Pulp Transplantation in Necrotic Mature Teeth With Periapical Radiolucency

NCT ID: NCT07258888

Last Updated: 2025-12-09

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

21 participants

Study Classification

INTERVENTIONAL

Study Start Date

2023-11-05

Study Completion Date

2025-09-05

Brief Summary

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This randomized clinical trial aims to compare autologous dental pulp transplantation alone or combined with concentrated growth factor (CGF) with conventional root canal treatment in necrotic mature teeth with periapical radiolucency. The primary objective is to evaluate whether autologous pulp transplantation can facilitate the return of vitality in necrotic teeth. A secondary objective is to assess whether the addition of CGF provides any further clinical benefit.

Twenty-one patients with single-rooted teeth presenting with periapical lesions are randomly allocated into three groups (n = 7 per group): Group 1 receives autologous pulp transplantation, Group 2 receives pulp transplantation combined with CGF, and Group 3 receives conventional root canal treatment. Donor pulp tissue is obtained from the patient's own non-carious third molars. Clinical and radiographic follow-up is planned at 3, 6, and 12 months, including electrical pulp testing, periapical radiographs, and cone-beam computed tomography (CBCT).

Detailed Description

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This study investigates the clinical applicability of autologous dental pulp transplantation as a potential biologic treatment alternative for necrotic mature teeth with periapical radiolucency. The trial explores whether transplantation of the patient's own pulp tissue, with or without the addition of concentrated growth factor (CGF), can promote tissue regeneration and functional recovery. The design includes three treatment groups to evaluate the effects of pulp transplantation alone, pulp transplantation combined with CGF, and conventional root canal therapy.

Participants are adults presenting with single-rooted teeth diagnosed with pulp necrosis and periapical pathology. Following randomization, the allocated intervention is performed under standardized clinical protocols. Donor pulp tissue is harvested atraumatically from non-carious third molars of the same patient. Outcome assessments include vitality testing and radiographic evaluations at predetermined follow-up intervals. The study aims to provide foundational clinical evidence regarding the feasibility, safety, and regenerative potential of autologous pulp transplantation techniques to inform future clinical applications.

Conditions

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Pulpal Regeneration Pulp Revascularization

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

This study used a parallel-group design with three treatment arms. Twenty-one patients with necrotic mature teeth were randomly assigned (1:1:1 ratio) to one of three groups: Group 1 received autologous dental pulp transplantation, Group 2 received pulp transplantation combined with concentrated growth factor (CGF), and Group 3 underwent conventional root canal therapy. Participants were followed for 12 months to evaluate pulp vitality and periapical healing.
Primary Study Purpose

TREATMENT

Blinding Strategy

SINGLE

Outcome Assessors
Outcome evaluations and statistical analyses were performed by blinded examiners independent of the clinical operators.

Study Groups

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Conventional Root Canal Therapy

Patients undergo standard root canal preparation and obturation with gutta-percha and sealer using lateral condensation, followed by restoration.

Group Type ACTIVE_COMPARATOR

Conventional root canal therapy

Intervention Type PROCEDURE

Standard root canal instrumentation, irrigation, obturation with gutta-percha and sealer, and restoration.

Autologous dental pulp transplantation

Harvest of autologous third-molar pulp; canal disinfection; transplantation; MTA coronal seal; restoration.

Group Type ACTIVE_COMPARATOR

Autologous dental pulp transplantation

Intervention Type PROCEDURE

Harvest of autologous pulp tissue from third molar, canal disinfection, placement into recipient tooth, MTA sealing, composite restoration.

Pulp transplantation with CGF

Same as pulp transplantation with the addition of autologous concentrated growth factor (CGF) placed over the transplanted pulp prior to MTA seal.

Group Type ACTIVE_COMPARATOR

Pulp transplantation with CGF

Intervention Type PROCEDURE

Same as above, but CGF membrane placed over transplanted pulp before MTA sealing.

Interventions

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Conventional root canal therapy

Standard root canal instrumentation, irrigation, obturation with gutta-percha and sealer, and restoration.

Intervention Type PROCEDURE

Autologous dental pulp transplantation

Harvest of autologous pulp tissue from third molar, canal disinfection, placement into recipient tooth, MTA sealing, composite restoration.

Intervention Type PROCEDURE

Pulp transplantation with CGF

Same as above, but CGF membrane placed over transplanted pulp before MTA sealing.

Intervention Type PROCEDURE

Eligibility Criteria

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Inclusion Criteria

* Adults aged 18-40 years
* Presence of single-rooted permanent teeth diagnosed with:
* Pulp necrosis or
* Irreversible pulpitis with radiographic periapical lesions
* Availability of a caries-free, periodontally healthy third molar suitable for donor pulp harvesting

Good general health, with no systemic diseases

-Ability to understand the study procedures and provide written informed consent

Exclusion Criteria

* Multi-rooted teeth or teeth with complex canal anatomy
* Systemic diseases or medical conditions that may affect wound healing (e.g., diabetes, immunosuppression)
* Lack of a suitable donor third molar for pulp harvesting
* Advanced periodontal attachment loss or active periodontal disease
* Pregnancy or lactation
* Recent use of antibiotics or anti-inflammatory drugs (\<1 month)
* Inability or unwillingness to attend scheduled follow-ups
Minimum Eligible Age

18 Years

Maximum Eligible Age

40 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Kahramanmaras Sutcu Imam University

OTHER

Sponsor Role lead

Responsible Party

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Aliye Kamalak

Assoc Prof

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Aliye Kamalak, Associate Professor Dr.

Role: PRINCIPAL_INVESTIGATOR

Kahramanmaraş Sütçü İmam University, Faculty of Dentistry, Department of Endodontics

Locations

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ahramanmaraş Sütçü İmam University, Faculty of Dentistry

Kahramanmaraş, onikişubat, Turkey (Türkiye)

Site Status

Countries

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Turkey (Türkiye)

References

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Cehreli ZC, Unverdi GE, Ballikaya E. Deciduous Tooth Pulp Autotransplantation for the Regenerative Endodontic Treatment of Permanent Teeth With Pulp Necrosis: A Case Series. J Endod. 2022 May;48(5):669-674. doi: 10.1016/j.joen.2022.01.015. Epub 2022 Feb 1.

Reference Type RESULT
PMID: 35114270 (View on PubMed)

Yan H, De Deus G, Kristoffersen IM, Wiig E, Reseland JE, Johnsen GF, Silva EJNL, Haugen HJ. Regenerative Endodontics by Cell Homing: A Review of Recent Clinical trials. J Endod. 2023 Jan;49(1):4-17. doi: 10.1016/j.joen.2022.09.008. Epub 2022 Oct 18.

Reference Type RESULT
PMID: 36270575 (View on PubMed)

Kim U, Kim S, Choi SM, Kang MK, Chang I, Kim E. Regenerative Endodontic Procedures With Minced Pulp Tissue Graft in Mature Permanent Teeth: A Clinical Study. J Endod. 2025 Jan;51(1):43-53.e2. doi: 10.1016/j.joen.2024.10.004. Epub 2024 Oct 12.

Reference Type RESULT
PMID: 39401572 (View on PubMed)

Study Documents

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Document Type: Individual Participant Data Set

Data sharing will follow institutional policies and ethical guidelines to ensure participant confidentiality.

View Document

Related Links

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https://dishekimligi.ksu.edu.tr/

Official website of the Faculty of Dentistry, Kahramanmaraş Sütçü İmam University - the institution where the study was conducted.

Other Identifiers

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Project No: 2024/3-13D

Identifier Type: OTHER_GRANT

Identifier Source: secondary_id

KSU-PT-2024-11

Identifier Type: -

Identifier Source: org_study_id

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