Endodontically Treated Teeth
Conditions
Keywords
Diode laser, Endodontic retreatment, IL-8 expression
Brief summary
This clinical trial will be conducted to evaluate the amount of Il-8 expression before and after the application of intracanal irradiation with diode laser 980 nm versus placebo in failed endodontic cases with periapical lesions.
Detailed description
* Thorough medical and dental history for the eligible patients * Thorough intraoral and extraoral diagnosis * Local anesthesia * Isolation and removal of any previous filling or restoration * Removal of old gutta percha and establish patency to the full working length. * 1st sample: will be collected using 3 sterile paper points * Chemo-mechanical preparation. * 2nd sample collection • Laser group: The canals will be irradiated with a high-power diode laser, with wavelength of 980 nm, maximum output of 3 watts and coupled with a fiber optic tip of 200 µm diameter. • Mock laser application (Placebo group): The fiberoptic tip will be inserted inside the root canal, mimicking the laser irradiation, but not activated. * 3rd sample collection * A piece of dry cotton will be placed in the access cavity, and then will be sealed with glass ionomer filling material * 2nd visit: 1 week later, 4th sample collection then Obturation * Number of visits & follow up period: Two visits
Interventions
After endodontic retreatment, root canals will be irradiated with a 980 nm diode laser coupled with optical fibre 200 μm (Litemedics, Italy) with setting 1.2-watt power, in pulsed mode. The irradiation protocol will be of 5-sec irradiation followed by a 10-sec pause, which constituted one lasing cycle. The lasing cycle will be performed four times for each tooth. The tip will be positioned 1 mm short of the apex. Followed by activation during which it will be slowly dragged at a speed of approximately 2 mm/ sec in a way that the root canals will be irradiated from the apical to the coronal portion, in a helicoidal movement touching the canal walls.
After endodontic retreatment, mock laser application (Placebo group) will be applied: The fiberoptic tip will be inserted inside the root canal, mimicking the laser irradiation group, but not activated
Sponsors
Study design
Eligibility
Inclusion criteria
* failed previously treated endodontic single-rooted teeth with chronic periapical lesions; with radiographic evidence of periapical radiolucency of not less than 1 cm diameter will be selected. * Teeth with straight root canals. * No contributory medical history. * No previous administration of analgesics and/or antibiotics within the previous 2 weeks.
Exclusion criteria
* Retreatment cases with complications such as separated instruments, perforations, ledges, resorption, transportation, calcifications, immature apices and over fillings. * Teeth with curved roots. * Swelling or sinus tract. * Mutilated teeth that interfere with proper isolation and seal between visits. * Subjects with generalized periodontitis, or if the tooth has a probing depth of more than 3 mm. * Subjects with uncontrolled diabetes or debilitating diseases. * Pregnant or nursing females. * Systemic disorders that necessitate antibiotic prophylaxis or prevent the use of Ibuprofen.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| quantification of IL-8 | one week | \- After collection of all the samples, quantification of IL-8 will be determined using ELISA kit before (S-1), after chemo-mechanical preparation (S-2), after intracanal irradiation or placebo effect (S-3) and last after one week of the treatment (S-4). The kit is used according to the manufacturer's recommendations. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Postoperative pain | 6, 12, 24 hours and 7 days | Following the first visit, the modified visual analogue scale (VAS scale) with 11 points where 0 means no pain and 10 means maximum pain will be used to record patient's level of pain |
Countries
Egypt