Assessment of Postoperative Pain After Using Two Formulations of Calcium Hydroxide Intracanal Medication .

NCT ID: NCT05021809

Last Updated: 2022-03-22

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

UNKNOWN

Clinical Phase

PHASE4

Total Enrollment

60 participants

Study Classification

INTERVENTIONAL

Study Start Date

2021-07-25

Study Completion Date

2022-11-30

Brief Summary

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Calcium hydroxide is advocated as an intracanal medication for various purposes, including prevention of post-treatment symptoms. Calcium hydroxide has a pain-controlling effect at different times when compared to non-intracanal medication .

Aim:

The aim of the study to compare between postoperative pain after using two formulations of calcium hydroxide intracanal medication with and without iodoform .

Detailed Description

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The most persuasive factor for a patient to visit a dental health care professional is the existence of odontalgia. Accordingly, the pain after a dental therapy results in demotivation of the patient. Unfortunately, mild to severe pain following a tooth-preserving therapy such as root canal treatment is reported to be experienced by 40% of the patients.

The majority of patients with symptomatic necrotic teeth had significant postoperative pain and required analgesic medication to manage this pain.

There is a correlation between the intensity of preoperative pain and postoperative pain ,The preoperative pain has a significant influence on postoperative pain.

Several strategies are suggested to manage or prevent post instrumentation pain. One of them is insertion of intracanal medicament.

The interappointment intracanal medicaments are suggested for disinfection of the infected root canal system in multi-visit endodontic treatment. Calcium hydroxide (Ca(OH)2) is considered as a universal intracanal medicament for this purpose.

Additionally, calcium hydroxide is hypothesized to exert a pain-preventing effect indirectly through its antimicrobial and tissue modifying properties .

Significantly high healing rates have been shown with short term use of calcium hydroxide Ca(OH)2 in teeth with apical periodontitis. As a temporary root filling, it has been shown to be an effective antimicrobial agent when applied for a minimum of 1 week.

Calcium hydroxide is a suitable material of choice as an inter-appointment dressing for teeth diagnosed with pulpal necrosis and apical periodontitis.

Calcium hydroxide reduced pain risk than no intracanal medication within the 1-14 days interval as well as triple-antibiotic paste within the first day and was similar to corticosteroid/antibiotics combination.

Iodoform has bacteriostatic property by releasing free iodine.Thereby, iodine eliminates the infection of root canal and periapical tissue by precipitating protein and oxidizes essential enzymes.

The use of calcium hydroxide-iodoform-silicon-oil paste as nonsurgical approach for treatment of periapical lesions showed a high success rate.

As clinicians , one of the most important goals to achieve is reducing the pain of the patient. Up to our knowledge, none of the previous studies investigated the postoperative pain incidence after application of Ca(OH)2 with iodoform as an intracanal medication .

Conditions

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Necrotic Pulp With Symptomatic Apical Periodontitis

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

SINGLE

Participants
Blind allocation will be followed in the study .

* Group A: will not receive any intracanal medication.(control group)
* Group B :will recieve calcium hydroxide intracanal medication without iodoform (Metapaste)
* Group c: will receive calcium hydroxide intracanal medication with iodoform (Metapex).

Study Groups

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Group A

control group will not receive any intracanal medication

Group Type NO_INTERVENTION

No interventions assigned to this group

Group B

Calcium hydroxide intracanal medication without iodoform (Metapaste )

Group Type ACTIVE_COMPARATOR

Calcium hydroxide intracanal medication application

Intervention Type DRUG

The patient will be anaesthized with Articaine hydrochloride 40 mg/ml + 1/100000 Epinephrine bitartrate solution . Then the rubber dam isolation will be conducted, the access will be opened and then cleaning and shaping will be done by using Protaper Next rotary file system and irrigation by sodium hypochlorite 2.5% by side vented needle, EDTA 17%, sodium hypochlorite and the final rinse by saline where the canal will be dried by absorbent paper point. The application of calcium hydroxide intracanal medication will be done according to the manufacturer instructions then temporization by glass ionomer will be applied .

Group C

Calcium hydroxide intracanal medication with iodoform (Metapex)

Group Type ACTIVE_COMPARATOR

Calcium hydroxide intracanal medication application

Intervention Type DRUG

The patient will be anaesthized with Articaine hydrochloride 40 mg/ml + 1/100000 Epinephrine bitartrate solution . Then the rubber dam isolation will be conducted, the access will be opened and then cleaning and shaping will be done by using Protaper Next rotary file system and irrigation by sodium hypochlorite 2.5% by side vented needle, EDTA 17%, sodium hypochlorite and the final rinse by saline where the canal will be dried by absorbent paper point. The application of calcium hydroxide intracanal medication will be done according to the manufacturer instructions then temporization by glass ionomer will be applied .

Interventions

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Calcium hydroxide intracanal medication application

The patient will be anaesthized with Articaine hydrochloride 40 mg/ml + 1/100000 Epinephrine bitartrate solution . Then the rubber dam isolation will be conducted, the access will be opened and then cleaning and shaping will be done by using Protaper Next rotary file system and irrigation by sodium hypochlorite 2.5% by side vented needle, EDTA 17%, sodium hypochlorite and the final rinse by saline where the canal will be dried by absorbent paper point. The application of calcium hydroxide intracanal medication will be done according to the manufacturer instructions then temporization by glass ionomer will be applied .

Intervention Type DRUG

Eligibility Criteria

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Inclusion Criteria

* .single-rooted teeth with pulpal necrosis and symptomatic apical periodontitis with visible radiographic disturbance of periapical lamina dura. The diagnosis of pulp necrosis was confirmed by negative response to cold test, electric pulp tester and clinically by absence of blood upon access cavity .
* Clinical signs of apical periodontitis.
* Teeth with sufficient coronal tooth structure for adequate rubber dam isolation were selected .
* Patients who are over 18 years old .

Exclusion Criteria

* Presence of open apices
* Presence of non-restorable teeth
* Presence of large carious lesions approaching the root.
* Presence of calcification or resorption .
* Patients who had received antibiotics during the last 3 months .
* Teeth with periodontal probing depth \> 4 ml.
* Teeth with previous root canal treatment .
* Teeth with fluctuant facial swelling .
* Pregnant females.
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Suez Canal University

OTHER

Sponsor Role lead

Responsible Party

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Sarah Alaa El Din Mohamed Hamed El Abyad

demonstrator at endodontic department

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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marwa es sharaan, PHD

Role: PRINCIPAL_INVESTIGATOR

Suez Canal University

Locations

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Endodontic Clinic At Faculty of Dentistry ,Suez Canal University

Ismailia, , Egypt

Site Status RECRUITING

Countries

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Egypt

Central Contacts

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Sarah ad elabyad, bachelors

Role: CONTACT

01008922535 ext. +2

Nelly mo abdelsalam, PHD

Role: CONTACT

01006623416 ext. +2

Facility Contacts

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sarah ad elabyad, bachelors

Role: primary

01008922535 ext. +2

nelly mo abdelsalam, phd

Role: backup

01006623416 ext. +2

References

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Walton RE, Holton IF Jr, Michelich R. Calcium hydroxide as an intracanal medication: effect on posttreatment pain. J Endod. 2003 Oct;29(10):627-9. doi: 10.1097/00004770-200310000-00003.

Reference Type BACKGROUND
PMID: 14606782 (View on PubMed)

Sebastian R, Drum M, Reader A, Nusstein J, Fowler S, Beck M. What is the Effect of No Endodontic Debridement on Postoperative Pain for Symptomatic Teeth with Pulpal Necrosis? J Endod. 2016 Mar;42(3):378-82. doi: 10.1016/j.joen.2015.12.001. Epub 2016 Jan 20.

Reference Type BACKGROUND
PMID: 26806591 (View on PubMed)

Madarati AA, Zafar MS, Sammani AMN, Mandorah AO, Bani-Younes HA. Preference and usage of intracanal medications during endodontic treatment. Saudi Med J. 2017 Jul;38(7):755-763. doi: 10.15537/smj.2017.7.18345.

Reference Type BACKGROUND
PMID: 28674723 (View on PubMed)

Other Identifiers

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360/2021

Identifier Type: -

Identifier Source: org_study_id

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