Comparative Evaluation of Clinical and Radiographic Treatment Outcomes of Garlic Gel and Calcium Hydroxide as an Intracanal Medicament in Nonsurgical Root Canal Treatment of Permanent Teeth.

Phase 3Not Yet RecruitingNCT07289971

University of Health Sciences Lahore96 enrolled

Overview

Researchers want to check how well garlic works inside permanent teeth as a medicament during root canal treatments. Garlic has shown to possess many helpful properties, like reducing inflammation, helping wounds heal, and antimicrobial characteristics. Because conventional medicaments can be expensive or have potential side effects, researchers are actively exploring natural options like garlic. Some lab studies have already shown that garlic gel can kill the microbes inside the teeth. However, no real-life clinical or X-ray studies have been done on using garlic in permanent teeth. This study may help scientists find a much safer and effective new material for dental treatments in the future.

Clinical trials are needed to evaluate the effectiveness of Allium sativum as an intracanal medicament due to its various useful properties, such as anti-inflammatory, wound healing action, and antimicrobial properties. To overcome the problems with synthetic medicament, researchers are looking for natural alternatives due to their low cost, easy availability, and safety. The objective of the study is to evaluate and compare the clinical and radiographic treatment outcomes of using garlic gel and calcium hydroxide paste as an intracanal medicament in nonsurgical root canal treatment of permanent teeth in terms of: * Pain. * Tenderness to palpation. * Tenderness to percussion. * Size of Periapical radiolucency.

Study Type

INTERVENTIONAL

Allocation

RANDOMIZED

Purpose

TREATMENT

Masking

DOUBLE

Enrollment

Conditions

Apical Periodontitis

Interventions

Allium Sativum as an intracanal medicamentDRUG

Patients will receive informed consent, clinical exam, and preoperative radiographs. After anesthesia and rubber dam isolation, access, cleaning, and shaping of canals will be performed using standard endodontic techniques. A sterile paper point will be placed in the canal for pH evaluation, followed by placement of garlic gel with lentulo spiral and temporary restoration of MD Temp and GC Gold Label 2 GIC. Patients will return after 14 days; if symptoms persist, the medicament will be replaced, and the patient will be reviewed again after 14 days and then after one month. Final obturation will only be done once all symptoms have resolved. If the experimental group continues to show symptoms after three dressings, the case will be considered a failure and treated conventionally. When asymptomatic, the medicament will be removed, canals will be irrigated, dried, obturated with gutta-percha and Endoplus sealer. Radiographic outcomes will be evaluated after 6 months by 2 endodontists.

Eligibility

Sex: ALLMin age: 15 YearsMax age: 45 YearsHealthy volunteers:

Medical Language ↔ Plain English

Inclusion Criteria: * Patients with the physical status of ASA I and ASA II according to ASA classification. * Patients aged from 15-45 years. * Mature permanent single-rooted teeth with closed apices. * Patients with clinical signs of symptomatic apical periodontitis (pain, tenderness to palpation, and percussion). * Patients having radiographic evidence of periapical radiolucency of endodontic origin. * Patients who have not taken antibiotics for the past 14 days. * Cooperative patients who show good compliance. Exclusion Criteria: * Patients with physical status of ASA III, IV, and V according to ASA classification. * Teeth with a calcified pulp chamber in periapical radiography. * Patients who have undergone previous endodontic treatment failure and those with the presence of sinus tract on clinical examination. * Teeth having advanced periodontal disease, with the basic periodontal examination (BPE) of 3 and 4. * Presence of internal and external resorption of the root as viewed on the periapical radiograph. * Presence of vertical root fracture and perforation as viewed on the periapical radiograph

Outcomes

Primary Outcomes

CLINICAL AND RADIOGRAPHIC OUTCOMES

Clinical success will be based on the absence of the following clinical signs and symptoms: Pain Tenderness to palpation of adjacent soft tissues Tenderness to percussion of involved tooth Radiographic outcomes will be measured in terms of size of Periapical radiolucency. The Periapical status will be assessed using the periapical index (PAI) scoring system by Orstavik. Each tooth will be assigned one of the Periapical index scores for 5 categories within the scale. SCORE POSSIBLE OUTCOME 1. Normal periapical structure 2. Small changes in bone structures 3. Change in bone structure with mineral loss 4. Periodontitis with well-defined radiolucency 5. Severe periodontitis with exacerbating features Periapical radiolucency will be classified as resolved if the Periapical index score is less than or equal to score of 2.

Time frame: Time frame for clinical outcomes: Baseline to 2 weeks Time frame for radiographic outcomes: Baseline to 6 months