Chronic Apical Periodontitis, Periapical Healing
Conditions
Brief summary
This prospective randomized clinical study will investigate the association between MMP-2 and MMP-3 gene polymorphisms and radiographic healing outcomes following nonsurgical root canal treatment in patients with chronic apical periodontitis. A total of 50 patients will undergo standardized endodontic treatment and will be followed for 12 months. Genotyping will be performed using baseline DNA samples, and periapical healing will be assessed using the Periapical Index (PAI). The relationship between genetic variations and treatment outcomes will be analyzed to determine whether host-related genetic factors influence healing patterns after root canal therapy.
Interventions
PROCEDURENonsurgical Root Canal Treatment
All participants will undergo standardized nonsurgical root canal treatment performed under a uniform clinical protocol. After local anesthesia and rubber dam isolation, working length will be determined electronically and radiographically. Root canal preparation will be completed with rotary instrumentation up to size 30/.06, accompanied by sodium hypochlorite irrigation, EDTA, and ultrasonic activation. Canals will then be obturated in the same visit using gutta-percha and epoxy resin-based sealer with the warm vertical condensation technique. Periapical healing outcomes at 12 months will be evaluated in relation to MMP-2 and MMP-3 genetic polymorphisms.
Sponsors
TC Erciyes University
Study design
Observational model
COHORT
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
18 Years to 65 Years
Healthy volunteers
No
Inclusion criteria
* Single-rooted teeth * PAI score ≥ 3 * Fully developed root apices * Periodontal probing depth less than 5 mm * Indication for primary nonsurgical root canal treatment
Exclusion criteria
* Previous endodontic treatment in the selected tooth * Diagnosis of symptomatic apical abscess * Presence of root fracture or internal/external resorption * Use of systemic antibiotics within the previous 4 weeks * Analgesic intake within 48 hours before treatment * Ongoing immunosuppressive therapy * Pregnancy or breastfeeding
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Radiographic Periapical Healing | 12 months after treatment | The primary outcome will be radiographic healing assessed using the Periapical Index (PAI) scoring system on standardized periapical radiographs. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Association Between MMP Genotypes and Healing Outcomes | Baseline (genotyping) and 12 months after treatment | The association between MMP-2 (rs243865) and MMP-3 (rs3025058) genotypes and radiographic healing outcomes will be evaluated. Genotype and allele distributions will be compared between healed and non-healed groups to determine the potential influence of genetic polymorphisms on periapical healing following root canal treatment. |
Outcome results
None listed