One Vs Two Visits Root Canal Treatments in Infected Teeth

NCT ID: NCT04605445

Last Updated: 2024-12-16

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

RECRUITING

Clinical Phase

NA

Total Enrollment

1000 participants

Study Classification

INTERVENTIONAL

Study Start Date

2020-11-18

Study Completion Date

2031-12-31

Brief Summary

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The primary aim of the study is to compare the outcome of one vs two visits endodontics (root canal treatments) performed in general dental practice of infected (necrotic) teeth, one and four years after treatment. Secondary aims are to compare the root filling quality and the frequency of complications for both treatment modalities.

A pilot study will identify the shortcomings of the protocol, which will be revised accordingly.

A multi-center study in several clinics from five counties throughout Sweden is planned. Consecutive eligible patients (see inclusion and exclusion criteria) with one tooth each will be included.

The study sample size calculation was based on a judgement that a minimal worthwhile effect of less than 10% was not clinically relevant. The presumption was that successful outcomes would be of 75% and 65% for the different treatment arms, respectively. Three hundred and fifty six patients per group are thus needed to detect that difference as statistical significant with a power of 80% and an alfa-error of 5%. To compensate for around 30% drop-outs a number of 1000 patients will be recruited.

Patients will be randomly enrolled in two arms: one in which the endodontic treatment (root canal treatment) is performed in one visit, and in the other arm in two visits. The allocation sequences for one vs multiple visit endodontics will be computer generated followed by a dark colored envelope concealed allocation.

The patients will be contacted by telephone 5-7 days post-operatively, and a control visit at the clinic will be scheduled one month post-operatively to assess complications related to the treatment.

A clinical control will be performed at the clinic one and four years after treatment. Intra-oral radiographs will be taken. The radiographs will be examined by two blinded and independent observers. A successful outcome is defined by clinical and radiographic normalcy.

The statistical methods selected to analyse the primary outcome will be the Chi square test of 2x2 tables, or Fisher´s exact test when proportions are small and the expected value \<5. The calculations will be two-tailed. Results will be considered statistically significant at p\<0.05.

Detailed Description

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Conditions

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Apical Periodontitis Pain Tooth Loss Dental Pulp Necrosis

Keywords

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Endodontics General Dental Practice Single Visit Multiple Visits Infection Barrier

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

DOUBLE

Investigators Outcome Assessors

Study Groups

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1 visit endodontics

Root canal treatment is performed in one visit.

Group Type EXPERIMENTAL

1 visit root canal treatment (endodontics)

Intervention Type PROCEDURE

Endodontics (root canal treatment). In the enrolment visit, access, opening and identification of root canals can be performed and a suitable temporization will be placed in the tooth if needed. Root canal treatment can be completed in the same visit or performed in another visit where cleaning, shaping and root filling procedures, temporization or permanent restoration will be performed. These procedures are part of the normal clinical praxis. No rigid protocol will be implemented, as a pragmatic design was chosen.

2 visits endodontics

Root canal treatment is performed in two visits.

Group Type ACTIVE_COMPARATOR

2 visits root canal treatment (endodontics)

Intervention Type PROCEDURE

Endodontics (root canal treatment). In the enrolment visit, access, opening and identification of root canals can be performed and a suitable temporization will be placed in the tooth if needed. Root canal treatment can be started, or performed in another visit, lasting 2 visits. In the first visit cleaning and shaping is performed and a medication is put in place in the canals, and the tooth is temporized until the next visit at least one week apart. In the second visit the tooth is root filled and temporization or permanent restoration will be performed. These procedures are part of the normal clinical praxis. No rigid protocol will be implemented, as a pragmatic design was chosen.

Interventions

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1 visit root canal treatment (endodontics)

Endodontics (root canal treatment). In the enrolment visit, access, opening and identification of root canals can be performed and a suitable temporization will be placed in the tooth if needed. Root canal treatment can be completed in the same visit or performed in another visit where cleaning, shaping and root filling procedures, temporization or permanent restoration will be performed. These procedures are part of the normal clinical praxis. No rigid protocol will be implemented, as a pragmatic design was chosen.

Intervention Type PROCEDURE

2 visits root canal treatment (endodontics)

Endodontics (root canal treatment). In the enrolment visit, access, opening and identification of root canals can be performed and a suitable temporization will be placed in the tooth if needed. Root canal treatment can be started, or performed in another visit, lasting 2 visits. In the first visit cleaning and shaping is performed and a medication is put in place in the canals, and the tooth is temporized until the next visit at least one week apart. In the second visit the tooth is root filled and temporization or permanent restoration will be performed. These procedures are part of the normal clinical praxis. No rigid protocol will be implemented, as a pragmatic design was chosen.

Intervention Type PROCEDURE

Eligibility Criteria

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Inclusion Criteria

* Patient older than 17 years.
* Permanent tooth excluding third molars.
* Necrotic tooth with/without clinical and/or radiological signs of apical (juxta radicular) periodontitis (non-bleeding pulp in the canal orifice. In case of a multi rooted tooth, a non-bleeding pulp in at least one root canal orifice) where orthograde endodontic treatment is planned.

Exclusion Criteria

* Patients with severe general disease and/ or where endodontic treatment requires special consideration for health reasons (eg radiation-treated jaw bone in the area or increased susceptibility to infection).
* Systemic involvement (fever).
* Swelling (extra- and/or intra oral).
* Previously root canal treated tooth (instrumented and/or rotfilled).
* Confirmed or strong suspicion of transverse or longitudinal root fracture.
* Trauma to the tooth (\<6 month).
* Marginal bone loss \>1/3 of the root lenght.
* Root resorption.
* Non restorable tooth.
* Endodontic treatment is not considered feasible because rubberdam cannot be used on the tooth.
* Follow-up at the clinic of the treatment after\> 1 year is considered not feasible.
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Norrbottens County Council

OTHER_GOV

Sponsor Role collaborator

Landstinget i Kalmar Län

OTHER

Sponsor Role collaborator

Blekinge County Council

UNKNOWN

Sponsor Role collaborator

Kronoberg County Council

OTHER_GOV

Sponsor Role collaborator

Odontologisk Forskning i Region Skåne (OFRS)

UNKNOWN

Sponsor Role collaborator

County Council of Halland, Sweden

OTHER_GOV

Sponsor Role collaborator

Smile Tandvård

UNKNOWN

Sponsor Role collaborator

Aragón Dental

UNKNOWN

Sponsor Role collaborator

Kalmar County Council

UNKNOWN

Sponsor Role collaborator

Oris Dental

UNKNOWN

Sponsor Role collaborator

Malmö University

OTHER

Sponsor Role lead

Responsible Party

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Annika E Björkner

Associate Professor

Responsibility Role PRINCIPAL_INVESTIGATOR

Locations

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Folktandvården Region Kronoberg

Vaxjo, Kronoberg County, Sweden

Site Status RECRUITING

Folktandvården Region Norrbotten

Luleå, Norrbotten County, Sweden

Site Status RECRUITING

Folktandvården Region Kalmar

Kalmar, , Sweden

Site Status NOT_YET_RECRUITING

Smile Tandvård

Luleå, , Sweden

Site Status RECRUITING

Aragón Dental

Malmo, , Sweden

Site Status NOT_YET_RECRUITING

Oris Dental

Malmo, , Sweden

Site Status NOT_YET_RECRUITING

Folktandvården Region Halland

Varberg, , Sweden

Site Status RECRUITING

Countries

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Sweden

Central Contacts

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Annika Björkner, PhD

Role: CONTACT

Phone: +46-(0)40-6658532

Email: [email protected]

Catherine Benavente Hansson, DDS

Role: CONTACT

Phone: +46-(0)665 87 95

Email: [email protected]

Facility Contacts

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Veronica Asp Lockby

Role: primary

Fernando Mota de Almeida, PhD

Role: primary

Elin Lundgren, DDS

Role: backup

Elena Shmarina

Role: primary

Anna Gatu

Role: primary

Lars Armbäck, DDS

Role: backup

Veronica Aragón, DDS

Role: primary

Catherine Benavente Hansson, DDS

Role: primary

Maria Wattsgård

Role: primary

Other Identifiers

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EPN 2020-00207

Identifier Type: -

Identifier Source: org_study_id