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The Effects of EndoActivator on Postoperative Pain and Root Canal Treatment Success

Not Applicable
Completed
Conditions
Root Canal Infection
Periapical Periodontitis
Interventions
Procedure: Control Needle Irrigation
Procedure: Sonic Activation with EndoActivator
Registration Number
NCT06339905
Lead Sponsor
Istanbul Medipol University Hospital
Brief Summary

This study evaluates postoperative pain and radiographic healing of asymptomatic posterior teeth with chronic apical periodontitis following root-canal treatment performed using EndoActivator for irrigation activation.

Detailed Description

Aim: To evaluate postoperative pain and radiographic healing of asymptomatic posterior teeth with chronic apical periodontitis following root-canal treatment performed using EndoActivator for irrigation activation.

Methodology: In this clinical trial, root-canal treatment was performed on 140 posterior teeth with chronic apical periodontitis. After routine canal preparation, patients were assigned to either a control group treated using conventional needle irrigation (CNI) without activation or to sonic irrigation activation with EndoActivator. All treatment was completed in a single visit. Patients provided self-assessments of the severity of postoperative pain at 1, 2,3 and 7 days using a Verbal Rating Scale (VRS) and Wong Baker Face Scale. Patients were recalled at 12 months for clinical and radiographic examinations. Periapical healing was evaluated using a periapical index (PAI), with scores of 1 or 2 considered to represent treatment success and scores of 3, 4, or 5 to represent treatment failure. Data were analyzed using one-way ANOVA and Kruskal-Wallis tests, with differences of P \< 0.05 considered statistically significant.

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
140
Inclusion Criteria
  • 18-60 patient's age
  • Being systemically healthy
  • Having posterior teeth (molar or premolar) with chronic apical periodontitis lesion (PAI≥3)
Exclusion Criteria
  • Clinically symptomatic teeth
  • Patients with complicated systemic disease (ASA 3 - 6)
  • Teeth with open apex
  • Teeth having curvature more than 20 degree
  • Not having enough tooth structure to be isolated with rubber dam
  • Patients with severe periodontal defects or deep periodontal pockets (probing depth> 4 mm)
  • A history of taking analgesics 12 hours ago or antibiotics 1 month ago
  • Patients who cannot come to control sessions

Study & Design

Study Type
INTERVENTIONAL
Study Design
FACTORIAL
Arm && Interventions
GroupInterventionDescription
Conventional needle irrigation (control)Control Needle IrrigationConventional needle irrigation was performed with short, in-and-out vertical strokes of 2-3 mm at a rate of approximately 100 strokes per minute.
Sonic Activation with EndoActivatorSonic Activation with EndoActivatorSonic irrigation was performed using an EndoActivator sonic handpiece (Dentsply Tulsa Dental Specialties, Tulsa, OK, USA). A suitable-size activator tip was selected and loosely placed at 2 mm from working length, and the device was operated at 10,000 cycles/min using a pumping action to move the tip to produce vertical strokes of 2-3 mm.
Primary Outcome Measures
NameTimeMethod
change from baseline postoperative pain at 1 week1,2,3 and 7 days

Pain was measured using a Verbal Rating Scale with 4 levels, as follows: 0, no pain; 1, slight pain (mild discomfort, no treatment needed); 2, moderate pain (pain required analgesics for relief); 3, severe pain (pain and/or swelling not relieved by simple analgesics and required unscheduled visit) and Wong Baker Face Scale with six different facial expression. Patients were provided forms and asked to record preoperative pain as well as pain at 1,2,3 and 7 days postoperatively, and to note down the number of analgesics taken. Patients returned their completed forms at their 1-week follow-up visits.

change from baseline periapical index at 1 yearClinical and radiographic examinations were performed on the 1 day of treatment, and 1 year after treatment.]

Periapical tissue was evaluated using a 5-point periapical index (PAI) (Ørstavik et al. 1986) and scored as follows: 1: Normal periapical structures; 2: Small changes in bone structures; 3: Changes in bone structure with some mineral loss; 4: Periodontitis with well-defined radiolucent area; 5: Severe periodontitis with exacerbating features.

Treatment was considered successful if the patient had no discomfort, no percussion/palpation pain, no sinus tract, no mobility or associated soft-tissue swelling, and a PAI score of ≤ 2. Treatment was considered a failure if the patient could not perform normal masticatory functions, experienced discomfort and percussive pain upon examination, and/or had a PAI score of ≥ 3 .

Secondary Outcome Measures
NameTimeMethod

Trial Locations

Locations (1)

Istanbul Medipol University, Faculty of Dentistry

🇹🇷

Istanbul, Esenler, Turkey

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