An interventional study of TotalFill BC Sealer HiFlow and AH Plus in Dental Pulp Necrosis and Pain, Postoperative, sponsored by Ataturk University. Not yet recruiting. Open to participants aged 18 Years to 65 Years. Per ClinicalTrials.gov, last updated 2026-11-12.
Sponsored by Ataturk University · Not applicable, Interventional, and Treatment
The goal of this clinical trial is to learn whether the type of root canal sealer affects pain after root canal treatment in adults aged 18 to 65 who need root canal treatment of a single-rooted upper front tooth with a non-vital (dead) pulp and no signs of infection around the root tip. The main questions it aims to answer are:
Does a bioceramic-based sealer (TotalFill BC Sealer HiFlow) cause a different level of pain after treatment than an epoxy resin-based sealer (AH Plus)? Does the need for pain medicine after treatment differ between the two sealers?
Researchers will compare the bioceramic-based sealer with the epoxy resin-based sealer, which is widely used as a standard reference material, to see if one causes less pain after the root canal is filled.
Participants will:
Receive root canal treatment of one tooth, filled with the warm vertical compaction technique using one of the two sealers, assigned by chance; participants will not know which sealer was used Rate their pain on a 0-100 scale at 6, 12, and 24 hours and on days 3, 5, and 7 after treatment Record whether and when they took pain medicine (paracetamol) Return for a check-up visit one week after treatment
Background: Postoperative pain is a common complication of root canal treatment, and the chemical composition of the root canal sealer has been proposed as one of the factors influencing its incidence and intensity. Epoxy resin-based AH Plus is widely regarded as the reference sealer, whereas calcium silicate-based bioceramic sealers have gained popularity because of their biocompatibility, alkaline pH and hydraulic setting properties. Clinical evidence comparing these sealers in terms of postoperative pain remains inconsistent, and data obtained with warm vertical compaction are limited.
Design: This is a prospective, randomized, active-controlled, parallel-group, single-center clinical trial conducted at the Department of Endodontics, Faculty of Dentistry, Ataturk University (Erzurum, Turkey). Asymptomatic single-rooted maxillary anterior teeth with a diagnosis of pulp necrosis and normal apical tissues (periapical index score ≤2) will be included. A total of 70 participants (35 per group) will be allocated to one of two groups: Group 1, TotalFill BC Sealer HiFlow (FKG Dentaire SA, Switzerland); Group 2, AH Plus (Dentsply Sirona). Allocation will be performed using a computer-generated randomization sequence (www.randomizer.org). Participants will be blinded to group allocation; because pain will be self-reported by the participants, outcome assessment will also be blinded. Due to the different handling properties of the sealers, the operator cannot be blinded.
Treatment protocol: All treatments will be performed by a single operator following a standardized protocol. After local anesthesia and rubber dam isolation, the access cavity will be prepared and the working length determined with an electronic apex locator. Root canals will be shaped with a rotary instrumentation system and irrigated with 2.5% sodium hypochlorite, followed by a final rinse with distilled water. After drying, the assigned sealer will be applied and the canal obturated with the warm vertical compaction technique in both groups. Preoperative clinical and radiographic findings, including the periapical index (PAI) score, will be recorded on a standardized form.
Outcome assessment: Participants will rate their pain on a 100-mm Visual Analogue Scale (VAS) at 6, 12 and 24 hours and on days 3, 5 and 7 after treatment. Paracetamol 500 mg will be recommended as rescue medication, and analgesic intake (yes/no, day and time) will be recorded. Participants will be clinically re-examined one week after treatment for percussion and palpation sensitivity, swelling and sinus tract.
Statistical analysis: Normality will be tested with the Shapiro-Wilk test. Between-group comparisons will be performed with the independent-samples t-test or Mann-Whitney U test, and categorical variables with the chi-square or Fisher's exact test. Changes in pain over time will be analyzed with repeated-measures ANOVA or the Friedman test, as appropriate. The level of significance will be set at p\<0.05.
156 studies on the registry are indexed under Dental Pulp Necrosis; 43 are open to participants now.
This study's planned enrollment of 70 is above the median of 45 across 147 interventional studies indexed under Dental Pulp Necrosis.
Browse Dental Pulp Necrosis studies →Ataturk University is the lead sponsor of 460 studies on the registry; 126 are open to participants now.
Counted across the registry records on this site, refreshed daily.
Inclusion Criteria:- Age between 18 and 65 years
Exclusion Criteria:- Systemic disease or pregnancy
Underlined terms in the criteria open these too. Explained by clinicaltrials.gg, not part of the registry record. The study team decides who can take part.
The anaesthetists’ scale of health before surgery: I is healthy, II has a mild illness that is under control, III a severe one, IV a severe illness that is a constant threat to life. V and VI are used for the critically ill and for organ donors.
Before you join, the study team explains what taking part involves — its purpose, what happens, the risks and possible benefits — and answers your questions, so you can decide freely. Consent is usually recorded on a form (the informed consent form, ICF) signed by you or, where the law allows, by someone legally authorised to decide for you.
You can keep asking questions during the study, you are told of new information that matters, and you can choose to leave at any time.
ASA physical status
The anaesthetists’ scale of health before surgery: I is healthy, II has a mild illness that is under control, III a severe one, IV a severe illness that is a constant threat to life. V and VI are used for the critically ill and for organ donors.
Explained by clinicaltrials.gg, not part of the registry record. The study team decides who can take part.
Informed consent
Before you join, the study team explains what taking part involves — its purpose, what happens, the risks and possible benefits — and answers your questions, so you can decide freely. Consent is usually recorded on a form (the informed consent form, ICF) signed by you or, where the law allows, by someone legally authorised to decide for you.
You can keep asking questions during the study, you are told of new information that matters, and you can choose to leave at any time.
Explained by clinicaltrials.gg, not part of the registry record. The study team decides who can take part.
Root canal treatment completed in a single visit; root canal obturated with warm vertical compaction using gutta-percha and TotalFill BC Sealer HiFlow (FKG Dentaire SA, Switzerland).
Device: TotalFill BC Sealer HiFlow
Root canal treatment completed in a single visit; root canal obturated with warm vertical compaction using gutta-percha and AH Plus (Dentsply Sirona).
Device: AH Plus
A premixed calcium silicate-based bioceramic root canal sealer applied with gutta-percha using the warm vertical compaction technique.
An epoxy resin-based root canal sealer applied with gutta-percha using the warm vertical compaction technique.
Postoperative Pain Intensity
Pain intensity after root canal treatment will be self-reported by participants on a 100-mm Visual Analogue Scale (VAS), where 0 indicates "no pain" and 100 indicates "unbearable/most severe pain". Higher scores indicate more severe pain.
Time frame: 6, 12 and 24 hours and 3, 5 and 7 days after root canal obturation
Analgesic Intake
The number and proportion of participants who take rescue analgesic medication (paracetamol 500 mg) due to postoperative pain, together with the day and time of intake, will be recorded.
Time frame: Up to 7 days after root canal obturation
Clinical Signs at One-Week Recall
The presence of tenderness to percussion, tenderness to palpation, swelling and sinus tract will be clinically assessed and recorded as present or absent.
Time frame: 7 days after root canal obturation
No study locations are listed for this record.
Start is estimated for Oct 2026; primary completion for Jan 2027, 2 months later.
Of 66 non-industry interventional studies with no phase under Dental Pulp Necrosis, half reached primary completion within 16 months of starting (the median), counting those still running; a quarter within 9 and three quarters within 35. This study's planned 2 months is below that.
Counting every sponsor, half of 67 studies reached it within 15 months; a quarter within 9 and three quarters within 31.
How these figures are worked out, and which studies are left out of them.
From the registry record's own update history. This site started tracking changes on Sep 25, 2026; for anything earlier, see the record history on ClinicalTrials.gov ↗
This study is not yet recruiting, as verified in Oct 2026. You cannot join it, but the record below documents what was studied.
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