Bacterial Reduction of Rotary Versus Manual Filing System Using Different Irrigants in Primary Molars

NCT ID: NCT06418386

Last Updated: 2024-05-29

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

COMPLETED

Clinical Phase

NA

Total Enrollment

30 participants

Study Classification

INTERVENTIONAL

Study Start Date

2022-09-12

Study Completion Date

2024-05-12

Brief Summary

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This study will evaluate and compare the microbial efficacy of rotary and manual filing system using Neem extract, NaOCL and saline . with hypotheses that neem can used alternative to sodium hypochlorite and there is no difference between rotary and manual filling in bacterial reduction.

Detailed Description

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The calculated sample size of the study will be 22 participants for each group at 5% level of significance and 80 % power 30 participants for each group (10 for The sample size will be increased tocompensate for incomplete data and to increase the study each subgroup) topower

Grouping:

30 child will be selected from the Pediatric Clinic, Faculty of Dentistry, Mansoura University .the child should have 2 contralateral primary molars indicated for pulpectomy. The children will be randomly divided into 2 main groups according to type of file used in root canal preparation: Group I with manual file. Group II with rotary file.

Then the children will be randomly sub grouped according to irrigant that will be used:

Group IA and group II A with normal saline. Group IB and group II B with neem . Group IC and group II C with NaOCl . clinical procedures :

1. Psychological management of child
2. X-ray for inclusion criteria
3. The procedural tooth is anesthetized and isolated with rubber dam. The tooth and adjacent rubber dam will be disinfected with tincture of iodine solution
4. . All carious tissue will be removed by sterilized round bur and root canal access will be done
5. On gaining the access, distal cannel of mandibular primary molars and palatal cannel of maxillary primary molars will be chosen for sampling procedure.
6. A sterile broach will be inserted to obtain root cannel content then sterile paper point inserted to root canal and will be left for 1 min 19 The paper point will be removed with sterilized tweezer which will immediately transferred to tube containing transport medium (eppendrof of containing 200 μl nutrient broth medium).
7. In-group 1 will be prepared with manual files the irrigation with saline in IA, with neem in IB and irrigation with NaOCl in IC.
8. In group II will be prepared with rotary files the irrigation with saline in IIA, with neem in IIB, with NaOCl in IIC
9. The sterile paper point will be introduced into root cannel and will be left for 1 min, the paper point will be removed with sterilized tweezer and then transferred to a tube containing transport medium 19.
10. Post irrigation sample and pre-preparation sample will be transferred to microbiological laboratory.
11. Canals will be filed with obturation material(Metapex)then crown will be restored with glass inomar and stainless steel crown

Laboratory procedures :

1. All samples will be incubated on blood agar aerobically and anaerobically at 37 for 48-72 hours and aspectically streak the plates 19,20.
2. Identification of bacteria by culture characteristics ,microscopic examination and biochemical reaction 21.
3. Number of colony forming unit will be counted (CFU/ml)

Conditions

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Necrotic Pulp

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

The children will be randomly divided into 2 main groups according to type of file used in root canal preparation:

Group I with manual file. Group II with rotary file.

Then the children will be randomly sub grouped according to irrigant that will be used:

Group IA and group II A with normal saline. Group IB and group II B with neem . Group IC and group II C with NaOCl
Primary Study Purpose

TREATMENT

Blinding Strategy

SINGLE

Outcome Assessors

Study Groups

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manual saline

manual k files for pulpectomy and normal saline irrigation

Group Type ACTIVE_COMPARATOR

manual saline IA

Intervention Type PROCEDURE

* The procedural tooth is anesthetized and isolated with rubber dam. The tooth and adjacent rubber dam will be disinfected with tincture of iodine solution, All carious tissue will be removed by hight speed handpiece, distal cannel of mandibular primary molars and palatal cannel of maxillary primary molars will be chosen for sampling procedure.
* A sterile broach will be inserted to obtain root cannel content then sterile paper point inserted to root canal and will be left for 1 min ,The paper point will be removed with sterilized tweezer which will immediately transferred to tube containing transport medium (eppendrof of containing 200 μl nutrient broth medium),using manual k file starting with #15 and irrigation with normal saline
* Post irrigation sample and pre-preparation sample will be transferred to microbiological laboratory Canals will be filed with obturation material(Metapex)then crown will be restored with glass inomar and stainless steel crown

manual neem extract

manual k files and 100% neem extract

Group Type EXPERIMENTAL

manual neem IB

Intervention Type PROCEDURE

* The procedural tooth is anesthetized and isolated with rubber dam. The tooth and adjacent rubber dam will be disinfected with tincture of iodine solution
* . All carious tissue will be removed by high speed hand piece

, distal cannel of mandibular primary molars and palatal cannel of maxillary primary molars will be chosen for sampling procedure.
* A sterile broach will be inserted to obtain root cannel content then sterile paper point inserted to root canal and will be left for 1 min 19 The paper point will be removed with sterilized tweezer which will immediately transferred to tube containing transport medium (eppendrof of containing 200 μl nutrient broth medium).
* using manual file and irrigation with neem leaf extract 100%
* Post irrigation sample and pre-preparation sample will be transferred to microbiological laboratory Canals will be filed with obturation material(Metapex)then crown will be restored with glass inomar and stainless steel crown

manual sodium hypochlorite

mannul k files and 1% sodium hypochlorite

Group Type EXPERIMENTAL

manual sodium hypochlorite IC

Intervention Type PROCEDURE

* adjacent rubber dam will be disinfected with tincture of iodine solution
* . All carious tissue will be removed by hight speed hand piece
* distal cannel of mandibular primary molars and palatal cannel of maxillary primary molars will be chosen for sampling procedure.
* A sterile broach will be inserted to obtain root cannel content then sterile paper point inserted to root canal and will be left for 1 min 19 The paper point will be removed with sterilized tweezer which will immediately transferred to tube containing transport medium (eppendrof of containing 200 μl nutrient broth medium).
* using manual file and irrigation with 1% sodium hypochlorite
* Post irrigation sample and pre-preparation sample will be transferred to microbiological laboratory Canals will be filed with obturation material(Metapex)then crown will be restored with glass inomar and stainless steel crown

rotary saline

AF baby files for pediatric( fanta ) and normal saline

Group Type EXPERIMENTAL

rotary saline IIA

Intervention Type PROCEDURE

* shaping and cleaning done with using AF baby fanta files open file:#17 taper 08,then #20 taper 04 ,yellow then #25 taper 04 red , then #30 taper 04 blue . the files activated with torque 2 and speed 350 . Irrigation with normal saline
* Post irrigation sample and pre-preparation sample will be transferred to microbiological laboratory Canals will be filed with obturation material(Metapex)then restored with glass inomar and stainless steel crown

rotary neem

AF baby files for pediatric( fanta ) and 100% NEEM EXTRACT

Group Type EXPERIMENTAL

rotary neem IIB

Intervention Type PROCEDURE

* The procedural tooth is anesthetized and isolated with rubber dam as mentioned
* All carious tissue will be removed by high speed hand piece ,distal cannel of mandibular primary molars and palatal cannel of maxillary primary molars will be chosen for sampling procedure.
* A sterile broach will be inserted to obtain root cannel content then sterile paper point inserted to root canal and will be left for 1 min The paper point will be removed with sterilized tweezer which will immediately transferred to tube containing transport medium (eppendrof of containing 200 μl nutrient broth medium).
* using AF baby fanta files SAME AS METION BEFORE ,and irrigation with 100%neem extract
* Post irrigation sample and pre-preparation sample will be transferred to microbiological laboratory Canals will be filed with obturation material(Metapex)then crown will be restored with glass inomar and stainless steel crown

rotary sodium hypochloride

AF baby files for pediatric( fanta ) and 1% sodium hypochloride

Group Type EXPERIMENTAL

rotary sodoium hypochlorite IIC

Intervention Type PROCEDURE

* The procedural tooth is anesthetized and isolated with rubber dam as mentioned
* All carious tissue will be removed by hight speed hand piece,distal cannel of mandibular primary molars and palatal cannel of maxillary primary molars will be chosen for sampling procedure.
* A sterile broach will be inserted to obtain root cannel content then sterile paper point inserted to root canal and will be left for 1 min The paper point will be removed with sterilized tweezer which will immediately transferred to tube containing transport medium (eppendrof of containing 200 μl nutrient broth medium).
* using AF baby fanta files SAME AS MENTION BEFORE , and irrigation with 1% sodium hypochlorite
* Post irrigation sample and pre-preparation sample will be transferred to microbiological laboratory Canals will be filed with obturation material(Metapex)then crown will be restored with glass inomar and stainless steel crown

Interventions

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manual saline IA

* The procedural tooth is anesthetized and isolated with rubber dam. The tooth and adjacent rubber dam will be disinfected with tincture of iodine solution, All carious tissue will be removed by hight speed handpiece, distal cannel of mandibular primary molars and palatal cannel of maxillary primary molars will be chosen for sampling procedure.
* A sterile broach will be inserted to obtain root cannel content then sterile paper point inserted to root canal and will be left for 1 min ,The paper point will be removed with sterilized tweezer which will immediately transferred to tube containing transport medium (eppendrof of containing 200 μl nutrient broth medium),using manual k file starting with #15 and irrigation with normal saline
* Post irrigation sample and pre-preparation sample will be transferred to microbiological laboratory Canals will be filed with obturation material(Metapex)then crown will be restored with glass inomar and stainless steel crown

Intervention Type PROCEDURE

manual neem IB

* The procedural tooth is anesthetized and isolated with rubber dam. The tooth and adjacent rubber dam will be disinfected with tincture of iodine solution
* . All carious tissue will be removed by high speed hand piece

, distal cannel of mandibular primary molars and palatal cannel of maxillary primary molars will be chosen for sampling procedure.
* A sterile broach will be inserted to obtain root cannel content then sterile paper point inserted to root canal and will be left for 1 min 19 The paper point will be removed with sterilized tweezer which will immediately transferred to tube containing transport medium (eppendrof of containing 200 μl nutrient broth medium).
* using manual file and irrigation with neem leaf extract 100%
* Post irrigation sample and pre-preparation sample will be transferred to microbiological laboratory Canals will be filed with obturation material(Metapex)then crown will be restored with glass inomar and stainless steel crown

Intervention Type PROCEDURE

manual sodium hypochlorite IC

* adjacent rubber dam will be disinfected with tincture of iodine solution
* . All carious tissue will be removed by hight speed hand piece
* distal cannel of mandibular primary molars and palatal cannel of maxillary primary molars will be chosen for sampling procedure.
* A sterile broach will be inserted to obtain root cannel content then sterile paper point inserted to root canal and will be left for 1 min 19 The paper point will be removed with sterilized tweezer which will immediately transferred to tube containing transport medium (eppendrof of containing 200 μl nutrient broth medium).
* using manual file and irrigation with 1% sodium hypochlorite
* Post irrigation sample and pre-preparation sample will be transferred to microbiological laboratory Canals will be filed with obturation material(Metapex)then crown will be restored with glass inomar and stainless steel crown

Intervention Type PROCEDURE

rotary saline IIA

* shaping and cleaning done with using AF baby fanta files open file:#17 taper 08,then #20 taper 04 ,yellow then #25 taper 04 red , then #30 taper 04 blue . the files activated with torque 2 and speed 350 . Irrigation with normal saline
* Post irrigation sample and pre-preparation sample will be transferred to microbiological laboratory Canals will be filed with obturation material(Metapex)then restored with glass inomar and stainless steel crown

Intervention Type PROCEDURE

rotary neem IIB

* The procedural tooth is anesthetized and isolated with rubber dam as mentioned
* All carious tissue will be removed by high speed hand piece ,distal cannel of mandibular primary molars and palatal cannel of maxillary primary molars will be chosen for sampling procedure.
* A sterile broach will be inserted to obtain root cannel content then sterile paper point inserted to root canal and will be left for 1 min The paper point will be removed with sterilized tweezer which will immediately transferred to tube containing transport medium (eppendrof of containing 200 μl nutrient broth medium).
* using AF baby fanta files SAME AS METION BEFORE ,and irrigation with 100%neem extract
* Post irrigation sample and pre-preparation sample will be transferred to microbiological laboratory Canals will be filed with obturation material(Metapex)then crown will be restored with glass inomar and stainless steel crown

Intervention Type PROCEDURE

rotary sodoium hypochlorite IIC

* The procedural tooth is anesthetized and isolated with rubber dam as mentioned
* All carious tissue will be removed by hight speed hand piece,distal cannel of mandibular primary molars and palatal cannel of maxillary primary molars will be chosen for sampling procedure.
* A sterile broach will be inserted to obtain root cannel content then sterile paper point inserted to root canal and will be left for 1 min The paper point will be removed with sterilized tweezer which will immediately transferred to tube containing transport medium (eppendrof of containing 200 μl nutrient broth medium).
* using AF baby fanta files SAME AS MENTION BEFORE , and irrigation with 1% sodium hypochlorite
* Post irrigation sample and pre-preparation sample will be transferred to microbiological laboratory Canals will be filed with obturation material(Metapex)then crown will be restored with glass inomar and stainless steel crown

Intervention Type PROCEDURE

Eligibility Criteria

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Inclusion Criteria

* age group 4 -8 years.
* good health.
* No recent history of antibiotic coverage for at least two weeks
* necrotic teeth.
* restorable tooth structure.

Exclusion Criteria

* more than 2/3 resorption of root.
* uncooperative patient.
* detection perforation on radiograph.
Minimum Eligible Age

4 Years

Maximum Eligible Age

8 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

Yes

Sponsors

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Mansoura University

OTHER

Sponsor Role lead

Responsible Party

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Menna Mahgoub

principle investigator

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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mansoura university

Role: STUDY_CHAIR

Mansoura University

Locations

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Mansoura University

Al Mansurah, , Egypt

Site Status

Countries

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Egypt

References

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Susila AV, Sai S, Sharma N, Balasubramaniam A, Veronica AK, Nivedhitha S. Can natural irrigants replace sodium hypochlorite? A systematic review. Clin Oral Investig. 2023 May;27(5):1831-1849. doi: 10.1007/s00784-023-04913-7. Epub 2023 Feb 18.

Reference Type BACKGROUND
PMID: 36808559 (View on PubMed)

Sundaram D, Narayanan RK, Vadakkepurayil K. A Comparative Evaluation on Antimicrobial Effect of Honey, Neem Leaf Extract and Sodium Hypochlorite as Intracanal Irrigant: An Ex-Vivo Study. J Clin Diagn Res. 2016 Aug;10(8):ZC88-91. doi: 10.7860/JCDR/2016/19268.8311. Epub 2016 Aug 1.

Reference Type BACKGROUND
PMID: 27656571 (View on PubMed)

Lakshmanan L, Jeevanandan G. Microbial Evaluation of Root Canals after Biomechanical Preparation with Manual K-files, Manual H-files, and Kedo-SG Blue Rotary Files: An In Vivo Study. Int J Clin Pediatr Dent. 2022 Nov-Dec;15(6):687-690. doi: 10.5005/jp-journals-10005-2457.

Reference Type BACKGROUND
PMID: 36866149 (View on PubMed)

Other Identifiers

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M18060722

Identifier Type: -

Identifier Source: org_study_id

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