View clinical trials related to Periapical Periodontitis.
Filter by:This is a randomized, prospective, double-blind, controlled clinical trial designed to evaluate 3 distinct clinical approaches used during endodontic therapy: Group 1- Root canal treatment in single visit (RCT-SV); Group 2- Root canal treatment in two visits with intracanal dressing (RCT-TVWD); Group 3- Root canal treatment in two visits without intracanal dressing (RCT-TVWOD). A total of 210 adult patients ages 18 to 60 years, with at least one tooth diagnosed with asymptomatic apical periodontitis and periradicular lesion will be randomized and will undergo one of the types of clinical approaches during endodontic therapy. Patients' postoperative pain levels will also be recorded in periods of 24, 48, 72 hours and 7 days. Subsequently, clinical findings and long-term follow-up evaluations, with periradicular repair will be performed by periapical radiograph and computed tomography (cone-beam) at 6th, 12th and 24th months.
Inflammatory process begins around root apex as a result of bacterial infection of pulp cavity in chronic apical periodontitis. Bone destruction can begin in apical region after immunological reactions at the end of inflammatory process, and radiolucent periapical lesion seems in this way. If bone destruction around apical region is in the rate of 30%, we can notice this difference eventually. Histological manifestations of periapical inflammation can be observed in the result of pulp necrosis and inflammation around apical region. Mocelular methods can determine the type of therapy in various diseases. Each region and tissue reserve specific host factors. Vast majority of pulpal inflammation was trigerred by microorganisms. Certain bacterial virulence factors may damage host tissue directly, other virulence factors can stimulate prolonged non-specific immune response causing tissue damage. In the last phase of infection, immunopathological destruction of pulp tissue is observed due to humoral response. IL-17 is an important inflammatory cytokine released from T cells of the immune system. TNF-alpha and RANKL are also mediators responsible for bone destruction metabolism. TNF is a cytokine mediating immunologic changes during periodontal disease. TNF induction stimulate secondary mediators taking part as chemotactic cytokines. TNF has two different types; TNF-alpha and TNF-beta. TNF-alpha is a polypeptide cytokine produced by macrophages and monocytes. TNF-alpha stimulates bone resorption . There has been limited researches analyzing GCF, blood and tissue of pulp, dentin-derived fluid and periapical fluid for molecular diagnosis so far. GCF is a fluid derived from gingival groove. This fluid contains a lot of host factors such as anticor, bacterial antigen, protein and cytokines. GCF sampling is a non-invasive method, it can be used to provide diagnostic information in all clinical cases. In this study, we will evaluate the levels of IL-17, TNF-alpha and RANKL in the gingival crevicular fluid of teeth with periapical lesion diagnosed with chronic apical periodontitis. Thus, it will be evaluated whether these markers can be used for diagnosis and follow-up of the disease in teeth with periapical lesions.
The aim of this prospective cohort observational study is: (i) to assess the endodontic treatment outcome in a private specialist endodontic office in Slovenia; (ii) to estimate the effect of various pre-, intra- and postoperative factors onto endodontic treatment outcome.
Aim: The aim of this study was to examine post-operative pain (PP) severity after conventional irrigation and sonic activation methods, with and without laser disinfection in mandibular molar teeth diagnosed with symptomatic apical periodontitis. Methods: In total, 80 patients with symptomatic apical periodontitis were included in this randomized clinical study. There were four different irrigation and disinfection groups. In group 1, conventional irrigation only was applied. In group 2, EDDY (VDW, Munich, Germany), a sonic irrigation activation system, was applied. In groups 3 and 4, irradiation with a 980-nm diode laser was performed, following irrigation with the conventional method (needle irrigation) and EDDY (VDW) irrigation system, respectively. PP was assessed using a visual analogue scale (VAS). The patients were instructed to record their PP using this scale 8, 24, 48 hours and 7 days post-procedure, in addition to their analgesic intake. A chi-square test, Fisher's exact chi-square test and Fisher-Freeman-Halton exact test were used to assess qualitative data. Inter-group and intra-group parameters were assessed using the Kruskal-Wallis test and Wilcoxon's test at a significance level of p < 0.05 (for both).
To evaluate the effect of primary non-surgical endodontic therapy on glycaemic control in type 2 diabetic patients with asymptomatic apical periodontitis.After fulfilling the eligibility criteria, patients will be informed about the study and written consent to participate in the study will be acquired from each patient after explaining risks, benefits and alternative treatments.The endodontic treatment for all patients will be performed by a single operator (S.A) following a standardized protocol. The control group will receive no endodontic treatment during the study period. After completion of the study, these patients will be given primary non-surgical endodontic treatment. The patients in control group will be rendered the necessary treatment, if they become symptomatic and/or deny the consent during the course of the study. These patients will be excluded from the study.
The chief aim of root canal treatment is to reduce the microbial content and prevent further recontamination in the canal. Properly cleaned, shaped and obturated teeth will be having fewer chances of treatment failure. Every tooth has variable, complex canal anatomy consisting of ramifications and lateral canal. The instrumentation alone cannot reach all the areas for cleaning. For proper cleaning and removal of all microorganisms, the canal should be irrigated with any biocompatible, lubricant and antimicrobial agent. An irrigant should have a high compatibility factor, with canals, with obturating material and sealer. It should remove all the superficial barriers from canal tubules and allow sealer penetration, which aids in better adhesion and decreases the chances for recontamination. Objectives: This study aims to compare the effect of experimental endodontic irrigant Sapindus mukorossi with 17% EDTA, on the microleakage, sealer penetration and interaction with sodium hypochlorite. Ninety single-rooted teeth will be allocated into 2 experimental groups and a control group of 30 teeth each. The endodontic procedure will be done with protaper files. The sample in group 1 will be irrigated with 3.0% NaOCl after that by 17% EDTA and the sample in group 2 final irrigation will be given with Ethanolic extract of Sapindus mukorossi. After the preparation and final irrigation of all teeth, sterile saline will be used to flush all canals and dried using paper points. Obturation will be done with lateral condensation by gutta-percha. Teeth will be incubated at 37ºc and 100% humidity for 7 days. Varnish will be applied on the root surface except for apical 3mm. The teeth will be sectioned longitudinally and examined at 2 and 5mm from the root apex. The maximum depth of sealer penetration will be measured using a scanning electron microscope and microleakage will be tested through a dye penetration method under a stereomicroscope. Testing of interaction between irrigant and hypochlorite will be done by placing 1ml irrigant with 1 ml sodium hypochlorite in a round bottom test tube and left for 1 week at 37ºc. An independent observer will look for precipitation formation or color changes
The purpose of this study is to evaluate the effects of photobiomodulation (PBM) on postoperative pain after endodontic treatment in mandibular molar teeth diagnosed with symptomatic apical periodontitis.
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 .
The aim of this study is to evaluate the effects of intraoral cryotherapy on the inflammatory cytokine levels during root canal treatment and postoperative pain intensity and incidence. Mandibular premolar teeth of 30 patients diagnosed with asymptomatic apical periodontitis will be included to the study for this purpose. The experimental protocols consist clinical and laboratory phases. In clinical phase, procedures of cryotherapy and control groups will be applied in 2-visit-root canal treatment. The samples, which were collected during root canal treatment, will be subjected to enzyme-linked immunosorbent assay (ELISA) analysis in laboratory. Levels of interleukin and inflammatory destructive enzymes will be determined in collected samples. During the analysis of visual analogue scale scores, the correlation between the changes of the cytokine and proteolytic enzyme levels and presence and intensity of pain will be evaluated.
There is lack of evidence on resolution of signs of systemic inflammatory markers by successful elimination of periapical inflammation by endodontic treatment. Complete blood count (CBC) may have potential to detect various inflammatory conditions but its use for this purpose is sparsely reported. To the best of our knowledge effect of chronic apical periodontitis on various parameters of complete blood count has not been studied.