differ significantly between the tested groups (<jats:italic>p<\/jats:italic>\u2009=\u20090.499), the results showed that the presence of sealer extrusion was associated with higher significant pain score (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001).<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusion<\/jats:title>\n            <jats:p>The postoperative pain score after Single-Visit RCT for patient diagnosed as asymptomatic irreversible pulpitis was low to moderate pain score, presence of sealer extrusion increased the postoperative pain intensity. Regardless the type of sealer, different obturation techniques did not associated with postoperative pain intensity, while regardless the obturation technique, AH Plus sealer was associated with higher postoperative pain intensity than CeraSeal sealer. Postoperative pain was related to presence of sealer extrusion.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1007\/s00784-025-06487-y","type":"journal-article","created":{"date-parts":[[2025,9,11]],"date-time":"2025-09-11T01:20:44Z","timestamp":1757553644000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["The effect of different obturation techniques on post-obturation pain and sealer extrusion in single-visit root canal treatment: a prospective clinical randomized study"],"prefix":"10.1007","volume":"29","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7692-3587","authenticated-orcid":false,"given":"Hisham","family":"Mahmoud Hamdy Abada","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-9210-8809","authenticated-orcid":false,"given":"Mohamed","family":"Abd El Rahman El Shreif","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-4094-6485","authenticated-orcid":false,"given":"Faten","family":"Mohamed Ahmed Ghonimy","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8084-7479","authenticated-orcid":false,"given":"Ebtesam","family":"Osama Abo El-Mal","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-7181-6599","authenticated-orcid":false,"given":"Dana","family":"Saeed Abd Elmonem El gemaie","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2025,9,11]]},"reference":[{"key":"6487_CR1","doi-asserted-by":"publisher","first-page":"e44134","DOI":"10.7759\/cureus.44134","volume":"15","author":"NK Urkande","year":"2023","unstructured":"Urkande NK, Mankar N, Nikhade PP, Chandak M (2023) Beyond tradition: non-surgical endodontics and vital pulp therapy as a dynamic combination. Cureus 15:e44134. https:\/\/doi.org\/10.7759\/cureus.44134","journal-title":"Cureus"},{"key":"6487_CR2","doi-asserted-by":"publisher","DOI":"10.7717\/peerj.13756","author":"A Ko\u00e7er","year":"2022","unstructured":"Ko\u00e7er A, \u00d6zkan HD, Turk T (2022) Postoperative pain intensity and incidence following single visit root canal treatment with different obturation techniques: a randomized clinical trial. PeerJ. https:\/\/doi.org\/10.7717\/peerj.13756","journal-title":"PeerJ"},{"key":"6487_CR3","doi-asserted-by":"publisher","first-page":"209","DOI":"10.23805\/JO.2022.14.04.3","volume":"14","author":"C Bugea","year":"2022","unstructured":"Bugea C, Cerutti F, Ongaro F et al (2022) Postoperative pain and one year follow up success rate of warm vertical compaction, single cone, coneless and bioconeless obturation methods. J Osseointegration 14:209\u2013216. https:\/\/doi.org\/10.23805\/JO.2022.14.04.3","journal-title":"J Osseointegration"},{"key":"6487_CR4","doi-asserted-by":"publisher","first-page":"689","DOI":"10.1016\/j.joen.2018.02.010","volume":"44","author":"I Graunaite","year":"2018","unstructured":"Graunaite I, Skucaite N, Lodiene G et al (2018) Effect of resin-based and bioceramic root canal sealers on postoperative pain: a split-mouth randomized controlled trial. J Endod 44:689\u2013693. https:\/\/doi.org\/10.1016\/j.joen.2018.02.010","journal-title":"J Endod"},{"key":"6487_CR5","doi-asserted-by":"publisher","unstructured":"Pontoriero DIK, Ferrari Cagidiaco E, Maccagnola V et al (2023) Outcomes of endodontic-treated teeth obturated with bioceramic sealers in combination with warm gutta-percha obturation techniques: a prospective clinical study. J Clin Med 12. https:\/\/doi.org\/10.3390\/jcm12082867","DOI":"10.3390\/jcm12082867"},{"key":"6487_CR6","doi-asserted-by":"publisher","first-page":"442","DOI":"10.21726\/rsbo.v9i4.1026","volume":"9","author":"AC Pereira","year":"2013","unstructured":"Pereira AC, Nishiyama CK, de Pinto L C (2013) Single-cone obturation technique: a literature review. RSBO 9:442\u2013447. https:\/\/doi.org\/10.21726\/rsbo.v9i4.1026","journal-title":"RSBO"},{"key":"6487_CR7","doi-asserted-by":"publisher","first-page":"c332","DOI":"10.1136\/BMJ.C332","volume":"340","author":"KF Schulz","year":"2010","unstructured":"Schulz KF, Altman DG, Moher D (2010) CONSORT 2010 statement: updated guidelines for reporting parallel group randomised trials. BMJ 340:c332. https:\/\/doi.org\/10.1136\/BMJ.C332","journal-title":"BMJ"},{"key":"6487_CR8","doi-asserted-by":"publisher","first-page":"1588","DOI":"10.1016\/j.joen.2023.08.023","volume":"49","author":"M B\u00fcker","year":"2023","unstructured":"B\u00fcker M, S\u00fcmb\u00fcll\u00fc M, Ali A et al (2023) The effects of calcium silicate- and calcium hydroxide\u2013based root canal sealers on postoperative pain: a randomized clinical trial. J Endod 49:1588\u20131594. https:\/\/doi.org\/10.1016\/j.joen.2023.08.023","journal-title":"J Endod"},{"key":"6487_CR9","first-page":"43","volume":"9","author":"American Association of Endodontists","year":"2020","unstructured":"American Association of Endodontists (2020) Glossary of endodontic terms 2020. Gloss Endod Terms 9:43","journal-title":"Gloss Endod Terms"},{"key":"6487_CR10","doi-asserted-by":"publisher","first-page":"20","DOI":"10.1111\/j.1600-9657.1986.tb00119.x","volume":"2","author":"D \u00d8rstavik","year":"1986","unstructured":"\u00d8rstavik D, Kerekes K, Eriksen HM (1986) The periapical index: a scoring system for radiographic assessment of apical periodontitis. Dent Traumatol 2:20\u201334. https:\/\/doi.org\/10.1111\/j.1600-9657.1986.tb00119.x","journal-title":"Dent Traumatol"},{"key":"6487_CR11","doi-asserted-by":"publisher","unstructured":"(2013) World medical association declaration of helsinki: ethical principles for medical research involving human subjects. JAMA 310:2191\u20132194. https:\/\/doi.org\/10.1001\/JAMA.2013.281053","DOI":"10.1001\/JAMA.2013.281053"},{"key":"6487_CR12","doi-asserted-by":"publisher","unstructured":"Drukteinis S, Camilleri J (2020) Bioceramic materials in clinical endodontics. Bioceram Mater Clin Endod 1\u2013101. https:\/\/doi.org\/10.1007\/978-3-030-58170-1","DOI":"10.1007\/978-3-030-58170-1"},{"key":"6487_CR13","doi-asserted-by":"publisher","first-page":"e144","DOI":"10.4317\/JCED.59034","volume":"14","author":"A Khandelwal","year":"2022","unstructured":"Khandelwal A, Jose J, Teja KV, Palanivelu A (2022) Comparative evaluation of postoperative pain and periapical healing after root canal treatment using three different base endodontic sealers - a randomized control clinical trial. J Clin Exp Dent 14:e144\u2013e152. https:\/\/doi.org\/10.4317\/JCED.59034","journal-title":"J Clin Exp Dent"},{"key":"6487_CR14","doi-asserted-by":"publisher","first-page":"3053","DOI":"10.1007\/S00784-018-2721-6","volume":"23","author":"A Atav Ates","year":"2019","unstructured":"Atav Ates A, Dumani A, Yoldas O, Unal I (2019) Post-obturation pain following the use of carrier-based system with AH plus or iRoot SP sealers: a randomized controlled clinical trial. Clin Oral Investig 23:3053\u20133061. https:\/\/doi.org\/10.1007\/S00784-018-2721-6","journal-title":"Clin Oral Investig"},{"key":"6487_CR15","doi-asserted-by":"publisher","unstructured":"Ferreira N, de Gollo S, Boscato EKF et al (2020) Postoperative pain after root canal filling with different endodontic sealers: a randomized clinical trial. Braz Oral Res 34. https:\/\/doi.org\/10.1590\/1807-3107bor-2020.vol34.0069","DOI":"10.1590\/1807-3107bor-2020.vol34.0069"},{"key":"6487_CR16","doi-asserted-by":"publisher","first-page":"343","DOI":"10.1055\/S-0039-3399457","volume":"13","author":"B Fonseca","year":"2019","unstructured":"Fonseca B, Coelho MS, Bueno CEDS et al (2019) Assessment of extrusion and postoperative pain of a bioceramic and resin-based root canal sealer. Eur J Dent 13:343\u2013348. https:\/\/doi.org\/10.1055\/S-0039-3399457","journal-title":"Eur J Dent"},{"key":"6487_CR17","doi-asserted-by":"publisher","first-page":"1021","DOI":"10.1111\/IEJ.14069","volume":"57","author":"F Zamparini","year":"2024","unstructured":"Zamparini F, Lenzi J, Duncan HF et al (2024) The efficacy of premixed bioceramic sealers versus standard sealers on root canal treatment outcome, extrusion rate and post-obturation pain: a systematic review and meta-analysis. Int Endod J 57:1021\u20131042. https:\/\/doi.org\/10.1111\/IEJ.14069","journal-title":"Int Endod J"},{"key":"6487_CR18","doi-asserted-by":"publisher","first-page":"793","DOI":"10.1007\/s10266-023-00830-z","volume":"111","author":"MA Seron","year":"2023","unstructured":"Seron MA, Nunes GP, Ferrisse TM et al (2023) Postoperative pain after root canal filling with bioceramic sealers: a systematic review and meta-analysis of randomized clinical trials. Odontology 111:793\u2013812. https:\/\/doi.org\/10.1007\/s10266-023-00830-z","journal-title":"Odontology"},{"key":"6487_CR19","doi-asserted-by":"publisher","DOI":"10.4103\/JCDE.JCDE_115_24","author":"R Nagpal","year":"2024","unstructured":"Nagpal R, Taneja S, Kiran Bhalla V (2024) The effect of bioactive glass-based, bioceramic based and epoxy amine resin based root canal sealers on post-obturation pain: a double blinded randomized controlled trial. J Conserv Dent. https:\/\/doi.org\/10.4103\/JCDE.JCDE_115_24","journal-title":"J Conserv Dent"},{"key":"6487_CR20","doi-asserted-by":"publisher","first-page":"318","DOI":"10.1111\/iej.13870","volume":"56","author":"M Co\u015far","year":"2023","unstructured":"Co\u015far M, Kandemir Demirci G, \u00c7al\u0131\u015fkan MK (2023) The effect of two different root canal sealers on treatment outcome and post-obturation pain in single-visit root canal treatment: a prospective randomized clinical trial. Int Endod J 56:318\u2013330. https:\/\/doi.org\/10.1111\/iej.13870","journal-title":"Int Endod J"},{"key":"6487_CR21","doi-asserted-by":"publisher","first-page":"1278","DOI":"10.1016\/j.joen.2021.05.008","volume":"47","author":"JPSC Drumond","year":"2021","unstructured":"Drumond JPSC, Maeda W, Nascimento WM et al (2021) Comparison of postobturation pain experience after apical extrusion of calcium silicate\u2013 and resin\u2013based root canal sealers. J Endod 47:1278\u20131284. https:\/\/doi.org\/10.1016\/j.joen.2021.05.008","journal-title":"J Endod"},{"key":"6487_CR22","first-page":"1739","volume":"17","author":"A Paz","year":"2018","unstructured":"Paz A, Vasconcelos I, Ginjeira A (2018) Evaluation of postoperative pain after using bioceramic materials as endodontic sealers evaluation of postoperative pain after using bioceramic materials as endodontic sealers. EC Dent Sci 17:1739\u20131748","journal-title":"EC Dent Sci"},{"key":"6487_CR23","doi-asserted-by":"publisher","first-page":"488","DOI":"10.1111\/EOS.12065","volume":"121","author":"G Lodiene","year":"2013","unstructured":"Lodiene G, Kopperud HM, \u00d8rstavik D, Bruzell EM (2013) Detection of leachables and cytotoxicity after exposure to methacrylate- and epoxy-based root canal sealers in vitro. Eur J Oral Sci 121:488\u2013496. https:\/\/doi.org\/10.1111\/EOS.12065","journal-title":"Eur J Oral Sci"},{"key":"6487_CR24","doi-asserted-by":"publisher","first-page":"83","DOI":"10.4103\/0972-0707.153054","volume":"18","author":"A Kaur","year":"2015","unstructured":"Kaur A, Shah N, Logani A, Mishra N (2015) Biotoxicity of commonly used root canal sealers: a meta-analysis. J Conserv Dent 18:83. https:\/\/doi.org\/10.4103\/0972-0707.153054","journal-title":"J Conserv Dent"},{"key":"6487_CR25","doi-asserted-by":"publisher","first-page":"229","DOI":"10.1016\/j.joen.2008.10.025","volume":"35","author":"RK Scarparo","year":"2009","unstructured":"Scarparo RK, Grecca FS, Fachin EVF (2009) Analysis of tissue reactions to methacrylate resin-based, epoxy resin-based, and zinc oxide-eugenol endodontic sealers. J Endod 35:229\u2013232. https:\/\/doi.org\/10.1016\/j.joen.2008.10.025","journal-title":"J Endod"},{"key":"6487_CR26","doi-asserted-by":"publisher","first-page":"683","DOI":"10.1016\/J.JOEN.2014.01.030","volume":"40","author":"NB Ruparel","year":"2014","unstructured":"Ruparel NB, Ruparel SB, Chen PB et al (2014) Direct effect of endodontic sealers on trigeminal neuronal activity. J Endod 40:683\u2013687. https:\/\/doi.org\/10.1016\/J.JOEN.2014.01.030","journal-title":"J Endod"},{"key":"6487_CR27","doi-asserted-by":"publisher","first-page":"72","DOI":"10.1016\/J.JOEN.2014.06.007","volume":"41","author":"J Camilleri","year":"2015","unstructured":"Camilleri J (2015) Sealers and warm gutta-percha obturation techniques. J Endod 41:72\u201378. https:\/\/doi.org\/10.1016\/J.JOEN.2014.06.007","journal-title":"J Endod"},{"key":"6487_CR28","doi-asserted-by":"publisher","first-page":"307","DOI":"10.1016\/j.joen.2019.10.032","volume":"46","author":"D Ricucci","year":"2020","unstructured":"Ricucci D, Grande NM, Plotino G, Tay FR (2020) Histologic response of human pulp and periapical tissues to tricalcium silicate\u2013based materials: a series of successfully treated cases. J Endod 46:307\u2013317. https:\/\/doi.org\/10.1016\/j.joen.2019.10.032","journal-title":"J Endod"},{"issue":"15","key":"6487_CR29","doi-asserted-by":"publisher","first-page":"Page229","DOI":"10.3390\/MA15010229","volume":"2022","author":"V Chopra","year":"2021","unstructured":"Chopra V, Davis G, Baysan A (2021) Physico-Chemical properties of calcium-silicate vs. resin based sealers\u2014a systematic review and meta-analysis of laboratory-based studies. Mater 2022(15):Page229\u201315229. https:\/\/doi.org\/10.3390\/MA15010229","journal-title":"Mater"},{"key":"6487_CR30","doi-asserted-by":"publisher","DOI":"10.3390\/ma15155146","volume":"15","author":"M Song","year":"2022","unstructured":"Song M, Park MG, Kwak SW et al (2022) Pilot evaluation of sealer-based root canal obturation using epoxy-resin-based and calcium-silicate-based sealers: a randomized clinical trial. Materials 15:1\u20139. https:\/\/doi.org\/10.3390\/ma15155146","journal-title":"Materials"}],"container-title":["Clinical Oral Investigations"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00784-025-06487-y.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s00784-025-06487-y\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00784-025-06487-y.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,16]],"date-time":"2025-10-16T06:11:40Z","timestamp":1760595100000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s00784-025-06487-y"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,9,11]]},"references-count":30,"journal-issue":{"issue":"10","published-online":{"date-parts":[[2025,10]]}},"alternative-id":["6487"],"URL":"https:\/\/doi.org\/10.1007\/s00784-025-06487-y","relation":{},"ISSN":["1436-3771"],"issn-type":[{"value":"1436-3771","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,9,11]]},"assertion":[{"value":"21 April 2025","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"22 July 2025","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"11 September 2025","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The authors declare no competing interests.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"<!--Emphasis Type='Bold' removed-->Conflict of interest"}},{"value":"The ethical board at the institution university approved the protocol for this study, the ethical approval number is (KFSIRB200-86). Protocol registration at ClinicalTrials.gov No. NCT06146894.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethical approval"}}],"article-number":"445"}}