Chronic Apical Periodontitis
Conditions
Keywords
Periapical Healing, Irrigation Activation, Sonic Activation, Passive Ultrasonic Irrigation, Laser-Activated Irrigation, Periapical Index, Fractal Analysis, Root Canal Treatment
Brief summary
This study aims to evaluate the effects of different irrigation activation methods on periapical healing in teeth with chronic apical periodontitis. Patients underwent root canal treatment using one of three irrigation activation methods: sonic activation, passive ultrasonic irrigation, or laser-activated irrigation. Periapical healing is evaluated by comparing baseline and follow-up periapical radiographs using the Periapical Index (PAI) and fractal analysis. PAI is used to assess changes in periapical status, while fractal dimension analysis is used to quantitatively evaluate changes in the trabecular bone structure in the periapical region. The study aims to determine whether the irrigation activation method used during root canal treatment influences subsequent periapical healing.
Interventions
Irrigating solutions were activated using an Er:YAG laser with the following parameters: SSP mode (50 μs), 0.3 W, 15 Hz, and 20 mJ. A radial laser tip was positioned in the coronal pulp chamber, and activation was performed for three 20-second cycles, for a total activation time of 60 seconds.
Irrigating solutions were activated using a sonic activation device. The activation tip was positioned 2 mm short of the working length, and sonic activation was performed for three 20-second cycles, for a total activation time of 60 seconds.
Irrigating solutions were activated using a passive ultrasonic irrigation device in endodontic mode. The activation tip was positioned 2 mm short of the working length, and ultrasonic activation was performed for three 20-second cycles, for a total activation time of 60 seconds.
Sponsors
Recep Tayyip Erdogan University
Study design
Allocation
NON_RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
SINGLE (Subject)
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* Participants aged 18 years or older * Systemically healthy participants * Mandibular premolar teeth diagnosed with pulp necrosis and chronic apical periodontitis * Teeth undergoing single-visit root canal treatment
Exclusion criteria
* Use of any analgesic medication within 24 hours before root canal treatment or use of corticosteroid medications * Use of antibiotics within 1 week before root canal treatment * Pregnancy or breastfeeding * Presence of any systemic disease, including conditions requiring antibiotic prophylaxis * Presence of mental or psychiatric disorders * Presence of swelling or pain on palpation before treatment * Presence of root resorption in the study tooth * Presence of generalized periodontitis * Presence of a periodontal pocket depth greater than 3 mm in the study tooth * Teeth with root fracture, ankylosis, or pathological mobility * Presence of a cystic lesion, defined as a lesion surrounded by a well-defined radiopaque border and causing displacement of adjacent teeth * Teeth with radiographically very narrow or wide root canals * Participants who did not attend the follow-up visit at least 6 months after root canal treatment
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Change in Periapical Index (PAI) | Baseline and at least 6 months after root canal treatment | Periapical healing will be assessed using the Periapical Index (PAI) on periapical radiographs. PAI scores range from 1 to 5, with lower scores indicating healthier periapical conditions and higher scores indicating greater severity of periapical pathology. Changes in PAI scores between baseline and follow-up radiographs will be evaluated. |
| Change in Fractal Dimension (FD) | Baseline and at least 6 months after root canal treatment | Fractal dimension (FD) will be calculated from standardized regions of interest on periapical radiographs using ImageJ software and the box-counting method. Changes in FD values between baseline and follow-up radiographs will be evaluated to quantitatively assess changes in the trabecular bone structure in the periapical region. |
Countries
Turkey (Türkiye)
Outcome results
None listed