Effect of N-acetylcysteine Versus Calcium Hydroxide Used as an Intracanal Medicament on the Intensity of Postoperative Pain, Bacterial Load Reduction and Levels of MMP -9 in Periapical Fluids in Patients With Necrotic Pulp

December 16, 2022 updated by: Safwa Essam Mohammed Ahmed Abd el-glil, Cairo University

Effect of N-acetylcysteine Versus Calcium Hydroxide Used as an Intracanal Medicament on the Intensity of Postoperative Pain, Bacterial Load Reduction and Levels of MMP -9 in Periapical Fluids in Patients With Necrotic Pulp: A Randomized Clinical Trial

To compare the effect of N-acetylcysteine versus calcium hydroxide as intra canal medication on:

  • Intensity of postoperative pain.
  • Bacterial load reduction.
  • levels of MMP -9 in Periapical Fluids.

Study Overview

Status

Status

Indicates the current recruitment status or the expanded access status.
Not yet recruiting

Conditions

Conditions

The disease, disorder, syndrome, illness, or injury that is being studied. On ClinicalTrials.gov, conditions may also include other health-related issues, such as lifespan, quality of life, and health risks.

Intervention / Treatment

Intervention / Treatment

A process or action that is the focus of a clinical study. Interventions include drugs, medical devices, procedures, vaccines, and other products that are either investigational or already available. Interventions can also include noninvasive approaches, such as education or modifying diet and exercise.

Study Type

Study Type

Describes the nature of a clinical study. Study types include interventional studies (also called clinical trials), observational studies (including patient registries), and expanded access.
Interventional

Enrollment (Anticipated)

Enrollment

The number of participants in a clinical study. The "anticipated" enrollment is the target number of participants that the researchers need for the study.
30

Phase

Phase

The stage of a clinical trial studying a drug or biological product, based on definitions developed by the U.S. Food and Drug Administration (FDA). The phase is based on the study's objective, the number of participants, and other characteristics. There are five phases: Early Phase 1 (formerly listed as Phase 0), Phase 1, Phase 2, Phase 3, and Phase 4. Not Applicable is used to describe trials without FDA-defined phases, including trials of devices or behavioral interventions.
  • Early Phase 1

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Locations

  • Egypt
      • Cairo, Egypt
        • Faculty of Dentistry-Cairo University
        • Contact:

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Eligibility Criteria

The key requirements that people who want to participate in a clinical study must meet or the characteristics they must have. Eligibility criteria consist of both inclusion criteria (which are required for a person to participate in the study) and exclusion criteria (which prevent a person from participating). Types of eligibility criteria include whether a study accepts healthy volunteers, has age or age group requirements, or is limited by sex.

Ages Eligible for Study

18 years to 60 years (Adult)

Accepts Healthy Volunteers

No

Genders Eligible for Study

All

Description

Inclusion Criteria:

  • Patients who are free from any physical or mental handicapping condition.

  • Males & Females with

    • Mandibular single rooted permanent premolar teeth.
    • Absence of spontaneous pain.
    • Slight widening in the periodontal membrane space or with periapical radiolucency not exceeding 2*2 mm radiographically.
  • Patients' acceptance to participate in the trial.
  • Patients who can understand pain scale and can sign the informed consent (Appendix I)

Exclusion Criteria:

  1. Medically compromised patients.
  2. Pregnant women
  3. Patients undergoing previous endodontic treatment or analgesics and/or antibiotics have been administrated by the patient during the past 24 hours preoperatively.
  4. Patients reporting bruxism or clenching.
  5. Teeth that show association with acute periapical abscess and swelling.
  6. Greater than grade I mobility or pocket depth greater than 5mm.
  7. Non-restorable teeth or teeth that could not be adequately isolated with a rubber dam
  8. Teeth with vital pulp.
  9. Immature teeth.
  10. Radiographic evidence of external or internal root resorption vertical root fracture, perforation, calcification.

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Primary Purpose: Treatment
  • Allocation: Randomized
  • Interventional Model: Parallel Assignment
  • Masking: Double

Arms and Interventions

Participant Group / Arm

Participant Group / Arm

A group or subgroup of participants in a clinical trial that receives a specific intervention/treatment, or no intervention, according to the trial's protocol.
Intervention / Treatment

Intervention / Treatment

A process or action that is the focus of a clinical study. Interventions include drugs, medical devices, procedures, vaccines, and other products that are either investigational or already available. Interventions can also include noninvasive approaches, such as education or modifying diet and exercise.
Experimental: N-acetylcysteine
intracanal medication of NAC paste
Drug: N-acetyl cysteine
intracanal medication of NAC with concentration 1 gm/ml in the form of a paste
Active Comparator: Calcium hydroxide
intracanal medication of Ca(OH)2 paste
Drug: Calcium hydroxide
intracanal medication of calcium hydroxide paste (metapaste)

What is the study measuring?

Primary Outcome Measures

Primary Outcome Measures

In a clinical study's protocol, the planned outcome measure that is the most important for evaluating the effect of an intervention/treatment. Most clinical studies have one primary outcome measure, but some have more than one.
Outcome Measure
Measure Description
Time Frame
Intensity of postoperative pain
Time Frame: 6 hours post-instrumentation.
Intensity of postoperative pain will be measured using numerical rating scale (NRS)
6 hours post-instrumentation.
Intensity of postoperative pain
Time Frame: 12 hours post-instrumentation
Intensity of postoperative pain will be measured using numerical rating scale (NRS)
12 hours post-instrumentation
Intensity of postoperative pain
Time Frame: 24 hours post-instrumentation
Intensity of postoperative pain will be measured using numerical rating scale (NRS)
24 hours post-instrumentation
Intensity of postoperative pain
Time Frame: 48 hours post-instrumentation
Intensity of postoperative pain will be measured using numerical rating scale (NRS)
48 hours post-instrumentation
Intensity of postoperative pain
Time Frame: 6 hours post-obturation.
Intensity of postoperative pain will be measured using numerical rating scale (NRS)
6 hours post-obturation.
Intensity of postoperative pain
Time Frame: 12 hours post-obturation
Intensity of postoperative pain will be measured using numerical rating scale (NRS)
12 hours post-obturation
Intensity of postoperative pain
Time Frame: 24 hours post-obturation
Intensity of postoperative pain will be measured using numerical rating scale (NRS)
24 hours post-obturation
Intensity of postoperative pain
Time Frame: 48 hours post-obturation
Intensity of postoperative pain will be measured using numerical rating scale (NRS)
48 hours post-obturation

Secondary Outcome Measures

Secondary Outcome Measures

In a clinical study's protocol, a planned outcome measure that is not as important as the primary outcome measure for evaluating the effect of an intervention but is still of interest. Most clinical studies have more than one secondary outcome measure.
Outcome Measure
Measure Description
Time Frame
Bacterial load reduction
Time Frame: Sample 1 (S1): after access preparation and pre-instrumentation.
Bacterial counting using agar Culture technique
Sample 1 (S1): after access preparation and pre-instrumentation.
Bacterial load reduction
Time Frame: Sample 2 (S2): at the end of 1st visit post-instrumentation.
Bacterial counting using agar Culture technique
Sample 2 (S2): at the end of 1st visit post-instrumentation.
Bacterial load reduction
Time Frame: Sample 3 (S3): after 2 weeks intracanal medicament placement (pre-obturation)
Bacterial counting using agar Culture technique
Sample 3 (S3): after 2 weeks intracanal medicament placement (pre-obturation)
Periapical MMP-9 level
Time Frame: at 1st visit post- instrumentation.
using ELISA
at 1st visit post- instrumentation.
Periapical MMP-9 level
Time Frame: after 2 weeks at 2nd visit (pre-obturation).
using ELISA
after 2 weeks at 2nd visit (pre-obturation).

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Sponsor

The organization or person who initiates the study and who has authority and control over the study.
Cairo University

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Anticipated)

Study Start

The actual date on which the first participant was enrolled in a clinical study. The "anticipated" study start date is the date that the researchers think will be the study start date.
February 1, 2023

Primary Completion (Anticipated)

Primary Completion

The date on which the last participant in a clinical study was examined or received an intervention to collect final data for the primary outcome measure. Whether the clinical study ended according to the protocol or was terminated does not affect this date. For clinical studies with more than one primary outcome measure with different completion dates, this term refers to the date on which data collection is completed for all the primary outcome measures. The "anticipated" primary completion date is the date that the researchers think will be the primary completion date for the study.
February 1, 2024

Study Completion (Anticipated)

Study Completion

The date on which the last participant in a clinical study was examined or received an intervention/treatment to collect final data for the primary outcome measures, secondary outcome measures, and adverse events (that is, the last participant's last visit). The "anticipated" study completion date is the date that the researchers think will be the study completion date.
March 1, 2024

Study Registration Dates

First Submitted

First Submitted

The date on which the study sponsor or investigator first submitted a study record to ClinicalTrials.gov. There is typically a delay of a few days between the first submitted date and the record's availability on ClinicalTrials.gov (the first posted date).
December 9, 2022

First Submitted That Met QC Criteria

First Submitted That Met QC Criteria

The date on which the study sponsor or investigator first submits a study record that is consistent with National Library of Medicine (NLM) quality control (QC) review criteria. The sponsor or investigator may need to revise and submit a study record one or more times before NLM's QC review criteria are met. It is the responsibility of the sponsor or investigator to ensure that the study record is consistent with the NLM QC review criteria.
December 16, 2022

First Posted (Actual)

First Posted

The date on which the study record was first available on ClinicalTrials.gov after National Library of Medicine (NLM) quality control (QC) review has concluded. There is typically a delay of a few days between the date the study sponsor or investigator submitted the study record and the first posted date.
December 27, 2022

Study Record Updates

Last Update Posted (Actual)

Last Update Posted

The most recent date on which changes to a study record were made available on ClinicalTrials.gov. There may be a delay between when the changes were submitted to ClinicalTrials.gov by the study's sponsor or investigator (the last update submitted date) and the last update posted date.
December 27, 2022

Last Update Submitted That Met QC Criteria

Last Update Submitted That Met QC Criteria

The most recent date on which the study sponsor or investigator submitted changes to a study record that are consistent with National Library of Medicine (NLM) quality control (QC) review criteria. It is the responsibility of the sponsor or investigator to ensure that the study record is consistent with the NLM QC review criteria.
December 16, 2022

Last Verified

Last Verified

The most recent date on which the study sponsor or investigator confirmed the information about a clinical study on ClinicalTrials.gov as accurate and current. If a study with a recruitment status of recruiting; not yet recruiting; or active, not recruiting has not been confirmed within the past 2 years, the study's recruitment status is shown as unknown.
December 1, 2022

More Information

Terms related to this study

Additional Relevant MeSH Terms

Other Study ID Numbers

Other Study ID Numbers

Identifiers or ID numbers other than the NCT number that are assigned to a clinical study by the study's sponsor, funders, or others. These numbers may include unique identifiers from other trial registries and National Institutes of Health grant numbers.
  • safwaendo91

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

Undecided

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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