The goal of this clinical trial is to learn whether regenerative endodontic treatment (RET) should be performed in one visit or two visits in people with mature permanent teeth with chronic apical periodontitis. RET is a dental treatment used for teeth with necrotic pulp and infection around the root. The procedure disinfects the root canal and promotes the formation of new tissue inside the canal space, which may support healing of the tissues around the tooth root. The main questions this study aims to answer are: Does single-visit RET cause different levels of postoperative pain compared with two-visit RET? Do teeth treated with single-visit or two-visit RET show different levels of healing around the root? Participants will receive RET using either a single-visit or two-visit treatment protocol. Participants will record their pain levels during the first week after treatment using a visual analog scale (VAS). Participants will return for follow-up visits at six months and one year, when dental radiographs will be taken to evaluate healing around the tooth root.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
SINGLE
Enrollment
32
Regenerative endodontic treatment was performed in a single clinical visit in mature permanent teeth diagnosed with chronic apical periodontitis. During the procedure, the root canal system was cleaned through chemomechanical preparation using mechanical instrumentation and irrigation solutions. Apical bleeding was then induced to create a biological scaffold within the canal space. A mineral trioxide aggregate (MTA) coronal barrier was placed over the blood clot. After the setting of MTA, the access cavity was restored with a definitive coronal restoration the following day.
Regenerative endodontic treatment was performed in multiple clinical visits in mature permanent teeth diagnosed with chronic apical periodontitis. During the first visit, the root canal system was cleaned through chemomechanical preparation using mechanical instrumentation and irrigation solutions, and an intracanal medicament was placed. At the second visit, the intracanal medicament was removed and apical bleeding was induced to create a biological scaffold within the canal space. MTA coronal barrier was placed over the blood clot. After the setting of MTA, the access cavity was restored with a definitive coronal restoration the following day.
Marmara University Faculty of Dentistry
Istanbul, Istanbul, Turkey (Türkiye)
Primer success
Primary success is defined as the absence of clinical symptoms and evidence of periapical healing on radiographs.
Time frame: 12 months
Secondary success
Positive response to electric pulp testing is assessed.
Time frame: 12 months
Postoperative Pain
Postoperative pain is assessed using a visual analog scale (VAS), and overall pain is calculated using the area under the curve (AUC) of VAS scores.
Time frame: 8 hours, 24 hours, 48 hours, and 7 days after each treatment visit
Periapical Lesion Area
Changes in periapical lesion area are assessed using digital radiographic analysis.
Time frame: Baseline and 12 months
Mean Gray Value
Changes in bone density in the periapical region are assessed using mean gray value measurements obtained from digital radiographs.
Time frame: Baseline and 12 months
Fractal Dimension
Changes in trabecular bone microarchitecture in the periapical region are assessed using fractal dimension analysis.
Time frame: Baseline and 12 months
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