Effect of Apical Enlargement to Different Preparation Sizes and Tapers on Pain and Bacterial Reduction in Necrotic Pulp

Cairo University (CU)

Status: Not yet enrolling

Conditions: Necrotic Pulp

Treatments: Other: Root canal instrumentation EdgeFile X7 to size #45/0.06; Other: Root canal instrumentation EdgeFile X7 to size #45/0.04; Other: Root canal instrumentation EdgeFile X7 to size #35/0.04; Other: Root canal instrumentation EdgeFile X7 to size #35/0.06

Study type: Interventional

Funder types: Other

Identifiers

NCT05620147

2/11/2022

Details and patient eligibility

About

The aim of this prospective randomized clinical trial is to evaluate the effect of different apical size and taper preparation (35. 04; 35. 06; 45. 04 and 45. 06) on postoperative pain at 6, 12, 24, 48 and 72 hours, and intra-canal bacterial count in patients having mandibular premolars with necrotic pulps.

Full description

• Patients will be clinically and radiographically examined and their eligibility will be assessed. Eligible patients will be treated in one visit.
• Patients will be randomly assigned to one of 4 groups: experimental groups of root canal instrumentation with EdgeFile X7 to size #35/0.06 or #45/0.04 or #45/0.06 or the comparator group to size #35/0.04. Intra-canal bacterial count will be measured using a culture technique. Bacterial samples will be taken before and after root canal instrumentation. After endodontic treatment, patients will be given postoperative instructions and informed, in case of pain, to receive ibuprofen 400 mg as rescue medication.
• Postendodontic pain intensity and incidence at the different pain categories (No, mild, moderate, severe) will be assessed at 6, 12, 24, 48 and 72 hours postoperatively using Numerical Rating Scale (NRS).

Enrollment: 56 estimated patients

Sex: All

Ages: 18 to 35 years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• Systemically healthy patients, American Society of Anesthesiologists (ASA) I and II.
• Patient's age ranges between 18 to 35 years with no sex predilection.
• Patients with single-rooted mandibular premolars with asymptomatic necrotic pulp.
• Patients who can understand the Numerical Rating Scale (NRS).
• Patients able to sign informed consent.

Exclusion criteria

• Pregnant females.
• Mandibular premolars with periodontal pockets greater than 5 mm or greater than grade I mobility.
• Patients have a positive history of antibiotic use or analgesic use within the past week or required antibiotic premedication for dental treatment (such as prosthetic joint prophylaxis).
• Patients have teeth that have been previously accessed.
• Teeth with extensive crown destruction by caries that will not permit rubber dam placement.
• Teeth associated with acute periapical abscess, swelling or a fistulous tract.
• Radiographic evidence of external or internal root resorption vertical root fracture, perforation, calcification.

Trial design

Primary purpose: Prevention

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: Double Blind

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56 participants in 4 patient groups

Root canal instrumentation EdgeFile X7 to size #35/0.06

Experimental group

Description:

The mechanical preparation will be continued using EdgeFile X7 #35 .04 and #35 .06

Treatment:

Other: Root canal instrumentation EdgeFile X7 to size #35/0.06

Root canal instrumentation EdgeFile X7 to size #45/0.04

Experimental group

Description:

The mechanical preparation will be continued using EdgeFile X7 #35 .04, #40 .04 and #45 .04

Treatment:

Other: Root canal instrumentation EdgeFile X7 to size #45/0.04

Root canal instrumentation EdgeFile X7 to size #45/0.06

Experimental group

Description:

The mechanical preparation will be continued using EdgeFile X7 #35 .04, #40 .04, #45 .04 and #45 .06

Treatment:

Other: Root canal instrumentation EdgeFile X7 to size #45/0.06

Root canal instrumentation EdgeFile X7 to size #35/0.04

Active Comparator group

Description:

The mechanical preparation will be continued using EdgeFile X7 #35 .04

Treatment:

Other: Root canal instrumentation EdgeFile X7 to size #35/0.04