Postoperative Pain After Root Canal Filling with Different Bioceramic Endodontic Sealers: A Double-Blind Randomized Clinical Pilot Trial

Background/Objectives: Postoperative pain is one of the most frequently reported complications following endodontic treatment. Bioceramic sealers have gained widespread clinical acceptance. However, comparative clinical data on postoperative pain between specific bioceramic sealers remains limited. This double-blind randomized clinical pilot trial aimed to evaluate and compare the incidence and intensity of postoperative pain following root canal obturation using two bioceramic sealers—Bio-C Sealer (Angelus, Brazil) and TotalFill BC Sealer (FKG Dentaire, Switzerland)—over a seven-day follow-up period. Methods: A total of 30 patients requiring non-surgical root canal treatment were recruited from the dental clinics at Al-Baha University, Saudi Arabia, and randomly allocated into two equal groups (n = 15 per group). All root canals were prepared and then obturated using the tested sealers with the single-cone technique. Postoperative pain was assessed using the Visual Analog Scale (VAS) at 24 h, 48 h, 72 h, and 7 days post-treatment. Statistical analysis was performed using Fisher’s exact test, Chi-square tests, and the independent t-test, with a significance threshold set at p < 0.05. Results: At 24 h, postoperative pain was reported by 33.3% of patients in the Bio-C Sealer group and 26.7% in the TotalFill BC Sealer group, with no statistically significant difference (p = 1.000). By 48 h, all patients in the TotalFill BC Sealer group were completely asymptomatic, whereas 13.3% of patients in the Bio-C Sealer group continued to report pain (p = 0.483). No significant associations were identified between postoperative pain and gender, tooth type, sealer extrusion, or preoperative pain status in either group (p > 0.05). Conclusions: Within the limitations of this randomized clinical pilot trial, the preliminary data suggest similar short-term clinical performance between Bio-C Sealer and TotalFill BC Sealer in terms of both the incidence and intensity of postoperative pain following non-surgical root canal treatment.