Treatment of Young Permanent Teeth With Different Adjuvant Approaches

University of Belgrade

Status: Completed

Conditions: Necrotic Pulp; Periodontitis, Apical; Treatment

Treatments: Device: Laser-device group; Drug: Sodium hypochlorite group; Drug: Essential Oil

Study type: Interventional

Funder types: Other

Identifiers

NCT05291195

36/7

Details and patient eligibility

About

To determine microbiology assessment of infected root canal in young permanent teeth, as well as antimicrobial efficiency of different adjuvant treatment modalities including photodynamic therapy (PDT), high-power diode laser, and essential oils following mechanic-chemical treatment in the treatment of periapical periodontitis in these teeth.

Full description

To determine antimicrobial efficiency of adjuvant photodynamic therapy (PDT) and high-power diode laser, and essential oils in the treatment of chronic periapical periodontitis in young permanent teeth.

Material and Methods: Young permanent teeth with chronic periapical periodontitis were selected and randomly divided into tests and control groups. Adjuvant treatment approaches were randomly performed following standard mechanical-chemical endodontic treatment:

1. Experimental laser-device 1, PDT group: adjuvant PDT (n=10)
2. Experimental laser-device 2, Diode laser (940 nm, 1W) (n=10)
3. Experimental essential oil (n=10)
4. Experimental sodium hypochlorite (NaoCL) group (n= 10) solely mechanical instrumentation with 1.5 % of NaOCl irrigation was performed (positive control).

Afterwards, each root canal was filled with calcium hydroxide, and definitive obturation was done seven days respectively.

Microbiological analyses of root canals were assessed after accessing the canal (sample 1), following mechanical-chemical treatment (sample 2), and adjuvant treatment approaches (sample 3). The microbiological identification and quantification were provided by MALDI -TOF spectrometry and plate count assay. To evaluate the efficiency of treatment modalities, radiography records were additionally used.

Enrollment: 40 patients

Sex: All

Ages: 7 to 18 years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• Had signed informed consent by the parents or legal guardian ;
• Systemically healthy children;
• Had not been submitted to antibiotic therapy in the previous 3 months;
• Had a least one young permanent anterior tooth (incisor or canine) or the first premolar with pulp necrosis and presence of a chronic periapical lesion (CPP);
• Had no endodontic treatment of the selected tooth;
• Had no signs of an acute condition;

Exclusion criteria

• Presence of systemic diseases such as diabetes mellitus, asthma, chronic infections, immunosuppressive diseases or other that could compromise the patient immune system
• Use anti-inflammatory or immunosuppressive therapy in the last 6 months;
• Patients with antibiotic prophylactic requirements before dental treatment;

Trial design

Primary purpose: Treatment

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: Triple Blind

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40 participants in 3 patient groups

Laser-devices group

Experimental group

Description:

Mechanico-chemical root canal preparation and root canal disinfection were be performed by means of mechanic-chemical methods including hand instruments followed by 1.5% sodium hypochlorite. Afterwards, depending on allocations, in the laser devices group, adjuvant treatment approaches were be performed by means of laser devices either photodynamic therapy (HELBO, Photodynamic Systems GmbH), or high power diode laser (940nm, Biolase).

Treatment:

Drug: Sodium hypochlorite group

Device: Laser-device group

Sodium hypochlorite

Experimental group

Description:

Mechanico-chemical root canal preparation and root canal disinfection were be performed by means of mechanic-chemical methods including hand instruments followed by 1.5% sodium hypochlorite (pH 12), at room temperature (21 degrees Celsius).

Treatment:

Drug: Sodium hypochlorite group

Essential oil

Experimental group

Description:

Mechanico-chemical root canal preparation and root canal disinfection were be performed by means of mechanic-chemical methods including hand instruments followed by 1.5% sodium hypochlorite (pH 12), at room temperature (21 degrees Celsius). Depending on allocations, in the essential oil group, the canals were be treated with adjuvant essential oil of Cymbopogon martinii and Thymus vulgaris (Herba oils, Herba doo, Belgrade, Serbia)

Treatment:

Drug: Essential Oil

Drug: Sodium hypochlorite group