Removal of Intracanal Medicaments by Different Techniques Using Cone Beam Computed Tomography Analysis (Ca(OH)2 - CBCT)

July 17, 2026 updated by: Mahmoud Basuoni Basuoni Aboseira, Tanta University

"Removal of Intracanal Medicament by Different Techniques: (Cone Beam Computed Tomography Analysis) (Clinical Study)"

the goal of this study is to evaluate the efficency of different activation techniques in removal of intracanal medication using cone beam computed tomography analysis

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.

Detailed Description

the primary etiological factors for pulpal and periradicular diseases are microorganisms. Therefore, the primary purpose of endodontic treatment is to completely eradicate microorganisms from the root canal. This is achieved through chemo-mechanical preparation of the canal, which includes proper cleaning and shaping by instrumentation and irrigation.

Complexity of the root canal system compromises the eradication of microorganisms completely by traditional methods. The remaining bacteria may multiply between appointments and reach the same previous concentration. Therefore, intracanal medicaments play an important role in canal disinfection.

Intracanal medication becomes more necessary in cases involving bacteria that are resistant to routine treatment, as well as in situations where successful completion of therapy is hindered by persistent pain or continuous exudate.

The concept is to temporarily fill the root canal with a material that would chemically and physically enhance eradication and prevent the proliferation of microorganisms.

The most commonly used intracanal medicament is calcium hydroxide (Ca(OH)2), Through releasing hydroxyl ions disrupts the structural integrity of bacterial cytoplasmic membranes. In addition, Ca(OH)₂ indirectly affects anaerobic microorganisms within the root canal through a reaction between calcium ions and aqueous carbon dioxide, resulting in degradation of bacterial lipopolysaccharides.

Moreover, the biological properties of Ca(OH)₂ as antimicrobial action, induction of hard tissue deposition, and promotion of improved tissue repair all of this make that it considered as the material of choice of intracanal medicament.

However , despite its benefits, Ca (OH)₂ remnants on the canal walls showed multiple disadvantages such as; affecting sealer penetration into dentinal tubules, weakening their final bond to dentin and delaying the setting of some sealers such as zinc oxide eugenol so, Ca (OH)₂ remnants still one of the obstacles during complete the root canal obturation and interference with the physical properties of sealers has been shown to increase apical leakage and eventually compromise the outcome of endodontic treatment.

Additional disadvantages of Ca (OH)₂ include the challenge of removing it from the root canal walls and complete removal of it prior to final obturation is critical. However, manual irrigation alone was unable to completely remove intracanal medicament regardless of the agent use Numerous methods have been suggested for the removal of Ca (OH)₂ from the root canal such as : (1) Manual irrigation with a syringe (2) Manual dynamic agitation (3) Canal brush (4) Passive ultrasonic irrigation (5) Sonic irrigation (6) XP-shaper (7) XP-finisher (8) Rins Endo (9) Endo vac Numerous methods have been used to assess the amount of Ca (OH)₂ remnants within the root canal. These include digital photographs, stereomicroscopy, scanning electron microscopy, and micro-computed tomography.

However, the recent availability of cone beam computed tomography (CBCT) is considered an accurate, noninvasive imaging technique and has been employed to evaluate the quantity of residual intracanal calcium hydroxide. CBCT provides a three-dimensional volume measurement without the need to section the specimens Group assignment

Patients will be randomly divided into three equally treated groups (n=10) According to the type of activation technique as follow:

Group 1: Manual Dynamic Agitation (MDA)* Group 2: Sonic Activation† Group 3: XP-finisher activation‡

After intracanal medicament placement, the volume of the medicament will be measured using CBCT analysis software†††. The patient will then be recalled after one week[19]. At the recall visit, the tooth will be isolated and the intracanal medicament will be removed according to the assigned group:

Group 1: MDA Group 2: Sonic Activation Group3: XP-finisher activation Following intracanal medicament removal according to each group, a second CBCT scan will be taken for evaluation. CBCT interpretation will be used to detect the remnants of intracanal medicament and measure its volume using the cone-beam analysis software After image evaluation, the canal will be dried with sterile paper points, and root canal obturation will be performed using gutta-percha cone* and a resin-based sealer*, employing the cold lateral condensation technique.

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 (Estimated)

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.
  • Not Applicable

Contacts and Locations

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

Study Contact

Study Contact

The name and contact information for the person who can answer enrollment questions for a clinical study. Each location where the study is being conducted may also have a specific contact, who may be better able to answer those questions.

Study Locations

  • Egypt
    • Gharbia Governorate
      • Tanta, Gharbia Governorate, Egypt, 31773
        • Faculty of Dentistry, Tanta University
        • Contact:
        • Principal Investigator:
          • Ahmed h labib, professor of endodontics
        • Sub-Investigator:
          • Mohammed f Ali Mansour, lecturer of endodontics
        • Sub-Investigator:
          • Mahmoud B Basuoni Aboseira, BDS

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

  • Adult

Accepts Healthy Volunteers

No

Description

Inclusion Criteria:

  1. Restorable mature non-vital single canal anterior tooth with or without signs of periapical pathosis.
  2. Teeth without anatomical variations
  3. Medically free patients

Exclusion Criteria:

  1. Non-restorable tooth
  2. Retreatment cases
  3. Teeth with root fractures
  4. Teeth with root resorption

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: None (Open Label)

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: Manual Dynamic Agitation (MDA)
Removal of intracanal calcium hydroxide using manual dynamic agitation
Procedure: Manual Dynamic Agitation
Manual dynamic agitation was used for the removal of intracanal calcium hydroxide following standardized root canal preparation and irrigation.
Experimental: Sonic Activation
Removal of intracanal calcium hydroxide using sonic activation
Procedure: Sonic Activation
Sonic activation was used for the removal of intracanal calcium hydroxide following standardized root canal preparation and irrigation.
Experimental: XP-Endo Finisher Activation
Removal of intracanal calcium hydroxide using XP-Endo Finisher activation
Procedure: XP-Endo Finisher Activation
XP-Endo Finisher activation was used for the removal of intracanal calcium hydroxide following standardized root canal preparation and irrigation.

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
Volume of Remnants of Intracanal Calcium Hydroxide
Time Frame: 1 week after intracanal medicament placement
The volume of remnants of intracanal calcium hydroxide after removal using the assigned activation technique, measured by cone beam computed tomography (CBCT).
1 week after intracanal medicament placement

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.
Tanta University

Investigators

Investigators

A researcher involved in a clinical study. Related terms include site principal investigator, site sub-investigator, study chair, study director, and study principal investigator.
  • Principal Investigator: Ahmed H Labib, professor of endodontics, Faculty of Dentistry, Tanta University
  • Study Director: Mohammed F Ali Mansour, lecturer of endodontics, Faculty of Dentistry, Tanta 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 (Estimated)

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.
August 1, 2026

Primary Completion (Estimated)

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, 2027

Study Completion (Estimated)

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, 2027

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).
July 17, 2026

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.
July 17, 2026

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.
July 22, 2026

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.
July 22, 2026

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.
July 17, 2026

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.
July 1, 2026

More Information

Terms related to this study

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.
  • END/5-26/3587

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

NO

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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