In comparison with other sealer types, resin-based sealers do not raise postsurgery pain occurrence, intensity, and consumption of analgesic agents.

This systematic review aimed to determine if root canal obturation with resin-based sealers raises the occurrence and intensity of postoperative pain in comparison with other sealer types.

Databases like Web of Science, Google Scholar, gray literature, Medline, Scopus, and Cochrane Library were explored. Studies that assessed postsurgery pain following obturation using other sealer types and resin-based sealers were incorporated. Using Cochrane RoB 2.0 tool,  the risk of bias was assessed for randomized clinical trials (RCTs).

With the aid of ROBINS-I tool, the risk of bias was determined for non-randomized clinical trials (nRCTs). For conducting quantitative analyses, estimation of standardized mean differences (SMD), pooled relative risks (RR), and 95% confidence intervals was done.

Out of 524 studies, 11 clinical studies (3 nRCTs and 8 RCTs) involving 1,123 teeth were incorporated. 

Notably, 7 studies presented raised risk of overall bias and 4 studies were allocated a low risk of overall bias. Quantitative assessments were carried out with 6 studies for pain incidence, 5 studies for pain intensity, and 4 studies for analgesic consumption.

No considerable difference was noted between resin-based sealers and other sealer types in occurrence of postsurgery pain at 24 hours (Risk ratio [RR] 1.102), 48 hours (RR 0.943), 72 hours (RR 1.019), and one week (RR 0.559), in pain intensity at 12 hours (SMD 0.100), 24 hours (SMD 0.090), and 48 hours (SMD 0.217), and in analgesic consumption at 24 hours (RR 2.253) and 72 hours (RR 0.650).

Root canal obturation via resin-based sealers does not elevate the occurrence and intensity of postsurgery pain.