Evaluation of the Impact of Different Final Irrigation Activation Modes on Healing of Periapical Lesions Related to Permanent Mandibular First Molars Using CBCT.
Necrotic Pulp With Symptomatic Apical Periodontitis
Investigational drug(s) / intervention(s)
root canal treatment
root canal treatment: single visit root canal treatment with final irrigation protocol according to arm
Study summary
The goal of this clinical trial is to learn how different ways of activating the cleaning liquid (irrigation) during endodontic treatment affect healing of infections at the root tip (periapical lesions) in adults aged 20 to 40 with a lower first molar tooth.
The main question it aims to answer is:
Does the way the cleaning liquid is moved inside the tooth during endodontic treatment change how well the infection at the root tip heals after 12 months?
Researchers will compare four irrigation methods to see which one helps the infection heal best:
A regular needle and syringe (the standard endodontic method) Ultra X, which uses sound waves to push the liquid through the tooth Endo Vac, which uses gentle suction to pull the liquid through the tooth I Vac, which combines suction and sound waves
Participants will:
Have their endodontic treatment done in one visit by the same dentist Be randomly placed into one of the four groups Return for check-ups at 3, 6, and 9 months after endodontic treatment Come back at 12 months for a final check-up and a 3D dental scan (CBCT) to measure how much the infection has healed
Eligibility
Sex
ALL
Min age
20 Years
Max age
40 Years
Healthy volunteers
Accepted
Inclusion Criteria:
* \- Medically free patients with no systemic disease: (American Society of Anesthesiologists / (ASA Class I or II).
* The age range is between 20 to 40 years.
* Patients have restorable Mandibular permanent molars that were diagnosed with necrotic pulp with symptomatic apical periodontitis (with small to moderate periapical lesion/≤ 5mm) .
* Positive patient's acceptance for participating in the study.
* Patients able to sign informed consent.
* Both male and female patients are eligible.
* Good oral hygiene.
* Mandibular first molars with two roots (mesial and distal), each presenting a Weine Type III canal configuration.
Exclusion Criteria:
* \- Medically compromised patients.
* Pregnant or lactating females.
* Psychologically disturbed patients.
* Patients with a history of allergy to any medication used in the study were excluded.
* Mandibular first molar with:
* Wide or open apex.
* Vital pulp tissues.
* Periodontally affected with grade 2 or 3 mobility.
* Not restorable teeth.
* Abnormal anatomy and calcified canals.
* Previous root canal treatment.
Primary outcome measure(s)
healing of periapical lesion — 12 month percent reduction lesion size after root canal treatment using CBCT-PAI scores
This page summarises publicly available registry data for informational purposes — not medical advice. Eligibility is determined by each study team; patients should discuss participation with their clinician.
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