Pain After PRP Revascularization and Endodontic Treatment of Non-vital Mandibular Molars With Apical Periodontitis

Study Overview
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Brief Summary
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randomized clinical trial which Evaluate thr Post-operative Pain Following Platelet Rich Plasma (PRP) Revascularization versus Conventional Endodontic Treatment of Non-vital Mature Mandibular Molars with Chronic Peri-apical Periodontitis

Detailed Description
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it will be done in 2 visits where in the firist visit, i will finish cleaning and shaping of the canals and inject double antibiotic paste as intracanal medication. in the second visit, removal of intracanal medication then obturaton of the canals in the control group. while in the intervention group,over instrumentation of the canals beyond the working length using k-file size 20-35 to establish bleeding in the canals.then blood sample is collected for PRP preparation then injected into the canal.the patient will record post operative pain 6,12,24,48 hours then 3,4,5 days later.then they will do CBCT at 6, 12 months after the treatment to assess peri-apical healing

Official Title
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Evaluation of Post-operative Pain Following Platelet Rich Plasma (PRP) Revascularization Versus Conventional Endodontic Treatment of Non-vital Mature Mandibular Molars With Chronic Peri-apical Periodontitis

Conditions
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Postoperative Pain

Intervention / Treatment
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* Procedure: Platelet rich plasma PRP
* Procedure: root canal treatment


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Medically free patients, between 18-40 years Patients with necrotic pulp in mandibular molar permanent teeth with closed apex Exclusion Criteria: Illiterate patient Patients with systemic diseases Pregnant women Patients that have allergy to ciprofloxacin or metronidazole Teeth that: Have vertical root fracture, coronal perforation, and calcification. re-treatment cases Non restorable Patients that have T.M.J. disorder

Ages Eligible for Study
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Minimum Age: 15 Years
Maximum Age: 35 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Double


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Revascularization<br>platelet rich plasma injected in the canals | Procedure: Platelet rich plasma PRP<br>* blood sample is collected to prepare platelet rich plasma injected in the canal<br>|
| Active Comparator: root canal treatment<br>endodontic treatment obturated with gutta percha | Procedure: root canal treatment<br>* conventional root canal treatment and obturation with guttapercha<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Post-operative Pain | postoperative pain evaluated using NRS scale It is a numerical rating scale from 0-10 with 0 representing no pain and 10 representing worst pain | 5 days | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| healing | healing of periapical tissue evaluated radiographically | 12 months |