Influence of Apical Patency Concept Upon Postoperative Pain After Root Canal Treatment
Condition: Postoperative Pain
MeSH terms: Pain, Postoperative
Study type: Interventional

Summary: 
      The aim of this clinical study is to evaluate the influence of apical patency concept
      implementation upon postoperative pain following root canal treatment in a single visit
      approach in molars with pulpal disease.
    

Detailed description: 
      All patients will be treated in a single session approach regardless of the group. All molars
      will be anesthetized either through infiltration in case of maxillary molars or inferior
      alveolar nerve block in case of mandibular molars using Octocaine 2% with epinephrine 1:
      100,000 (Lidocaine HCl, Novocol Pharmaceutical, Ontario, Canada.). Rubber dam will be
      applied; and access will be opened using Endo access bur.

      Canals will be scouted using manual patency file in a watch winding maneuver and then coronal
      flaring will be performed using Gates Glidden drill #3 in a brushing motion away from
      dangerous zone. Root canals will be copiously irrigated using 10 ml 2.5% sodium hypochlorite
      NaOCl (Clorox; Egyptian Company for household bleach, Egypt) delivered using 28 Gauge safety
      Steri Irrigation Tip (DiaDent Group International, Burnaby, BC, Canada) inserted 3 mm below
      cementoenamel junction. Working length will be determined using electronic apex locator Root
      ZX II (J. Morita Mfg. Corp, Kyoto, Japan) and confirmed radiographically using parallel
      technique with receptor holding device. Canals will be irrigated again with 10ml 1.5% NaOCl,
      which will be delivered 2mm coronal to apical canal terminus. Irrigation will be
      hydro-dynamically agitated with EndoActivator device (Dentsply Maillefer, Baillagues,
      Switzerland) using yellow tips #20/06 inserted 2mm short of working length for 60 seconds.
      Root canals will be shaped using ProTaper next rotary Ni-Ti files (Dentsply Maillefer,
      Baillagues, Switzerland). In Gp A, apical patency will be maintained till obturation using
      electronic apex locator confirmed radiographically while in Gp B apical patency will not be
      maintained. Finally, Root canals will be obturated using cold lateral compaction technique.
      The molars will be permanently restored using composite resin restoration and will be
      scheduled for extra coronal restoration.
    

Intervention name(s): apical patency; Non-apical surgery
Intervention type(s): Procedure; Procedure
Intervention description(s): In Gp A, apical patency will be maintained till obturation using electronic apex locator confirmed radiographically. Finally, Root canals will be obturated using cold lateral compaction technique. The molars will be permanently restored using composite resin restoration and will be scheduled for extra coronal restoration.; in Gp B apical patency will not be maintained. Finally, Root canals will be obturated using cold lateral compaction technique. The molars will be permanently restored using composite resin restoration and will be scheduled for extra coronal restoration
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Single (Outcomes Assessor)
Primary purpose: Prevention