Chronic Apical PeriodontitisNCT07892690
Effect of Cyperus Articulatus on Bacterial Reduction and Postoperative Pain
A study testing Cyperus articulatus in people with Chronic Apical Periodontitis, run by Minia University at 1 site in Egypt.
Trial summary
Successful endodontic treatment depends on effective elimination of microorganisms from the infected root canal system and prevention of reinfection. However, complete disinfection remains difficult because of the complex anatomy of the root canal system, allowing residual microorganisms to persist and contribute to… Read more about this study
- Who is it for?
- Ages 22 to 45 yearsHealthy volunteers can take part
- Conditions the study is for
- Chronic Apical Periodontitis
- What is being tested?
- Cyperus articulatus
- Type of treatment
- Surgery or procedure
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 60 participants
- Where
- 1 siteEgypt
- Study dates
- 25 Sep 2026to 30 Sep 2027
- Phase
- Interventional
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 22 to 45 years
- All sexes
- Healthy volunteers accepted
- Adult
Who may be able to join
- Healthy adult Patient.
- Medically free patients.
- Mandibular permanent premolar teeth:
- Diagnosed clinically with necrotic pulp.
- Absence of pain.
- Radiographic evidence of chronic apical periodontitis .
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- Radiographic evidence of single root with single canals.
- Normal occlusal contact with opposing teeth.
- Patients' acceptance to participate in the trial.
Who cannot join
- Medically compromised patients having significant systemic disorders (ASA III or IV).
- If analgesics or antibiotics have been administrated by the patient during the past 24 hours preoperatively as it might alter their pain perception.
- Pregnant women: to avoid radiation exposure, anaesthesia, medication and hormonal fluctuation that might increase pain prevalence.
- Patients reporting bruxism, clenching, TMJ problems or traumatic occlusion: to avoid further pressure on inflamed tooth which induce subsequent irritation and inflammation.
- Patients with two or more adjacent teeth requiring endodontic treatment.
- Teeth that requires further procedural steps or multidisciplinary approach, which is out of this experiment's scope:
- Association with swelling or fistulous tract. ii. Acute periapical abscess. iii. Mobility Grade II or III. iv. Pocket depth more than 5mm. v. Previous root canal treatment. vi. Non-restorable. vii. Immature root. viii. Radiographic evidence of external or internal root resorption, vertical root fracture, perforation, calcification.
- Inability to perceive the given instructions.
Trial locations and contacts
1 site in 1 country. Contact the study team or a site near you to ask about taking part.
Egypt1 site, 1 recruiting
- Recruiting
Endodontics Department Faculty of Dentistry,Minia University
Minya
Rehab Mahmoud Abdel Baky Radwan, M.D, +201092487412, rehab.mahmoud@mu.edu.eg
Ehab AbdelHamid Ahmed, M.D, +201003047570, ehab.hussein@dentistry.cu.edu.eg
About this study
Official title: Effect of Cyperus Articulatus on Bacterial Reduction and Postoperative Pain in Necrotic Permanent Teeth With Chronic Apical Periodontitis: (Randomized Clinical Trial)
Successful endodontic treatment depends on effective elimination of microorganisms from the infected root canal system and prevention of reinfection. However, complete disinfection remains difficult because of the complex anatomy of the root canal system, allowing residual microorganisms to persist and contribute to persistent apical periodontitis and treatment failure.
Read the detailed description
Mechanical instrumentation facilitates root canal shaping and irrigant penetration but cannot contact all canal walls. Consequently, microorganisms may persist within biofilms and dentinal tubules, making complete disinfection difficult. Therefore, intracanal medicaments are used as an adjunct to chemomechanical preparation, particularly in necrotic teeth with apical periodontitis.
Calcium hydroxide is the gold-standard intracanal medicament because of its antibacterial activity, ability to neutralize bacterial endotoxins, and capacity to promote mineralized tissue formation and periapical healing. Its antimicrobial effect is attributed to the release of hydroxyl ions that create a highly alkaline environment.
Despite these advantages, calcium hydroxide has limited efficacy against resistant microorganisms, particularly Enterococcus faecalis, and its activity may be reduced by the buffering effect of dentin. Consequently, researchers have investigated novel vehicles and bioactive compounds to enhance its antimicrobial performance.
The vehicle mixed with calcium hydroxide influences hydroxyl ion release, diffusion, and antimicrobial activity. Although sterile saline is the conventional aqueous vehicle, increasing interest has focused on natural products with antimicrobial, anti-inflammatory, antioxidant, and analgesic properties.
Cyperus articulatus essential oil has demonstrated promising antibacterial and antibiofilm activity against Enterococcus faecalis while maintaining acceptable cytocompatibility. When combined with calcium hydroxide, it may improve antimicrobial efficacy without compromising biocompatibility, but clinical evidence remains scarce.
Successful endodontic treatment depends on effective elimination of microorganisms from the infected root canal system and prevention of reinfection. However, complete disinfection remains difficult because of the complex anatomy of the root canal system, allowing residual microorganisms to persist and contribute to persistent apical periodontitis and treatment failure.
- Conditions
- Chronic Apical Periodontitis
- Being tested
- Cyperus articulatus
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
Cyperus articulatusProcedure or surgery
Also called Calcium hydroxide
to evaluate the effect of Cyperus articulatus versus Calcium hydroxide on bacterial reduction and postoperative pain in necrotic permanent teeth with chronic apical periodontitis
| Study group | Role | What they receive |
|---|---|---|
| Control Group | Experimental | about 20 participants will be subjected to Calcium hydroxide mixed with sterile saline for intracanal placement Receives: Procedure: Cyperus articulatus |
| Cyperus articulatus | Experimental | about 20 participants will be subjected to Cyperus articulates essential oil mixed with inert gel for intracanal placement.The amount of essential oil used will be standardized for all specimens to ensure uniform consistency and reproducibility. Receives: Procedure: Cyperus articulatus |
| Calcium Hydroxide Mixed with Cyperus articulatus | Experimental | about 20 participants will be subjected to Calcium hydroxide powder will be mixed with Cyperus articulatus essential oil using the same standardized powder-to-liquid ratio adopted in the control group until a smooth, homogeneous paste with adequate consistency is achieved.The amount of essential oil used will be standardized for all specimens to ensure uniform consistency and reproducibility. Receives: Procedure: Cyperus articulatus |
What is being measured
The primary outcome is the main question the study is designed to answer.
Anti-Microbial efficacy assessment
Assessment of The paper points of the Participants by quantitative microbiological analysis using colony-forming units (CFU/mL). and will be incubated and will be determined by bacterial counting using agar culture technique before and after root canal preparation (CFU/ml).
Measured: 7 days
Secondary outcomes (1)
Post Operative Pain
Intensity of post- operative pain level will be recorded at 6, 12, 24, 48, 72-hours and 7 days after Endodontic treatment by numerical Rating Scale using Numerical Rate Scale (NRS) and will be used to record the patients' pain levels. The NRS (0-10 scale) where as 0 means No pain and 10 means severe pain".
Measured: 7 days
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted23 Oct 2026
- Study start25 Sep 2026
- Primary completion15 Sep 2027 (estimated)
- Study completion30 Sep 2027 (estimated)
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Other trials for Chronic 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
- Parallel groups
- Masking
- None (open label)
- Enrolment
- 60 participants (estimated)
Sponsor and investigators
- Lead sponsor
- Minia University
- Sponsor type
- University, hospital or other
- Responsible party
- Principal investigator, Fahd Mohamed Salah, Minia University
- Investigators
- Rehab Mahmoud Abdel Baky Radwan, M.D, Study chair, Professor of Microbiology and Immunology,Faculty of Pharmacy,Deraya University
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT07892690
- Sponsor's protocol ID
- Cyperus Articulatus
- Status last verified
- Sep 2026
- First submitted
- 18 Oct 2026
- Last updated
- 23 Oct 2026
- Results posted
- No
- Data monitoring committee
- Yes
- FDA-regulated drug
- No
- FDA-regulated device
- No