Apical PeriodontitisNCT06226740
Effectiveness of Different Obturation Techniques
A study testing Single Visit Non Surgical Root Canal Treatment Protocol in people with Apical Periodontitis and Postoperative Pain, run by Abant Izzet Baysal University at 1 site in Turkey (Türkiye).
Trial summary
Aim: Evaluation of the effect of different obturation techniques on postoperative pain level and radiographic healing on non-surgical endodontic retreatment (NSER) applied in a single visit in teeth with single root canal and apical periodontitis (AP). Read more about this study
- Who is it for?
- Ages 18 to 65 yearsHealthy volunteers can take part
- Conditions the study is for
- Apical Periodontitis, Postoperative Pain, Endodontically Treated Teeth
- What is being tested?
- Single Visit Non Surgical Root Canal Treatment Protocol
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 63 participants
- Where
- 1 siteTurkey (Türkiye)
- Study dates
- 17 Sep 2021to 30 May 2022
- Phase
- Interventional
- Are there results?
- None posted in the registry
Key requirements
Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.
- Ages 18 to 65 years
- All sexes
- Healthy volunteers accepted
- Adult, Older adult
Who may be able to join
- Teeth with previously endodontic treatment but unsuccessful and developing AP, root canal obturation 2 mm shorter than the working length and teeth that do not show adequate obturation,
- Teeth with periapical lesion size less than 5mm,
- Patient with the ages of 18-65,
- Patient with dose not have systemic disease, does not use antihypertensive and antidiabetic drugs, does not have a pregnancy condition, does not use corticosteroids or antibiotics, mishaps
- Patient with no acute pain or extraoral swelling,
- Patient with no sinus tract and acute apical abscess,
- Patients with who volunteered to participate in the study and agreed to attend the control visits were included.
Who cannot join
- Teeth with internal or external root resorption,
- Teeth with vertical root fracture or open apex,
- Teeth with periapical lesion size more than 5 mm,
- Patient with systemic disease,
- Patient with systemic disorders related to bone metabolism and using drugs that may affect bone metabolism,
- Patient with acute pain and therefore using analgesic medication in the last 24 hours,
- Patient with using antibiotics 2 weeks before the treatment,
- Patients who could not attend control sessions were excluded from the study .
Trial locations and contacts
1 site in 1 country.
Turkey (Türkiye)1 site
Bolu Abant İzzet Baysal University
Bolu, Central, 14403
About this study
Official title: Evaluation of the Effects of Different Obturation Techniques on Postoperative Pain and Radiographic Healing Non Surgical Endodontic Retreatment in Single Visit in Teeth With Single Root Canals and Apical Periodontitis
Aim: Evaluation of the effect of different obturation techniques on postoperative pain level and radiographic healing on non-surgical endodontic retreatment (NSER) applied in a single visit in teeth with single root canal and apical periodontitis (AP).
Materials and Methods: 63 teeth with single-root canal and AP from 50 systemically healthy patients (mean age 34.19±9.75 years; 27 women, 23 men) were included in the study. Residual root canal filling materials were removed with retreatment files. All teeth were prepared using rotary files . The teeth were randomly divided into three groups according to the obturation technique; cold lateral compaction (CLC), continuous wave compaction (CWC), and gutta-core (TGC). Restorations are completed using direct composite resin in the same visit. In all cases, pain status were evaluated using the Numerical Pain Rating Scale (NRS) at preoperative, postoperative, 3rd hour, 24th hour, 48th hour, and 7th day. Periapical index (PAI) scores were recorded on preoperative and postoperative 6-month on the periapical radiographs for cases. Data were analyzed as statistically. Significance level was determined as p < 0.05.
Read the detailed description
All procedures were performed by a endodontist (XX) only in patients who met the inclusion criteria. All patients were informed about the risks of the study and alternative treatment options before participating. Anaesthesia was achieved with 4% articaine hydrochloride containing 1:100,000 adrenalin. None of the patients required additional anaesthesia. After rubber dam isolation, previous caries and restorations were removed with high and low speed sterile burs under water cooling. The previous root canal obturation of all teeth included in the study was removed with a similar treatment protocol. All files were used with a torque-controlled endodontic motor based on the appropriate torque and rpm values specified by the manufacturer. After determining the canal length with an electronic apex locator the apical patency was checked with a #10 K hand file. During the procedure, the canal was continuously irrigated with 5.25% sodium hypochlorite. In all irrigation procedures, a 27-gauge side-vented irrigation needle was used, which was set to be 2 mm shorter than the working length. No solvent was used during the NSER protocol. The literature has found that there is no definite consensus on the final apical diameter of the root canal when applying NSER. However, it has been reported that in primary endodontic treatment, the preparation should be completed with a larger file than the file used for apical region preparation. In this study, the final preparation was completed by using a case-specific file that was chosen to be larger than the apically compressed file while making the final preparation. The root canal was prepared with rotary files. For the final irrigation procedure is 2 mL of 5.25% NAOCl, distilled water, 17% ethylene diamine tetraacetic acid , distilled water, 2% chlorhexidine solutions were used respectively. The root canal were dried with paper points . Then, all teeth were randomly assigned one of the three study groups by using online software (http://www.random.org). (n:21).
Cold Lateral Compaction (CLC-Control Group): After the root canal preparation was completed, the working length was checked with the master cone and periapical radiography. The master cone was then covered with root canal sealer and placed in the root canal. Then, a gap was created for the .02 angled lateral cones using #30, 25 and 20 finger spreader. The obturation process continued until the spreader went 2 mm beyond the level of the canal orifice. Next, a hot excavator removed the coronal gutta-percha 1 mm below the canal orifice.
Continuous Wave Compaction (CWC): After the root canal preparation was completed, the working length was checked with the master cone and periapical radiography. Root canal sealer was applied to the root canal walls using a master cone. The plugger connected to the down-pack unit was adjusted to be 4 mm shorter than the working length. The master cone was cut 1 mm shorter than the working length with a heated plugger and applied to the root canal. Then, the heated plugger was advanced in the apical direction and the apical region was obturated. Obturation was completed in 2 stages with gutta-percha in the cartridge connected to the remaining root canal cavity back-fill unit and heated to 200 °C. Heated gutta-percha was vertically condensed with plugger to 1 in the first stage and 2 in the second. The root canal obturation was completed by removing the gutta-percha 1 mm below the canal orifice.
Thermoplasticized Gutta-Cor (TGC): After the root canal preparation was completed, the working length was controlled with the master cone and periapical radiography. Root canal sealer was applied to the root canal walls using a master cone. Root canal obturation was completed with gutta-percha heated according to the manufacturer's instructions using. The heated gutta-percha was slowly inserted into the canal up to the working length. After cutting the handle of the obturators at the level of the canal orifice with a hot excavator, it was condensed into the canal using a gutta-percha plugger. The coronal gutta-percha were removed 1 mm below the canal orifice using a hot excavator.
In the same visit, all teeth were permanently restored using direct composite resin .
- Being tested
- Single Visit Non Surgical Root Canal Treatment Protocol
- Keywords
- warm vertical compaction, single visit, postoperative pain, non-surgical endodontic retreatment, cold lateral compaction, numeric rating scale
- Medical subject headings
- Periapical Periodontitis, Pain, Postoperative, Tooth, Nonvital
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
Single Visit Non Surgical Root Canal Treatment ProtocolOther
The current study aimed to compare the effects of different obturation techniques on postoperative pain level and radiographic healing in non-surgical endodontic treatment applied in a single visit in teeth with single root canal and apical periodontitis.
| Study group | Role | What they receive |
|---|---|---|
| Cold Lateral Compaction (Control group) | Experimental | After the root canal preparation was completed, the working length was checked with the master cone and periapical radiography. The master cone was then covered with root canal sealer and placed in the root canal. Then, a gap was created for the .02 angled lateral cones using #30, 25 and 20 finger spreader. The obturation process continued until the spreader went 2 mm beyond the level of the canal orifice. Next, a hot excavator removed the coronal gutta-percha 1 mm below the canal orifice. Receives: Other: Single Visit Non Surgical Root Canal Treatment Protocol |
| Warm Vertical Compaction | Experimental | After the root canal preparation was completed, the working length was checked with the master cone and periapical radiography. Root canal sealer was applied to the root canal walls using a master cone. HeatPlugger connected to the down-pack unit of the obturation system was adjusted to be 4 mm shorter than the working length. The master cone was cut 1 mm shorter than the working length with a heated plugger and applied to the root canal. Then, the heated plugger was advanced in the apical direction, and the apical region was obturated. Obturation was completed in 2 stages with gutta-percha in the gutta-percha cartridge connected to the remaining root canal cavity back-fill unit and heated to 200 °C. Heated gutta-percha was vertically condensed with HeatPlugger to 1 in the first stage and 2 in the second. The root canal obturation was completed by removing the gutta-percha 1 mm below the canal orifice. Receives: Other: Single Visit Non Surgical Root Canal Treatment Protocol |
| Gutta Core | Experimental | After the root canal preparation was completed, the working length was controlled with the master cone and periapical radiography. Root canal sealer was applied to the root canal walls using a master cone. Root canal obturation was completed with heated gutta-percha according to the manufacturer's instructions. The heated gutta-percha was slowly inserted into the canal up to the working length. After cutting the handle of the obturators at the level of the canal orifice with a hot excavator, it was condensed into the canal using a gutta-percha plugger. The coronal gutta-percha was removed 1 mm below the canal orifice using a hot excavator. Receives: Other: Single Visit Non Surgical Root Canal Treatment Protocol |
What is being measured
The primary outcome is the main question the study is designed to answer.
Evaluation of postoperative pain that may occur due to treatment
In this study, postoperative pain observed after treatment was measured using the Numeric Rating Scale (NRS).
Measured: 1 week
Radiographic evaluation of healing of periapical tissues at 6 months after treatment
In this study, periapical radiographs obtained using a parallel film holder before and after treatment of the patients included in the study were evaluated according to the Periapical Index (PAI) scores.
Measured: 6 months
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted26 Jan 2024
- Study start17 Sep 2021
- Primary completion29 Nov 2021
- Study completion30 May 2022
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Publications (1)Papers the sponsor has linked to this study.
- Other trials for Apical PeriodontitisStudies of the same condition, open and under way.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
More details
For doctors and researchers: how the study is designed, who runs it, and its registry IDs.
Study design
- Study type
- Interventional
- Phase
- Phase N/A
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Crossover
- Masking
- Double blind
- Who is masked
- Participant, Investigator
- Enrolment
- 63 participants (actual)
Sponsor and investigators
- Lead sponsor
- Abant Izzet Baysal University
- Sponsor type
- University, hospital or other
- Responsible party
- Principal investigator, Merve Işık, Abant Izzet Baysal University
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT06226740
- Sponsor's protocol ID
- AIBU-DHF-MI-01
- Status last verified
- Jan 2024
- First submitted
- 4 Dec 2023
- Last updated
- 26 Jan 2024
- Results posted
- No
- FDA-regulated drug
- No
- FDA-regulated device
- No
- Individual data sharing
- Undecided
Publications
Isik M, Aydin ZU. Effect of different obturation techniques on treatment results in single-visit non-surgical endodontic retreatment: randomized controlled clinical study. BMC Oral Health. 2024 Nov 28;24(1):1449. doi: 10.1186/s12903-024-05240-3.
PubMed 39609817
Study at a glance
From the registry record, last updated by the sponsor on 26 Jan 2024. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Evaluation of the Effects of Different Obturation Techniques on Postoperative Pain and Radiographic Healing Non Surgical Endodontic Retreatment in Single Visit in Teeth With Single Root Canals and Apical Periodontitis
- ClinicalTrials.gov ID
- NCT06226740
- Acronym / sponsor ID
- AIBU-DHF-MI-01
- Keywords
- warm vertical compaction, single visit, postoperative pain, non-surgical endodontic retreatment, cold lateral compaction, numeric rating scale
- Study type
- Interventional
- Recruitment status
- Completed
- Enrolment
- 63 participants (actual)
- Lead sponsor
- Abant Izzet Baysal UniversityUniversity, hospital or other
- Study start
- 17 Sep 2021 (actual)
- Primary completion
- 29 Nov 2021 (actual)
- Study completion
- 30 May 2022 (actual)
- First posted
- 26 Jan 2024 (actual)
- Results
- Not posted in the source record
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
Aim: Evaluation of the effect of different obturation techniques on postoperative pain level and radiographic healing on non-surgical endodontic retreatment (NSER) applied in a single visit in teeth with single root canal and apical periodontitis (AP).
Materials and Methods: 63 teeth with single-root canal and AP from 50 systemically healthy patients (mean age 34.19±9.75 years; 27 women, 23 men) were included in the study. Residual root canal filling materials were removed with retreatment files. All teeth were prepared using rotary files . The teeth were randomly divided into three groups according to the obturation technique; cold lateral compaction (CLC), continuous wave compaction (CWC), and gutta-core (TGC). Restorations are completed using direct composite resin in the same visit. In all cases, pain status were evaluated using the Numerical Pain Rating Scale (NRS) at preoperative, postoperative, 3rd hour, 24th hour, 48th hour, and 7th day. Periapical index (PAI) scores were recorded on preoperative and postoperative 6-month on the periapical radiographs for cases. Data were analyzed as statistically. Significance level was determined as p < 0.05.
Detailed description
All procedures were performed by a endodontist (XX) only in patients who met the inclusion criteria. All patients were informed about the risks of the study and alternative treatment options before participating. Anaesthesia was achieved with 4% articaine hydrochloride containing 1:100,000 adrenalin. None of the patients required additional anaesthesia. After rubber dam isolation, previous caries and restorations were removed with high and low speed sterile burs under water cooling. The previous root canal obturation of all teeth included in the study was removed with a similar treatment protocol. All files were used with a torque-controlled endodontic motor based on the appropriate torque and rpm values specified by the manufacturer. After determining the canal length with an electronic apex locator the apical patency was checked with a #10 K hand file. During the procedure, the canal was continuously irrigated with 5.25% sodium hypochlorite. In all irrigation procedures, a 27-gauge side-vented irrigation needle was used, which was set to be 2 mm shorter than the working length. No solvent was used during the NSER protocol. The literature has found that there is no definite consensus on the final apical diameter of the root canal when applying NSER. However, it has been reported that in primary endodontic treatment, the preparation should be completed with a larger file than the file used for apical region preparation. In this study, the final preparation was completed by using a case-specific file that was chosen to be larger than the apically compressed file while making the final preparation. The root canal was prepared with rotary files. For the final irrigation procedure is 2 mL of 5.25% NAOCl, distilled water, 17% ethylene diamine tetraacetic acid , distilled water, 2% chlorhexidine solutions were used respectively. The root canal were dried with paper points . Then, all teeth were randomly assigned one of the three study groups by using online software (http://www.random.org). (n:21).
Cold Lateral Compaction (CLC-Control Group): After the root canal preparation was completed, the working length was checked with the master cone and periapical radiography. The master cone was then covered with root canal sealer and placed in the root canal. Then, a gap was created for the .02 angled lateral cones using #30, 25 and 20 finger spreader. The obturation process continued until the spreader went 2 mm beyond the level of the canal orifice. Next, a hot excavator removed the coronal gutta-percha 1 mm below the canal orifice.
Continuous Wave Compaction (CWC): After the root canal preparation was completed, the working length was checked with the master cone and periapical radiography. Root canal sealer was applied to the root canal walls using a master cone. The plugger connected to the down-pack unit was adjusted to be 4 mm shorter than the working length. The master cone was cut 1 mm shorter than the working length with a heated plugger and applied to the root canal. Then, the heated plugger was advanced in the apical direction and the apical region was obturated. Obturation was completed in 2 stages with gutta-percha in the cartridge connected to the remaining root canal cavity back-fill unit and heated to 200 °C. Heated gutta-percha was vertically condensed with plugger to 1 in the first stage and 2 in the second. The root canal obturation was completed by removing the gutta-percha 1 mm below the canal orifice.
Thermoplasticized Gutta-Cor (TGC): After the root canal preparation was completed, the working length was controlled with the master cone and periapical radiography. Root canal sealer was applied to the root canal walls using a master cone. Root canal obturation was completed with gutta-percha heated according to the manufacturer's instructions using. The heated gutta-percha was slowly inserted into the canal up to the working length. After cutting the handle of the obturators at the level of the canal orifice with a hot excavator, it was condensed into the canal using a gutta-percha plugger. The coronal gutta-percha were removed 1 mm below the canal orifice using a hot excavator.
In the same visit, all teeth were permanently restored using direct composite resin .
Study design
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Crossover
- Masking
- Double blind (participant, investigator)
- Number of arms
- 3
| Arm | Type | Receives |
|---|---|---|
| Cold Lateral Compaction (Control group) | Experimental | Other: Single Visit Non Surgical Root Canal Treatment ProtocolAfter the root canal preparation was completed, the working length was checked with the master cone and periapical radiography. The master cone was then covered with root canal sealer and placed in the root canal. Then, a gap was created for the .02 angled lateral cones using #30, 25 and 20 finger spreader. The obturation process continued until the spreader went 2 mm beyond the level of the canal orifice. Next, a hot excavator removed the coronal gutta-percha 1 mm below the canal orifice. |
| Warm Vertical Compaction | Experimental | Other: Single Visit Non Surgical Root Canal Treatment ProtocolAfter the root canal preparation was completed, the working length was checked with the master cone and periapical radiography. Root canal sealer was applied to the root canal walls using a master cone. HeatPlugger connected to the down-pack unit of the obturation system was adjusted to be 4 mm shorter than the working length. The master cone was cut 1 mm shorter than the working length with a heated plugger and applied to the root canal. Then, the heated plugger was advanced in the apical direction, and the apical region was obturated. Obturation was completed in 2 stages with gutta-percha in the gutta-percha cartridge connected to the remaining root canal cavity back-fill unit and heated to 200 °C. Heated gutta-percha was vertically condensed with HeatPlugger to 1 in the first stage and 2 in the second. The root canal obturation was completed by removing the gutta-percha 1 mm below the canal orifice. |
| Gutta Core | Experimental | Other: Single Visit Non Surgical Root Canal Treatment ProtocolAfter the root canal preparation was completed, the working length was controlled with the master cone and periapical radiography. Root canal sealer was applied to the root canal walls using a master cone. Root canal obturation was completed with heated gutta-percha according to the manufacturer's instructions. The heated gutta-percha was slowly inserted into the canal up to the working length. After cutting the handle of the obturators at the level of the canal orifice with a hot excavator, it was condensed into the canal using a gutta-percha plugger. The coronal gutta-percha was removed 1 mm below the canal orifice using a hot excavator. |
Who may qualify
- Ages
- 18 to 65 years
- Sex
- All
- Healthy volunteers
- Accepted
- Age groups
- Adult, Older adult
Key inclusion criteria (7 listed)
- Teeth with previously endodontic treatment but unsuccessful and developing AP, root canal obturation 2 mm shorter than the working length and teeth that do not show adequate obturation,
- Teeth with periapical lesion size less than 5mm,
- Patient with the ages of 18-65,
- Patient with dose not have systemic disease, does not use antihypertensive and antidiabetic drugs, does not have a pregnancy condition, does not use corticosteroids or antibiotics, mishaps
- Patient with no acute pain or extraoral swelling,
Key exclusion criteria (8 listed)
- Teeth with internal or external root resorption,
- Teeth with vertical root fracture or open apex,
- Teeth with periapical lesion size more than 5 mm,
- Patient with systemic disease,
- Patient with systemic disorders related to bone metabolism and using drugs that may affect bone metabolism,
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| Single Visit Non Surgical Root Canal Treatment ProtocolThe current study aimed to compare the effects of different obturation techniques on postoperative pain level and radiographic healing in non-surgical endodontic treatment applied in a single visit in teeth with single root canal and apical periodontitis. | Other | Cold Lateral Compaction (Control group), Gutta Core, Warm Vertical Compaction |
Primary outcome
Evaluation of postoperative pain that may occur due to treatment
Time frame: 1 week
In this study, postoperative pain observed after treatment was measured using the Numeric Rating Scale (NRS).
Radiographic evaluation of healing of periapical tissues at 6 months after treatment
Time frame: 6 months
In this study, periapical radiographs obtained using a parallel film holder before and after treatment of the patients included in the study were evaluated according to the Periapical Index (PAI) scores.
Results and safety
The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 26 Jan 2024.
- Derived from this study: PubMed 39609817Isik M, Aydin ZU. Effect of different obturation techniques on treatment results in single-visit non-surgical endodontic retreatment: randomized controlled clinical study. BMC Oral Health. 2024 Nov 28;24(1):1449. doi: 10.1186/s12903-024-05240-3.
- Individual participant dataSharing planned: Undecided
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Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part. This study is not recruiting at the moment.
The record lists no contact. Use the official record to reach the sponsor.
1 site in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A study testing Single Visit Non Surgical Root Canal Treatment Protocol in people with Apical Periodontitis and Postoperative Pain, run by Abant Izzet Baysal University at 1 site in Turkey (Türkiye).
The full registered description is in the About this study section and the official record.
Who may be eligible to take part?
The sponsor lists 7 inclusion and 8 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.
Is this clinical trial currently recruiting?
The record says: finished, as of the sponsor's last update on 26 Jan 2024. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 1 site in Turkey (Türkiye). Whether a site is taking part right now should be confirmed with that site. See every site.
What are the possible benefits and risks?
They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.
Are results available for this study?
The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.
How can a doctor refer a patient or contact the research team?
The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
Evaluation of postoperative pain that may occur due to treatment (time frame: 1 week). The study lists 2 primary outcomes in all. It is what the study was designed to measure, not a finding.
Where can I read the original study information?
On the ClinicalTrials.gov record for NCT06226740, which also lists 1 linked publication.
Does a listing mean the treatment is approved or proven to work?
No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.
How often is this information updated?
AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 26 Jan 2024.