Minimally Invasive Root Canal Treatment With Active Disinfection on Single Rooted Teeth With Periapical Lesions
NCT Number: NCT06467643
Status: COMPLETED
Study Type: INTERVENTIONAL
Phases: NA
Conditions: Radiographic Healing of Periapical Lesions Following Ultrasonic Activation of Heated Sodium Hypochlorite Without Instrumentation of Root Canals
Interventions: PROCEDURE: non-instrumented root canal treatment with passive ultrasonic activation of heated sodium hypochlorite|PROCEDURE: conventional root canal treatment with passive ultrasonic activation of heated sodium hypochlorite
Sponsor: Saint-Joseph University
Sex: ALL
Age: ADULT
Enrollment: 19
Study Design: Allocation: RANDOMIZED|Intervention Model: PARALLEL|Masking: TRIPLE (PARTICIPANT, INVESTIGATOR, OUTCOMES_ASSESSOR)|Primary Purpose: TREATMENT
Start Date: 2023-07-07
Completion Date: 2024-04-07
Locations: Saint Joseph University, Beirut, Lebanon

Summary:
A novel form of root canal treatment RCT, referred as minimally invasive endodontics MIE, has emerged recently to adopt a unique approach that emphasize reducing tooth structural changes post-treatment (32). MIE seeks to maintain as much of the tooth's healthy coronal, cervical, and radicular anatomy as practical. Access opening, root canal cleaning and shaping, as well as surgical endodontics are all potential areas where MIE can be applied in endodontic therapy (34,36). Technological and technical progress, based on new tools, files and devices, are now allowing the simplification of this approach.

In the context of endodontics, the question may be whether conventional therapeutic approaches are minimally invasive enough (32,34), or whether a less invasive approach is required. This preliminary clinical study examined radiographically a minimally invasive shaping protocol combined with heated multi-sonic based irrigation to achieve disinfection with the removal of the least amount of dentin from the root's hard tissue during root canal shaping, compared to conventionally instrumented root canals, by focusing on the following aspects:

* The change in the area of the periapical lesion (measured in square millimeters) between T0, T3, T6 and T9
* The speed of repair of healed/healing periapical lesions (absolute speed of shrinkage and relative speed of shrinkage).

In addition, this study evaluated the association between radiographic outcomes and the type of endodontic treatment. Results obtained concerning the mentioned factors were compared across both techniques as well as the available ex-vivo and in vivo studies present in the literature. With the objective of cleaning and disinfecting the root canals as a complex while conserving root integrity, further efforts, to adopt such technique in posterior teeth where the mastication force and stress are at their most, could be done to set guidelines for an effective and more conservative root canal therapy.

Primary Outcome Measures: radiographic healing based of the area percentage change of lesions, the treatment outcome was presented in four categories: undetected lesion, reduction, enlargement, or unchanged. Reduction and enlargement of the radiolucency were determined only when the change in size of radiolucency was 20% or more. An unchanged lesion was defined as a lesion change less than 20%., 9 months|radiographic healing based on the periapical index score by Ørstavik et al. 1986, Treatment outcome scores with PAI were adjusted to reflect clinical success (PAI1 and PAI2 at follow-up), uncertain (PAI3 at follow-up for initial PAI4,5) and failure (persisting PAI3 and any PAI4 or PAI5 at follow-up). Failure was also recorded if the patient did not appear at any follow up recalls, a tooth had been extracted, or had evidence of a sinus tract involving the periapical area at recall., 9 months