Objective: To explore the influence of screw conveyor and simple use of conveyor head to transport iRoot SP sealant on root canal filling effect. Methods: The clinical data of 102 patients (194 teeth) with root canal filling of maxillary premolars were retrospectively analyzed. According to the filling methods, the patients were divided into observation group (55 cases, 99 teeth, screw conveyor filling) and control group (47 cases, 95 teeth, simple use of conveyor head filling). The root canal filling time and root canal filling quality were compared between the two groups. Visual analogue scale (VAS) was used to compare the pain status in the two groups immediately after filling and at 1 week, 1 month and 2 months after filling. The differences in periodontal indexes [periodontal probing depth (PD), probing bleeding index (PBI), plaque index (PI)] were compared, and the complications were recorded. Results: The root canal filling time in observation group was shorter than that in control group [(17.25±2.16) min vs. (20.58±3.02) min, P<0.05], and the excellent and good rate of filling was higher than that in control group (89.90% vs. 78.95%, P<0.05). There was no difference in VAS score between the two groups immediately after filling (P>0.05). At each time point after filling, the VAS score in observation group was lower than that in control group (P < 0.05). After treatment, the periodontal indexes in the two groups were improved, but there were no differences between groups (P>0.05), and no differences were observed in the incidence rates of complications (P>0.05). Conclusion: Compared with simple use of conveyor head, screw conveyor can better shorten the filling time, improve the quality, and relieve the postoperative pain. Both methods are beneficial to periodontal health, with safety.