Clinical trial NCT06853028: The Role of Root Canal Treatment in Alleviating Endodontic Pain-Induced Asymmetry and Restoring Muscle Balance
Official title: The Role of Root Canal Treatment in Alleviating Endodontic Pain-Induced Asymmetry and Restoring Muscle Balance: a Prospective Cohort Study
Study type: OBSERVATIONAL
Overall status: COMPLETED
Conditions: Temporomandibular Disorders (TMD)
Acute Apical Periodontitis of Pulpal Origin
Keywords: root canal treatment
ultrasonography
endodontic pain
acute apical periodontitis
masticatory laterality
Lead sponsor: Cukurova University
Sponsor class: OTHER
First posted: 2025-02-28
Enrollment: 20
Sex: ALL
Minimum age (years): 18
Maximum age (years): 60
Standard ages: ADULT
Accepts healthy volunteers: no
Observational model: COHORT
Time perspective: PROSPECTIVE
Sampling method: PROBABILITY_SAMPLE
Study population: •. 20 systemically healthy patients (11 female, 9 male) aged 18-60 years

* Patients with masticatory laterality due to tooth pain for at least 30 days
* First and second maxillary or mandibular molars with acute apical periodontitis due to deep caries
* Teeth with moderate or severe pain according to the VAS (no pain (0 mm), mild pain (1-3 mm), moderate pain (4-6 mm), and severe pain (7-10 mm))
* Teeth that responded positively to percussion test
* Teeth without periapical pathosis

Brief summary: The study hypothesizes that masticatory laterality caused by acute apical periodontitis pain result in muscle asymmetry. Furthermore, it posits that successful root canal treatment, by restoring normal bilateral chewing function, will reduce this asymmetry, as evidenced by ultrasonographic measurements of the masseter and anterior temporal muscles.The main question it aims to answer is:

Can bilateral chewing function be restored after root canal treatment procedures in patients with masticatory laterality due to painful teeth due to acute apical periodontitis?


Eligibility criteria: Inclusion Criteria

* Patients with masticatory laterality due to tooth pain for at least 30 days
* First and second maxillary or mandibular molars with acute apical periodontitis due to deep caries
* Teeth with moderate or severe pain according to the VAS (no pain (0 mm), mild pain (1-3 mm), moderate pain (4-6 mm), and severe pain (7-10 mm))
* Teeth that responded positively to percussion test
* Teeth without periapical pathosis were included in the study. Exclusion Criteria
* Systemic conditions affecting muscle structure or function, such as neuromuscular or endocrine disorders.
* Non-endodontic odontogenic pain.
* Prior endodontic treatment of the relevant tooth within the last 30 days.
* History of trauma or surgery to the head, face, or teeth within the last six months.
* Severe communication disorders or psychological issues.
* Inability to complete treatment in a single visit due to exudation or bleeding
* Patients with masticatory laterality due to missing tooth on any side of the dental arch
* Patients who have painful teeth in opposite sides of the dental arch
* TMD patients were excluded from the study.

Primary outcomes:
measure: Ultrasonography
timeFrame: immediately before root canal treatment, 1 week after and 3 months after the treatment
Secondary outcomes:
Other outcomes:
Locations:
city: Adana
country: Turkey
facility: Çukurova Üniversitesi Diş Hekimliği Fakültesi, Gültepe, Sarıçam/Adana/Türkiye
Study officials:
References:
citation: Elbarbary M, Sgro A, Khazaei S, Goldberg M, Tenenbaum HC, Azarpazhooh A. The applications of ultrasound, and ultrasonography in dentistry: a scoping review of the literature. Clin Oral Investig. 2022 Mar;26(3):2299-2316. doi: 10.1007/s00784-021-04340-6. Epub 2022 Jan 14.
citation: Jeon HM, Ahn YW, Jeong SH, Ok SM, Choi J, Lee JY, Joo JY, Kwon EY. Pattern analysis of patients with temporomandibular disorders resulting from unilateral mastication due to chronic periodontitis. J Periodontal Implant Sci. 2017 Aug;47(4):211-218. doi: 10.5051/jpis.2017.47.4.211. Epub 2017 Aug 21.
citation: Daline IH, Slade GD, Fouad AF, Nixdorf DR, Tchivileva IE. Prevalence of painful temporomandibular disorders in endodontic patients with tooth pain. J Oral Rehabil. 2023 Jul;50(7):537-547. doi: 10.1111/joor.13457. Epub 2023 Apr 14.